UNASSIGNED: Sleep disorders represent common complaints in different medical illnesses. They encompass a risk for diverse inflammatory, metabolic, and cardiovascular diseases. Sleep disorders include disorders of hypersomnolence, insomnia, parasomnias, sleep-related movement disorders, circadian rhythm sleep-wake-disorders, and sleep-related breathing disorders, each one of which was associated with increased cardiovascular disease risk in a different mechanism. In this review, the authors address the most recent research on the correlation between sleep and CVD.
UNASSIGNED: The literature on sleep disorders and their potential links to various cardiovascular diseases was reviewed in narrative form. For the published papers up to June 2023, the authors searched the databases of PubMed and Google Scholar. Literature demonstrating the relationship between these illnesses, pathophysiological mechanisms, diagnosis, and various therapeutic approaches was included.
UNASSIGNED: Sleep disorders were significantly linked to heart rate variability, hypertension, and obesity, which can eventually result in cardiovascular consequences and affect mortality and morbidity. The disruption in sleep cycles, which can be noticed in different sleep disorders, can obviously result in blood pressure, heart rate, and other cardiac functions. The clinical assessment acts as the cornerstone in the diagnosis of different spectrums of sleep disorders. The management of sleep disorders ranges from cognitive-behavioral therapy to continuous positive airway pressure (CPAP).
UNASSIGNED: Additional research on the topic is needed to pinpoint any potential links and pathological processes. To improve clinical treatment and preventive measures, further observational studies should emphasize the reliability of early diagnostic signs.

Associations between obstructive sleep apnea (OSA) and sleep bruxism (SB) are the subject of discussion but have not been confirmed definitively. Therefore, the objective of this meta-analysis was to examine the relationship between OSA and SB. This systematic review was conducted in accordance with PRISMA 2020 guidelines. PubMed, Embase and Web of Science were screened up to February 2024. The risk of bias was assessed with the Joanna Briggs Institute tool. 2260 records were identified, but only 14 studies were included. The odds of SB presence in OSA did not differ from the control group (OR: 1.23, 95 % CI: 0.47-3.20). The chance of SB compared to controls also did not differ in mild OSA (OR: 1.56, 95 % CI: 0.76-3.18), in moderate OSA (OR: 1.51, 95 % CI: 0.77-2.94) and in severe OSA (OR: 1.50, 95 % CI: 0.68-3.29). Additionally, the odds of SB were not increased in moderate OSA in comparison to mild OSA (OR: 1.14, 95 % CI: 0.63-2.94), in severe OSA compared to moderate OSA (OR: 1.31, 95 % CI: 0.61-2.79) or in severe OSA compared to mild OSA (OR = 1.42, 95 % CI: 0.69-2.93). The presence of SB in OSA did not differ between genders (OR: 2.14, 95 % CI: 0.65-7.05). The quality of the major studies included is low; therefore, the noted lack of correlation between OSA and SB may require further research. The relationship between OSA and SB seems to be multi-faceted. Presented results should not exempt clinicians from exact diagnosis of concomitant sleep conditions in OSA subjects.

UNASSIGNED: Mental health is a growing area of concern for elite athletes.
UNASSIGNED: To determine the sex differences in mental health symptoms in elite athletes.
UNASSIGNED: PubMed, EMBASE, and Cochrane Library databases were used.
UNASSIGNED: Included studies included comparisons of mental health symptoms of athletes by sex.
UNASSIGNED: Systematic review and meta-analysis were conducted following the PRISMA guidelines.
UNASSIGNED: Level 2a.
UNASSIGNED: The rate ratio (RR) was calculated as the rates in female and male athletes. Data were pooled using a random-effects model.
UNASSIGNED: Of 1945 articles identified, 60 articles were included. Male athletes reported higher alcohol misuse (RR, 0.74; CI, 0.68-0.80), illicit drug abuse (RR, 0.82; CI, 0.75-0.89), and gambling problems (RR, 0.14; CI, 0.08-0.25). Female athletes reported higher overall anxiety (RR, 1.17; CI, 1.08-1.27), depression (RR, 1.42; CI, 1.31-1.54), distress (RR, 1.98; CI, 1.40-2.81), and disordered eating (RR, 2.19; CI, 1.58-3.02). Sleep disturbances were reported at similar rates in male and female athletes (RR, 1.13; CI, 0.98-1.30).
UNASSIGNED: Female and male athletes have significant differences in reported mental health symptoms. Female athletes are more likely to report anxiety, depression, distress, and disordered eating, while male athletes report more alcohol misuse, illicit drug abuse, and gambling. Monitoring and evaluation of mental health is a necessary part of any sport, including access to resources. Longitudinal studies following athletes over time to determine the development and causation for mental health symptoms should be included in future research directions.

Current evidence suggests that iron deficiency (ID) plays a key role in the pathogenesis of conditions presenting with restlessness such as attention deficit hyperactivity disorder (ADHD) and restless legs syndrome (RLS). In clinical practice, ID and iron supplementation are not routinely considered in the diagnostic work-up and/or as a treatment option in such conditions. Therefore, we conducted a scoping literature review of ID guidelines. Of the 58 guidelines included, only 9 included RLS, and 3 included ADHD. Ferritin was the most frequently cited biomarker, though cutoff values varied between guidelines and depending on additional factors such as age, sex, and comorbidities. Recommendations surrounding measurable iron biomarkers and cutoff values varied between guidelines; moreover, despite capturing the role of inflammation as a concept, most guidelines often did not include recommendations for how to assess this. This lack of harmonization on the interpretation of iron and inflammation biomarkers raises questions about the applicability of current guidelines in clinical practice. Further, the majority of ID guidelines in this review did not include the ID-associated disorders, ADHD and RLS. As ID can be associated with altered movement patterns, a novel consensus is needed for investigating and interpreting iron status in the context of different clinical phenotypes.

Introduction: Employees working in shifts are exposed to many threats affecting their health, quality of life and safety at work. Those who perform their work only at night are particularly vulnerable. The purpose of the review is to identify risks to the health, quality of life and sleep of shift health workers. Method: A systematic review (SR) was used in the analysis. Electronic databases were searched. The search was limited to the latest studies published in the last five years: 2019-2023. Results: Finally, 36 articles were included in the review. Most authors have shown a link between sleep disturbance or its quality and shift work/night work. Moreover, a three-shift schedule was the most significant factor for poorer subjective sleep quality when compared to other work schedules. Furthermore, many authors have shown a link between shift/night work and health problems, which include cardiometabolic risk, glucose intolerance, breast cancer and immune vulnerability. Conclusions: The research results clearly show a significant impact of night work on the increased risk of sleep disorders and health disturbance. Healthcare workers should be aware of the risks associated with night work in order to take measures preventing sleep/health problems. Shift/night workers should have the opportunity to be screened for disorders linked with their work.

The aims were (i) to determine the effects of Cognitive behavioral therapy for insomnia (CBT-I) on sleep disturbances, pain intensity and disability in patients with chronic musculoskeletal pain (CMP), and (ii) to determine the dose-response association between CBT-I dose (total minutes) and improvements in sleep disorders, pain intensity and disability in patients with CMP. A comprehensive search was conducted in PubMed/MEDLINE, Web of Science, CINAHL, and SCOPUS until December 17, 2023. Randomized clinical trials (RCTs) using CBT-I without co-interventions in people with CMP and sleep disorders were eligible. Two reviewers independently extracted data and assessed risk of bias and certainty of the evidence. A random effects meta-analysis was applied to determine the effects on the variables of interest. The dose-response association was assessed using a restricted cubic spline model. Eleven RCTs (n = 1801 participants) were included. We found a significant effect in favor of CBT-I for insomnia (SMD: -1.34; 95%CI: -2.12 to -0.56), with a peak effect size at 450 min of CBT-I (-1.65, 95%CI: -1.89 to -1.40). A non-significant effect was found for pain intensity. A meta-analysis of disability was not possible due to the lack of data. This review found benefits of CBT-I for insomnia compared to control interventions, with a large effect size. In addition, it was estimated that a 250-min dose of CBT-I had a large effect on reducing insomnia and that the peak effect was reached at 450 min. These novel findings may guide clinicians in optimizing the use of CBT-I in people with CMP and insomnia.

OBJECTIVE: Circadian clocks are evolved endogenous biological systems that communicate with environmental cues to optimize physiological processes, such as the sleep-wake cycle, which is nearly related to quality of life. Sleep disorders can be treated using pharmacological strategies targeting melatonin, orexin, or core clock genes. Exercise has been widely explored as a behavioral treatment because it challenges homeostasis in the human body and affects the regulation of core clock genes. Exercise intervention at the appropriate time of the day can induce a phase shift in internal clocks. Although exercise is a strong external time cue for resetting the circadian clock, exercise therapy for sleep disorders remains poorly understood.
METHODS: This review focused on exercise as a potential treatment for sleep disorders by tuning the internal circadian clock. We used scientific paper depositories, including Google Scholar, PubMed, and the Cochrane Library, to identify previous studies that investigated the effects of exercise on circadian clocks and sleep disorders.
RESULTS: The exercise-induced adjustment of the circadian clock phase depended on exercise timing and individual chronotypes. Adjustment of circadian clocks through scheduled morning exercises can be appropriately prescribed for individuals with delayed sleep phase disorders. Individuals with advanced sleep phase disorders can synchronize their internal clocks with their living environment by performing evening exercises. Exercise-induced physiological responses are affected by age, sex, and current fitness conditions.
CONCLUSIONS: Personalized approaches are necessary when implementing exercise interventions for sleep disorders.

OBJECTIVE: Insomnia is one of the most common diseases among the elderly. The elderly with long-term insomnia are more likely to have symptoms such as vertigo, fatigue, and immunity decline. Acupuncture is increasingly being used to treat insomnia. The purpose of this review is to summarize the critical acupoints in the treatment of senile insomnia and evaluate the effectiveness of the treatment. To provide a research basis for acupuncture treatment of senile insomnia in the future.
METHODS: We will search the clinical studies on acupuncture in the treatment of senile insomnia published by CNKI (China National Knowledge Infrastructure), Wanfang (Wan Fang Data Knowledge Service Platform), CSTJ (China Science and Technology Journal Database), Pubmed, and ScienceDirect before December 31, 2023. Acupoint will be analyzed using TCMISS (TCM Inheritance Assistance Platform).
RESULTS: 265 literatures were retrieved, and 94 were selected as the criteria. The results showed that there were 90 acupoints related to treatment. The acupoints with the highest frequency were shenmen (HT7), sanyinjiao (SP6), baihui (GV20), zusanli (ST36), neiguan (PC6), xinshu (BL15), taixi (KI3), and sishencong (EX-HN1) anmian (JLSXX-QX), shenshu (BL23). The most frequently used meridians were bladder meridian (BL), governor vessel (GV), and stomach meridian (ST). They were mainly distributed in the lower limbs and head. The most frequent specific points are the five transport points and source points. The most frequently used combinations are \"shenmen (HT7) - sanyinjiao (SP6)\", \"shenmen (HT7) - baihui (GV20)\", and \"shenmen (HT7) - neiguan (PC6)\". Association rule analysis showed that the acupoints with the highest confidence were shenmen (HT7), neiguan (PC6), and sanyinjiao (SP6). Network topology analysis showed that sanyinjiao (SP6), zusanli (ST36), and shenmen (HT7) were the core acupuncture points for the treatment of senile insomnia.
CONCLUSIONS: The primary Acupuncture acupoints for senile insomnia are shenmen (HT7), sanyinjiao (SP6), baihui (GV20), zusanli (ST36), and neiguan (PC6), indicating that these acupoints have a strong correlation with senile insomnia. Sanyinjiao (SP6), zusanli (ST36), and shenmen (HT7) may be the core acupuncture acupoints for the treatment of senile insomnia.

OBJECTIVE: Herbal and natural supplements have gained popularity as alternative treatments to insomnia and sleep disorders due to their perceived safety and potential effectiveness. This literature review summarizes the current evidence on the efficacy, safety, and mechanisms of action of commonly used supplements for sleep, including valerian, hops, kava, German chamomile, cherry, tryptophan, theanine, melatonin, magnesium, and zinc.
METHODS: We conducted literature review of clinical research on herbal and supplements for sleep reported to date. We summarized key findings and reviewed outcomes related to clinical efficacy and side effects.
RESULTS: Findings suggest that certain supplements, particularly valerian, hops, and melatonin, could be effective in improving sleep quality and reducing insomnia symptoms through modulation of neurotransmitter systems and regulation of sleep-wake cycles. However, the strength of the evidence varies with unestablished optimal dosages, formulations, and treatment durations. Although generally considered safe, these supplements are not without risks, such as rare but serious adverse effects associated with kava and potential interactions with prescription medications. The quality and purity of supplements also vary widely due to a lack of strict regulations.
CONCLUSIONS: Healthcare providers should remain informed about the latest research and work closely with patients to develop personalized treatment plans. Herbal and natural supplements may offer promising alternatives or adjunct treatments for insomnia and sleep disorders, but their use should be guided by the best available evidence and individual patient requirements. Larger, well-designed clinical trials are needed to establish the efficacy and safety of these supplements for clinical decision-making.

OBJECTIVE: Idiopathic hypersomnia (IH) is characterized by excessive sleepiness during the day, prolonged sleep at night, and difficulty waking up. The true prevalence of IH is uncertain. ICSD provides criteria for diagnosing IH; however, the definition has evolved. Managing IH involves using pharmacologic and non-pharmacologic approaches, although the most effective strategies are still unclear. The objective of this scoping review was to identify the extent, range, and nature of the available evidence, identify research gaps, and discuss the implications for clinical practice and policy.
METHODS: To conduct this review, a comprehensive search was conducted across scientific databases, without any restrictions on the date or study type. Eligible studies examined the effectiveness of pharmacologic and non-pharmacologic treatments for IH and reported the outcomes of these interventions. Data from the studies were screened, analyzed, and synthesized to provide an overview of the available literature landscape.
RESULTS: 51 studies were included in this review, which used various methods and interventions. Pharmacological treatments, particularly modafinil, have been frequently studied and have yielded positive results. There is also emerging evidence for alternative medications such as low-sodium oxybate and pitolisant. Non-pharmacological approaches, such as CBT-H and tDCS have also shown promise in managing IH.
CONCLUSIONS: This review highlights the complexity of managing IH management and emphasizes the need for personalized multidisciplinary approaches. Pharmacological interventions are important in managing IH and can be complemented by non-medication strategies. Larger-scale studies are necessary to advance our understanding of IH and to improve treatment outcomes.