Menstrual disturbances and its association with sleep disturbances: a systematic review

Relationships between Premenstrual Syndrome (PMS) and Diet Composition, Dietary Patterns and Eating Behaviors

Premenstrual Syndrome (PMS) is a disorder between gynecology and psychiatry which includes cognitive, affective, and somatic symptoms from mild to severe. The most severe form of PMS is premenstrual dysphoric disorder (PMDD) and it is considered a form of depressive disorder. An association between diet composition and the occurrence of PMS and its severity have been suggested. As such, this manuscript discusses the relationships between diet composition, dietary patterns and eating behaviors, and PMS. PubMed, Embase, Cochrane, and Web of Science databases were searched for related studies up to 18 January 2024. A text search with the following keywords singly or in combination was conducted: "Premenstrual syndrome", "Nutrition", "Diet composition", "Dietary patterns", and "Eating behaviors". Studies published so far showed that low intake of simple carbohydrates, fats, salt, and alcohol, and high of fresh, unprocessed foods rich in B vitamins, vitamin D, zinc, calcium, and omega-3 fatty acids may help prevent the onset of PMS and reduce the severity of its symptoms. However, further studies are needed to formulate definitive recommendations for the use of vitamins, micronutrients and other dietary ingredients supplementation in women with PMS to improve functioning, overall well-being, and physical health. Large, randomized, double-blind clinical trials across diverse populations are necessary to formulate clear recommendations for supplementation in women with PMS.

Assessing sleep quality in elite and junior cyclists

In the pursuit of optimal recovery, the significance of sleep cannot be overstated for elite cyclists, including high-level cyclists within the junior category. This study aims to assess the sleep quality of elite athletes of different categories and disciplines, including junior. The sleep quality of 112 high-level cyclists (males n = 80; females n = 32) participating in endurance and sprint disciplines was evaluated using the Pittsburgh Sleep Quality Index (PSQI). A noteworthy 41% of both elite and junior cyclists displayed poor sleep quality. No significant differences were observed between elite and junior cyclists in terms of sleep quality, but there was a medium effect size, indicating greater sleep efficiency in junior cyclists [0.36 (0.16, 0.53)]. Gender differences were found, with females exhibiting worse PSQI scores (males = 4.00 [2.25]; females 5.00 [3.00]; p = 0.035). Endurance cyclists spent more time in bed compared to cyclists from sprinting disciplines (8:30 [1.00] and 8:00 [1:03], respectively; p = 0.019). These findings reveal poor sleep habits, even among individuals classified as good sleepers by the PSQI, emphasizing the importance of preventing sleep disorders in cyclists. This study provides valuable insights into athlete sleep quality, encompassing various categories, genders, and cycling disciplines. In conclusion, elite cyclists demonstrate suboptimal sleep quality, suggesting the potential for interventions utilizing the PSQI. These findings advocate for the incorporation of sleep quality assessments into routine evaluations for athletes.

Inhalation effect of lychee-scented candles on stress and sleep quality among adults and the elderly: a pilot randomized controlled study

[Purpose] This pilot study aims to investigate the effects of inhaling lychee-scented candles on stress and sleep quality among adults and the elderly. [Participants and Methods] Thirty participants were randomly assigned to either the control (n=15) or experimental (n=15) groups. The experimental group inhaled the scent from the lychee soy wax candle prior to going to bed for four weeks (20 minutes/session, three days/week). Perceived stress was assessed using the Suanprung Stress Test-20 (SPST-20), while sleep quality was assessed using the Thai-Pittsburgh Sleep Quality Index (Thai-PSQI). All outcomes were determined at the baseline two weeks to four weeks after scent inhalation. [Results] The results indicated significant differences in sleep quality between the two groups. The experimental group showed a statistically significant improvement in sleep quality compared to the control group. Although, there was no difference between groups, the experimental group presented significant decrease in stress as time passed whereas the opposite trend was seen for the control group. [Conclusion] This preliminary study suggests that the inhalation of lychee soy wax candles over a four-week period improved sleep quality in adults and the elderly but had no effect on reducing stress.

An RCT META analysis based on the effect of tai chi exercise therapy on the outcome of elderly patients with moderate-to-severe sleep disorders-A systematic review study

Background

According to statistics, about one-fifth of the world's elderly people suffer from sleep disorders, and the problem of sleep disorders in the elderly is extremely serious, and this problem is one of the important causes of chronic diseases such as hypertension, hyperlipidemia, diabetes mellitus, and coronary heart disease in the elderly. The positive effect of Tai Chi exercise therapy on sleep problems has been confirmed, but at present, the effect of the specific duration of Tai Chi exercise on the improvement of elderly people with moderate to severe sleep disorders varies.

Objective

META analysis was used to investigate and find that long-term Tai Chi exercise therapy has the best effect on improving sleep in elderly patients with moderate to severe sleep disorders. Methods: META analysis was performed using Revman 5.3 after searching Web of science, Pubmed, Scopus, The Cochroae Library, OVID, CBM, CNKI, VIP, and other databases, and then filtering and extracting.

Results

A total of seven papers were included. Meta-analysis showed that tai chi exercise was more effective in improving sleep problems in elderly patients with sleep disorders compared to the control group, and the difference was significant. This was demonstrated by a decrease in the global Pittsburgh Sleep Quality Index (PSQI) score [SMD = -0.66, 95 % CI (-0.91, -0.41), P < 0.00001], as well as its subdomains of subjective sleep quality [SMD = -0.79, 95 % CI (-1.06, -0.52), P < 0.00001], sleep latency [SMD = -0.80, 95 % CI (-1.21, -0.40), P < 0.00001], sleep duration [SMD = -0.38, 95 % CI (-0.72, -0.04), P = 0.03], habitual sleep efficiency [SMD = -0.58, 95 % CI (-0.84, -0.31), P < 0.0001], sleep disturbance [SMD = -0.51, 95 % CI (-0.78, -0.25), P = 0.00001] and daytime dysfunction [SMD = -0.33, 95 % CI (-0.59, -0.07), P = 0.01]. Improvement was also observed in the Epworth Sleepiness Scale (ESS) and Insomnia Severity Index Scale (ISI). The results showed that the optimal duration and frequency of Tai Chi exercise therapy for improving moderately severe elderly patients with sleep disorders was long-term.

Conclusion

This study systematically assessed the efficacy of Tai Chi exercise therapy for elderly patients with moderate-to-severe sleep disorders. Through a meta-analysis of relevant randomized controlled trials (RCTs), it aims to determine the effectiveness of Tai Chi exercise in improving sleep quality in elderly patients with moderate-to-severe sleep disorders, as well as to compare its effects with those of traditional treatments; to analyze the safety of Tai Chi exercise for this patient population and assess its feasibility as a non-pharmacological therapy; and to fill the research gaps and provide more comprehensive and systematic evidence support. This study provides a practical approach to reducing the risk of medication side effects in older adults with sleep disorders and offers a potentially effective non-pharmacological treatment option, especially for those who are unable or unwilling to use medication. Tai chi exercise may not only improve sleep, but also improve coordination, muscle strength, balance, and reduce stress and anxiety in older adults. It also helps older adults socialize and enhances their social connections and emotional support. This study suggests that community centers or activity centers for the elderly can organize tai chi classes to promote the participation of older adults, and can be used as a scientific exercise rehabilitation tool in clinical treatment, incorporating tai chi practice into daily life, such as tai chi practice at a fixed time every day or every week, which not only helps to improve the sleep disorders of older adults, but also improves their overall quality of life.