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.

Background Narcolepsy is a chronic sleep disorder that is characterized by excessive daytime sleepiness and cataplexy. It has been increasingly diagnosed over the years, impacting productivity and employment rates. Awareness of healthcare providers is crucial for the early identification and management of this condition. Objectives This study assessed physicians\' knowledge of narcolepsy in the Makkah region of Saudi Arabia. Method This cross-sectional study was conducted from February to November 2023. An online self-administered questionnaire has been used to target physicians working in the Makkah region of Saudi Arabia. The utilized questionnaire assessed demographic and professional data as well as the participants\' knowledge of narcolepsy. Statistical analysis was performed using RStudio (R version 4.3.1.). Statistical differences in knowledge were assessed using Pearson\'s chi-squared and Fisher\'s exact tests. Factors associated with knowledge of narcolepsy were investigated through univariable and multivariable regression analyses expressed using beta coefficients and 95% confidence intervals (95% CIs). Statistical significance was considered at p < 0.05. Results A total of 226 physicians participated in this study. Male physicians (54.4%, n = 123), practicing in governmental hospitals (77.9%, n = 176) and residing in Makkah City (43.4%, n = 98) were predominant. Non-surgical specialties represented 73.5% (n = 166) of the sample. Around 81% (n = 184) of the participants were aware of narcolepsy, with a significant difference according to professional status (p = 0.045). The majority of physicians have correctly identified narcolepsy as a sleep disorder (78.3%, n = 177), but only 32.3% (n = 73) have identified its typical onset age group and recognized that there are two types of narcolepsy. Almost half of the respondents indicated a lack of knowledge about the diagnostic criteria for narcolepsy in the DSM-5 (52.2%, n = 118). Only 27.4% (n = 62) recognized the correct diagnostic criteria. Half of the sample (51.3%, n = 116) recognized the use of multiple sleep latency tests for the diagnosis. For factors associated with higher participants\' knowledge, non-surgical specialties showed significantly higher knowledge scores compared to surgical specialties (beta = 0.91, 95% CI, 0.13 to 1.7, p = 0.024). Conclusion This study has revealed a significant lack of knowledge about narcolepsy among physicians in Makkah region. This raises concerns about the timely identification, proper understanding, and accurate diagnosis of patients with narcolepsy. Adequate understanding of narcolepsy is crucial to avoid its misdiagnosis or delays in receiving appropriate treatment and support, ultimately impacting their quality of life.

UNASSIGNED: To explore the combined effects of sleep disorders and depression on chronic low back pain (CLBP) in American adults.
UNASSIGNED: In this cross-sectional study, the data of all participants were obtained from the National Health and Nutrition Examination Survey (NAHNES) between 2009 and 2010. CLBP was defined as persistent LBP for a consecutive three-month period. Sleep disorders were self-reported and were diagnosed by a doctor before. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depressive symptoms by trained personnel. Potential covariates were selected using weighted univariate logistic regression models. Weighted univariate and multivariate logistic regression models were used to evaluate the separate and combined effects of sleep disorders and depression on CLBP, respectively. Results were presented as odds ratios (ORs) and 95% confidence intervals (CIs). Associations were further explored in the subgroups of age, chronic kidney disease (CKD), diabetes, and having pain outside the low back.
UNASSIGNED: A total of 5275 participants were included. Among them, 542 (10.28%) had CLBP. The mean age of all participants was 47.19 (0.53), and 50.65% (n=2668) were female. Sleep disorder (OR=1.52, 95% CI: 1.17-1.98) or depressive symptoms (OR=3.06, 95% CI: 2.41-3.88) were associated with higher odds of CLBP. Compared to participants without sleep disorders and depression symptoms, participants in both conditions had an increased risk of CLBP (OR=3.95, 95% CI: 2.58-6.05, P for trend <0.001). The combined effects of sleep disorders and depressive symptoms were also found in the population aged <45 years, ≥45 years, with and without CKD, with and without diabetes, and no pain outside the low back.
UNASSIGNED: Sleep disorders and depressive symptoms may increase the odds of reporting CLBP. Further research is necessary to explore the effectiveness of multidisciplinary interventions targeting sleep disorders, depressive symptoms, and CLBP.

Smoking a cigarette before bed or first thing in the morning is a common habit. In this review, the relationship between smoking and sleep is investigated based on the existing literature. Out of 6504 unique items that were identified via a PubMed search related to smoking and sleep, 151 were included in this review. Tobacco smoking disrupts sleep architecture by reducing slow wave and rapid eye movement (REM) sleep and undermining sleep quality. Furthermore, smoking affects sleep-related co-morbidities, such as obstructive sleep apnea-hypopnea syndrome (OSAHS), insomnia, parasomnias, arousals, bruxism, and restless legs, as well as non-sleep-related conditions such as cardiovascular, metabolic, respiratory, neurologic, psychiatric, inflammatory, gynecologic and pediatric issues, while poor sleep quality also seems to worsen the chances of successful smoking cessation. In conclusion, the existing literature suggests that there is a wicked relation between smoking and sleep.

BACKGROUND: Sleep disorders have a significant impact on asthma. The aim of this study was to explore the association between nocturnal bedtime and asthma among adults in the United States.
METHODS: This study was a cross-sectional analysis involving 11,475 participants from the National Health and Nutrition Examination Survey (NHANES) during the period of 2015-2018. Nocturnal bedtime was categorized into three distinct groups: 2100 h or earlier, between 2100 h and 2300 h, and 2300 h or later. The association between night bedtime and asthma was detected using multivariable logistic regression analyses. Additionally, subgroup analyses were conducted to assess the impact of subgroups.
RESULTS: After adjustment for confounders, a positive association was revealed between later bedtime (after 2300 h) and the prevalence of asthma (OR = 1.20, 95%CI: 1.01-1.43). In the subgroup analysis, the following factors were associated with increased risk: 18-39 years (OR = 1.23, 95%CI: 1.02-1.48); female sex (OR = 1.30, 95%CI: 1.01-1.68); Hispanic patients (OR = 1.66, 95%CI: 1.17-2.37); heavy drinkers (OR = 1.52, 95%CI: 1.17-1.96); Body Mass Index (BMI) (< 25 kg/m2) (OR = 1.45, 95%CI: 1.13-1.87); vigorous physical activity (OR = 1.32, 95%CI: 1.05-1.65);Significant interactions were found between nocturnal bedtime and asthma based on age, sex, eosinophils (EOS) percent and depression (P Interaction < 0.05).
CONCLUSIONS: Our results confirmed a moderately increased risk of asthma attributed to later bedtime, especially in 18-39 years, women and patients of Hispanic ethnicity. Future studies should investigate the underlying mechanisms of this association and explore the clinical implications for asthma management.

A randomized, double-blind and controlled study was conducted to assess the effectiveness of the intake of 250 mL of lactose-free skimmed milk enriched with ashwagandha (Withania somnifera) alone or combined with tryptophan vs. non-enriched milk (control) on the subjective quality of sleep in healthy adults with sleep problems. The duration of supplementation was 90 days. Fifty-two eligible subjects were assigned to the study arms of ashwagandha 250 mg, ashwagandha 250 mg plus tryptophan 175 mg, ashwagandha 600 mg, and control with 13 subjects in each group. It was hypothesized that ashwagandha plus tryptophan could be superior to ashwagandha alone for improving sleep-related variables. Changes in the visual analogue scale (VAS) for sleep quality were significantly higher in the three experimental groups as compared with controls (p = 0.014). Improvements in the subscales of the Pittsburg Sleep Quality Index (PSQI) were found in all groups, but between-group differences were not significant. In the index of insomnia severity, decreases were higher in the three experimental groups as compared with controls especially in the group of ashwagandha 600 mg. Daytime somnolence was also reduced in the three experimental groups. Changes in anxiety levels and Morningness-Eveningness Questionnaire were not observed. The study products did not elicit changes in body composition and were well tolerated and safe. The data did not support the hypothesis, as the combination of ashwagandha and tryptophan did not show greater benefits in improving sleep quality than ashwagandha alone. However, the results from the three experimental groups containing ashwagandha were more favorable compared to the placebo group.

BACKGROUND: Pediatric Sleep Questionnaire (PSQ) is a valid, reliable tool for screening for sleep-related breathing disorders (SRBDs) translated into several languages since 2000. The diagnostic accuracy of an Arabic version of the PSQ has never been tested. Our aim was to translate the original version of PSQ into Arabic (Arabic-PSQ), validate it as a reliable screening tool, and compare it to the gold standard diagnostic method for SRBDs.
METHODS: This was a prospective longitudinal study of 54 children (2-14 years) who were to undergo polysomnography (PSG). SRBD was assessed by administering the Arabic version of PSQ to the parents of these children. The validity and reliability of the Arabic-PSQ were assessed. Data were analyzed using Stata 16. Correlation between with polysomnographic indices and PSQ scores, as well as measurement of the diagnostic accuracy were determined. Receiver operating characteristic analysis between the mean PSQ scores and binary PSG results was done and the area under curve (AUC) value was calculated.
RESULTS: Thirty-four (63%) children were diagnosed with obstructive sleep apnea by PSG (Apnea-Hypopnea Index [AHI] ≥1), 26 of whom were accurately identified with the Arabic-PSQ (76.5%). Arabic-PSQ showed comparable validity and reliability. Using a cutoff of 0.33, the score showed a significant correlation with AHI: Rs: 0.30 (P = 0.029). The sensitivity was 76.5%, the specificity was 50%, the positive predictive was 72.2%, the negative predictive value was 55.6%, the positive likelihood ratio was 1.63, and the negative likelihood ratio was 0.37.
CONCLUSIONS: The Arabic-PSQ is a valid tool for the screening of Arabic-speaking populations for SRBD. It is valuable for directing the diagnostic approach in a timely and cost-effective manner.

Sleep holds significant importance for maintaining health and aiding in illness recovery. Its deprivation impacts all human organ systems, from cognitive function, social interaction, and work capacity to cellular regeneration and immune function. Therefore, sleep plays a crucial role in our body and maintaining health and well-being. Given its importance and close relationship with the neurodevelopment and growth of children and adolescents, this topic is highly significant in pediatric and adolescent health consultations. Family physicians, due to their proximity and understanding of the individual within their family, have the prerogative to contribute to family literacy, empower them, and significantly enhance the quality of life and overall health.

UNASSIGNED: Surgical pain affects postoperative sleep quality, and they jointly form a vicious cycle of mutual influence. The cycle of postoperative pain and sleep disorders could lead to delirium, cardiovascular disease, and hyperalgesia, which significantly affect patients\' postoperative recovery. Thus, exploring this phenomenon is of great importance for surgical patients, and warrants further investigation.
UNASSIGNED: By employing bibliometric methods, this study systematically analyzes the publications on postoperative pain-sleep disorders, identifies research trends and field dynamics, and ultimately provides insights for further progress in this research area.
UNASSIGNED: In this study, we searched the Web of Science database for studies on postoperative pain and sleep disorders from 2013 to 2023, and analyzed the number of publications, journals, authors, institutions, country regions, and keywords by utilizing CiteSpace, VOSviewer, and Bibliometrix.
UNASSIGNED: The 1894 retrieved publications showed a trend of increasing number of publications and correlations between postoperative pain and sleep disorders from 2013 to 2023. The top countries for publications included the USA, China, etc., establishing a global collaborative network centered around the USA, China, and Europe. The top institutions for publications included University of California System, Harvard University, etc. The top authors include Christine Miaskowski, Steven M. Paul, Qiuling Shi, etc. These publications involved multiple disciplines including surgery, neurology, and anesthesiology, and various research funds including NIH, HHS, NSFC, etc. The top journals for publications included the European Archives of Oto-Rhino-Laryngology, etc. Keywords that appear most frequently in this field include \"pain\", \"surgery\", \"quality of life\", \"sleep\", \"depression\", and \"outcomes\". The thematic map indicated that the hot topics in this area include obstructive sleep apnea, tonsillectomy, children, pain, quality of life, and sleep. The undeveloped topics with research potential included postoperative pain, analgesia and dexmedetomidine, breast cancer, fatigue, and lung cancer.
UNASSIGNED: The increased number of publications and correlations between postoperative pain and sleep disorders, and the collaborative network across the USA, China, and Europe indicate a growing global interest in this area. This study also provides valuable insights into the trend of hot topics and frontiers and shows that this is an evolving and dynamic research area.

UNASSIGNED: Many studies across the globe have observed the significant effect of sleep disturbance on the academic achievement of medical students. Objective: This research was conducted to define the prevalence of sleep disturbance and to discover the consequences and management of this condition among undergraduate pharmacy students of Mohammed Al-Mana College for Medical Sciences (MACHS).
UNASSIGNED: We conducted a questionnaire-based online survey among different levels of MACHS pharmacy students.
UNASSIGNED: A total of 165 students participated in the study, of whom 132 (80%) were females and 33 (20%) were males. Most of the participants, 142 (86.06%), were staying with their parents, whereas few of them were staying alone (23; 13.94%). While a handful of them, 29 (17.58%), did not have their bedrooms, most of them had their bedrooms (136; 82.42%). When asked about drinking caffeine-rich products in the afternoon or at night, most of them responded \"sometimes\" (78; 47.27%), followed by the category \"always\" (61; 36.97%), \"rarely\" (15; 9.09%), and then the category of students who responded \"not at all\" (11; 6.67%). Overall, 35 (21.21%) of the study participants had a smoking habit, 72 (43.63%) tried to treat their sleep disturbance, whereas 42 (25.45%) were getting treatment for insomnia.
UNASSIGNED: Most pharmacy students at MACH College, especially females, have sleep problems. Mostly, the prevalence is common during exam periods, and it mildly affects their grade point average.