BACKGROUND: Demanding intensive care unit (ICU) work environments may lead to sleep disturbances in nurses, impacting their health and potentially patient safety. Yet, the prevalence remains unclear around the world.
OBJECTIVE: To quantify the prevalence of sleep disturbances in intensive care nurses.
METHODS: Systematic review and meta-analysis. A database search was conducted in Embase, PubMed, Web of Science, Scopus and CINAHL from their inception to April 2024 for relevant studies. Data from observational studies (cross-sectional or cohort) that reported the prevalence of sleep disturbances, assessed using the Pittsburgh Sleep Quality Index (PSQI > 5), pooled in random-effects meta-analyses. Subgroup analyses were used to investigate variations in the prevalence estimates in terms of available variables. A Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)-compliant protocol was registered in PROSPERO (CRD42023476428).
RESULTS: In total, 24 articles were included in this study published from 1996 to 2023. Included studies were from 15 unique countries. Almost all of the studies were descriptive cross-sectional studies (n = 22; 91.7%). The included studies encompassed a range of intensive care nurses, from 42 to 605, involving a total of 3499 intensive care nurses. The reported proportion of intensive care nurses with sleep disturbances ranged from 20.0% to 100.0%, with a median of 76.7% (interquartile range: 62.9-85.7). The pooled prevalence of sleep disturbances in intensive care nurses was 75.1% (95% confidence interval: 37.2-53.1; 95% prediction interval: 30.5-95.4).
CONCLUSIONS: Sleep disturbance is a common issue in intensive care nurses. The study results highlight the importance of implementing effective interventions as early as possible to improve ICU sleep quality.
CONCLUSIONS: High prevalence of sleep disturbances among intensive care nurses necessitates global interventions. Gender-neutral approaches that acknowledge comparable risks and stable prevalence over time require long-term strategies. Raising awareness through programmes is vital for implementing evidence-based interventions to promote sleep health in intensive care nurses.

OBJECTIVE: Irritable bowel syndrome (IBS) is a diagnosis defined by gastrointestinal (GI) symptoms like abdominal pain and changes associated with defecation. The condition is classified as a disorder of the gut-brain interaction (DGBI), and patients with IBS commonly experience psychological distress. The present study focuses on this distress, defined from reports of fatigue, anxiety, depression, sleep disturbances, and performance on cognitive tests. The aim was to investigate the joint contribution of these features of psychological distress in predicting IBS versus healthy controls (HCs) and to disentangle clinically meaningful subgroups of IBS patients.
METHODS: IBS patients ( n = 49 ) and HCs ( n = 28 ) completed the Chalder Fatigue Scale (CFQ), the Hamilton Anxiety and Depression Scale (HADS), and the Bergen Insomnia Scale (BIS), and performed tests of memory function and attention from the Repeatable Battery Assessing Neuropsychological Symptoms (RBANS). An initial exploratory data analysis was followed by supervised (Random Forest) and unsupervised (K-means) classification procedures.
RESULTS: The explorative data analysis showed that the group of IBS patients obtained significantly more severe scores than HCs on all included measures, with the strongest pairwise correlation between fatigue and a quality measure of sleep disturbances. The supervised classification model correctly predicted belongings to the IBS group in 80% of the cases in a test set of unseen data. Two methods for calculating feature importance in the test set gave mental and physical fatigue and anxiety the strongest weights. An unsupervised procedure with K = 3 showed that one cluster contained 24% of the patients and all but two HCs. In the two other clusters, their IBS members were overall more impaired, with the following differences. One of the two clusters showed more severe cognitive problems and anxiety symptoms than the other, which experienced more severe problems related to the quality of sleep and fatigue. The three clusters were not different on a severity measure of IBS and age.
CONCLUSIONS: The results showed that psychological distress is an integral component of IBS symptomatology. The study should inspire future longitudinal studies to further dissect clinical patterns of IBS to improve the assessment and personalized treatment for this and other patient groups defined as disorders of the gut-brain interaction. The project is registered at https://classic.
RESULTS: gov/ct2/show/NCT04296552 20/05/2019.

UNASSIGNED: Medical staff have experienced anxiety, sleep disturbances, and suicide due to the COVID-19 epidemic. Thus, this study examined the relationship between corona disease anxiety, sleep problems, and suicidal ideation in medical staff and how resiliency and cognitive flexibility mediate it.
UNASSIGNED: This descriptive-analytical cross-sectional study examined medical staff. In 2022, participants were affiliated with Hamadan University of Medical Sciences, Iran educational and treatment centers. Sampling was done at primary COVID-19 treatment centers. Data was collected using validated instruments. Ethics were observed during data collecting.
UNASSIGNED: Path analysis was employed to test hypotheses. Analysis showed significant positive relationships between Corona disease anxiety and sleep disturbances (p = 0.001, β = 0.438) and suicidal ideation (p = 0.001, β = 0.310). Conversely, negative and significant associations were identified between resiliency and cognitive flexibility with sleep disturbances and suicidal ideation.
UNASSIGNED: The study illustrates how medical staff\'s psychological health is linked to COVID-19. High Corona disease anxiety causes sleep disturbances and suicidal thoughts. Resilience and cognitive flexibility modulated Corona disease anxiety, sleep problems, and suicidal thoughts. The comprehensive study focuses on medical staff mental health issues, suggesting targeted solutions.

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BACKGROUND: The arousal state has been demonstrated to be involved in the fundamental pathophysiological mechanism of sleep disturbances. Tai chi (TC) and repetitive transcranial magnetic stimulation (rTMS) have been documented to alleviate sleep disturbances by interfering with different arousal components. It is reasonable to assume that combining TC and rTMS could induce synergistic and longer-lasting benefits for sleep disturbances.
METHODS: Thirty-eight older community-dwelling people were randomly assigned to one of three groups: TC plus rTMS (n = 12), TC alone (n = 13), and treat-as-usual (TAU) (n = 13). The interventions were conducted three times per week for 4 weeks for the two intervention groups. The primary outcome was the insomnia severity, while the secondary outcomes were the actigraphy-assessed sleep patterns, use of hypnotic medications, mood states, and quality of life. The mediator outcomes included self-reported somatic arousal and cognitive arousal as well as electroencephalogram (EEG)-assessed cortical arousal. The assessments were conducted at baseline (T0), post-intervention (T1), and 3-month follow-up (T2).
RESULTS: Significant improvements in the insomnia severity were observed in the TC plus rTMS group compared with the TAU group at T1 (Cohen\'s d = 1.62, p = 0.003) and T2 (Cohen\'s d = 1.97, p < 0.001). In contrast, significant improvements in the TC alone group were found only at T2 (Cohen\'s d = 1.03, p = 0.010) when compared with the TAU group. Significant interaction effects were noted on the actigraphy-assessed sleep efficiency (p = 0.015) and total sleep time (p = 0.004), depression (p = 0.003) and stress scores (p = 0.002), and mental function in relation to quality of life (p = 0.042). However, none of the mediators elucidated how combining TC and rTMS could improve the insomnia severity.
CONCLUSIONS: The research findings are expected to guide further clinical practice in the management of sleep disturbances among older adults using various interventions. Future studies are needed to unravel the underlying mechanism and optimize the protocol to maximize the therapeutic benefits.

UNASSIGNED: COVID-19 has probably contributed to sleep disturbance among nurses, especially those working at emergency departments (EDs). Sleep disorders in nurse managers can negatively impact their health and impair work performance and decision-making. This study aimed to explore the quality of sleep among nurses working in EDs and its influencing factors during the COVID-19 pandemic.
UNASSIGNED: In this study, a cross-sectional design was employed to assess the sleep quality of nurses working in EDs during the COVID-19 pandemic. The research recruited a convenience sample of emergency nurses, who were selectively sourced from four hospitals in Hail City. This recruitment occurred over the period from April to July 2022. Descriptive data analysis was conducted using SPSS, with the significance level set at 0.05.
UNASSIGNED: Among the 216 participants in the study, the majority (55.6%) were aged between 30 and 39 years, and 73.6% were female. Additionally, 64.4% were married, while 69.4% had a bachelor\'s degree, 20% held a diploma, and the remaining had a master\'s degree. Notably, a significant 81.5% of the nurses reported poor sleep quality, as assessed by the Pittsburgh Sleep Quality Index (PSQI), with an overall mean score of 10.55 indicating poor sleep. The study highlighted that poor sleep quality among nurses was linked to being female, being married, and not exercising regularly. Better sleep was associated with nurses who manage fewer patients per shift and have adequate monthly income.
UNASSIGNED: The prevalence of poor sleep quality among Emergency nurses during the COVID-19 pandemic is high. There is a pressing need for targeted interventions to enhance sleep quality among ED nurses. Improving sleep quality is not only essential for the wellbeing of these nurses but is also likely to contribute to better patient care.

Background and aim Poor sleep is known to be associated with functional gastrointestinal (GI) problems in the general population, but the exact mechanisms underlying the relationship remain unclear. Deeper insights into the exact mechanisms underlying the connection may benefit individuals suffering from these conditions without efficient treatments. Therefore, this study investigated the association between functional GI symptom levels and sleep-related characteristics in the general population of Japan. Methods In this cross-sectional questionnaire-based observational study, data including the self-reported level of poor sleep and functional GI symptoms in the last one month were collected from consecutive individuals who visited a hospital in Miyagi Prefecture, Japan, for regular medical checkups between April 2020 and March 2023. The levels of other physical and mental conditions, such as stress at home, fatigability, irritability, thermoregulatory problems, and edema in the limbs, were measured with an 11-point Numerical Rating Scale (NRS) between 0 and 10. Additional sleep-related specific information, such as sleep length, wake-up time, bedtime, trouble falling asleep, and nocturnal awakening, were further collected. Correlations with functional GI symptoms in these characteristics were evaluated by bivariate correlation analyses and generalized regression analyses. Results A total of 151 consecutive adults aged ≥18 years (77 males and 74 females) participated in this study. In bivariate correlation analyses, chronic GI symptom levels were significantly correlated with stress at home (p=0.0005), fatigability (p=0.0008), irritability (p=0.0022), edema in the limbs (p<0.0001), and sleep problem (p<0.0001). In the following generalized regression analysis, significant correlations with GI symptom levels were observed in sleep problems (p=0.0042) and edema in the limbs (p=0.0256). Further bivariate correlation analyses using sleep-related subscales revealed that trouble falling asleep in bed (p=0.0001), midnight awakening (p=0.0143), and wakeup time (p=0.0465) were correlated with GI symptom levels. In the following generalized regression analysis, a significant correlation with GI symptom levels was observed in trouble falling asleep (p=0.0239). Conclusion Functional GI symptoms in the general population of Japan were associated with poor sleep, even after adjusting for daily stress and irritability levels. Among the sleep-related characteristics, trouble falling asleep was associated with GI dysfunctions. Assessing sleep-related information and achieving good sleep quality with smooth sleep induction may be a clue to relieving GI dysfunctions with uncertain causes.

This research on sleep disturbances emerged during the COVID-19 pandemic. Our study investigated the association between self-reported sleep disturbances among teleworkers and the preventive measures employers took to improve their working environment. Answers obtained via a web survey gathered from 1086 teleworkers (517 in the spring of 2021 and 569 in the spring of 2022) were analysed. The odds of self-reported sleep disturbances were significantly higher for all preventive measures in the group of respondents reporting a lack of a particular measure. The highest odds ratios were observed for the statement \"My employer identified conditions where I am teleworking\" (adjusted OR = 2.98, 95% CI 2.10-4.23) and \"Online team-building events were organised\" (adjusted OR = 2.85, 95% CI 1.88-4.35). The results of our study have revealed that workplace interventions that serve as a mediator for sleep disorders, even if they are not directly targeted at managing sleep disturbances or stress, can reduce the number of teleworkers reporting sleep disturbances. According to our knowledge, this is the first study reporting the effectiveness of employer interventions that help teleworkers manage their sleep disturbances.

BACKGROUND: Suicidality is a complex clinical phenomenon reflecting vulnerability to suicidal behavior which can be explained via the biopsychosocial paradigm and in relationship with a variety of country-specific factors. Data on suicides within the Russian population are inconsistent (from 11.7 up to 25.1 per 100.000), whereas the population\'s suicidality risks have not been investigated in detail. Suicidality estimates during the multifactorial influence of the COVID-19 pandemic could serve as a basis to learn more about this mental health indicator.
METHODS: The current study is a part of the COMET-G international project (40 countries, n=55.589), which represents an analysis of data collected from Russia\'s general population (n=7714, 33±12 y.o., 61% female) to estimate suicidality using the Risk Assessment Suicidality Scale (RASS) and its relationships with socio-demographic, clinical, and life-habit characteristics during the COVID-19 pandemic. The evaluation of the statistical data (descriptive statistics, ANOVA, LASSO linear regression, significant at α=0.05) was undertaken using TIBCO Statistica.
RESULTS: According to the RASS, at least 20.68%, and up to 29.15%, of the general population in Russia demonstrated increased risk of suicidality during the pandemic. Modelling these risks pointed to the key vulnerabilities related to mental and behavioral disorders, such as (i) current severe depression and a history of mental disorders, (ii) bipolar disorder, (iii) use of illicit drugs surprisingly outranking the alcohol misuse, and psychiatric compounds (hypnotics), highlighting sleep quality deterioration, (iv) a history of suicide attempts and self-harm - though not self-reported changes in depression - in response were predictors of the risk of suicidality, which can be explained by the phenomenon of \"learned suicidality\", a habitual behavioral suicidality pattern completion accumulated over the background. Such (v) socio-demographic indicators as younger age (disregarding the gender factor), a marital status of single, having no children, living with fewer people in the household, a recent increase in family conflicts, increased need for emotional support, decreased need for communication, and not believing in precautionary measures against COVID-19, contributed to the increase of suicidality risk in the context of the pandemic.
CONCLUSIONS: The findings of this study revealed new suicide risk factors that should be taken into account in suicidality risk assessments for the Russian population and in the implementation of suicide prevention programs in the region.
UNASSIGNED: Суицидальность — сложный клинический феномен, отражающий уязвимость к суицидальному поведению, который следует объяснять с позиций биопсихосоциальной парадигмы и во взаимосвязи с целым рядом специфических для каждой конкретной страны факторов. Данные о суицидах в российской популяции противоречивы (от 11,7 до 25,1 на 100 000), а популяционные риски суицидальности детально не изучались. Изменения суицидальности в ответ на многофакторное влияние пандемии COVID-19 дают основание для более глубокого изучения этого показателя психического здоровья на национальном уровне.
UNASSIGNED: Настоящее исследование является частью международного проекта COMET-G (40 стран, n=55 589). В нем изучались собранные в общей российской популяции (n=7714, 33±12 лет, 61% женщин) данные оценки суицидальных тенденций с помощью шкалы оценки риска суицидальности (RASS) и анализировались взаимосвязи данного показателя с социально-демографическими, клиническими, жизненными характеристиками в период пандемии COVID-19. Статистическая обработка данных (описательная статистика, ANOVA, регрессия LASSO, линейная регрессия, значимость при α=0,05) проводилась с помощью программы TIBCO Statistica.
UNASSIGNED: В период пандемии повышенный суицидальный риск, оцененный по шкале RASS выявлен у от 20,68% до 29,15% населения России. По результатам линейной регрессии суицидального риска со стороны психических и поведенческих расстройств выявлены ключевые факторы, ассоциированные с высоким риском: (i) текущая тяжелая депрессия и психические расстройства в анамнезе, (ii) биполярное расстройство, (iii) употребление наркотиков, значимость которых превышала таковую для фактора употребления алкоголя, и прием гипнотиков, сопряженный с ухудшением качества сна. (iv) Суицидальные попытки и эпизоды самоповреждающего поведения, но не усиление депрессии, предсказывали связанное с пандемией увеличение суицидальных мыслей и высокий риск суицидальности, что можно объяснить феноменом “выученной суицидальности” — паттерном привычной реализации суицидального поведения, , выработанным в течение прошлого опыта. (v) Такие социально-демографические показатели, как более молодой возраст (вне зависимости от гендерного фактора), одинокое проживание вне семьи, отсутствие детей, общее небольшое число членов семьи, недавнее увеличение семейных конфликтов, повышенная потребность в эмоциональной поддержке, сниженная потребность в общении, неверие в меры предосторожности против COVID-19, также ассоциировались с увеличением суицидального риска в условиях пандемии.
UNASSIGNED: Результаты данного исследования выявили новые факторы суицидального риска, которые следует учитывать при оценке риска суицидальности для российского населения и при реализации национальных программ предотвращения суицидов.

OBJECTIVE: Sleep disturbances are amongst most frequent non-motor symptoms of Parkinson\'s Disease (PD), and they are similarly frequently reported in other alpha-syncleinopathies, such as Dementia with Lewy Bodies (DLB) and Multiple System Atrophy (MSA). More recently, the orexin system has been implicated in control of arousal based on salient environmental set points, and its dysregulation in sleep issues in alpha-synucleinopathies suggested by the findings from the translational animal models. However, its role in the patients with alpha-synucleinopathies remains unclear. We thus set to systematically review, and to critically assess, contemporary evidence on the association of the orexinergic system and sleep disturbances in alpha-synucleinopathies. In this systematic review, studies investigating orexin and sleep in alpha-synucleinopathies (Rapid Eye Movement (REM) Behaviour Disorder (RBD), Parkinson\'s Disease (PD), Dementia with Lewy Bodies (DLB), Multiple System Atrophy (MSA)) were identified using electronic database searches of PubMed, Web of Science and PsychINFO using MeSH terms, keywords, and title words such as \"Alpha-synucleinopathies\" AND \"Orexin\" AND \"Sleep Disturbances\".
RESULTS: 17 studies were included in this systemic review, of which 2 studies on RBD, 10 on PD, 4 on DLB, and 1 on MSA patients. Taken together, RBD and PD studies suggest a potential adaptive increase in orexin levels in early stages of the neurodegenerative process, with reduced levels more often reported for later, more advanced stages of illness. To date, no differences in orexin levels were demonstrated between MSA patients and healthy controls. There is a dearth of studies on the role of orexin levels in alpha-synucleinopathies. Moreover, significant methodologic limitations in the current body of work, including use of non-standardised research protocols and lack of prospective, multi-centre studies, disallow for any finite conclusion in regards to underlying pathomechanisms. Nonetheless, a picture of a complex, multifaceted relationship between the dysregulation of the orexinergic pathway and sleep disturbances in alpha-synucleinopathies is emerging. Hence, future studies disentangling orexinergic pathomechanisms of alpha-syncleinopathies are urgently needed to obtain a more comprehensive account of the role of orexinergic pathway in alpha-synucleinopathies. Pharmacological manipulations of orexins may have multiple therapeutic applications in treatment strategies, disease diagnosis, and might be effective for treating both motor and non-motor symptoms.