Search Results (110)

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

It is noteworthy that disturbances in circadian rhythms and irregular sleep patterns can exert influence over the onset of Type 2 Diabetes (T2DM). Similarly, they can impact the development of Type 1 Diabetes (T1DM). In recent decades, there has been a notable trend towards both reduced and extended sleep durations, with a concurrent rise in occurrences of compromised sleep quality attributable to sleep fragmentation. These sleep disturbances, along with clinically recognized sleep disorders such as sleep apnea and insomnia, have been increasingly associated with a range of detrimental health outcomes. Of particular concern is the growing evidence linking sleep dysregulation to an augmented risk of metabolic diseases, including diabetes. In addition to sleep duration and quality, emerging research suggests that an individual’s chronotype, reflecting their preferred time for going to sleep, may also exert an influence on disease development, particularly T2DM. The habit of going to bed late when compared to the tendency of going to bed early tends to cause significant disruptions to daily social engagements. Eventually, this misalignment may lead to discrepancies in sleep schedules between weekdays and weekends, commonly referred to as social jetlag. The current review aims to discuss the complex relationship between circadian rhythm misalignment, triggered by improper sleep habits such as short or long sleep duration, disrupted chronotype, social jetlag, and sleep disorders, on the subsequent impact on the development of diabetes. Overall, current evidence suggests that circadian rhythm disruption and sleep disorders contribute significantly to metabolic dysregulation and diabetes risk, highlighting the importance of sleep health in prevention and management of diabetes. Full article

Background: Advanced glycation end products (AGEs) accumulate in tissues with age and are associated with the risk of chronic diseases. However, evidence regarding lifestyle factors related to AGE accumulation in healthy adolescents is limited. The aim of this study was to explore dietary and lifestyle factors that may attenuate tissue AGE accumulation, using skin autofluorescence (SAF) as a noninvasive proxy marker, in healthy Japanese early adolescent girls. Methods: This cross-sectional study included 315 first-year junior high school girls aged 12–13 years from a private school in Japan. SAF was measured on the volar forearm using an AGE Reader MU. Dietary intake was assessed using a validated brief diet history questionnaire (BDHQ-15y). Lifestyle factors, including weekday sleep duration, were assessed using a self-administered questionnaire. Health-related variables (including weight-loss dieting) were also collected. Associations between SAF and each factor were analyzed using generalized linear models and nonparametric tests, with multivariable adjustment for potential confounders. Results: The mean SAF was 1.06 ± 0.13 arbitrary units. No significant associations were observed between SAF and health-related characteristics, nutrient intakes, or major food-group intakes. Longer weekday sleep duration was significantly associated with lower SAF (p for trend = 0.019) and remained significant after multivariable adjustment (p for trend = 0.018). A similar association was observed for better perceived restorative sleep (p for trend = 0.033; adjusted p for trend = 0.048). Conclusions: In healthy early adolescent girls, longer weekday sleep duration and better perceived restorative sleep were associated with lower SAF, whereas dietary intake was not. Given the largely irreversible age-related accumulation of AGEs, promoting healthy sleep during adolescence may help attenuate AGE accumulation early in life and reduce long-term AGE-related disease risk. Prospective studies with more detailed dietary assessments are needed to clarify dietary influences and confirm temporality. Full article

Light exposure is a primary zeitgeber for the human circadian system and plays a key role in shaping sleep–wake patterns during adolescence, a period marked by biological sensitivity and social constraints. How the temporal organization and spectral composition of daily light exposure differ between weekdays and weekends remains poorly understood. Eighteen adolescents (15–17 years) were monitored for seven days using wrist actigraphy with integrated light sensors. Sleep parameters, nonparametric circadian rhythm indices, and time-resolved profiles of ambient and spectral (blue, green, and red) light exposure were analyzed. Repeated-measures ANOVA tested the effects of time of day and day type. Total sleep time and time in bed were longer on weekdays than on weekends (p < 0.05), while sleep latency and WASO did not differ. Circadian indices indicated preserved rhythmic organization. Light exposure showed a robust diurnal profile, with higher spectral irradiance on weekends (p < 0.001), especially in the morning and early afternoon. Significant time × day-type interactions were observed across all spectral bands (p < 0.001), indicating systematic reshaping of daily light profiles. Adolescents exhibit weekday–weekend differences in the temporal and spectral organization of light exposure, affecting the amplitude and shape of overall daily profiles. Full article

Delayed marriage and non-marriage have become increasingly important issues in Japan, where marriage remains closely related to household formation and well-being. This study examines which sociodemographic characteristics are associated with being married and how marital status correlates with economic conditions, health behaviors, subjective well-being, and COVID-19-related measures. Using annual panel data from 2014 to 2022, we first conducted descriptive comparisons between married and non-married individuals and then estimated a Bayesian panel logit model with respondent-specific effects to account for unobserved heterogeneity. The analysis was designed to identify associations rather than causal effects. The results showed the strongest positive associations with being married for individuals aged 30–49 years, consistent with delayed marriage. Employment attributes such as holding side work and managerial positions were positively associated with marriage, whereas nonprofit employment and self-employment were negatively or imprecisely associated. Financial assets and total debt were positively correlated with marriage, consistent with joint household formation. Higher happiness and life hope were positively associated with being married; regular exercise and longer weekend sleep were negatively associated, whereas longer weekday sleep was positively associated. In addition, respondent-specific effects revealed substantial heterogeneity beyond observed covariates. These findings identify key socioeconomic and behavioral domains associated with marriage in Japan, highlight the importance of unobserved heterogeneity, and provide evidence that may help identify groups prone to delayed marriage under changing social and economic conditions. Full article

Background/Objectives: Comprehensive Geriatric Assessment (CGA) is essential for maintaining quality of life (QOL) and independence in older adults. Still, its implementation is labor-intensive and difficult to sustain in aging societies such as Japan. Digital technologies may enable continuous, scalable CGA in daily living environments. This study aimed to develop and preliminarily evaluate a digital CGA (D-CGA) framework by integrating data from multiple monitoring devices, as a preparatory step toward Artificial Intelligence (AI)-supported personalized care planning. Methods: Four devices (Handy, Apple Watch, Withings Sleep, and Vieureka) were selected. Due to ethical constraints in Japan, a pilot study was conducted with graduate students. Participants underwent continuous monitoring for five weekdays. Common and device-specific measurement items were extracted, visualized, and compared across devices. Heart rate data were examined using correlation-based analyses. Baseline CGA was conducted before monitoring. Results: Distributional and temporal characteristics of physiological measures were explored separately for daytime and nocturnal periods. Continuous heart rate and respiratory rate data were successfully collected across monitoring days, demonstrating the feasibility of real-life data acquisition using the selected devices. Heart and respiratory rates showed distinct distributional patterns between daytime and nocturnal periods, supporting context-specific physiological characterization. Conclusions: This pilot study demonstrates the feasibility of integrating multi-device data for D-CGA and provides foundational reference data for future studies of older adults. The results support the potential of D-CGA to inform personalized care and guide subsequent large-scale and clinical investigations. Full article

Background/Objectives: To examine associations of mentally active and passive sedentary behavior (SB) with sleep quality and duration in pregnant women of advanced (AMA) and younger (YMA) maternal age, separately, and evaluate effects of SB patterns (weekends vs. weekdays). Methods: This secondary analysis of an observational, clinic-based, cross-sectional study included pregnant women of AMA (n = 225; 37.8 ± 2.6 years) and YMA (n = 710; 27.5 ± 3.8 years) from any trimester. SB and sleep were assessed using the Arabic version of the Sedentary Behavior Questionnaire and the Pittsburgh Sleep Quality Index, respectively. Logistic regression models evaluated associations of maternal mental activity-based SB with sleep outcomes. Results: Higher mentally passive SB on weekdays was unfavorably associated (odds ratios ranged between 1.58 and 2.12; p < 0.05 for all), and on weekends was paradoxically and favorably associated (odds ratios ranged between 0.53 and 0.62; p < 0.05 for all) with sleep quality only in pregnant women of AMA. Higher mentally passive SB across the week or on weekdays was unfavorably associated (odds ratios ranged between 1.11 and 1.65; p < 0.05 for all), while higher mentally passive SB on weekends and mentally active SB across the week or on weekends were paradoxically and favorably associated (odds ratios ranged between 0.57 and 0.91; p < 0.05 for all) with a higher adherence to sleep duration recommendations in both pregnancy groups. Conclusions: These findings suggest that some relationships between mental activity-based SB and prenatal sleep health may vary across maternal age groups. The cross-sectional design limits causal inference, emphasizing the need for longitudinal and randomized studies on mental activity-based SB and sleep health in pregnant women of AMA and YMA. Full article

The circadian phase difference between morning and evening types is a fundamental aspect of chronotype. However, results of categorizations into chronotypes based on reported sleep times show low concordance with those based on measurements of the hormonal or physiological or molecular rhythm–markers of the circadian phase. This might be partially explained by the profound individual differences in the phase angle between the sleep–wake cycle and these rhythms that depends on chronotype, age, sex, and other factors. Here, we examined the possibility of using self-reported sleep times in the condition of 5-days-on/2-days-off school/work schedule to estimate circadian phase differences between various chronotypes. In an in silico study, we determined that, for such an estimation, similarities of the compared chronotypes in weekend sleep duration and weekend–weekday gap and in risetime are required. In the following empirical and simulation studies of sleep times reported by 4940 survey participants, we provided examples of the estimation of circadian differences between chronotypes, and the model-based simulations of sleep times in morning and evening types exemplified a way to confirm such estimations. The results of in silico, empirical, and simulation studies underscore the possibility of using bedtimes and risetimes for direct estimation of the circadian phase differences between individuals in real-life situations, such as a 5-days-on/2-days-off school/work schedule. Additionally, the results of these studies on different chronotypes provided further mathematical modeling and empirical evidence for our failure to sleep more on weekends to recover/compensate/pay back/ catch up on lost sleep. Full article

Objective: Our objective was to determine the relationship between sleep dimensions and obesity risk in the pediatric population. Methods: This systematic literature review was performed following PRISMA guidelines. Peer-reviewed original research focusing on sleep parameters in the pediatric population aged 0–18 years, with obesity risk measured using objective measures, was included. Results: The review analyzed 27 studies, comprising 85,669 participants aged 0–18 years. The majority of the studies observed an inverse relationship between short sleep duration and obesity risk, with insufficient sleep translating to negative weight status, increased waist circumference, and higher obesity prevalence. Sleeping late on both weekdays and weekends increases the risk of obesity. Only four studies assessed sleep quality, with inconsistent findings. Sleep duration and timing had a stronger effect on obesity risk than sleep quality. Conclusions: Sleep duration was an independent determinant of obesity risk in the pediatric population, while sleep timing and quality showed an inconsistent association. Full article

Background: Adults with congenital heart disease (CHD) are living longer but face increasing comorbidities. Sleep is a key health determinant, yet objective data in CHD remain limited. This study compared sleep characteristics of adults with CHD and controls using wearable technology and a Health Application Programming Interface (API). Methods: A total of 175 CHD patients (33.1 ± 10.3 years, 49.2% women) and 52 controls (34.4 ± 12.4 years, 40.4% women) completed seven continuous days of wrist-worn Garmin Vivosmart^® 5 during routine follow-up at the TUM Klinikum Deutsches Herzzentrum. Sleep duration, phases, Sleep Scores, and weekday-weekend differences were analyzed, and multivariate models examined clinical and demographic predictors. Results: Total sleep duration and rapid eye movement (REM) sleep did not differ between groups. CHD patients had more deep sleep (83 ± 19 vs. 75 ± 16 min, p = 0.004) but lower Sleep Scores (74 ± 9 vs. 77 ± 9, p = 0.041). Within CHDs, deep sleep was higher on weekends than on weekdays (p = 0.033). Multivariate analyses showed no overall group effect, but age (p = 0.016), sex (p = 0.013), and body mass index (BMI; p < 0.001) significantly predicted sleep outcomes. Regression analyses in CHDs revealed female sex associated with longer REM sleep (p < 0.001), while higher BMI consistently predicted poorer outcomes. Disease severity was linked to lower Sleep Scores. Conclusions: Sleep in CHDs is broadly comparable to controls, but BMI, sex, and disease severity significantly shape outcomes. The additional variability between weekends and weekdays and a higher risk of sleep-disordered breathing, according to the literature, underscores that sleep is an underestimated target for prevention and clinical care in CHD. Full article

Background: Allergic diseases, such as allergic rhinitis, eczema, and asthma, are prevalent among adolescents and are associated with various health concerns, including poor sleep quality and mental health problems. Although previous research has investigated the general association between allergic conditions and sleep disturbances, few studies have examined how allergic diseases relate to sleep duration. Methods: We performed secondary analysis of the data obtained from the 19th Korea Youth Risk Behavior Survey (2023), which included 52,880 middle and high school students. Data was analyzed using complex sample design techniques, descriptive statistics, t-tests, and analyses of variance and covariance conducted to explore associations between allergic diseases and sleep duration on weekdays. Covariates included sex, school type, academic performance, socioeconomic status, and residential type. Results: The average weekday sleep duration among adolescents was 6.2 h, which was significantly shorter than that recommended by the U.S. Centers of Disease Control and Prevention (8–10 h). Among allergic conditions, allergic rhinitis was significantly associated with reduced sleep duration (p = 0.001), unlike asthma (p = 0.119) and eczema (p = 0.586). Additional differences in sleep duration were observed by sex, academic performance, socioeconomic status, and living arrangements. Conclusions: Managing allergic rhinitis may be crucial to promoting adequate sleep during adolescence. Furthermore, future research should incorporate physiological indicators to assess sleep quality, as self-reported measures may not capture sleep disturbances such as night-time awakenings. These findings can inform the development of integrated health strategies to enhance physical and psychological well-being of adolescents. Full article

Background: Although higher sedentary behavior (SB) and lower physical activity (PA) have been associated with poor prenatal sleep quality, the influence of specific exchanges of SB and types of PA on sleep quality during pregnancy remains unexplored. Objectives: This secondary, cross-sectional analysis examined associations between the statistical replacement of patterns (weekdays, weekends) and domains (leisure, occupational, commuting) of SB with moderate (MPA), vigorous (VPA), or moderate-to-vigorous (MVPA) PA and sleep quality among pregnant women in Saudi Arabia. Methods: Participants (n = 935; age = 30 ± 5.6 years; first trimester = 24.1%, second trimester = 33.9%, third trimester = 42.0%) self-reported their patterns and domains of SB, PA, and sleep quality using validated instruments. Adjusted isotemporal substitution models evaluated the associations of exchanging 30 min of different SB and PA with sleep quality. Results: Replacing 30 min of total or leisure SB on weekdays with 30 min of MPA was associated with improved sleep quality (β = −0.519 and −0.590, respectively; p < 0.05) only among those in their first trimester. Paradoxically, replacing 30 min of total, leisure, occupational, or commuting SB across the week, on weekdays, and weekends with 30 min of VPA was associated with poor prenatal sleep quality (β ranged between 1.258 and 7.217; p < 0.05 for all). Exchanging SB with MPVA or different domain-specific SB did not influence sleep quality (p > 0.05 for all). Conclusions: These novel findings suggest that although replacing SB with PA may help enhance sleep quality in pregnant women, particularly during the first trimester, the underlying associations are likely multifaceted. The variable relationships observed emphasize the importance of considering patterns and domains of SB and intensity of PA used as a replacement, rather than total duration solely, to improve prenatal sleep quality, especially during early pregnancy, particularly in Saudi Arabia. Full article

Morningness-eveningness is usually assessed as either a trait or a state using either a morning–evening preference scale or sleep timing reported for free days, respectively. These assessments were implemented in numerous studies exploring the associations between morningness-eveningness and health, mood, and sleep problems. Evening types almost always had more problems than morning types. We examined these associations in university students with conflicting results of trait and state assessments of morningness-eveningness and tried to confirm their chronotype using a multidimensional chronotyping approach that recognizes four types other than morning and evening (lethargic, vigilant, napping, and afternoon). The conflicting trait and state assessments of morningness-eveningness were found in 141 of 1582 students. Multidimensional chronotyping supported morningness of morning types with late weekend sleep timing, and the associations with health, mood, and sleep problems resembled the associations of other morning types (i.e., these associations persisted despite late sleep timing). In contrast, evening types with early weekend sleep timing were more likely classified as lethargic or napping types rather than evening types. They did not resemble evening types in their associations with health, mood, and sleep problems (i.e., early sleep timing did not change these associations). Model-based simulations of the sleep–wake cycles of students with conflicting trait and state assessments suggested that their bedtimes cannot be solely determined by their biological clocks. On weekdays or weekends, mind-bedtime procrastination can lead to missing the bedtime signal from their biological clocks (i.e., self-deprivation of sleep or, in other words, voluntary prolongation of the wake phase of the sleep–wake cycle). Full article

Worsening adolescent mental health is a significant social issue. Although dreams may reflect one’s mental state, few studies have focused on adolescents. Therefore, this study investigated the relationship between dream content and mental health, specifically anxiety disorder and depressive symptoms, among Japanese adolescents. This cross-sectional study obtained data on gender, grade, age, lifestyle habits, weekday sleep duration, anxiety disorder symptoms, depressive symptoms, and dreams from Japanese high school students. The data were analyzed via multiple logistic regression analyses. The prevalence of anxiety and depressive symptoms increased with the frequency of “rumination at bedtime”, “memory of dreams”, “emotional carryover”, and “awakening by frightening”, “unpleasant”, “film-like”, “fantastical”, and “recurring” dreams. However, this was not the case for “pleasant dreams”. Furthermore, “rumination at bedtime” (anxiety disorder symptoms: adjusted odds ratio: 10.60; 95% confidence interval: 5.92–18.97; depressive symptoms: 8.79, 5.58–13.87) and “unpleasant dreams” (anxiety disorder symptoms: 5.25, 2.86–9.64; depressive symptoms: 10.13, 5.57–18.44) exhibited particularly high odds ratios. “Rumination at bedtime” and “unpleasant dreams” may serve as early indicators of declining mental health. School- and parent-led interventions aimed at improving mental well-being may help prevent the progression or exacerbation of anxiety and depressive symptoms among adolescents. Full article

Background/Objectives: Overweight and obesity (OW/OB) in immigrant children is a complex multifactorial issue. This work aims to present the OW/OB profile and lifestyle habits of immigrant children and compare them with their native counterparts. Methods: A cross-sectional study (ASOMAD) was conducted in a representative sample of children aged 8–12 years in Madrid from 2020 to 2023. Parental origin, physical activity (PA), screen time, adherence to Mediterranean Diet, sleep, and body composition were assessed by validated methods. OW/OB was determined according to IOTF guidelines. T-tests, chi-square tests, and two-way ANOVA tests were applied based on the variables’ characteristics. Results: A total of 587 children (54% boys, aged 9.54 ± 1.19 y), 33.2% immigrants, were studied. OW/OB rate was higher in immigrants (39.7% boys and 37.4% girls) than in natives (18.0% boys and 17.7% girls) (p < 0.05). Immigrant boys were 30.64 ± 8.39 min/day less active than natives (p < 0.001). Both male and female immigrant children devoted considerably more weekday hours to screen time than natives (2.76 ± 2.75; 2.02 ± 2.47 vs. 2.09 ± 2.29; 1.32 ± 1.38; p < 0.05, respectively). Immigrant children consumed significantly less fish and olive oil and more pasta or rice almost every day (5 or more/week), ate at fast-food restaurants, consumed fewer dairy products and baked goods or pastries for breakfast (p < 0.05), and exhibited worse diet quality compared to Spanish ones. Conclusions: Immigrant children exhibited a higher prevalence of OW/OB, higher screen time, lower PA time, and ate less fish and olive oil and more pasta than natives. Additional research is required to explore the causes of these issues and enhance the lifestyle within this group. Full article