Search Results (704)

Population-based evidence on sleep quality in Kazakhstan remains limited. This study describes sleep quality as a multidimensional construct among adults in Kazakhstan using data collected during the first national survey wave after the adoption of a single national time zone. The survey was designed as a national post-transition baseline assessment and not as an evaluation of the causal impact of the time-zone reform. Associations with socio-demographic, behavioural, clinical, and regional factors were examined. We conducted a nationally representative cross-sectional survey of adults aged 18–69 years in Kazakhstan from May to October 2025 using a multistage stratified cluster design. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). Poor sleep quality was defined as a global PSQI score > 5. Complete PSQI data were available for 5872 participants. Descriptive analyses examined the global PSQI score and the seven component scores. Survey-weighted multivariable logistic regression was used to identify factors independently associated with poor sleep quality. The weighted prevalence of poor sleep quality was 28.1%, and the weighted mean global PSQI score was 4.43. The greatest component burden was attributable to sleep latency (mean 0.87), subjective sleep quality (0.82), and sleep disturbances (0.80), whereas use of sleep medication contributed minimally (0.11). Poor sleep quality was more common among women, older adults, urban residents, and participants with diabetes, current smoking, heavy episodic drinking, and depressive symptoms. In the adjusted model, female sex (aOR 1.37, 95% CI 1.19–1.57), age 55 years or older versus 18–24 years (1.98, 1.53–2.55), diabetes (1.47, 1.22–1.78), current smoking (1.28, 1.10–1.50), heavy episodic drinking (1.43, 1.16–1.76), and depressive symptoms (4.26, 3.52–5.15) were independently associated with higher odds of poor sleep quality. Rural residence was inversely associated with the outcome (0.71, 0.61–0.84). Compared with the North, higher odds were observed in the Central region (2.00, 1.46–2.74), East (1.94, 1.48–2.53), West (1.48, 1.17–1.88), and Almaty city (2.18, 1.72–2.76). Poor sleep quality is common among adults in Kazakhstan and is characterized primarily by difficulties with sleep initiation, perceived sleep quality, and nocturnal disturbances. The findings provide national post-transition baseline evidence and suggest that sleep health surveillance in Kazakhstan should prioritize demographic, mental health, behavioural, and regional inequalities while avoiding causal interpretation of the time-zone reform itself. Full article

Background/Objectives: Sleep disturbance is common in older adults and is associated with impaired daily functioning and poorer health-related outcomes. This study examined whether a 12-week Health Qigong program could improve subjective and objective sleep quality in older adults with self-reported sleep disturbance. Methods: Sixty adults aged 55 years or older who reported poor sleep and had Pittsburgh Sleep Quality Index total scores above 5 were randomly allocated to an intervention group or a control group (30 participants per group; 10 men and 20 women in each group). Both groups received health education and lifestyle guidance, and the intervention group completed supervised Health Qigong sessions twice weekly. Sleep quality was assessed before and after the intervention using the Pittsburgh Sleep Quality Index and wrist actigraphy. Results: Baseline characteristics were comparable between groups. In adjusted post-intervention comparisons, the intervention group showed lower Pittsburgh Sleep Quality Index scores, higher sleep efficiency, less wake after sleep onset, fewer awakenings, shorter average awake time, and longer total sleep time than the control group. The adjusted group difference for sleep onset latency was not significant. Conclusions: These preliminary findings suggest that Health Qigong may be a feasible community-based practice for improving sleep quality in older adults with self-reported sleep disturbance. The overall pattern was more consistent with improvement in sleep continuity than in sleep onset latency, although this interpretation should remain cautious because no direct contrast between sleep maintenance and sleep initiation was tested. Full article

This study investigated whether baseline sleep quality influences the effects of a 12-week multicomponent exercise program on sleep quality and physical function in community-dwelling older adults. Twenty-five older adults were classified according to baseline sleep quality using the Pittsburgh Sleep Quality Index into a Good Sleep (GS, n = 8) group and a Poor Sleep (PS, n = 17) group. The exercise program was performed three times per week for 12 weeks, with each 60 min session consisting of warm-up, multicomponent exercise, and cool-down. Outcome measures included sleep quality (PSQI), physical performance assessed by the Short Physical Performance Battery, and health-related fitness tests. A significant group × time interaction was observed for PSQI total score (p = 0.035). The PS group showed a significant reduction in PSQI score (−1.71 points, p < 0.01), indicating improved sleep quality, with favorable changes in subjective sleep quality, sleep latency, use of sleeping medication, and daytime dysfunction. However, the PS group demonstrated significant improvements in gait speed, grip strength, and 2 min walking performance. A significant group × time interaction was observed for the 30 s chair stand test (p = 0.011), with the GS group showing greater improvements in lower-extremity muscular endurance. Baseline sleep quality was associated with the pattern of adaptation to multicomponent exercise. Older adults with poor sleep quality experienced meaningful improvements in sleep, whereas those with good sleep quality showed greater gains in muscular endurance. These findings support the inclusion of sleep assessment when designing individualized exercise interventions for older adults. Full article

Background/Objectives: Nocturnal glycemic variability in pediatric type 1 diabetes (T1D) disrupts caregiver sleep and quality of life; advanced hybrid closed-loop (AHCL) systems may be associated with reduced caregiver burden by providing more stable overnight glucose control. We aimed to evaluate changes in caregiver-reported sleep quality and continuous glucose monitoring (CGM) targets three months after transition to an AHCL system. Methods: We conducted a prospective single-center real-world study in a tertiary pediatric diabetes unit that included children aged 6–17 years with T1D who switched from continuous subcutaneous insulin infusion (MiniMed) and intermittently scanned CGM (FreeStyle Libre 2) to an AHCL system (MiniMed 780G) with Guardian 4 sensor. Caregivers completed the Pittsburgh Sleep Quality Index (PSQI) at baseline and after 3 months; CGM metrics (TIR 70–180 mg/dL, TAR1 180–250 mg/dL, TAR2 > 250 mg/dL, TBR1 54–70 mg/dL, TBR2 < 54 mg/dL) were extracted at the same time points. Analyses used Shapiro–Wilk, Wilcoxon signed-rank, Spearman correlations, and McNemar tests (α = 0.05). Results: Twenty-two caregivers completed baseline PSQI; 16 provided PSQI data at three months. The proportion with PSQI > 5 decreased from 56.3% to 18.8% (p = 0.034), and 81.3% showed lower global PSQI at 3 months (p = 0.018). The largest mean improvements were observed in daytime dysfunction (−0.94), subjective sleep quality (−0.81), and sleep duration (−0.63), with slight increases in sleep disturbance (+0.13) and sleep-medication use (+0.13). The proportion of participants meeting international CGM consensus targets improved: the percentage achieving TIR > 70% increased from 26.7% to 80.0% (p = 0.008); those meeting TAR > 180 mg/dL < 30% increased from 26.7% to 80.0% (p = 0.008); and those meeting TAR2 > 250 mg/dL < 5% increased from 20.0% to 53.3% (p = 0.008). Hypoglycemia-related targets showed no significant change, and no episodes of symptomatic or level 3 hypoglycemia were reported. Exploratory analyses suggested that poorer PSQI at 3 months was associated with greater Δ TBR1, and increases in TAR2 with higher sleep disturbance and sleep-medication use. Conclusions: Transition to an AHCL system was associated with improvements in caregiver-reported sleep and attainment of CGM consensus targets within three months. Residual nocturnal hyperglycemia was associated with features of ongoing sleep disturbance, highlighting the potential relevance of individualized alert settings, sleep-focused education, and inclusion of objective sleep measures in future studies. Full article

Sleep disturbances and poor sleep quality are growing public health concerns, adversely affecting both physical and mental health. While exogenous melatonin supplements are used to manage the condition, there is limited evidence available on the efficacy of sustained-release (SR) melatonin formulations. This multicenter, randomized, double-blind, placebo-controlled clinical trial evaluated the efficacy and safety of melatonin-SR capsules (2 mg) in healthy adults with poor sleep quality. Participants aged 30–60 years with poor sleep quality received melatonin-SR (2 mg) or a placebo capsule at night for 28 days. Changes from baseline to day 28 in polysomnography (PSG)-derived sleep parameters, Pittsburgh Sleep Quality Index (PSQI), WHO-5 Well-Being Index, sleep diary parameters, and safety profile were evaluated. Of 62 enrolled participants, 59 (melatonin-SR, n = 28; placebo, n = 31) completed the study. Compared with placebo, melatonin-SR supplementation resulted in significant improvements at day 28 in PSG-derived sleep efficiency (change from baseline: 3.49 for melatonin-SR vs. −6.30% for placebo; p = 0.001) and total sleep time (change from baseline: 23.83 for melatonin-SR vs. −39.25 min for placebo; p = 0.001), along with significant reductions in sleep onset latency (change from baseline: −10.28 for melatonin-SR vs. 16.70 min for placebo; p = 0.031) and wake after sleep onset (change from baseline: −14.92 for melatonin-SR vs. 24.71 min for placebo; p = 0.001). Melatonin-SR supplementation demonstrated a large treatment effect for the improvement in sleep efficiency compared with placebo (Cohen’s d = 0.9). A significant reduction in PSQI global scores was observed in the melatonin-SR group from day 07 onwards (change from baseline on day 07: −2.21 vs. −0.23; day 14: −4.86 vs. −0.65; and day 28: −5.61 vs. −0.65 for melatonin-SR and placebo, respectively; p = 0.001). Improvement in subjective psychological well-being was significant from day 14 onwards (change from baseline on day 14: 9.86 vs. 0.77; and day 28: 13.29 vs. 0.77 for melatonin-SR and placebo, respectively; p = 0.001). A significant improvement in subjective sleep parameters at day 28 (p < 0.05) was observed. Reported adverse events in both groups were mild and transient in nature. Supplementation with melatonin-SR 2 mg capsule at night for 28 days was found to be effective and safe in improving objective and subjective sleep quality outcomes and overall well-being in the trial population. Full article

Sleep disturbance is a central feature of depression and a proposed pathway through which Bright-Light Therapy (BLT) exerts antidepressant effects. However, little is known about how sleep reorganises day by day during BLT or whether these dynamics relate to symptom improvement. We analysed daily sleep diaries from 66 patients with depression undergoing three weeks of BLT in routine outpatient care. Generalised Additive Mixed Models characterised daily trajectories in sleep timing, continuity, duration, and Subjective Sleep Quality, and weekly changes in sleep regularity were assessed using Root Mean Square of the Successive Differences. Structural Equation Modelling examined whether within-person deviations in sleep parameters mediated changes in depressive symptoms. Sleep timing showed gradual adjustment across treatment, with a progressive 48 min advance in weekday sleep onset. Sleep regularity improved from Week 1 to Week 2 before partially reversing, and the probability of nocturnal awakenings followed a non-linear trajectory. Other sleep parameters showed weaker directional trends. Improvements in Subjective Sleep Quality accounted for a modest portion of the association between treatment progression and reductions in depressive symptoms, whereas changes in sleep timing and regularity were not associated with symptom change. These findings indicate that sleep reorganises gradually during outpatient BLT, with different sleep dimensions evolving on distinct timescales and Subjective Sleep Quality emerging as one observable component linked to symptom improvement. More broadly, the results highlight the value of day-to-day modelling for understanding sleep–mood dynamics during real-world chronotherapy. Full article

Firefighters face high-stress occupational demands and irregular shift work that negatively impact sleep quality, which is intrinsically linked to long-term physical and psychological health. This cross-sectional study examines how the physical sleep environment (home vs. work) and station sleeping arrangements (bunk-style vs. individual dorm-style quarters) influence subjective sleep quality in this population. Sixty-six career firefighters (Age = 40.89 ± 11.05 years), completed the Pittsburgh Sleep Quality Index (PSQI) to assess their sleep in both home and fire station environments, with data analyzed using Wilcoxon Signed Ranks and Mann–Whitney U tests. The results reveal significant differences (p < 0.001), with sleep duration, efficiency, subjective quality, and global PSQI scores all performing significantly better at home than at work. Notably, no significant differences were found between bunk-style and dorm-style sleeping quarters at the station. These findings suggest that firefighters experience poorer sleep while on duty regardless of room design, indicating that operational stressors like call volume and nocturnal arousal may be more influential on sleep quality than the physical arrangement of sleeping quarters, and could inform organizational policies and wellness programs aimed at reducing occupational fatigue. Full article

Background: Sleep disturbances are linked to adverse outcomes in postpartum women. While behavioral interventions can potentially improve sleep, research in this area during the postpartum period is limited. This study aims to evaluate the effect of a behavioral education program on sleep quality among postpartum women. Methods: A quasi-experimental design with a pretest–posttest approach was employed, including a control group for comparative analysis. The research was conducted at the Maternal and Child Health Center in Egypt, focusing on the sleep disturbances experienced by postpartum women. The study involved 280 postpartum women (140 in the study group and 140 in the control group) who had given birth within the last two months. Results: Post-intervention, the study group demonstrated significant improvements in all components of sleep quality, with p-values < 0.001. Conversely, the control group experienced a deterioration in sleep quality, with 77.9% reporting poor sleep quality post-intervention. Conclusion: The behavioral education program significantly enhanced sleep quality among postpartum women, suggesting that such interventions should be integrated into maternal healthcare practices to improve postpartum sleep management. Full article

Sleep apnea is a prevalent sleep-related breathing disorder characterized by recurrent cessations or reductions in airflow during sleep. It significantly impacts the quality of life, yet current diagnostic methods like polysomnography (PSG) are expensive and uncomfortable, limiting accessibility and ease of use. We developed a novel non-contact biosensing system using secondary laser speckle pattern analysis and dedicated image processing algorithms for apnea-like breathing cessations. The proposed method was tested on $14$ healthy subjects with diverse body characteristics, aged 22–50 years (mean $33.1 \pm 9.3$ years) and body mass index (BMI) ranging from $19.6$ to $28.7$ kg/m² (mean $24.6 \pm 3.0$ kg/m²) at different ‘simulated’ sleeping positions (back-lying, stomach-lying and side-lying), using voluntary breath-holding protocols to simulate apnea-like cessations lasting 10–20 s (short duration) and 20–30 s (long duration). To evaluate the performance of the system without selection bias, two complementary five-fold cross-validation procedures were applied: a participant-level and a class-level stratification. Using class-wise stratification, the system achieved an overall accuracy of $87.0 \pm 3.0\%$ (95% CI: [85.3%, 88.7%]), long-cessation sensitivity of $91 \pm 12.4\%$$(95\% \mathrm{C}\mathrm{I}:[83.8\%,98.2\%\left]\right)$ and a short-cessation sensitivity of $88.0 \pm 11\%$$\left(95\% \mathrm{C}\mathrm{I}:[81.6\%,94.4\%]\right)$. The two-class classification strategy confirm the robustness of the approach, supporting the potential of secondary laser speckle pattern analysis as a low-cost, non-contact alternative for home-based sleep apnea screening. Full article

Background/Objectives: Sleep continuity is a key determinant of daytime functioning; however, accessible and well-tolerated interventions remain limited. We investigated whether Bacillus coagulans IDCC 1201 improves objective sleep continuity and subjective sleep quality in adults with sleep disturbance. Methods: In this 4-week, randomized, double-blind, placebo-controlled trial, 80 adults (aged 19–65 years) received B. coagulans IDCC 1201 (5.0 × 10⁹ CFU/day) or a placebo; 78 participants completed the study. The primary endpoint was the change in polysomnography-derived sleep efficiency from baseline to week 4. Results: Compared with the placebo, B. coagulans IDCC 1201 significantly improved sleep efficiency (Δ +13.71 ± 21.14 vs. −0.15 ± 13.35%; p = 0.002) and increased sleep duration (total sleep time: Δ +49.56 ± 76.33 vs. −0.50 ± 48.02 min; p = 0.002), accompanied by reduced nocturnal wakefulness (wake after sleep onset: Δ −44.40 ± 72.32 vs. +1.88 ± 44.36 min; p = 0.003; and total wake time: Δ −12.28 ± 20.22 vs. +0.53 ± 12.32 min; p = 0.004). Sleep-stage distribution also favored B. coagulans IDCC 1201, with greater increases in stage 2 and REM duration compared with the placebo (between-group p = 0.008 and 0.032, respectively). Subjective sleep quality showed greater improvement with B. coagulans IDCC 1201 (Pittsburgh Sleep Quality Index change: Δ −3.67 ± 3.37 vs. −1.64 ± 2.83; p = 0.036), yielding lower week 4 scores (5.87 ± 2.26 vs. 8.28 ± 3.62; p = 0.001). No significant safety concerns were identified. Conclusions: These findings indicate that strain-defined probiotic could be used as a nutritional approach for sleep health, particularly for targeting sleep fragmentation and maintenance. Full article

Objective: While the benefits of physical activity are well-documented, the internal mechanisms linking sports interest to adolescent Subjective Well-being (SWB) remain under-explored. This study addresses this gap by investigating the association between Sports Learning Interest and SWB and examining the serial mediating roles of Social Anxiety and Sleep Quality. Methods: Using a stratified random sampling method, 1764 primary and secondary students were surveyed with validated instruments, including the PSQI and the Index of Well-Being. Data were analyzed using Hayes’ PROCESS macro (Model 6) to test the hypothesized chain mediation effects. Results: Sports Learning Interest significantly and positively predicted SWB. The model identified three significant indirect pathways: independent mediation by Social Anxiety, independent mediation by Sleep Quality, and a serial chain from Social Anxiety → Sleep Quality (total indirect effect = 0.18, 95% CI [0.15, 0.21]). Notably, Sleep Quality emerged as the core mediator, accounting for 29.9% of the total effect. Conclusions: Enhancing sports interest is positively associated with SWB through a “psychological-physiological” dual channel—specifically by its association with lower social anxiety and subsequently better sleep. These findings provide empirical evidence for designing school-based interventions that integrate physical education with mental health promotion. Full article

Background/Objectives: Sleep quality is a critical determinant of recovery after total joint arthroplasty (TJA), yet multidimensional trajectories of sleep health remain poorly defined. This study aimed to describe the trajectory of sleep health and sleep quality before and after hip or knee arthroplasty, and to examine the influence of sex and surgical site. Methods: A single-centre, prospective cohort study was conducted including 316 patients scheduled for primary hip or knee arthroplasty. Sleep was assessed two months before surgery and at one and six months postoperatively, using the Pittsburgh Sleep Quality Index (PSQI) and the RU-SATED scale. Statistical analyses used linear mixed-effects models with random intercepts for participants. Effect sizes (Cohen’s d) were derived from the residual variance of the mixed models. Results: At baseline, 40% of patients had poor sleep quality. Estimated marginal mean PSQI scores were 5.30 (95% CI: 4.87 to 5.73) preoperatively, 5.71 (5.27 to 6.15) at one month, and 4.19 (3.73 to 4.65) at six months, representing a reduction of 1.11 points (95% CI: 0.69 to 1.54; Cohen’s d = 0.49, 95% CI: 0.30 to 0.68; p < 0.001) from baseline to six months. The proportion of patients with poor sleep quality (PSQI > 5) fell from 40% to 28%, a 12 percentage-point absolute reduction reflecting individual-level transitions across the validated clinical threshold. Exploratory component analyses showed improvements in subjective sleep quality, sleep duration, sleep efficiency, and sleep disturbance. RU-SATED scores increased from 9.72 (95% CI: 9.46 to 9.98) to 10.45 (10.19 to 10.72) at six months, an improvement of 0.73 points (95% CI: 0.47 to 1.00; Cohen’s d = 0.44, 95% CI: 0.27 to 0.60; p < 0.001). Women undergoing knee arthroplasty had significantly worse sleep scores than men at baseline and one month postoperatively, though both sexes followed parallel recovery trajectories (time-by-sex interaction p > 0.30), with the absolute sex difference narrowing by six months. In hip arthroplasty, no significant sex differences or time-by-sex interactions were observed after adjusting for the age imbalance between sexes. Conclusions: Arthroplasty was associated with significant improvements in multidimensional sleep health by six months, though the first postoperative month represents a period of stagnation or slight decline. Women undergoing knee arthroplasty consistently reported worse sleep than men, although the recovery trajectory was parallel between sexes. These findings highlight the potential value of integrating sleep assessment into perioperative care, particularly for women scheduled for knee arthroplasty, though whether targeted sleep interventions improve clinical outcomes remains to be established through prospective intervention studies. Full article

Background: Sleep disturbance is highly prevalent in dementia syndromes and increasingly viewed as a correlate of disease expression, not just ageing. This study investigated associations between subjective sleep quality, cognitive performance, and structural MRI markers in a dementia syndromes sample, comparing Alzheimer’s disease (AD) and non-AD groups, with exploratory inclusion of objective sleep and nocturnal blood pressure in a sub-sample. Methods: Observational cross-sectional design with 128 memory clinic patients (41 AD, 87 non-AD). Subjective sleep quality assessed via Pittsburgh Sleep Quality Index (PSQI). Cognitive measures: Mini-Mental State Examination (MMSE) for global cognition, Symbol Digit Modalities Test (SDMT) for processing speed, Trail Making Tests (TMT-A/B), and CLOX-1/2 for executive function. MRI markers: Scheltens scale (medial temporal atrophy), Fazekas scale (white matter hyperintensities). An exploratory sub-sample (N = 24) included additional nocturnal and daytime blood pressure monitoring; these data were analyzed descriptively and are reported as hypothesis-generating only. Analyses: group comparisons, Spearman correlations, hierarchical and logistic regression models in the full sample, and descriptive analyses with Spearman correlations in the exploratory sub-sample. Results: The AD group reported poorer sleep quality (higher PSQI) and worse cognitive performance across domains compared with the non-AD group (p < 0.001). Higher PSQI scores were associated with poorer cognitive outcomes, particularly executive function and processing speed, after adjustment for demographics and structural MRI markers (e.g., β = −0.181 to −0.425 for MMSE/SDMT). In the exploratory sub-sample (N = 24), PSQI was correlated with SDMT (ρ = −0.653) and TMT-A (ρ = 0.788). Conclusions: Subjective sleep quality was associated with cognitive performance in individuals with dementia syndromes after accounting for structural MRI markers. These findings suggest that subjective sleep disturbance may represent a complementary clinical dimension warranting further longitudinal research, including evaluation of whether sleep-focused interventions may offer clinical benefits. Full article

Previous studies indicate that the main predictors of stress-related disorders in firefighters are pre- and post-trauma factors, rather than intensity or type of traumatic event. This study aimed to identify risk and protective factors contributing to the development of Post-Traumatic Stress Disorder (PTSD) and other stress-related conditions in Portuguese firefighters who battled the 2017 forest fires. To assess the prevalence of PTSD and related conditions, a set of self-report measures—including PHQ-15 (somatic symptoms), PCL-5 (PTSD), PSQI (sleep quality), and DASS-21 (depression, anxiety, stress)—was completed by 96 firefighters and 96 individuals from the general population, who served as a comparison group. In addition, semi-structured interviews were conducted with 79 firefighters, focusing on their perceptions of PTSD, exposure to duty-related traumatic events, and coping strategies employed to manage stress. Findings indicated that firefighters reported higher levels of somatic symptoms, sleep disturbance, and PTSD than the general population. Organizational support, working conditions, professional experience and training were identified as protective factors, while a sense of belongingness and peer relationship were considered resources for managing stress reactions. Firefighters also associated social and media pressures with the development or exacerbation of stress-related symptoms. Collectively, these results highlight the relevance of both subjective and contextual factors and may inform prevention, intervention, and treatment strategies for stress-related psychopathologies. Full article

This paper presents a modular system architecture and an automated signal processing pipeline designed to quantify neurophysiological relaxation responses to fragrance using consumer-grade wearable electroencephalography (EEG). By integrating real-time data streaming via Open Sound Control (OSC) with a high-performance backend, the platform enables objective assessment of olfactory stimuli through a reproducible Sleep Readiness Index (SRI) derived from spectral power shifts. To mitigate the signal quality constraints inherent in portable hardware, the framework utilizes a robust suite of engineering controls, including zero-phase filtering and automated artifact rejection, ensuring data integrity across short-window trials. Validation through construct-level analysis of public sleep datasets and synthetic sensitivity testing confirms the index’s directional reliability, while runtime benchmarking demonstrates sub-millisecond compute times suitable for interactive wellness applications. Ultimately, this framework provides a transparent, auditable engineering scaffold that replaces subjective self-reports with a standardized, within-session proxy metric for comparative fragrance evaluation. Full article