Sex differences in sleep: impact of biological sex and sex steroids

Nightmares Fluctuate Across the Menstrual Cycle and May be More Pronounced in Women With Premenstrual Syndrome

INTRODUCTION

Premenstrual syndrome (PMS) affects nearly half of women worldwide and is associated with sleep disturbances, though the specific relationship between PMS and nightmares remains underexplored. Clinical observations suggest a potential link, leading this study to investigate whether women with PMS experience more frequent or intense nightmares compared to those without PMS.

METHODS

We conducted a prospective case series of seven women experiencing nightmares, all of whom participated in weekly imagery rehearsal therapy (IRT) over 1-month. Each participant completed the daily record of severity of problems (DRSP) to assess PMS symptoms and kept daily dream diaries throughout one menstrual cycle, tracking nightmare frequency, intensity, and emotional valence. The nightmare severity index (NSI) was administered at the beginning and end of the study. Descriptive analysis was used for the dream metrics, and the Wilcoxon signed-rank test was employed to assess changes in NSI scores.

RESULTS

Women with PMS exhibited an increase in nightmare frequency during the premenstrual phase, but no formal statistical comparisons were made between PMS and non-PMS groups regarding dream frequency or intensity. A significant reduction in NSI scores (p = 0.03) was observed across the entire sample, though this effect was not significant in the PMS subgroup.

CONCLUSIONS

This case series is the first, to our knowledge, to provide detailed longitudinal data indicating that nightmare frequency may fluctuate across the menstrual cycle and could be more pronounced in women with PMS. While IRT effectively reduced nightmare severity overall, its specific impact on nightmares in women with PMS requires further research in larger studies.

Associations of weekend compensatory sleep and weekday sleep duration with psychotic-like experiences among Chinese adolescents

OBJECTIVE

Insufficient sleep on weekdays among adolescents and its negative effects on mental health is a concerning public health issue. This study examined the relationship between weekday sleep duration, weekend compensatory sleep (WCS), and psychotic-like experiences (PLEs) in a large sample of Chinese adolescents.

METHODS

A total of 39,731 junior high school students were recruited in this cross-sectional study. A self-report questionnaire was used to assess sleep duration, social-demographical characteristics, anxiety and depressive symptoms, and PLEs. Logistic regression and stratified analysis were performed to explore the associations between WCS and PLEs.

RESULTS

The prevalence of current PLEs was 12.4 % in this study. The average weekday sleep duration among adolescents was 7.7 ± 1.0 h. 93.2 % of participants reported WCS, with an average duration of 1.8 ± 1.6 h. WCS was significantly associated with a lower risk of PLEs (OR = 0.79, 95 % CI: 0.70-0.90). Moreover, 0-2 h of WCS was linked to a reduced risk of PLEs, regardless of whether students with weekday sleep duration <8 h (OR = 0.74, 95 % CI: 0.61-0.91) or ≥8 h (OR = 0.69, 95 % CI: 0.57-0.82). However, the significant role of WCS >2 h against PLEs was observed only among adolescents with weekday sleep duration <8 h (OR = 0.79, 95 % CI: 0.65-0.97).

CONCLUSION

WCS was associated with a lower risk of PLEs in adolescents, particularly those with insufficient weekday sleep. These findings highlight the importance of sufficient sleep and the potential benefits of compensatory sleep on adolescents' mental health.

Sex differences in reward-based operant conditioning performance and neurotransmitter changes following chronic sleep restriction stress in rats

BACKGROUND

Sleep deprivation significantly impairs cognitive function, which disrupts daily life. However, sex differences in these impairments are not well understood, as most preclinical studies primarily use male animals, neglecting potential differences between sexes. This study aims to investigate sex-specific differences in cognitive function under sleep deprivation using reward-based operant conditioning tasks.

RESULTS

Sprague-Dawley rats were pre-trained on a lever-press task and subsequently divided into control and chronic sleep restriction (CSR) groups. The CSR group underwent 14 days of sleep restriction. After CSR modeling, rats were assessed using the open field test, retraining on the lever-pressing task, signal discrimination task, and extinction task to evaluate motor abilities, memory formation, learning, and cognitive flexibility. CSR significantly impaired task performance in both sexes, with rats requiring more time and exhibiting lower accuracy. In the signal discrimination task, male rats showed longer feeding latency and lower accuracy compared to females. CSR also specifically increased the frequency of operant responses in male rats. In the extinction task, CSR enhanced exploration time and frequency in both sexes, with females exhibiting significantly higher exploration frequencies than males. Biochemically, CSR induced sex-specific alterations, including elevated serum MDA and MAO levels in males and increased serotonin, dopamine, and epinephrine in both sexes. Although activation was observed in metabolites of the tryptophan-kynurenine pathway, sex differences were evident in the kynurenic acid metabolism levels in the prefrontal cortex.

CONCLUSIONS

CSR impairs cognitive function in both male and female rats, with significant sex differences observed. Male CSR rats exhibited impaired signal discrimination, while CSR impaired extinction learning in female rats. These impairments are accompanied by CSR-induced oxidative stress, neurotransmitter dysregulation, and disturbances in the tryptophan metabolic pathway. These findings underscore the importance of considering sex differences in understanding the effects of sleep deprivation on cognitive function and developing targeted intervention strategies.

Is meeting 24-hour movement guidelines associated with a lower risk of frailty among adults?

BACKGROUND

The relationship between 24-hour (24-h) movement guidelines and frailty remains unclear. We aimed to investigate the associations between meeting 24-h movement guidelines and frailty and to conduct secondary analyses by age, gender, and ethnicity.

METHODS

In this study, we extracted data from the National Health and Nutrition Examination Survey (2007-2018) database. A total of 5,726 participants (50.25 ± 0.31 years) were included in this analysis, representing 38,240,356 noninstitutionalized U.S.

INDIVIDUALS

Three 24-h movement behaviors, namely, physical activity, sedentary behavior (SB), and sleep, were self-reported using the standardized questionnaires. The 49-item frailty index was used to measure frailty. Multivariable logistic regression models and trend tests were used to examine the associations between meeting 24-h movement guidelines and frailty. Sensitivity analyses were also conducted to ensure the robustness of our results.

RESULTS

The total age-adjusted prevalence of frailty was 30.5%. In the fully adjusted model, compared with not meeting any of the 24-h movement guidelines, the adjusted odds ratios (AORs) of frailty were 0.786 (95% CI: 0.545, 1.133), 1.161 (95% CI: 0.787, 1.711), and 0.915 (95% CI: 0.616, 1.358) for participants meeting only moderate to vigorous physical activity (MVPA), only SB, and only sleep guidelines, respectively, but no statistically significant differences were observed (all P values > 0.05). Participants who met the SB + sleep guidelines (AOR = 0.613, 95% CI: 0.423, 0.887), MVPA + sleep guidelines (AOR = 0.389, 95% CI: 0.255, 0.593), and MVPA + SB guidelines (AOR = 0.555, 95% CI: 0.383, 0.806) presented a significantly lower risk of frailty by 39%, 61%, and 45%, respectively. Meeting all 3 guidelines (AOR = 0.377, 95% CI: 0.264, 0.539) and meeting 2 guidelines (AOR = 0.527, 95% CI: 0.377, 0.736) were associated with a lower risk of frailty (P value < 0.001), showing a linear trend (P for trend < 0.001). The strength of these associations varied somewhat by age, gender, and ethnicity.

CONCLUSIONS

Significant associations between the 24-h movement guidelines and frailty were observed among U.S. adults. Future studies are warranted to examine the causality and trajectory of these associations.

Enhanced physical performance, attention, and mood states after a nap opportunity following a sleep restriction night in female athletes: A randomized controlled trial

This study examined the effects of two nap durations (40 minutes (N40) and 90 minutes (N90)) on physical performance, sleepiness, attention, mood states (Profile of Mood States, POMS), perceived exertion (RPE), pain perception (PP), recovery (PRS), and delayed onset muscle soreness (DOMS) in well-trained women. Fourteen female boxers underwent the digit cancellation test, POMS, and the 5-meter shuttle run test (5mSRT) under no-nap (N0), N40, and N90 conditions after either normal sleep (NSN) or sleep restriction (SRN). RPE and PP were assessed immediately post-5mSRT, while PRS and DOMS were recorded at 5 min and 24 h post-5mSRT. Total distance (TD) and higher distance (HD) were better in N40 and N90 after NSN compared to SRN (p < 0.05). Fatigue index (FI) was lower in N40 and N90 than in N0, and lower in N90 than N40 (p < 0.05). PRS improved and RPE, DOMS, and PP decreased significantly after N40 and N90 compared to N0, with N90 showing greater benefits (p < 0.05). Total POMS scores were better after N40 and N90 than N0, with N90 outperforming N40 (p < 0.05). Overall, N90 provided greater benefits than N40 in enhancing physical performance, attention, recovery, and mood, while reducing exertion, pain, and soreness after both NSN and SRN.

Sleep duration and its associated factors in schizophrenia patients: a large-scale cross-sectional survey

BACKGROUND

Sleep disturbance is a common condition in patients with schizophrenia. Studies have shown that insufficient sleep and excessive sleep lead to adverse health outcomes. This study aimed to identify the factors associated with short and long sleep duration, as well as the prevalence of somatic comorbidities in schizophrenia patients.

METHODS

This study was conducted in 24 mental health institutes of Guangdong Province using a multistage-stratified and random sampling method. All information was collected by face-to-face interview with a structured questionnaire. The association of sleep duration with sociodemographic and clinical factors was determined using multinomial logistic regressions. Subgroup analysis was performed in the various source of patients.

RESULTS

A total of 6 024 schizophrenia patients were enrolled in this study, among whom 8.6% (n = 521) reported short sleep duration and 47.2% (n = 2 850) had long sleep duration. The most common comorbid chronic diseases in the entire cohort were hypertension (8.0%), diabetes (6.8%) and hyperlipidemia (3.2%). Factors such as, current smoker, outpatients, benzodiazepines (BZDs), side effects, comorbidities, age of onset, and illness duration were positively associated with short sleep duration. On the other hand, personal annul income < 10 000 yuan, personal annul income ≥ 40 000 yuan, chronic patients, first-generation antipsychotics (FGAs) and side effects were positively associated with long sleep duration. In outpatient settings, overweight was associated with long sleep duration, whereas in inpatient settings, being female positively correlated with long sleep duration.

CONCLUSION

Disruption of sleep duration and somatic comorbidities are highly prevalent in patients with schizophrenia. This study demonstrates the complex relationships among socioeconomic information, clinical factors and sleep duration in schizophrenia, highlighting the need for developing targeted interventions and management strategies for sleep duration.

CLINICAL TRIAL NUMBER

Not applicable.

The Relationship Between Psychological Distress and Sleep Quality Among Middle-Aged and Older Adults: The Moderating Effect of Gender

BACKGROUND

Symptoms of psychological distress such as depression and anxiety as well as gender are known to be associated with sleep quality in middle-aged and older adults. However, little is known about the effect on sleep quality of interactions among these factors.

PURPOSE

This study was developed to investigate the moderating effect of gender on the relationship between psychological distress and sleep quality in middle-aged and older adults.

METHODS

A cross-sectional design, secondary data analysis of data on 5,590 individuals aged ≥ 45 years from the Taiwan Biobank database (2009-2018) was used. In this database, psychological distress was assessed using the Patient Health Questionnaire-4, and sleep quality was assessed using a self-report, one-question scale. Demographic data and health-related variables were evaluated as potential confounding factors. A hierarchical regression was conducted to examine the moderating effect of gender on the relationship between psychological distress and sleep quality after adjusting for potential confounders.

RESULTS

The participants with severe psychological distress were found to have a lower mean quality of sleep than those without ( p < .01), and males returned a better mean quality of sleep score than females ( p < .01). Moreover, a significant interaction effect between psychological distress and gender on sleep quality score was found ( b = 0.123, SE = 0.022, p = .03). In terms of participants with severe psychological distress, males reported significantly poorer sleep quality than females.

CONCLUSIONS

The findings provide evidence that gender moderates the relationship between sleep quality and psychological distress. Also, in terms of individuals with severe psychological distress, males reported worse sleep quality than women, indicating psychological distress impacts sleep quality in men more than women. Nurses should be aware of these findings when working with clinical professionals to tailor gender-specific education interventions to improve sleep quality and psychological health.

Sex Differences in Circadian Timing and Biological Night in Adolescents

Circadian rhythms, intrinsic 24-h cycles that drive rhythmic changes in behavior and physiology, are important for normal physiology and health. Previous work in adults has identified sex differences in circadian rhythms of melatonin, temperature, and the intrinsic period of the human circadian timing system. However, less is known about sex differences in circadian rhythms at other developmental stages. To address this gap, we considered a secondary analysis of sleep and circadian data from two studies involving adolescent participants during the academic year: (n = 32, 15 females). We collected 1 week of in-home actigraphy data to calculate sleep-wake parameters and in-laboratory salivary melatonin data collection in dim-light conditions was used to compute dim-light melatonin onset (DLMO) and offset (DLMOff) using a threshold of 4 pg/mL. We found that DLMO was an average of 96 min earlier, the time between DLMO and bedtime was an average of 56 min greater, and the biological night (time between DLMO and DLMOff) was 60 min longer in females compared to males, even though bedtimes and waketimes were not statistically different between the groups. In addition, after accounting for differences in bedtime, sex was still a significant predictor of DLMO. Conversely, no evidence was found indicating a difference in DLMOff or the phase angle between DLMOff and waketime by sex. These findings suggest that sex differences in circadian rhythms are present in adolescents and may have implications for circadian health during this important developmental period.

Low-to-Moderate Daytime Physical Activities Predicted Higher-Quality Sleep Among Habitually Active Agropastoralists

INTRODUCTION

The positive effects of physical activity (PA) on sleep are widely promoted by public health organizations and supported by abundant empirical evidence. Nonetheless, there remains a dearth of studies investigating the association between daytime PA and nighttime sleep among non-urban and nonindustrial populations that habitually engage in PA as part of their subsistence strategy.

METHODS

Here, we examined the bidirectional relationship between PA and sleep. We also looked at age, gender, and occupation-level differences in moderate-to-vigorous-intensity PA (MVPA), low-intensity PA (LPA), and sedentary activity durations among Basotho and Xhoxa agropastoralists residing in rural villages in the Eastern Cape, South Africa. We analyzed activity and sleep data collected from 113 individuals using MotionWatch actigraphy wristwatches across three field seasons (7111 individual days).

RESULTS

Percentage daily total MVPA decreased with age, though older participants maintained low activity levels and did not suffer from poorer sleep compared to younger participants. Herders spent more percentage of their day in higher-intensity activity than non-herders. Overall, women had greater daily percentage MVPA and lower percentage sedentary activity than men. Durations of total MVPA and LPA decreased total sleep time (TST) and improved sleep quality (increased sleep efficiency (SE), decreased fragmentation, and decreased percentage wake after sleep onset). Daytime PA measures were not affected by sleep duration or quality from the previous night.

CONCLUSIONS

Among this group of habitually active agropastoralists, low-to-moderate-intensity PA durations consistently predicted higher sleep quality. Our findings showed that sleep quality was more strongly affected by PA than sleep duration.

Sleep problems were unrelated to social media use in the late COVID-19 pandemic phase: A cross-national study

Sleep problems are commonly related to stress and mental health problems. However, social media use has become widespread in the general population during recent years, and their addictive potential may influence people's sleep routine. In addition, the COVID-19 pandemic gave rise to substantial mental health problems in the population, and restrictions in social life gave social media a unique position as means for both entertainment and interpersonal contact. The aim of the study was to examine sleep problems in relationship to social media use in a cross-national sample two years after the COVID-19 outbreak. Participants were 1405 adults from four countries who completed a cross-sectional online survey. The data were analyzed with independent samples t-tests, Chi Squared tests of independence, and single and multivariable logistic regression analyses. Of the 858 (61.1%) participants who reported sleep problems during the past weeks, a substantial proportion (n = 353, 41.1%) related their sleep problems to their experience with COVID-19. With adjustments for age, gender, employment, and psychological distress, more hours of daily social media use was not significantly associated with sleep problems. However, higher age (OR: 1.13, p = 0.01), female gender (OR: 1.69, p<0.001), having employment (OR: 1.34, p = 0.04), and higher levels of psychological distress (OR: 1.20, p<0.001) were independently associated with sleep problems. While the debate about the pros and cons of social media use continue, this study suggests that higher levels of social media use was not of great concern for people's sleep quality in the late COVID-19 pandemic phase. However, other aspects of social media use (eg, time of the day, content of interactions, associated stress experience) may be more relevant for understanding sleep problems and may be taken into consideration for people who experience such problems.

Influence of Socio-Demographic, Occupational and Lifestyle Variables on Sleep Time

Background

Socio-demographic, occupational and lifestyle variables influence total sleep time. Therefore, we aimed to evaluate the influence of those variables on sleep time, and to study risk factors of being a short sleeper.

Methods

The COVISTRESS international study is an online questionnaire using the secure REDCap® software. Total sleep time was evaluated using declared bedtime and time of awakening and was analyzed as a quantitative variable and as a qualitative variable.

Results

We included 549 respondents to the questionnaire, divided into 10-year age groups ranging from <30yo to ≥60yo. The mean quantity of sleep was 7.11±1.43 hours per night. Factors that reduce total sleep time were age (coefficient -0.19, 95CI -0.33 to 0.06), being an employee (-0.46, -0.85 to -0.06), working time (-0.18, -0.31 to 0.05), smoking ≥5 cigarettes/day (-0.5, -0.95 to -0.20), high stress at work (-0.64, -0.96 to -0.32) and at home (-0.66, -0.97 to -0.35). Being a student (0.61, 0.02 to 1.19), working less than 25h per week (0.57, 0.17 to 0.97) and telework (0.46, 0.02 to 0.89) increased total sleep time. The risk factors of being a short sleeper were age (odds ratio 1.27, 95CI 1.07 to 1.51), being an employee (2.58, 1.36 to 4.89), smoking ≥5 cigarettes/day (2.73, 1.54 to 4.84) and a high level of stress at work (2.64, 1.45 to 4.82) and at home (3.89, 2.25 to 6.63). Physical activity ≥2.5 hours/week tended to decrease the risk of being a short sleeper by 35%.

Conclusion

We demonstrated the concomitant impact of sociodemographic, occupational and lifestyle behavior on sleep, which may help to build efficient preventive strategy.

Exploring influencing factors of healthy lifestyles in rural area among older adults with diabetes based on socioecological model

Previous research on lifestyle has primarily focused on individual lifestyle factors, often overlooking the broader influence of social determinants. This study aimed to examine factors associated with healthy lifestyle scores (HLS) among older adults with diabetes, emphasizing modifiable behaviors within the framework of the socioecological model (SEM). A cross-sectional survey was conducted from July 1 to August 31, 2023, in Jia County, Henan Province, utilizing a whole-cluster sampling method. Influencing factors were categorized into five levels based on the socioecological model (SEM). We used Generalized linear models to examine the associations between these factors and HLS, while adjusting for potential confounders. The study included 5,451 eligible participants. The proportion of participants with healthy sleep habits was notably low (14.71%). Higher HLS were positively associated with being female, better cognitive competence, greater social engagement, and unemployment. In contrast, lower HLS were significantly associated with the presence of complications, depression, higher income, and residing farther from major roads. This study identified the key modifiable factors influencing HLS among older adults with diabetes. Disrupted sleep patterns emerged as a significant concern warranting targeted intervention. Medical insurance directly affects the accessibility and economic burden of medical resources. The government should further optimize medical insurance policies to facilitate patients in adopting healthier lifestyles choices.

Exploring Social-Ecological Pathways From Sexual Identity to Sleep Among Chinese Women: Structural Equation Modeling Analysis

Background

Women and sexual minority individuals have been found to be at higher risk for experiencing poor sleep health compared to their counterparts. However, research on the sleep health of sexual minority women (SMW) is lacking in China.

Objective

This study aimed to examine sleep quality and social support for Chinese women with varied sexual identities, and then investigate the in-depth relationships between sexual identity and sleep.

Methods

This was a cross-sectional web-based survey. All participants completed a structured questionnaire containing a set of sociodemographic items referring to the social-ecological model of sleep health, the Pittsburgh Sleep Quality Index, the Social Support Rating Scale, and social relationships and environment domains of the World Health Organization Quality of Life-abbreviated short version. Pearson correlation coefficients were used to examine the relationship between sleep quality and social support as well as the two domains of quality of life. Structural equation modeling analysis was used to explore the social-ecological relationships.

Results

A total of 250 cisgender heterosexual women (CHW) and 259 SMW were recruited from July to September 2021. A total of 241 (47.3%) women experienced poor sleep quality and the rate was significantly higher in SMW than in CHW (55.2% vs 39.2%, P<.001). Around one-fifth of SMW reported low levels of social support, which was significantly higher than that of CHW (21.6% vs 5.6%, P<.001). Pearson correlations showed that overall sleep quality was significantly negatively associated with social support with weak correlations (r=-0.26, P<.001). The final structural equation modeling analysis with satisfactory fit indices identified 6 social-ecological pathways, showing that alcohol use, objective support, utilization of support, and perceived social relationship and environment quality of life played important roles in the sleep quality of individuals from their sexual identity.

Conclusions

SMW experienced poorer sleep quality compared to CHW. Further research is recommended to address the modifiable factors affecting sleep and then implement tailored sleep improvement programs.

Sleep quality and physical fitness as modifiable contributors of fatigue in childhood cancer survivors

PURPOSE

Advances in cancer treatment have increased childhood cancer patient's survival rates. However, many childhood cancer survivors (CCS) face long-term effects such as fatigue. This study assessed fatigue in CCS and healthy controls (HCs), its contributors, and associated outcomes.

METHODS

This cross-sectional study included 90 CCS and 55 age and sex-matched HCs. Fatigue was measured using the Pediatric Quality of Life Multidimensional Fatigue Scale, and modifiable contributors included sleep quality (Pittsburgh Sleep Quality Index [PSQI]) and physical fitness (VO2 peak during a treadmill test). Quality of life (QoL) and emotional and cognitive functioning were evaluated using the Pediatric Quality of Life Inventory, Beck Depression Inventory II, Cognitive Failure Questionnaire, and the Impact of Event Scale-Revised. Stepwise linear regressions identified predictors of general, sleep/rest, cognitive, and total fatigue.

RESULTS

General, cognitive, and total fatigue were significantly higher in CCS compared to HCs (44.7% vs. 23%, p < .001; cognitive: 64.7% vs. 29.3%, p < .001; total fatigue: 56.5% vs. 25%, p < .001). Sex, PSQI, PSQI × sex, and PSQI × VO₂ were significant predictors for general fatigue, PSQI and PSQI × VO₂ for cognitive fatigue, and PSQI for sleep/rest and total fatigue. Cognitive and total fatigue correlated most strongly with cognitive and work-related functioning, whereas general and sleep/rest fatigue were more related to psychosocial functioning.

CONCLUSION

Fatigue is highly prevalent among CCS, with distinct factors influencing general, sleep/rest, cognitive, and total fatigue. Female survivors, those with poorer sleep quality and lower physical fitness, are at risk.

IMPLICATIONS FOR CANCER SURVIVORS

This study underscores the need for tailored interventions for each type of fatigue. Improving sleep quality, physical fitness, and psychological well-being may contribute to reducing fatigue and enhancing overall quality of life in CCS.

Investigating the relationship between prenatal androgen exposure and sleep quality: a comprehensive study using anthropometric measurements, questionnaires, actigraphy, and polysomnography

Background

The 2D:4D digit ratio (DR), representing the relative length of the index finger to the ring finger, is an anthropometric marker that shows sexual dimorphism, with males typically having a lower ratio than females. This parameter is linked to prenatal androgen exposure (PAE), which influences sexual differentiation of the brain and behavior. This study aimed to investigate the correlation between PAE and sleep among young adults.

Methods

Anthropometric measurements were used to assess PAE, while sleep was evaluated using the Pittsburgh Sleep Quality Index (PSQI), Morningness-Eveningness Questionnaire (MEQ), actigraphy, and polysomnography (PSG). Data was collected from 720 participants via surveys, with 290 completing all questionnaires. Of these, 138 underwent anthropometric measurements, and 38 were further recruited for actigraphy, PSG.

Results

Men exhibited a lower 2D:4D ratio than women, indicating higher PAE. The average PSQI score was 6.94 ± 2.98, and the MEQ score was 35.43 ± 19.59, with no significant gender differences in sleep quality or chronotype. Low PAE was associated with better sleep efficiency and a morning chronotype, but worse sleep quality in males. Actigraphy results showed no significant differences based on PAE. PSG data revealed that males with longer 2nd fingers and higher 2D:4D ratios were more likely to suffer from mild sleep apnea, a pattern not observed in women. PAE did not significantly impact other sleep architecture parameters.

Conclusions

PAE, indicated by the 2D:4D ratio, is linked to sleep efficiency and chronotype, with significant gender differences. Men with lower PAE exhibited poorer sleep quality, and those with certain finger length patterns were more prone to mild sleep apnea. These findings underscore the potential long-term impacts of PAE on sleep health and emphasize the need for further research into gender-specific sleep regulation mechanisms.

The impact of sleep deprivation on the functional connectivity of visual-related brain regions

BACKGROUND

Sleep deprivation(SD) is known to impair cognitive function and emotional regulation, however, its specific effects on the functional connectivity of visual-related brain regions remain unclear.

OBJECTIVES

This study aimed to investigate the impact of 36-h acute sleep deprivation on functional connectivity in visual neural circuits and its relationship with cognitive and emotional changes.

METHODS

Sixty healthy male participants were assessed before and after 36 h of sleep deprivation using resting-state fMRI, the Psychomotor Vigilance Task (PVT), the Epworth Sleepiness Scale (ESS), and the Profile of Mood States (POMS). Functional connectivity changes were analyzed using paired t-tests and False Discovery Rate (FDR) correction.

KEY RESULTS

Sleep deprivation significantly altered functional connectivity between the prefrontal cortex, hippocampus, and visual processing regions. These changes correlated with slower PVT reaction times, increased subjective sleepiness (ESS), and emotional disturbances (POMS), including heightened tension and reduced self-esteem.

CONCLUSIONS

The findings suggest that acute sleep deprivation impairs cognitive performance and emotional regulation by changing functional connectivity in key brain regions. These results may strengthen our understanding of neurobiology of SD and its potential negative effects.

Sex Differences in Sleep Profiles and the Effect of Elexacaftor/Tezacaftor/Ivacaftor on Sleep Quality in Adult People with Cystic Fibrosis: A Prospective Observational Study

BACKGROUND/OBJECTIVES

Recent studies indicate that sleep and sleep disorders differ between men and women, but corresponding data in people with chronic lung diseases are lacking. This study aims to answer the question of what the sex-specific differences in sleep profiles and responses to elexacaftor/tezacaftor/ivacaftor (ETI) therapy in people with cystic fibrosis (pwCF) are.

METHODS

Adult pwCF and a matched control group (adults with suspected sleep-disordered breathing undergoing in-laboratory polysomnography (PSG)) were included. PSG data at baseline and after 6 months' ETI therapy were compared between men (mwCF) and women (wwCF) with cystic fibrosis. PSG data at baseline and 6-month follow-up for mwCF/wwCF were compared with baseline PSG data for men/women in the control group. Daytime sleepiness was evaluated using the Epworth Sleepiness Scale (ESS). Correlations between change in percentage predicted forced expiratory volume in 1 s from baseline to 6 months were correlated with corresponding changes in key sleep parameters. Changes in transferrin during ETI therapy were also documented.

RESULTS

Twenty-eight pwCF (12 wwCF, 16 mwCF) and 28 matched controls were included. Both mwCF (4 ± 5 vs. 9 ± 20 events/h, p = 0.028) and wwCF (3 ± 3 vs. 8 ± 9 events/h, p = 0.004) had fewer respiratory events during sleep versus male and female controls, but worse sleep efficiency (75 ± 11% vs. 84 ± 11%; p = 0.004 and 76 ± 10% vs. 83 ± 11%; p = 0.011. The baseline ESS score was significantly higher in wwCF versus female controls (8 ± 4 vs. 14 ± 8; p = 0.040). Although some sleep parameters normalized during ETI therapy in pwCF, sleep quality remained poor. The transferrin levels at baseline (2.7 ± 0.4 vs. 2.2 ± 0.5; p = 0.049) and 6 months (3.8 ± 0.4 vs. 2.6 ± 0.5; p < 0.001) were significantly higher in the wwCF versus the mwCF, and the change from baseline during ETI therapy was significantly greater in women versus men (1.1 ± 0.6 vs. 0.4 ± 0.4; p < 0.001).

CONCLUSIONS

These data suggest that wwCF and mwCF should be managed differently with respect to their sleep.

Association Between Physical Activity and Sleep Health Among Community-Dwelling Adults Aged ≥50 in Ghana: The Mediating Role of Psychosomatic Factors

OBJECTIVES

Data on the direct and indirect associations between physical activity (PA) and sleep quality in old age via psychosomatic mechanisms (e.g. mobility, pain, loneliness, depression, and anxiety) remain scarce in low- and middle-income countries (LMICs). We explored the association of PA with poor sleep quality (PSQ) among individuals aged ≥ 50 in Ghana and explored the potential mediating factors in this association.

METHODS

We analyzed community-based data from the Aging, Health, Psychological Well-being, and Health-seeking Behavior Study. We assessed PA using the International Physical Activity Questionnaire (IPAQ). Two items on nighttime and daytime sleep problems in the last 30 days were used to measure PSQ. Multivariable ordinary least square (OLS) regressions and bootstrapping models were performed to evaluate the associations.

RESULTS

Overall, 1,201 participants (Mage = 66.15 ± 11.58 years; 63.3% female) were included in the analysis. PA was independently associated with decreased PSQ in the overall sample (B = -0.181, 95%I = -0.271 to -0.092) and in women (B = -0.195, 95%I = -0.305 to -0.084). The association was stronger in the ≥ 65 (B = -0.138) than in the 50-64 age group (B = -0.213). Mobility (37.06%), pain (23.66%), loneliness (6.71%), and comorbid anxiety and depression (8.95%) mediated the PA-PSQ association.

CONCLUSIONS

PA was associated with decreased PSQ levels, which was particularly explained by psychosomatic factors.

CLINICAL IMPLICATIONS

Clinicians encourage older adults to engage in regular PA and manage psychosomatic problems may improve their sleep health.

Multi-Night Electroencephalography Reveals Positive Association Between Sleep Efficiency and Hippocampal Subfield and Entorhinal Cortex Volumes in Healthy Aging

Age-related atrophy of the human hippocampus and the enthorinal cortex starts accelerating at around age 60. Due to the contributions of these regions to many cognitive functions seamlessly used in everyday life, this can heavily impact the lives of elderly people. The hippocampus is not a unitary structure, and mechanisms of its age-related decline appear to differentially affect its subfields. Human and animal studies have suggested that altered sleep is associated with hippocampal atrophy. Yet, we know little about subfield specific effects of altered sleep in healthy aging and their effect on cognition. Here, in a sample of 118 older middle-aged and older adults (Mage = 63.25 y, range: 50-80 y), we examined the association between highly reliable hippocampal subfield and entorhinal cortex volumetry (n = 112), sleep measures derived from multi-night recordings of portable electroencephalography (n = 61) and episodic memory (n = 117). Objective sleep efficiency-but not self-report measures of sleep-was associated with entorhinal cortex volume when controlling for age. Age-related differences in subfield volumes were associated with objective sleep efficiency, but not with self-report measures of sleep. Moreover, participants characterized by a common multivariate pattern of subfield volumes that contributed to positive sleep-subfield volume associations, showed lower rates of forgetting. Our results showcase the benefit of objective sleep measures in identifying potential contributors of age-related differences in brain-behavior couplings.

Subjective sleep quality and sleep habits of elderly inhabiting rural areas of Sambalpur district of Odisha, India

Sleep is an important physiological process that is essential for human beings because it maintains the circadian rhythm appropriately. The sleep behavior in the older population of India has not been studied adequately. Further, there is no report on the sleep behavior of the elderly population of Odisha, India. Therefore, this study has been designed to examine the status of sleep quality in the elderly living in rural areas of the Sambalpur district of western Odisha, India. This study includes1992 elderly subjects above the age of 60 years (945 females and 1047 males) who participated voluntarily. Data collection was done using a socio-demographic form and Pittsburgh Sleep Quality Index (PSQI) inventory to determine the sleep quality and related factors that might alter the quality of sleep. The prevalence rate of sleep quality was assessed for both groups and the independence of attributes was tested statistically using the Chi-square test with ap-value ≤0.05 was considered significant. Of the 1992 elderly participants, 1384 (69.5%) showed good sleep quality, and 608 (30.5%) had poor sleep quality. The factors, "female gender, marital status such as married" and "drinking habits of alcohol" are the statistically significant associations with good sleep quality among the elderly participants. The overall prevalence of good-quality sleep was high among the elderly participants living in rural areas of the Sambalpur district of western Odisha. These results might serve as a baseline database for future research endeavors. Further, a longitudinal study that has been planned might help in identifying the underlying factors that sustain good-quality sleep in a majority of the studied population.

Physical activity, body weight, and liver function as factors increasing Insomnia index among Korean adults: a cross-sectional analysis

BACKGROUND

This study aimed to elucidate the relationship between physical activity, body weight, liver function, and insomnia in Korean adults, thereby providing a foundation for health promotion strategies.

METHODS

We recruited 11,645 adults (8,051 males and 3,594 females). Participants underwent assessments using the Korean version of the Insomnia Severity Index, measures of physical activity (PA), anthropometric data (body weight, height, body mass index [BMI], and waist circumference [WC]), and liver function (alanine aminotransferase, aspartate aminotransferase [AST], and gamma-glutamyl transferase).

RESULTS

One-way ANOVA revealed significant differences among male groups in height (p < .001), weight (p = .036), BMI (p = .002), diastolic blood pressure (p = .008), AST (p = .036), recreational PA (p = .026), moderate PA (p < .01), vigorous PA (p < .01), and moderate-to-vigorous PA (p < .001). Similarly, significant differences were found among female groups in height (p < .001), weight (p = .001), BMI (p = .006), WC (p = .013), moderate PA (p < .001), vigorous PA (p < .001), and moderate-to-vigorous PA (p < .001).

CONCLUSION

To prevent insomnia, it is essential to enhance physical activity and manage factors related to body weight and liver function, such as BMI, WC, and AST. Increasing moderate-to-vigorous physical activity is particularly crucial, as it has a substantial positive impact on reducing body weight and improving liver function.

Novel perspective of 'poor sleep' in public health: a narrative review

A high percentage of people worldwide complain of sleep disturbances; however, the vast majority do not meet the diagnostic criteria for insomnia or other classic sleep disorders. Therefore, the 'classical' concept of poor sleep remains undetected, and patients stay ignored and unidentified. Also, poor sleep has been strongly associated with increased daytime function impairment, morbidity and mortality and is considered a risk factor for developing mental disorders. Poor sleep is the individual experience of insufficient restorative sleep and/or sleep satisfaction in adults who do not fulfil the criteria for sleep disorders. This article provides a review on the impact of poor sleep on a healthy life within the multidimensional concept of sleep health, including the COVID-19-affected period. We propose a wide definition of poor sleep and the key characteristics of poor sleepers and tools for (self) detection. We discuss sleep assessment methods that combine the ability to capture the subjective perception of the sleep experience and measure objective sleep parameters. We then report selected strategies to improve sleep health, focusing on healthy sleep habits, cognitive behavioural therapy, diet, exercise, food supplements and other sleep aids. Considering the current megalopolis way of life, young people are following a 24/24 hours 7 days/week rhythm of life, with increased exposure to noise and light pollution, night-shift work, higher commute time, increased global temperature and overuse of smartphones and screens. Therefore, there is an urgent need for increasing awareness of poor sleep and stimulating educational efforts targeted at poor sleepers and primary care specialists.

Disruptions to sleep and circadian rhythms are associated with poorer athlete mental health in female, but not male, elite Australian Rules footballers

Elite athletes are vulnerable to sleep and circadian disruption and associated mental health symptoms. This study aimed to investigate sex differences in sleep, circadian rhythms, and mental health, as well as the moderating role of sex in the prediction of mental health, among male professional and female semi-professional elite athletes. Participants were 87 elite Australian Rules football (ARF) athletes (43% female; mean [standard deviation] age 24.0 [4.1] years). Participants completed baseline questionnaires, 2 weeks of sleep/wake monitoring via actigraphy, and a circadian phase assessment (dim-light melatonin onset [DLMO]). Cross-sectional data were collected in training-only Australian Football League (AFL) Men's and Women's pre-season periods, with 53 providing data in two pre-seasons. Female athletes, relative to males, reported poorer mental health (a higher athlete psychological strain score), had a later mid-sleep time (by 28 min), reported a greater preference towards eveningness, and displayed a later circadian phase (by 33 min). For female athletes, lower sleep efficiency and lower sleep regularity were associated with poorer mental health. For female athletes, there were U-shaped relationships between both morningness-eveningness and phase angle (interval between sleep onset and DLMO time) and mental health. No significant relationships were found for male athletes. In summary, elite female ARF athletes reported poorer mental health, relative to males, especially when experiencing sleep or circadian disruption. Lifestyle factors associated with sex differences in ARF professionalism (scheduling, finances, supports) may contribute to these findings. Programmes to improve sleep, circadian alignment, and mental health among female semi-professional elite athletes should be strongly considered.

Acute sleep disruption reduces fear memories in male and female mice

Sleep problems are a prominent feature of mental health conditions including post-traumatic stress disorder (PTSD). Despite its potential importance, the role of sleep in the development of and/or recovery from trauma-related illnesses is not understood. Interestingly, there are reports that sleep disruption immediately after a traumatic experience can reduce fear memories, an effect that could be utilized therapeutically in humans. While the mechanisms of this effect are not completely understood, one possible explanation for these findings is that immediate sleep disruption interferes with consolidation of fear memories, rendering them weaker and more sensitive to intervention. Here, we allowed fear-conditioned mice to sleep immediately after fear conditioning during a time frame (18 h) that includes and extends beyond periods typically associated with memory consolidation before subjecting them to 6-h of sleep disruption. Mice exposed to this delayed regimen showed dramatic reductions in fear during tests conducted immediately after sleep disruption, as well as 24 h later. This sleep disruption regimen also increased levels of mRNA encoding brain-derived neurotrophic factor (BDNF), a molecule implicated in neuroplasticity, in the basolateral amygdala (BLA), a brain area implicated in fear and its extinction. These findings raise the possibility that the effects of our delayed sleep disruption regimen are not due to disruption of memory consolidation, but instead are caused by BDNF-mediated neuroadaptations within the BLA that actively suppress expression of fear. Treatments that safely reduce expression of fear memories would have considerable therapeutic potential in the treatment of conditions triggered by trauma.

Sleep and circadian rhythm disturbances as risk and progression factors for multiple chronic overlapping pain conditions: a protocol for a longitudinal study

Introduction

Chronic overlapping pain conditions (COPCs), such as chronic low back pain (cLBP) and fibromyalgia, frequently cooccur and incur substantial healthcare costs. However, to date, much focus has been placed on individual anatomically based chronic pain conditions, whereas little is known about the mechanisms underlying progression to multiple (more than 1) COPCs. This study aims to address the gap by investigating the role of common and modifiable risk factors, specifically sleep and circadian rhythm disturbances, in the development of multiple COPCs.

Methods

The study will enroll 300 participants with cLBP, including 200 with cLBP only and 100 with cLBP plus other COPCs (ie, fibromyalgia, temporomandibular disorders, irritable bowel syndrome, and chronic headaches) and follow them up for 12 months. Sleep and circadian rhythms will be assessed using wireless sleep electroencephalography, 24-hour evaluation of the rhythm of urinary 6-sulfatoxymelatonin, actigraphy, and sleep diaries. Pain amplification using quantitative sensory testing, psychological distress using validated self-report measures, and the number of pain sites using a pain body map will also be assessed.

Perspectives

This research aims to (1) comprehensively characterize sleep/circadian disturbances in individuals with single and multiple COPCs using multimodal in-home assessments; (2) examine the associations between sleep/circadian disturbances, changes in pain amplification, and psychological distress; and (3) investigate the relationship among these factors and the progression in the number of pain sites, a proxy for multiple COPCs. The findings will provide insights into the mechanisms leading to multiple COPCs, potentially informing treatment and prevention strategies for these complex conditions.

The effectiveness of exercise interventions targeting sleep in older adults with cognitive impairment or Alzheimer's disease and related dementias (AD/ADRD): A systematic review and meta-analysis

Sleep loss is associated with reduced health and quality of life, and increased risk of Alzheimer's disease and related dementias. Up to 66% of persons with Alzheimer's disease and related dementias experience poor sleep, which can predict or accelerate the progression of cognitive decline. Exercise is a widely accessible intervention for poor sleep that can protect against functional and cognitive decline. No previous systematic reviews have investigated the effectiveness of exercise for sleep in older adults with mild cognitive impairment or Alzheimer's disease and related dementias. We systematically reviewed controlled interventional studies of exercise targeting subjectively or objectively (polysomnography/actigraphy) assessed sleep in persons with mild cognitive impairment or Alzheimer's disease and related dementias. We conducted searches in PubMed, Embase, Scopus and Cochrane-Library (n = 6745). Nineteen randomised and one non-randomised controlled interventional trials were included, representing the experiences of 3278 persons with mild cognitive impairment or Alzheimer's disease and related dementias. Ten had low-risk, nine moderate-risk, and one high-risk of bias. Six studies with subjective and eight with objective sleep outcomes were meta-analysed (random-effects model). We found moderate- to high-quality evidence for the beneficial effects of exercise on self-reported and objectively-measured sleep outcomes in persons with mild cognitive impairment or Alzheimer's disease and related dementias. However, no studies examined key potential moderators of these effects, such as sex, napping or medication use. Our results have important implications for clinical practice. Sleep may be one of the most important modifiable risk factors for a range of health conditions, including cognitive decline and the progression of Alzheimer's disease and related dementias. Given our findings, clinicians may consider adding exercise as an effective intervention or adjuvant strategy for improving sleep in older persons with mild cognitive impairment or Alzheimer's disease and related dementias.

Sex-specific changes in sleep quality with aging: Insights from wearable device analysis

Prior studies evaluating sleep quality have found that women often have better polysomnography-defined sleep quality than men, but women subjectively report a greater frequency of sleep disturbances. Although these studies can be partially attributed to study design, it is currently unclear what may be causing these discrepancies. In this study, we aim to identify potential differences in objectively assessed sleep quality between men and women with further emphasis on subgroup analysis based on age. We hypothesize that women's sleep worsens after menopause. Sleep quality was assessed by comparing the Sleep Quality Index, Arousal Index, sleep efficiency and apnea-hypopnea index, as provided by the SleepImage Ring@ 2.3.0, between men and women, with a sub-group analysis performed by age (18-40 years, 41-50 years, 51-60 years, 61-70 years, and > 70 years), run separately for women and men. In total, 1444 subjects (704 women and 740 men) with a mean age of 53.6 ± 14.71 years were enrolled in this analysis. In women, a significant drop in Sleep Quality Index was noted after age 51 years. Regression analysis demonstrated that age, Arousal Index, sleep efficiency and apnea-hypopnea index correlated significantly with Sleep Quality Index - with age, Arousal Index and apnea-hypopnea index negatively correlated, and sleep efficiency positively correlated. The highest correlation coefficient was obtained for Arousal Index in both women and men. In women, age older than 50 years was associated with a more rapid decrease of sleep quality than men, as defined by an increase in Arousal Index and apnea-hypopnea index with a concurrent decrease in Sleep Quality Index.

Gender differences in sleep quality among Iranian traditional and industrial drug users

•The findings emphasize gender differences in sleep quality among different cultures, races, and ethnicities.•There are gender differences in sleep quality in Iranian traditional and industrial drug users.•Industrial drug users have a lower quality of sleep than traditional drug users.•The sleep quality of drug users (traditional and industrial) is lower than that of healthy people.

Sex differences in sleep deficits in mice with an autism-linked Shank3 mutation

BACKGROUND

Insomnia is more prevalent in individuals with Autism Spectrum Disorder (ASD), can worsen core-symptoms and reduces quality of life of both individuals and caregivers. Although ASD is four times more prevalent in males than females, less is known about sex specific sleep differences in autistic individuals. Recent ASD studies suggest that sleep problems may be more severe in females, which aligns with the sex bias seen in insomnia for the general population. We have previously shown that male mice with a mutation in the high confidence ASD gene Shank3, Shank3∆C, recapitulate most aspects of the ASD insomnia phenotype. The objective of the present study was to leverage the Shank3∆C model to investigate sex-specific effects in sleep using polysomnography.

METHODS

Adult male and female Shank3∆C and wildtype (WT) littermates were first recorded for 24 h of baseline recordings. Subsequently, they were sleep deprived (SD) for five hours via gentle handling and allowed 19 h of recovery sleep to characterize the homeostatic response to SD. Vigilance states (rapid eye movement (REM) sleep, non-rapid eye movement (NREM) sleep and wake) were assigned by manual inspection using SleepSign. Data processing, statistical analysis and visualization were conducted using MATLAB.

RESULTS

Sex and genotype effects were found during baseline sleep and after SD. At baseline, male Shank3∆C mice sleep less during the dark period (active phase) while female Shank3∆C mice sleep less during the light period (rest phase) and sleep more during the dark period. Both male and female Shank3∆C mice show reduced spectral power in NREM sleep. We detect a significant effect of sex and genotype in sleep onset latency and homeostatic sleep pressure (sleepiness). In addition, while male Shank3∆C mice fail to increase sleep time following SD as seen in WT, female Shank3∆C mice decrease sleep time.

CONCLUSIONS

Overall, our study demonstrates sex differences in sleep architecture and homeostatic response to SD in adult Shank3∆C mice. Thus, our study demonstrates an interaction between sex and genotype in Shank3∆C mice and supports the use of the Shank3∆C model to better understand mechanisms contributing to the sex differences in insomnia in ASD in clinical populations.

Daytime sleepiness and BMI exhibit gender and age differences in patients with central disorders of hypersomnolence

The aim of the present study was to examine gender and age-specific effects on subjective daytime sleepiness (as measured by the Epworth Sleepiness Scale), body weight and eating behaviour in patients with central disorders of hypersomnolence. Based on the European Narcolepsy Network database, we compared 1035 patients with narcolepsy type I and 505 patients with other central disorders of hypersomnolence ("narcoleptic borderland"), including narcolepsy type II (N = 308) and idiopathic hypersomnia (N = 174), using logistic regression and general linear models. In the entire study population, the Epworth Sleepiness Scale was higher in women (N = 735, mean age = 30 years, mean Epworth Sleepiness Scale = 16.6 ± SD 3.9) than in men (N = 805, mean age = 32 years, mean Epworth Sleepiness Scale = 15.8 ± SD 4.4). In women with narcolepsy type I (N = 475), both Epworth Sleepiness Scale and body mass index increased in parallel with age. In women of the narcoleptic borderland (N = 260), the Epworth Sleepiness Scale markedly peaked in their early 30s, while body mass index only started to rise at that age. This rise in body mass index following the Epworth Sleepiness Scale peak cannot be explained by sleepiness-induced uncontrolled eating, as self-reported uncontrolled eating was negatively associated with the Epworth Sleepiness Scale in this group. We propose that the narcoleptic borderland harbours a unique cluster of women in their fertile years with an unexplored aetiology requiring further investigation towards tailored interventions.

The importance of including both sexes in preclinical sleep studies and analyses

A significant effort in biomedical sciences has been made to examine relationships between sex and the mechanisms underlying various disease states and behaviors, including sleep. Here, we investigated biological sex differences in sleep using male and female C57BL/6J mice (n = 267). Physiological parameters were recorded for 48-h using non-invasive piezoelectric cages to determine total sleep, non-rapid eye movement (NREM) sleep, rapid eye movement (REM)-like sleep, and wakefulness (WAKE). We fit hierarchical generalized linear mixed models with nonlinear time effects and found substantial sex differences in sleep. Female mice slept less overall, with less NREM sleep compared to males. Females also exhibited more REM-like sleep and WAKE and had shorter NREM sleep bout lengths. We also conducted a simulation exercise where we simulated a hypothetical treatment that altered the sleep of female mice, but not male mice. In models that included an appropriate sex by treatment interaction, a female-specific treatment response was accurately estimated when sample sizes were equal but was not detected when sample sizes were unequal, and females were underrepresented. Failure to include both sexes in experimental designs or appropriately account for sex during analysis could lead to inaccurate translational recommendations in pre-clinical sleep studies.

Sex differences in the association between short sleep duration and obesity: A systematic-review and meta-analysis

AIMS

Obesity is a leading contributor to global morbidity and mortality. Short sleep duration is significantly associated with the incidence of obesity, however, it remains unclear whether this relationship is influenced by sex. The purpose of this meta-analysis was to systematically evaluate the evidence of whether the association between short sleep duration and obesity differs between males and females.

DATA SYNTHESIS

The protocol was registered with PROSPERO (CRD42023374205). From inception through June 2023, Medline, Embase and Web of Science databases were searched for longitudinal cohort studies with minimum 12 months of observation. The quality of studies was assessed using the Newcastle-Ottawa Quality Assessment for Cohort Studies. Results were pooled using a random effects model. Results are expressed as ratio of odds ratios (ROR) with 95% confidence interval (CI). ROR directly estimates the relative strength of the association of interest (measured as odds ratio [OR] between females and males). Sensitivity analysis was performed and inconsistency between studies was assessed using I2 statistics. A total of 4582 articles were retrieved with the search strategy, of which 6 were included. The meta-analysis indicated that the association between short sleep duration and obesity incidence was statistically significant in both men [OR 1.26 (95% CI 1.13-1.40)] and women [OR 1.36 (95% CI 1.16-1.59)]. However, it did not differ significantly between sexes ROR (women/men) 1.04 (95%CI 0.79-1.36; I2 20.1%).

CONCLUSIONS

This meta-analysis indicates that women and men who subjectively report short sleep duration have similarly increased risks of incident obesity.

The dynamic responses of mood and sleep physiology to chronic sleep restriction and subsequent recovery sleep

Healthy sleep of sufficient duration preserves mood and disturbed sleep is a risk factor for a range of psychiatric disorders. As adults commonly experience chronic sleep restriction (SR), an enhanced understanding of the dynamic relationship between sleep and mood is needed, including whether susceptibility to SR-induced mood disturbance differs between sexes. To address these gaps, data from N = 221 healthy adults who completed one of the two multi-day laboratory studies with identical 9-day SR protocols were analyzed. Participants randomized to the SR (n = 205) condition underwent 5 nights of SR to 4 hours of time-in-bed and were then randomized to one of the seven sleep doses that ranged from 0 to 12 hours in 2 hours increments; participants randomized to the control (n = 16) condition received 10 hours time-in-bed on all study nights. The Profile of Mood States (POMS) was used to assess mood every 2 hours during wakefulness and markers of sleep homeostasis (EEG slow-wave activity (SWA)) were derived via polysomnography. Mood progressively deteriorated across SR with marked disturbances in somatic mood components. Altered sleep physiology contributed to mood disturbance whereby increased EEG SWA was associated with increased POMS Total Mood Disturbance scores, a finding specific to males. The mood was restored in a dose-response fashion where improvements were greater with longer sleep doses. These findings suggest that when lifestyle and environmental factors are inhibited in the laboratory, the affective consequences of chronic sleep loss are primarily somatic mood disturbances. Altered sleep homeostasis may contribute to mood disturbance, yet sleep-dependent mechanisms may be sex-specific.

Sleep insufficiency and bedtime irregularity in children with ADHD: A population-based analysis

BACKGROUND

Sleep is impaired in children with attention-deficit/hyperactivity disorder (ADHD). However, population-based examination of indicators of sleep insufficiency and bedtime irregularity is limited. This investigation examined associations between ADHD, weeknight sleep insufficiency, and bedtime irregularity in a nationally-representative child sample, and indicators of these sleep outcomes in ADHD.

METHODS

Parents of children aged 3-17 years with ADHD (n = 7671) were surveyed through the 2020-2021 National Survey of Children's Health. Inverse probability of treatment weighting generated a weighted matched control sample (n = 51,572). Weighted generalized linear models were performed without and with age-stratification to examine associations between ADHD and sleep, adjusting for sociodemographics in the full sample, and between nineteen sociodemographic and clinical variables and sleep in ADHD.

RESULTS

Having ADHD was associated with increased odds of sleep insufficiency and bedtime irregularity relative to controls, even after adjusting for sociodemographic variables. In ADHD, older age was associated with lower sleep insufficiency and greater bedtime irregularity. Black race, increased poverty, higher ADHD severity, depression, and increased screen time were associated with greater sleep insufficiency and bedtime irregularity. Adverse childhood experiences (ACEs) were associated with greater sleep insufficiency. Behavioral/conduct problems, female sex, and absence of both ADHD medication use and ASD diagnosis were associated with poorer bedtime irregularity. Age-stratified results are reported in text.

CONCLUSIONS

Children with ADHD face heightened risk for insufficient sleep and irregular bedtimes. Findings suggest intervention targets (e.g., Black race, poverty, depression, screen time) to improve both sleep insufficiency and bedtime irregularity. Results highlight ACEs and behavioral/conduct problems as targets to improve sleep insufficiency and bedtime regularity, respectively. Age-stratified findings are discussed.

Menstrual-Cycle Symptoms and Sleep Characteristics in Elite Soccer Players

PURPOSE

To determine whether menstrual-cycle symptoms are associated with sleep in elite female athletes.

METHODS

Sleep was assessed for a minimum of 25 nights (range = 25-31) using activity monitoring and sleep diaries. Menstrual-cycle symptoms were collected over the same duration in 12 elite female professional soccer players. Generalized estimating equations were used to examine the relationship between the day of the menstrual cycle (from day 1) and total menstrual-cycle symptoms on sleep characteristics.

RESULTS

There was a significant relationship between sleep duration and the day of the menstrual cycle (P = .042) and total symptoms reported that day (P < .001), with sleep duration increasing by 21 minutes for every symptom reported. There was a negative day × symptom interaction on sleep duration (P = .004), indicating that with increased symptoms, the day of the menstrual cycle had a smaller relationship with sleep duration. Sleep efficiency (P = .950), wake after sleep onset (P = .217), and subjective sleep quality (P = .080) were not related to the day of the menstrual cycle. The total symptoms reported had no relationship with sleep efficiency (P = .220), subjective sleep quality (P = .502), or sleep latency (P = .740) but did significantly relate to wake after sleep onset (P < .001), with a significant day × symptom interaction (P < .001).

CONCLUSIONS

Sleep duration increased from day 1 of the menstrual cycle and was associated with the number of menstrual-cycle symptoms reported. All other sleep metrics remained unchanged; however, total symptoms reported were related to wake after sleep onset. Monitoring and managing menstrual-cycle symptoms should be encouraged due to a potential relationship with sleep characteristics.

A sociodemographic index identifies sex-related effects on insomnia in the Hispanic Community Health Study/Study of Latinos

Study Objectives

Sex differences are related to both biological factors and the gendered environment. We constructed measures to model sex-related differences beyond binary sex.

Methods

Data came from the baseline visit of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). We applied the least absolute shrinkage and selection operator penalized logistic regression of male versus female sex over sociodemographic, acculturation, and psychological factors jointly. Two "gendered indices," the gendered index of sociodemographic environment (GISE) and gendered index of psychological and sociodemographic environment, summarizing the sociodemographic environment (GISE) and psychosocial and sociodemographic environment (GIPSE) associated with sex, were calculated by summing these variables, weighted by their regression coefficients. We examined the association of these indices with insomnia, a phenotype with strong sex differences, in sex-adjusted and sex-stratified analyses.

Results

The distribution of GISE and GIPSE differed by sex with higher values in male individuals. In an association model with insomnia, male sex was associated with a lower likelihood of insomnia (odds ratio [OR] = 0.60, 95% CI [0.53, 0.67]). Including GISE in the model, the association was slightly weaker (OR = 0.63, 95% CI [0.56, 0.70]), and weaker when including instead GIPSE in the association model (OR = 0.78, 95% CI [0.69, 0.88]). Higher values of GISE and of GIPSE, more common in the male sex, were associated with a lower likelihood of insomnia, in analyses adjusted for sex (per 1 standard deviation of the index, GISE OR = 0.92, 95% CI [0.87, 0.99], GIPSE OR = 0.65, 95% CI [0.61, 0.70]).

Conclusions

New measures such as GISE and GIPSE capture sex-related differences beyond binary sex and have the potential to better model and inform research studies of sleep health.

On the basis of sex and sleep: the influence of the estrous cycle and sex on sleep-wake behavior

The recurrent hormonal fluctuations within reproductive cycles impact sleep-wake behavior in women and in rats and mice used in preclinical models of sleep research. Strides have been made in sleep-related clinical trials to include equal numbers of women; however, the inclusion of female rodents in neuroscience and sleep research is lacking. Female animals are commonly omitted from studies over concerns of the effect of estrus cycle hormones on measured outcomes. This review highlights the estrous cycle's broad effects on sleep-wake behavior: from changes in sleep macroarchitecture to regionally specific alterations in neural oscillations. These changes are largely driven by cycle-dependent ovarian hormonal fluctuations occurring during proestrus and estrus that modulate neural circuits regulating sleep-wake behavior. Removal of estrous cycle influence by ovariectomy ablates characteristic sleep changes. Further, sex differences in sleep are present between gonadally intact females and males. Removal of reproductive hormones via gonadectomy in both sexes mitigates some, but not all sex differences. We examine the extent to which reproductive hormones and sex chromosomes contribute to sex differences in sleep-wake behavior. Finally, this review addresses the limitations in our understanding of the estrous cycle's impact on sleep-wake behavior, gaps in female sleep research that are well studied in males, and the implications that ignoring the estrous cycle has on studies of sleep-related processes.

Effects of global postural re-education on stress and sleep quality in health sciences female students: a randomized controlled trial pilot study

Objective

The purpose of this study was to determine, for the first time, whether the application of a self-management program with global postural re-education (GPR) influences stress and sleep quality in female health science students.

Methods

In this randomized controlled trial pilot study, forty-one female health science students were randomized into a control group (n=21) and an intervention group (n=20). Participants underwent 8 weeks of self-management with and without GPR, after familiarization and therapy training. Outcomes included the State-Trait Anxiety Inventory (STAI) questionnaire and cortisol levels in saliva measured with the "CORTISOL Saliva ELISA SA E-6000" kit. Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI) and a Sleep Diary; total sleep time (TST), sleep onset latency (SOL), wakefulness after sleep onset (WASO), sleep efficiency (SE), and perceived sleep quality or satisfaction were assessed using the Likert scale.

Results

After self-treatment with GPR, participants in the intervention group showed lower cortisol levels compared to the control group (p = 0.041). Additionally, the intervention group demonstrated statistically significant improvements in sleep quality according to their PSQI (p = 0.010), STAI (p = 0.043), SOL (p = 0.049), and SE (p = 0.002).

Conclusion

This study shows that self-management through GPR helps reduce stress and improve sleep quality in female health science students.

Clinical Trial Registration

https://clinicaltrials.gov/, identifier NCT05488015.

Sex Differences in the Associations of mental Health, Suicidality, Screentime, and Sleep: A Mediation Effect Analysis of Sleep Using Youth Risk Behavioral Surveillance Survey 2021

Objective: This study was conducted to explore the sex differences in the direct and indirect associations among mental health/suicidality, sleep, and screen time. Methods: Using the 2021 Youth Risk Behavior Survey (YRBS) data, 9408 participants were included in the analyses. The associations of endogenous variables (mental health and suicidality), exogenous variable (screen time), mediator (sleep), and covariates (demographic features and risky behaviors) were analyzed using the Structural Equation Model and "medsem" package, as well as logistic regression and bootstrapping methods. To explore the sex differences in the mediation effect, the Likelihood Ratio Test was used for the multiple-group analysis to compare the unconstrained model with the mediation path-constrained model. Results: Screen time had a significant negative association with sleep duration (female: β = -.09, p < .001; male: β = -.04, p < .001), positive relations to mental health problems (female: β = .10, p < .001; male: β = .12; p < .001), and suicidality (female: OR: 1.07, 95% CI: 1.02-1.13; male: OR: 1.06, 95% CI: 1.01-1.23). Sleep duration is negatively associated with mental health problems (female: β = -.16, p < .001; male: β = -.14; p < .001) and negatively associated with the likelihood of suicidality (female: .89, 95% CI: .85-.94; male: OR: .84, 95% CI: .79-.90). Furthermore, female adolescents had higher frequencies in mental health problems, higher odds ratio in suicidality, shorter sleep duration, and bigger mediation effects of sleep, compared to their male counterparts. Conclusion: Mental health and suicidality were affected differently by screen time and sleep between female and male adolescents. Future research may continue to explore sex differences and their underlying reasons.

The effect of experimentally induced sleep fragmentation and estradiol suppression on neurobehavioral performance and subjective sleepiness in premenopausal women

STUDY OBJECTIVES

Menopause is associated with nighttime sleep fragmentation, declining estradiol, and impaired cognition. In a model of pharmacologically induced estradiol suppression mimicking menopause, we examined the impact of menopause-pattern sleep fragmentation on daytime neurobehavioral performance and sleepiness in premenopausal women.

METHODS

Twenty premenopausal women completed two five-night inpatient studies in the mid-to-late follicular phase (estrogenized) and after pharmacological estradiol suppression (hypo-estrogenized). During each study, participants had an uninterrupted 8-hour sleep opportunity for two nights, followed by three nights where sleep was experimentally fragmented to mimic menopause-pattern sleep disturbance, and during which the sleep opportunity was extended to prevent shortening of the sleep duration. Neurobehavioral performance and subjective sleepiness were measured using the Psychomotor Vigilance Task and Karolinska Sleepiness Scale (KSS).

RESULTS

Compared to unfragmented sleep, sleep fragmentation increased attentional lapses (+ 0.6 lapses, p < .05), slowed reaction time (+ 9.4 milliseconds, p < .01), and increased daytime sleepiness (+ 0.5 KSS score, p < .001). Estradiol suppression increased attentional lapses (+ 0.8; p < .001) and reaction time (+ 12.3, p < .01) but did not significantly affect daytime sleepiness. The effect of sleep fragmentation on neurobehavioral performance differed by estradiol state, such that the adverse effects of sleep fragmentation on attentional lapses (+ 0.9, trend p = .06) and reaction time (+ 15, p < .05) were observed only when estrogenized.

CONCLUSIONS

Menopause-pattern sleep fragmentation and estradiol suppression worsened neurobehavioral performance and daytime sleepiness, even while sleep duration was not reduced. The adverse effects of sleep fragmentation in the context of an adequate sleep duration highlight the importance of sleep continuity as a vital aspect of good sleep health.

Association of Sleep Patterns and Respiratory Disturbance Index with Physiological Parameters in Pediatric Patients with Self-Perceived Short Stature

OBJECTIVE

To investigate the relationships of sleep patterns and respiratory disturbance index (RDI) with key physiological parameters (height, body mass index (BMI), bone age (BA), and IGF-1 levels) in children aged 6 to 16 years with self-perceived short stature.

METHODS

For this cross-sectional study, conducted from October 2019 to November 2021, 238 children aged 6 to 16 years with self-perceived short stature were enrolled. The primary outcomes of sleep patterns and the RDI were non-invasively collected at home using the LARGAN Health AI-Tech Sleep Apnea and Sleep Quality Examination System, which operates based on polygraphy. Additionally, various physiological parameters, including height, BMI, bone age, and IGF-1 levels, were measured to assess their associations with sleep patterns and RDI.

RESULTS

Significant age-related reductions were observed in both the total and deep sleep durations. Children aged 6-9 years averaged 8.5 ± 1.0 h of total sleep, which decreased to 8.1 ± 1.1 h in ages 10-11 and further to 7.5 ± 0.9 h in ages 12-16 (p < 0.0001). Deep sleep followed a similar pattern, decreasing from 4.4 ± 1.1 h in the youngest group to 3.3 ± 1.0 h in the oldest (p < 0.0001). Notably, girls experienced significantly longer deep sleep than boys, averaging 4.0 ± 1.2 h compared to 3.6 ± 1.2 h (p = 0.0153). In a multivariable regression analysis, age (beta = 4.89, p < 0.0001) and RDI (beta = -0.54, p = 0.0022) were significantly associated with body height. Age and deep sleep duration (beta = -0.02, p = 0.0371) were significantly associated with BMI.

CONCLUSIONS

The results demonstrate significant age-related decreases in the total and deep sleep duration among children with self-perceived short stature, along with a notable association between RDI and body height and an association between deep sleep duration and BMI. These findings suggest that sleep disturbances in pediatric endocrine patients are intricately linked with physiological growth parameters. The identified correlations underline the importance of monitoring sleep patterns in this demographic to better understand the impact of endocrine disorders on developmental health. Further research is needed to explore interventions that could alleviate these sleep disturbances, thereby potentially improving outcomes for the affected children.

Biological Sex Influences Daily Locomotor Rhythms in Mice Held Under Different Housing Conditions

Daily rhythms are programmed by a central circadian clock that is modulated by photoperiod. Here, we recorded locomotor activity rhythms in C57Bl/6 or mPer2Luc mice of both sexes held under different housing conditions. First, we confirm that the structure of locomotor activity rhythms differs between male and female mice in both genetic backgrounds. Male mice exhibit a nightly "siesta," whereas female mice fluctuate between nights with and without a nightly siesta, which corresponds with changes in locomotor activity levels, circadian period, and vaginal cytology. The nightly siesta is modulated by the presence of a running wheel in both sexes but is not required for the infradian patterning of locomotor rhythms in females. Finally, photoperiodic changes in locomotor rhythms differed by sex, and females displayed phase-jumping responses earlier than males under a parametric photoentrainment assay simulating increasing day length. Collectively, these results highlight that sex and sex hormones influence daily locomotor rhythms under a variety of different environmental conditions.

Associations among early life adversity, sleep disturbances, and depressive symptoms in adolescent females and males: a longitudinal investigation

BACKGROUND

Exposure to adversity early in life (ELA) has been associated with elevated risk for depression during adolescence, particularly for females; the mechanisms underlying this association, however, are poorly understood. One potential mechanism linking ELA and sex differences in depressive symptoms is sleep disturbances, which increase during adolescence and are more common in females. Here, we examined whether sleep disturbances mediate the association between ELA and increases in depressive symptoms during adolescence and whether this mediation differs by sex.

METHODS

224 (N = 132 females) youth were recruited at age 9-13 years and assessed every 2 years across three timepoints. At the first timepoint, we conducted extensive interviews about stressful events participants experienced; participants provided subjective severity ratings of events and we objectively scored the severity of each event. Self-reported sleep disturbances and depressive symptoms were assessed at all timepoints. We conducted linear mixed models to estimate both initial levels and changes in sleep disturbances and depressive symptoms, and moderated mediation analyses to test whether initial levels and/or changes in sleep disturbances mediated the association of ELA (objective and subjective) with increases in depressive symptoms across adolescence and whether the mediations differed by sex.

RESULTS

While higher initial levels and increases in sleep problems were uniquely associated with increases in depressive symptoms for males and females, they were related to ELA differently by sex. For females, greater ELA (both objectively and subjectively rated) was associated with higher initial levels of sleep problems, which in turn were associated with increases in depressive symptoms from early to late adolescence. In contrast, for males, ELA exposure was not associated with either initial levels of, or increases in, sleep problems.

CONCLUSIONS

These findings highlight the role of sleep disturbances during the transition to adolescence in mediating sex differences in the effects of ELA on depressive symptoms.

Longitudinal associations between biopsychosocial stress indicators and sleep in older Puerto Rican adults

OBJECTIVES

To examine the association of biopsychosocial stress indicators (perceived stress, perceived discrimination, stressful life events, and allostatic load) with sleep outcomes (sleep duration and insomnia symptoms) and to examine sex and age interactions for associations between stress and sleep in older Puerto Rican adults.

METHODS

Secondary analyses were performed with 830 participants (72% female) from wave 2 (2006-2011) of the Boston Puerto Rican Health Study (BPRHS), a prospective population-based cohort study (45-75years at baseline) and Boston Puerto Rican Osteoporosis Study (BPROS) (2007-2012), an ancillary study of the BPRHS. Recruitment occurred in randomly selected census blocks using door-to-door and community-based activities. In-home data collection visits included a baseline assessment and follow-up interviews. Questionnaires assessed perceived stress, discrimination, stressful life events, and sleep. Allostatic load indicators were measured objectively. Regression models controlled for sociodemographic, behavioral, and health factors, with interaction analyses, followed by sex- and sex-by-age-stratified analyses.

RESULTS

In the prior 2years, participants with chronic stress had 50% greater odds of reporting nonoptimal sleep duration (<7 or >9 hours). Life events trajectories were significantly related to insomnia symptoms. Men ≥65years who experienced chronic stress had greater insomnia symptoms than women, or than men with low stress or acute stress.

CONCLUSIONS

Stressful life events may affect sleep duration and insomnia symptoms among older Puerto Rican adults, particularly men 65 years and older who experienced chronic stress. Given the differences in sleep patterns experienced by older adults and their relationships with health outcomes, identifying methods to support sleep health among those with chronic stress is important.

Sex Differences in the Relationship Between Self-Reporting of Snoring and Cardiovascular Risk:An Analysis of NHANES

Background

Identifying risk factors for cardiovascular disease (CVD) is critical for effective prevention and management. While classic CVD risk factors have been extensively studied, there is a scarcity of research on the association between snoring and CVD risk, particularly in the context of sex differences.

Methods

This study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2015 and 2020. Participants were initially categorized based on the severity of snoring or the presence of snoring.Within the snoring group, they were further classified by sex. Analysis was carried out using multivariate logistic regression.

Results

Our study included 12,681 participants aged 18 years or older. When compared to the non-snoring group, individuals in the moderate snoring group had a higher odds ratio (OR) of 1.418 (95% CI 1.083 to 1.857, p = 0.011), while those in the severe snoring group had a higher OR of 1.882 (95% CI 1.468 to 2.409, p < 0.001). In the snoring group, individuals were further categorized by gender: 4527 males and 4131 females. Importantly, male patients showed a higher OR for atrial fibrillation (4.945, 95% CI 1.187 to 20.598, p = 0.028) compared to females. Additionally, male patients had a higher OR for coronary heart disease (2.002, 95% CI 1.152 to 3.479, p = 0.014) compared to females.

Conclusion

Sex plays a significant role in the relationship between snoring and CVD risk. Males with snoring have a higher risk of developing CVD compared to females. In particular, male snorers are nearly five times more likely to develop atrial fibrillation and about twice as likely to experience coronary artery disease in comparison to female snorers. It is recommended that healthcare providers and public health officials prioritize cardiovascular risk assessments for male individuals who exhibit symptoms of snoring.

Physical Activity Habits and Sleep Duration According to Gender: A Cross-Sectional Study of Elementary School Children

(1) Background: The main goals of this study were to describe the physical activity (PA) and sleep habits of 8-12-year-old children according to their gender and to evaluate the relationship between PA and sleep habits (i.e., duration and timing). (2) Methods: A total of 236 children (114 boys and 122 girls) completed the Physical Activity Questionnaire for Older Children (PAQ-C) and an ad hoc sleep habits questionnaire. (3) Results: Boys were more physically active than girls (2.62 ± 0.51 vs. 2.46 ± 0.48, p = 0.026) and enacted higher PA levels in school recess (3.82 ± 1.36 vs. 3.56 ± 1.38, p = 0.003), during the afternoon (3.37 ± 1.20 vs. 2.89 ± 1.12, p = 0.003), and during weekends (3.54 ± 1.20 vs. 3.18 ± 0.48, p = 0.009). Per sleep habits, boys had a significantly later bedtime (21:53 ± 2:08 vs. 21:34 ± 2:14, p = 0.009) and a significantly smaller total sleep duration (9.64 ± 0.86 vs. 9.89 ± 0.87 h, p = 0.023) than girls. No significant correlations between PA and sleep habits were found. (4) Conclusions: We found differences in the PA and sleep habits between school-age boys and girls. Institutions and entities should consider designing specific interventions to improve PA and sleep habits according to gender.

Gender- and Obesity-Specific Association of Co-Exposure to Personal Care Product and Plasticizing Chemicals and Short Sleep Duration among Adults: Evidence from the National Health and Nutrition Examination Survey 2011-2016

There is limited evidence about the gender- and obesity-specific effects of personal care product and plasticizing chemicals (PCPPCs) on short sleep duration in adults. We evaluated the gender- and obesity-specific association of co-exposure to PCPPCs and short sleep duration among adults aged 20-60 years using the National Health and Nutrition Examination Survey (NHANES) 2011-2016, a secondary data source from the United States. Seventeen PCPPCs, including five phenols, two parabens, and ten phthalates, were detected, and sleep duration was assessed among 3012 adults. Logistic regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) were employed. We found that bisphenol A (BPA), mono (caboxy-isooctyl) phthalate (MCOP), and mono (3-carboxypropyl) phthalate (MCPP) were consistently positively associated with short sleep duration in both females and males regardless of obesity status, except for BPA with general obesity. In particular, mono benzyl phthalate (MBzP) revealed a positive association in females, mono (2-ethyl-5-oxohexyl) phthalate (MEOHP) revealed a positive association in males, and MiBP revealed a positive association in abdominal obesity. Similar associations were observed in the mixture. Our study highlights that PCPPCs are independently associated with an increasing risk of short sleep duration in adults both individually and as a mixture; however, gender- and obesity-specific differences may have little effect on certain individual PCPPCs on short sleep duration.

Reasons for why Medical Students Prefer Specific Sleep Management Strategies

OBJECTIVES

Insomnia symptoms are common among medical students. This study explored the perspectives of medical students about which sleep management strategies to use.

METHODS

Medical students responded to an online survey on their thoughts about the use of various sleep management strategies.

RESULTS

Of the 828 respondents, 568 (69%) provided responses to questions about the most preferred strategies and 450 (54%) provided responses about their least preferred strategies. About 48.5% felt their insomnia symptoms were too mild to see a clinician and 23.9% did not think their symptoms warranted sleep medication. Over 40% of students could not avoid work before sleep, have consistent sleep/wake times, or engage in regular exercise because of their busy and inconsistent schedules. Approximately 40-60% could not improve their sleep environment (e.g. better heating and bed) because of the associated costs. Over 80% reported an inability to change their pre-sleep habits (e.g. using electronics close to bedtime, using bed for activities other than sleep or sex). Half of the students disliked relaxation techniques or felt they would not help. Around 30-50% did not believe that changing caffeine and/or alcohol intake would affect their sleep.

CONCLUSIONS

Medical students may benefit from additional sleep education. Clinicians may need to discuss which strategies individual students prefer and modify their recommendations accordingly.

The interactive effect of sustained sleep restriction and resistance exercise on skeletal muscle transcriptomics in young females

Both sleep loss and exercise regulate gene expression in skeletal muscle, yet little is known about how the interaction of these stressors affects the transcriptome. The aim of this study was to investigate the effect of nine nights of sleep restriction (SR), with repeated resistance exercise (REx) sessions, on the skeletal muscle transcriptome of young, trained females. Ten healthy females aged 18-35 yr old undertook a randomized cross-over study of nine nights of SR (5 h time in bed) and normal sleep (NS; ≥7 h time in bed) with a minimum 6-wk washout. Participants completed four REx sessions per condition (days 3, 5, 7, and 9). Muscle biopsies were collected both pre- and post-REx on days 3 and 9. Gene and protein expression were assessed by RNA sequencing and Western blot, respectively. Three or nine nights of SR had no effect on the muscle transcriptome independently of exercise. However, close to 3,000 transcripts were differentially regulated (false discovery rate < 0.05) 48 h after the completion of three resistance exercise sessions in both NS and SR conditions. Only 39% of downregulated genes and 18% of upregulated genes were common between both conditions, indicating a moderating effect of SR on the response to exercise. SR and REx interacted to alter the enrichment of skeletal muscle transcriptomic pathways in young, resistance-trained females. Performing exercise when sleep restricted may not provide the same adaptive response for individuals as if they were fully rested.NEW & NOTEWORTHY This study investigated the effect of nine nights of sleep restriction, with repeated resistance exercise sessions, on the skeletal muscle transcriptome of young, trained females. Sleep restriction and resistance exercise interacted to alter the enrichment of skeletal muscle transcriptomic pathways in young, resistance-trained females. Performing exercise when sleep restricted may not provide the same adaptive response for individuals as if they were fully rested.