Working dogs perform complex tasks that require both physical and behavioral soundness. Two case studies demonstrate how fitness training moderated arousal levels, facilitated training, and improved performance measures in different situations. Fitness training can be beneficial when integrated as part of a working dog\'s training regimen because it can have a significant influence on their overall health, behavior, and ability to perform their working role effectively.

Disorder of arousal (DOA) is a form of non-rapid eye movement sleep parasomnia caused by partial or incomplete arousal from deep sleep. Most previous studies of patients with DOA analyzed prearousal hypersynchronous delta activity (HSDA), but few studies have described postarousal HSDA. Herein, we report a 23-year-old man with a history of abrupt arousal during sleep and confused behavior and speech since he was 14 years old. During video electroencephalography monitoring, he had 9 arousal events of getting up, sitting on the bed, looking around, or simple arousal, including eyes open, looking at the ceiling, or head flexion. During all arousal events, the postarousal electroencephalography pattern was prolonged HSDA for approximately 40 seconds. The patient was treated unsuccessfully for more than 2 years with an antiseizure medication (lacosamide); eventually, he responded to clonazepam that was administered for the possibility of DOA. Prolonged rhythmic HSDA without spatiotemporal evolution can appear as a postarousal electroencephalography pattern of DOA. When diagnosing DOA, it is important to recognize that postarousal HSDA can appear as a characteristic electroencephalography pattern of DOA.
Kang M, Shin D, Lee HC, Provini F, Jung KY. A case of disorder of arousal with prolonged postarousal hypersynchronous delta activity. J Clin Sleep Med. 2023;19(7):1365-1368.

Excessive emotional arousal has been shown to impact physiological health in both veterinary species and human animals. The focus of work in many models of veterinary behavioural medicine has predominantly been associated with reducing activation of the protective emotional systems; in particular, fear-anxiety. The management of the engaging emotional systems of desire-seeking, social play, care and lust has not traditionally been considered in the treatment of physiological health of veterinary species. This article reviews the literature in both veterinary and human fields on the relationship between emotional arousal of both protective and engaging emotional systems and physical health conditions. The current literature describing the regulatory control of sleep on emotional arousal is also discussed. An exemplary case report of a seven month old male entire Cocker Spaniel showing fly-snapping behaviour which had been non-responsive to leviteracetam (Keppra) is presented. The emotional health assessment and treatment of this case is described along with the short and long term (fourteen month follow up) outcomes to demonstrate that some patients presenting in this way can be effectively managed with an appropriate behavioural medicine treatment plan. The authors put forward the argument that an emotional health assessment should be considered an essential component of the work up of all such cases.

The Somnox sleep robot is promoted as sleep enhancing. The current study investigated individual effects, the acceptability and the safety of, and experiences with, a 3-week intervention in adults with insomnia. A repeated ABA single-case design (n = 4) was used to evaluate the effects of the sleep robot compared with baseline, as measured with a sleep diary and actigraphy. Pre-, post-, and 1-month follow-up assessments were conducted, measuring symptoms of insomnia, level of somatic arousal, and symptoms of depression and anxiety. Questions about adherence were included in the sleep diary. Individual interviews were conducted post intervention to explore the participants\' experiences with the sleep robot. The sleep diary and actigraphy data showed marginal differences, and if something, often a slight deterioration in the intervention phase. Three participants reported improvements regarding their sleep in the interviews compared with baseline, which mirrored the results on the questionnaires (insomnia and arousal) for two of the participants. The same three participants adhered to the intervention. Stable or improved self-assessed symptoms of depression and anxiety, and information from the individual interviews, suggest that the intervention is safe for adults with insomnia. The results regarding the effects of the sleep robot were mixed, and ought to be scrutinized in larger studies before confident recommendations can be made. However, the study supports the acceptability and safety of the intervention in adults with insomnia.

Training assessment is usually done by evaluating information derived from instructor\'s supervision related to the pilot\'s operational performance and behavior. However, this approach lacks objective measures, especially regarding the pilots\' mental states while accomplishing the flight training tasks. The study therefore aimed at developing and testing a method for gathering and analyzing in real-time pilots\' brain activity and skin conductance to improve the training evaluation. In this regard, Novice pilots\' neurophysiological signals were acquired throughout multi-crew training sessions. The results demonstrated how the methodology proposed was able to endow real-time pilots\' mental workload and arousal assessment for i) better evaluating training progress and operational behavior during the training session, and ii) for objectively comparing different training sessions.

From the perspective of emotional preference, studies have been conducted about landscape healing for subhealth people in the National High-Tech Zone (the study area). Combined with a preliminary practice investigation, Unity 2019 was used to make a digital roaming landscape, and 91 subjects with a history of mental subhealth diseases were randomly invited to participate in the immersive experimentation of the Human-Machine Environment Synchronisation (ErgoLAB) platform. After the experiment, the subjects were invited to fill in a Likert scale as the control group. The interest preference, emotion fluctuation, and healing effect of landscape colour were verified. The results show that: (1) The variation trend of interest reflected the concentration of interest in landscape, and the order of degree of interest, ranging from high to low, went Green > Yellow > Blue > Red > Orange > Purple > Cyan. (2) The subjects\' interest in landscape colour was correlated with the arousal of positive emotions. The correlation between interest in landscape colour and positive emotions, from high to low, went Blue > Green > Yellow, while the correlation between red, cyan, orange, and purple was not significant. (3) The mean skin conductance (SC) fluctuation variance of subjects was 5.594%, which confirmed that the healing effect of digital roaming landscape scenes was significant under the state of low arousal. According to the Likert scale data, subjects\' scores of the healing effect of landscapes, from high to low, went as follows: Green > Yellow > Red > Blue > Cyan > Orange > Purple. The results provide a new method for demonstrating the logical relationship between the digital landscape interest experience-emotional awakening-healing effect and providing a theoretical method and construction scheme for landscape colour configuration in the implementation of landscape healing projects.

Subjective insomnia complaints and objective sleep changes are mostly studied outside of clinical trial studies. In this study, we tested whether 240 genetic variants associated with subjectively reported insomnia were also associated with objective insomnia parameters extracted from polysomnographic recordings in three studies.
The study sample (total n = 2,770) was composed of the Wisconsin Sleep Cohort (n = 1,091) and the Osteoporotic Fractures in Men (n = 1,026) study, two population-based studies, and the Stanford Sleep Cohort, a sleep center patient-based sample (n = 653). Seven objective polysomnographic features related to insomnia defined outcome variables, with each variant allele serving as predictor. Meta-regression was performed, accounting for common confounders as well as variance differences between studies. Additionally, a normalized genetic risk score was generated for each subject to serve as a predictor variable in separate linear mixed models assessing objective insomnia features.
After correction for multiple testing, single-nucleotide polymorphisms associated with subjective insomnia were not significantly associated with 6 of 7 objective sleep measures. Only periodic limb movement index was significantly associated with rs113851554 (MEIS1), as found in previous studies. The normalized genetic risk score was only weakly associated with arousal index and duration of wake after sleep onset.
Our findings suggest that subjective insomnia does not have a strong genetic signature mapping onto objective (polysomnographic) sleep variables.
Foldager J, Peppard PE, Hagen EW, et al. Genetic risk for subjective reports of insomnia associates only weakly with polygraphic measures of insomnia in 2,770 adults. J Clin Sleep Med. 2022;18(1):21-29.

Here we show for the first time that the plasticity in morphology and duration of yawning in Macaca tonkeana can be associated with different functional contexts. Macaca tonkeana is classified as a tolerant macaque species characterized by social interactions minimally constrained by dominance rank or kinship. Tonkean macaques, as other egalitarian species, rely on a complex facial communicative system. We found that the degree of mouth opening (ranging from covered to uncovered tooth yawns) and the duration of yawning were not strictly dependent. The shortest uncovered tooth yawns were associated with an intense locomotor/physical activity and peaked immediately after stressful social events thus indicating an increase in arousal. In contrast, longer yawns, independently from teeth exposure, were primarily associated with a relaxed state of the subject. In conclusion, our study suggests that to explore the potential different functions of yawning, it is necessary to focus on the variability of its expression both in terms of morphology and duration, because not all yawns tell the same story.

A variety of behavioral interventions have been shown to improve symptoms of non-rapid eye movement parasomnias. Prior reports have typically examined outcomes of a single behavioral intervention. However, non-rapid eye movement parasomnias may benefit from a multipronged treatment approach similar to that used in the behavioral treatment of other sleep disorders. Through a series of 3 case reports, we demonstrate the utility of a case-conceptualization based, integrative approach to behavioral treatment of adult non-rapid eye movement parasomnias. For all patients (2 with disorders of arousal and 1 with sleep-related eating disorder), symptoms were satisfactorily reduced after 3-6 sessions. Treatment was tailored to each individual, but common elements included education, hypnosis, and identifying and reducing priming factors (eg, stress, insufficient sleep) and precipitating factors (eg, noise or touch from bed partners).

Exploding head syndrome (EHS) is an under-recognized parasomnia characterized by a complaint of sudden loud noise or a sense of explosion in the head that usually occurs at sleep onset. This paper is a report of 6 patients diagnosed with EHS through a structured clinical interview and video-polysomnography (vPSG) recordings. We also reviewed the available literature that addressed the presentation and clinical and PSG characteristics of EHS. The case series included 4 men and 2 women of a mean age of 44.2 years (between 13 and 77 years). Their episodes were variable in expression, between a sudden firecracker-like explosion to a gun-shot sound, mostly as if happening inside the head. EHS is always associated with distress but never with pain. Five out of 6 patients had other sleep-related problems with a close relationship of EHS symptoms to comorbid sleep disorder manifestations and exacerbations. The vPSG recordings of 5 patients were unremarkable. An attack of EHS was documented in 1 patient, arising during stage N2 of sleep. Three patients responded well to reassurance and treatment for the comorbid sleep disorder. The other 3 patients responded well to amitriptyline (10-50 mg). EHS is a well-characterized, underrecognized hypnic parasomnia with a benign course. Amitriptyline seems to be effective in persistent cases.