Correctional workers (CWs) report high levels of work stressors, frequent exposures to potentially psychologically traumatic events (PPTEs), and substantial mental health challenges. There is evidence of associations between sleep disturbances and diverse mental health challenges, including preliminary evidence from public safety personnel; however, replications and extensions would better inform interventions to support mental health. The current study was designed to examine associations between quality of sleep, work stress, and mental health disorders in a sample of diverse CWs employed in a provincial correctional service in Ontario, Canada. Data were analyzed from 943 CWs who participated in the cross-sectional, web-based Ontario Provincial Correctional Worker Mental Health and Well-Being Study conducted from December 2017 to June 2018. Sleep quality indicators included symptoms of insomnia, total hours of sleep per night on work nights and off-shift nights, number of days feeling rested per week, and overall sleep quality. Descriptive statistics, analyses of variance, correlational analyses, and logistic regression were used to examine relationships among sleep quality, stress of shift work, and mental health disorder symptoms. CWs slept an average of 6.0 h per night when working and 7.2 h during off-shift nights. CWs reported waking up feeling rested an average of 2.6 days per week and rated their overall quality of sleep in the fair to poor range. Many CWs (64.9%) screened positive for clinically significant symptoms of insomnia. There were also differences across occupational groups such that CWs working as correctional officers reported the most sleep problems. There were statistically significant relationships between insomnia and mental health disorder symptoms. Higher levels of stress from shift work were associated with worse sleep quality. CWs, especially those working as correctional officers in a provincial prison, reported many indicators consistent with poorer quality of sleep. Poor quality of sleep was also associated with work stress and mental health disorders.

BACKGROUND: Poor sleep quality can cause an increase in morning blood pressure surge (MBPS), an independent risk factor of cardiovascular disease (CVD) events. Awakening induced by external factors such as alarm clocks, may also contribute to increased MBPS.
OBJECTIVE: To (1) compare the MBPS and sleep quality parameters between natural and forced awakenings and (2) examine the potential impact of forced awakening on MBPS, independent of sleep quality.
METHODS: Thirty-two healthy adults participated in this pilot study, which included one night of natural awakening and one night of forced awakening (i.e., sleep was interrupted by an alarm after five hours). Objective and self-reported sleep quality parameters were measured using a multisensory wristband and sleep diaries, respectively, and beat-to-beat blood pressure variability was assessed using a continuous blood pressure monitor. Analyses included a paired t-test (objective 1) and linear mixed models (objective 2).
RESULTS: Participants predominantly consisted of young, healthy, and highly educated Asian adults. During the night of sleep with forced awakening, significantly higher MBPS, lower objective wakefulness after sleep onset, and lower self-reported sleep latency were observed, compared to the night with natural awakening. Forced awakening was significantly associated with increased MBPS after controlling for age, sex, mean arterial pressure, and sleep quality.
CONCLUSIONS: Forced awakening may significantly increase MBPS, consequently heightening the risk of CVD events. Study findings should be validated in a larger sample. Further research is also warranted to examine the impact of forced awakening on MBPS in individuals with CVD.

Background: Clonidine is a centrally acting anti-adrenergic agent that may have applications in post-traumatic stress disorder (PTSD), particularly for sleep.Objective: In this systematic review, we aimed to summarize the effect of clonidine on sleep quality and duration, nightmares, and PTSD symptom severity in adults with PTSD.Method: PubMed (Medline), Embase, PsycINFO, CINAHL, and clinicaltrials.gov were searched up to April 2023. Studies on clonidine use in adult PTSD patients reporting data on the effect on sleep, nightmares, and PTSD symptoms were included. A narrative summary and a meta-analysis of the study findings are presented.Results: Ten reports, accounting for N = 569 patients with PTSD (145 on clonidine and 436 controls), were included in the final selection. There were four case reports, four observational studies, one non-blind clinical trial, and one crossover randomized controlled trial (RCT). Median clonidine dose was 0.15 mg/day (range: 0.1-0.5 mg/day). Median follow-up time was 31 days (range: 3 days to 19 months). The quality of the evidence was rated from very low to low. There was marked between-study heterogeneity and low power in the individual studies, but many reported improved sleep quality, nightmare reduction, and improvement of PTSD symptoms for patients treated with clonidine. Meta-analysis was only possible for two studies reporting the effect of clonidine on nightmares, and showed no difference from the comparator (i.e. prazosin or terazosin) (odds ratio: 1.16; 95% confidence interval: 0.66 to 2.05), potentially pointing towards non-inferiority between these medications.Conclusions: Future research, such as well-powered RCTs, is needed to identify the efficacy in the lower dose range and the most suitable treatment group, and to obtain good evidence on the effects of clonidine in the treatment of sleep disorders related to PTSD.
Post-traumatic stress disorder (PTSD) is associated with hyperarousal and sleep disorders, reflecting adrenergic nervous system involvement.The use of anti-adrenergic drugs to target the sympathetic activation in PTSD is rational. However, previous reports on prazosin, a peripherally acting agent, yielded weak evidence.Clonidine, a central adrenergic antagonist, shows promise in improving sleep, nightmares, and PTSD symptoms, but further research is needed because the quality of the current evidence is low.

BACKGROUND: Psoriasis, a chronic inflammatory skin condition, affects approximately 3.0% of the US population, with patients often experiencing significant sleep disturbances. These disturbances include a higher prevalence of conditions such as obstructive sleep apnea, restless leg syndrome, and insomnia. Given the additional risks for cardiovascular disease, metabolic disorders, and depression linked to both poor sleep and psoriasis, addressing sleep issues in this patient group is critical.
METHODS: The study utilized National Health and Nutrition Examination Survey (NHANES) data, focusing on individuals aged ≥ 20 years who provided information on psoriasis status and sleep. Multistage stratified survey methodology was applied, with multivariable logistic regression models used to examine the association between psoriasis and sleep issues, adjusting for factors such as age, gender, and health history.
RESULTS: Psoriasis diagnosis was significantly associated with trouble sleeping (adjusted odds ratio [aOR] 1.88; 95% confidence interval [CI] 1.44-2.45). There was no significant association between psoriasis and sleep quantity. Older age, female gender, and a history of sleep disorders were predictors of trouble sleeping among psoriasis patients.
CONCLUSIONS: Psoriasis is significantly associated with sleep disturbances, independent of sleep duration. This underscores the need for clinical screening focusing on sleep quality rather than quantity in psoriasis patients to effectively identify and treat sleep-related comorbidities. Further research using objective sleep measures is warranted to guide clinical management and improve patient quality of life.

The incidence of diabetes mellitus is increasing, and the sleep quality of patients with diabetes mellitus is often affected. Baduanjin may act on biological rhythm of the body, skeletal muscle glucose metabolism, skeletal muscle fibers and suprachiasmatic nucleus (SCN) by regulating the expression of Bmal1 gene, thus regulating the blood glucose level and circadian rhythm of patients with type 2 diabetes mellitus (T2DM) and improving their physiological functions. This article reviews the regulatory effect and mechanism of Baduanjin on Bmal1 gene expression in diabetes patients, and discusses the possibility of Baduanjin to improve the sleep quality of T2DM patients by regulating Bmal1 gene expression. This review can provide a new field for the clinical application of traditional Chinese Qigong Baduanjin, and provide a new scientific basis for exercise therapy of diabetes.

BACKGROUND: Because of COVID\'s impact on social behavior, students have become more reliant on computer-facilitated communication to continue their studies and interact with friends. While it is known that the association between screen exposure and psychological well-being is both harmful and stronger among adolescents than younger children, what is less studied are the causal factors that may mediate the relationship.
OBJECTIVE: The objectives of this study were to analyze the relationship between screen exposure and two psychological outcomes, sleep quality and loneliness, using digital eye strain as a mediating factor. Eye strain is expected to have a direct and harmful influence on psychological well-being.
METHODS: A structured and validated questionnaire was transcribed and administered online. A nonrepresentative sample of 497 female college students in a North Indian city participated in the study. Digital eye strain, quality of sleep, and feeling of loneliness scores were assessed using latent class analysis.
RESULTS: The selected latent model suggested that Class 2 had a high percentage of students with network issues, the problem with space and noise, and various financial hardships, which had almost doubled the rate of loneliness (53.28%) and sleep-wake difficulties (75.41%) among the students affected with computer vision syndrome (89.75%).
CONCLUSIONS: There is an urgent need to examine the implications of digital exposure across gender and age to prevent future complications. Further, awareness for improving holistic well-being in the digital era should be promoted through various platforms.

OBJECTIVE: To study the features of the manifestation of insomnia and its impact on the condition and quality of life in patients with chronic tension-type headache.
METHODS: The study included 65 patients with chronic tension-type headache and insomnia. Patients filled out questionnaires on headache severity, sleep quality, emotional status and quality of life. Seventeen patients underwent polysomnography.
RESULTS: Patients with more severe insomnia had significantly more severe anxiety (p<0.001) and depression (p=0.025). Such patients assessed their quality of life worse according to the SF-12 questionnaire (p<0.002) and the Subjective Well-Being Scale (p<0.001), a higher level of central sensitization was observed in patients with more severe insomnia (p<0.001).
CONCLUSIONS: The negative impact of insomnia on the condition of patients is not so much an increase in pain as such, but rather its influence on the quality of the emotional state and life in general, as well as an increase in the interdependence and mutual influence of other clinical and psychophysiological manifestations of the disease. Therefore, the clinical significance of insomnia is the deterioration of a person\'s ability to tolerate pain, which is the main prerequisite for a decrease in quality of life.
UNASSIGNED: Изучить особенности проявления инсомнии и ее влияния на состояние и качество жизни у пациентов с хронической головной болью напряжения.
UNASSIGNED: В исследование включены 65 пациентов с хронической головной болью напряжения и инсомнией. Пациенты заполняли опросники по выраженности головной боли, качеству сна, эмоциональному статусу и качеству жизни. Семнадцати пациентам проведена полисомнография.
UNASSIGNED: У пациентов с более тяжелой инсомнией статистически значимо более выражены тревога (p<0,001) и депрессия (p=0,025). Такие пациенты хуже оценивали качество жизни по опросникам SF-12 (p<0,002) и шкале субъективного благополучия (p<0,001), более высокий уровень центральной сенситизации выявлен у пациентов с выраженной инсомнией (p<0,001).
UNASSIGNED: Негативное влияние инсомнии на состояние пациентов состоит в усилении не столько боли как таковой, сколько ее влияния на качество эмоционального состояния и жизни в целом, а также в усилении взаимозависимости и взаимовлияния других клинических и психофизиологических проявлений болезни. Следовательно, клиническое значение инсомнии состоит в ухудшении способности пациента переносить боль, что является основной предпосылкой для снижения качества жизни.

OBJECTIVE: To analyze complaints about sleep disorders and assess the incidence of various sleep disorders, using relevant scales, in patients with medication-overuse headache (MOH) in comparison with patients without MOH.
METHODS: The prospective case-control study included 171 patients, aged 18 years and older, with MOH (main group), and173 patients with primary headaches without MOH (control group). A neurologist conducted an initial examination and professional interview before the start of treatment. To diagnose sleep disorders, the International Classification of Sleep Disorders (3rd edition, 2014) was used. Additionally, an assessment was made using the Insomnia Severity Index Scale, the Epworth Sleepiness Scale (ESS) and the Lausanne Obstructive Sleep Apnea Syndrome Scale (NoSAS).
RESULTS: Statistically significant differences were revealed in the prevalence of the following complaints about sleep disorders in patients with MOH: lack of sleep (51.5%), frequent awakenings during sleep (43.3%), discomfort in legs before falling asleep or at rest in the evening (37.4%). Difficulties falling asleep occurred equally often in both patients with MOH (43.9%) and without MOH (37.0%), as well as daytime sleepiness (40.4% vs 36.4%) and the presence of snoring (13% of patients in each group). Patients with MOH were significantly more likely to suffer from chronic insomnia (60.2% and 47.4%, respectively, p=0.02; OR 1.7; 95% CI 1.1-2.6) and restless legs syndrome (37.4% and 22.0%, respectively, p=0.002; OR 2.1; 95% CI 1.3-3.4). The incidence of hypersomnia and obstructive sleep apnea syndrome did not have statistically significant differences.
CONCLUSIONS: Patients with MOH compared to patients without MOH have a significantly higher incidence of main complaints of sleep disorders, chronic insomnia and restless legs syndrome, which indicates the importance of sleep disorders in the pathogenesis of medication-overuse headaches and requires timely diagnosis and treatment to prevent the progression of both headaches and sleep disorders.
UNASSIGNED: Анализ жалоб на нарушения сна и оценка встречаемости различных расстройств сна с использованием шкал у больных с лекарственно-индуцированной головной болью (ЛИГБ) в сравнении с пациентами без ЛИГБ.
UNASSIGNED: В проспективное исследование по типу «случай-контроль» включен 171 пациент в возрасте 18 лет и старше, имеющий ЛИГБ (основная группа), а также 173 пациента с первичными головными болями без ЛИГБ (контрольная группа). Первичный осмотр и профессиональное интервью проведены врачом-неврологом до начала лечения с использованием стандартизированных опросников. Для диагностики нарушений сна использовалась Международная классификация нарушений сна (3-е издание, 2014). Дополнительно произведена оценка по шкалам индекса тяжести инсомнии, Эпвортской шкале дневной сонливости и Лозаннской шкале синдрома обструктивного апноэ сна (NoSAS).
UNASSIGNED: Статистически значимые различия выявлены в превалировании следующих жалоб на нарушения сна у больных с ЛИГБ: невыспанность по утрам (51,5%), частые пробуждения во время сна (43,3%), неприятные ощущения в ногах перед засыпанием или в состоянии покоя в вечернее время (37,4%). Трудности засыпания встречались одинаково часто у больных как с ЛИГБ (43,9%), так и без ЛИГБ (37,0%), так же как дневная сонливость (40,4% против 36,4%) и наличие храпа (13% больных в каждой из групп). Больные с ЛИГБ значительно чаще страдали хронической инсомнией (60,2 и 47,4% соответственно, p=0,02; ОШ 1,7; 95% ДИ 1,1—2,6) и синдромом беспокойных ног (37,4 и 22,0% соответственно, p=0,002; ОШ 2,1; 95% ДИ 1,3—3,4). Встречаемость гиперсомнии, синдрома обструктивного апноэ сна не имели статистически значимых различий.
UNASSIGNED: Больные с ЛИГБ, по сравнению пациентами без ЛИГБ, имеют значительно большую встречаемость основных жалоб на нарушения сна, хронической инсомнии и синдрома беспокойных ног, что указывает на важное значение нарушений сна в патогенезе ЛИГБ и требует своевременной диагностики и лечения для профилактики прогрессирования как головных болей, так и нарушений сна.

OBJECTIVE: To determine the prevalence of insomnia and the effectiveness of its treatment in patients with a painful form of diabetic polyneuropathy (DPN).
METHODS: Fifty patients with the painful form of DPN were randomly divided into 2 groups: the standard therapy group (ST) and the extended therapy group (ET). In the ST group, a single lesson on sleep hygiene was conducted, in the ET group there were 3-4 face-to-face individual sessions for the treatment of insomnia for two weeks. Both groups were interviewed at the time of hospitalization, after 3 and 6 months. The severity of polyneuropathy and the nature of neuropathic pain were assessed using the Neuropathic Neuropathy Impairment Score in the Lower Limbs (NIS-LL) and the Neuropathy Total Symptom Score - 9 (NTSS-9); the intensity of pain was assessed using a Visual Analog Scale (VAS). Sleep disorders were analyzed using the Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index (ISI).
RESULTS: Sleep disorders of varying severity were observed in 82% of patients in the initial survey. In both groups, improvement in sleep quality was noted during treatment, but significantly better results were in the ET group, the ISI score after 6 months was 7.15±2.08 for the ST group and 3.07±2.49 for the ET group (p<0.0001). In the ST group, there was no significant decrease in the intensity of pain and the severity of polyneuropathy in dynamics. In the ET group, a significant decrease in NTSS-9 and VAS scores was found during the initial survey and after 6 months (p<0.0001). The intensity of pain also significantly decreased in the ET group compared with the ST group (p<0.0001) at the end of follow-up, which indicates the importance of sleep normalization in the treatment of neuropathic pain.
CONCLUSIONS: Most patients with the painful form of DPN have insomnia. Treatment of insomnia has shown its effectiveness as part of a multimodal approach to the managing of neuropathic pain in DPN and improving the quality of life of patients.
UNASSIGNED: Определение распространенности инсомнии и эффективности ее коррекции у пациентов с болевой формой диабетической полинейропатии (ДПН).
UNASSIGNED: Пятьдесят пациентов с болевой формой ДПН случайным образом разделены на 2 группы: группу стандартной (СТ) и группу расширенной (РТ) терапии. В группе СТ проводилось однократное занятие по гигиене сна, в группе РТ — 3—4 очных индивидуальных сессии по коррекции инсомнии в течение 2 нед. Обеим группам проведено анкетирование на момент госпитализации, через 3 и 6 мес. Оценка выраженности полинейропатии и характера нейропатических болей проводилась с помощью шкалы нейропатических нарушений в ногах (NIS-LL) и шкалы общей оценки симптомов нейропатии (NTSS-9); интенсивность болевого синдрома оценивалась с помощью Визуальной аналоговой шкалы (ВАШ). Анализ нарушений сна проводился с использованием Питтсбургского индекса качества сна (PSQI) и Индекса тяжести инсомнии (ISI).
UNASSIGNED: У 82% пациентов при первичном опросе имелись нарушения сна различной степени выраженности. В обеих группах на фоне лечения отмечалось улучшение качества сна в динамике, однако достоверно лучшие результаты отмечены в группе РТ: для группы СТ балл по шкале ISI через 6 мес составил 7,15±2,08, для группы РТ — 3,07±2,49 (p<0,0001). В группе СТ значимого снижения интенсивности болевого синдрома и выраженности полинейропатии в динамике обнаружено не было. В группе РТ обнаружено статистически значимое снижение баллов по шкалам NTSS-9 и ВАШ при первичном опросе и через 6 мес (p<0,0001). Интенсивность болевого синдрома также достоверно снизилась в группе РТ в сравнении с группой СТ (p<0,0001) по окончании наблюдения, что свидетельствует о значимости нормализации сна в лечении нейропатической боли.
UNASSIGNED: У большинства пациентов с болевой формой ДПН имеется инсомния. Коррекция инсомнии показала свою эффективность в рамках мультимодального подхода к лечению нейропатической боли при ДПН и повышению качества жизни пациентов.

OBJECTIVE: To investigate the relationship between symptoms of trait anxiety, state anxiety and symptoms of insomnia and the degree of their influence on daytime functioning disorders in adolescent girls.
METHODS: The study included 50 healthy adolescent girls, senior school students, aged 15-17 years, selected as simple random sample. Insomnia symptoms and their impact on daytime functioning were assessed using the SLEEP-50 (S-50) questionnaire. Trait and state anxiety were assessed using the Spielberger questionnaire. The method of path analysis was used to identify significant associations.
RESULTS: There was a positive association of the severity of daytime functioning disorders with the severity of insomnia symptoms (β=0.45; p<0.001) and the level of trait anxiety (β=0.34; p=0.004). Trait anxiety was also a significant predictor of state anxiety (p<0.001), with a direct relationship between these parameters (β=0.62). Positive covariation of insomnia symptoms severity and state anxiety was found (β=0.53; p<0.001).
CONCLUSIONS: Improving sleep quality and daytime functioning in adolescents with insomnia symptoms should take into account personality characteristics. High levels of trait anxiety increase the negative effects of insomnia on the impaired daytime functioning.
UNASSIGNED: Изучение связи симптомов личностной тревожности, реактивной тревоги с симптомами инсомнии и степенью их влияния на нарушения функционирования в дневное время суток у девочек-подростков.
UNASSIGNED: В исследование вошли 50 практически здоровых девочек-подростков в возрасте 15—17 лет, учащихся старших классов школы, отобранных по принципу простой случайной выборки. Оценка симптомов инсомнии и их влияния на дневное функционирование осуществлялась при помощи опросника SLEEP-50 (S-50). Личностная тревожность и ситуативная тревога оценивались при помощи опросника Спилбергера. Применялся метод путевого анализа для выявления значимых ассоциаций.
UNASSIGNED: Выявлена положительная ассоциация выраженности нарушений функционирования в дневное время с выраженностью симптомов инсомнии (β=0,45; p<0,001) и уровнем личностной тревожности (β=0,34; p=0,004). Личностная тревожность также являлась значимым предиктором ситуативной тревоги (p<0,001), при этом между указанными параметрами отмечалась прямая связь (β=0,62). Определялась положительная ковариация выраженности симптомов инсомнии и ситуативной тревоги (β=0,53; p<0,001).
UNASSIGNED: Улучшение качества сна и дневного функционирования у подростков с симптомами инсомнии должно учитывать личностные характеристики. Высокий уровень личностной тревожности усиливает негативные последствия инсомнии в отношении показателей дневного функционирования.