Home-Based Behavioral Sleep Training for Shift Workers: A Pilot Study

SummaryThe full 2‐month lockdown to fight the coronavirus disease 2019 (COVID‐19) pandemic in 2020 led to substantial disruption of daily life and routines. The present study aimed to comprehensively identify the lockdown’s effects on sleep, daily rhythms and emotions of the French population. A survey was published online during the last week of the 2‐month full lockdown and 1,627 individuals completed the online survey. The survey was self‐administered and included standardised questionnaires. Sleep schedules were delayed during lockdown in more than half of the participants. New severe delayed sleep phase affected 10% of participants with sleep schedules delayed by ≥3 hr during the lockdown compared to before. A significant decrease in exposure to morning (p < 0.001) and evening natural light (p < 0.001), a significant increase in screen exposure time (with a significant screen exposure >3 hr during the evening for 45% of the participants during lockdown versus 18% before lockdown, p < 0.001), an increase in substance use for one‐quarter of participants, a poorer sleep quality in 56% of participants, and less regular sleep schedules in 48% of participants were observed. We also found a poorer sleep quality in women than men during lockdown (p = 0.004). The French full lockdown had a severe impact on sleep quality, sleep–wake rhythms, and sleep behaviours. The implementation of public health strategies for the prevention and care of sleep–wake cycles during lockdown are therefore essential.

Humans show near-24-h physiological and behavioral rhythms, which encompass the daily cycle of sleep and wakefulness. Exercise stimulates circadian rhythms, including those of cortisol, melatonin, and core body temperature, and affects sleep quality. We systematically reviewed studies that examined the effects of exercise intensity and timing on physiological circadian rhythms and sleep quality. In this systematic review, we used the online databases PubMed, Science Direct, Web of Science, and Embase. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two independent and experienced systematic reviewers performed the search and selected relevant studies. The participant, intervention, comparison, and outcome characteristics were: (1) adults; (2) exercise treatment; (3) no exercise treatment or different types of exercise (pre-exercise baseline); (4) cortisol, melatonin, or core body temperature measurement, and subjective or objective sleep quality assessments. We identified 9 relevant articles involving 201 participants (77.1% of whom were male). Our review revealed that short-term evening exercise delayed melatonin rhythm and increased nocturnal core body temperature; however, no negative effects on non-rapid eye movement sleep and sleep efficiency were observed. Moreover, no differences in sleep quality were observed between acute high-intensity and moderate-intensity exercises. With long exercise durations, the core body temperature tended to increase and return to baseline levels at 30-120 min. Our review showed that short-term evening exercise and high-intensity exercise did not have a significant negative effect on sleep quality but physiological circadian rhythm tended to alter. Longterm morning exercise tended to decrease cortisol concentrations after awakening and improve sleep quality. Future studies should examine the effects of long-term exercise timing and intensity on circadian rhythm and sleep.

24-h activity rhythm and sleep in depressed outpatients

Losing Sleep Over Cancer

BackgroundNearly 70% of individuals with multiple sclerosis (MS) experience sleep disturbances. Increasing physical activity in people with MS has been shown to produce a moderate improvement in sleep quality, and exercise has been shown to improve sleep quality in non-neurologically impaired adults.ObjectiveThe purpose of this pilot randomized controlled trial study was to examine the effect of two exercise interventions on sleep quality and daytime sleepiness in individuals with MS.MethodsTwenty-eight individuals with relapsing–remitting or secondary progressive MS were randomized into one of two 12-week exercise interventions: a supervised, moderate-intensity aerobic exercise (AE) program or an unsupervised, low-intensity walking and stretching (WS) program. Only individuals who were ≥ 70% compliant with the programs were included in analysis (n = 12 AE; n = 10 WS).ResultsBoth groups demonstrated a moderate improvement in sleep quality, although only the improvement by the WS group was statistically significant. Only the AE group demonstrated a significant improvement in daytime sleepiness. Change in sleep quality and daytime sleepiness was not correlated with disease severity or with change in cardiovascular fitness, depression, or fatigue.ConclusionThe mechanisms for improvement in sleep quality and daytime sleepiness need further investigation, but may be due to introduction of zeitgebers to improve circadian rhythm.

Identify the prevalence of circadian health disorders in ICU and hospitalized patients. Stablish the relationship of the circadian system with light, temperature, noise and nursing activities. Commonly, self-assessment through subjective questionnaires is used for research about sleep quality. However, more reliable and valid measures should be applied objectively to find out the real prevalence of the problem. There is a negative relationship between circadian rhythms and hospitalization. In this study, we will analyse sleep patterns and hospital environments to implement measures to improve the quality of care related to sleep. Descriptive observational study. It is estimated that 975 patients from 13 hospitals need to be recruited from ICU and hospitalization units. The sample should meet the following criteria: Patients over 18 admitted to ICU and medical units, length of stay between 96-148hr, with no visual, hearing or moderate-severe cognitive impairment.Variables: Sleep variables are collected with an electronic device (named Kronowise® and Kronobed®), circadian and infrared light exposure, environmental noise, temperature, unit structural characteristics, nursing care (from 0 to 6 a.m.) and, characteristics of hospitalization period. The study, registered on Clinical Trials, initiated in December 2019 and it will continue up to December 2022. Using objective and subjective measures of sleep and circadian rhythms, this study will shed light on the factors that negatively affect the hospitalized patients' sleep quality and circadian health. The ultimate goal is to design hospital guidelines to minimize the adverse effects on the dependent variables studied. Arguably, these guidelines will contribute to reducing the risk of these alterations and it will also serve to improve the nursing activities. We expect to obtain adequate results for the creation of a protocol to improve the circadian health, quality of care and health outcomes related to sleep in patients.

The use of mobile health applications (apps) is an effective strategy in supporting patients' self-management of heart failure (HF) in home settings, but it remains unclear whether they can be used to reduce sedentary behaviors and increase overall physical activity levels. The aims of this study were to determine the effect of an 8-week home-based mobile health app intervention on physical activity levels and to assess its effects on symptom burden and health-related quality of life. In this study, we collected repeated-measures data from 132 participants with HF (60.8 ± 10.47 years) randomized into a usual care group (n = 67) or an 8-week home-based mobile health app intervention group (n = 65). The intervention was tailored to decrease the time spent in sedentary behavior and to increase the time spent in physical activities performed at light or greater intensity levels. Physical activity levels were monitored for 2 weeks before the intervention and during the 8-week intervention using the Samsung mobile health app. Heart failure symptom burden and health-related quality of life were assessed at baseline, 2 weeks from baseline assessment, and immediately post intervention. At week 8, all participants in the intervention group demonstrated an increase in the average daily step counts above the preintervention counts (range of increase: 2351-7925 steps/d). Only 29 participants (45%) achieved an average daily step count of 10 000 or higher by week 6 and maintained their achievement to week 8 of the intervention. Repeated-measures analysis of variance showed a significant group-by-time interaction, indicating that the intervention group had a greater improvement in physical activity levels, symptom burden, and health-related quality of life than the usual care group. Home-based mobile health app-based interventions can increase physical activity levels and can play an important role in promoting better HF outcomes.

Bipolar disorder and delayed sleep-wake phase disorder: Findings on sustained attention, sleep, and circadian rhythm parameters

Exercise is a potential mechanism for mitigating some side effects caused by adrogen deprivation therapy (ADT) for metastatic castration-resistant prostate cancer (mCRPC) and home-based interventions may help eliminate barriers to physical activity. PURPOSE: To assess feasibility, adherence, and physiological changes following a home-based exercise intervention in men with mCRPC receiving ADT and androgen receptor targeting agents. METHODS: Men with mCRPC (age=71y ± 10, BMI=29.64 kg/m2 ± 3.4) completed body composition (DXA), muscular strength, physical function, and cardiopulmonary exercise testing (CPET) before and after a 12-week home-based exercise intervention (with weekly phone contact) using resistance band and wearable technology for tracking walking. Patient reported outcomes were used for the assessment of fatigue (FACIT-Fatigue), quality of life (FACT-P) and depression (Hospital Anxiety and Depression Scale). Feasibility (target: 67%) was determined as the % of patients who completed the intervention. Adherence (target: 75%) to the overall program and specific activities was determined as the number completed relative to prescribed. Physiological changes were assessed using paired samples t-tests and adherence rates with a single sample t-test. RESULTS: Fourteen men completed baseline testing and eight completed the intervention (57%), which was lower than the target value. Adherence was reached but did not statistically exceed the target value of 75% for overall (82.7% ± 9.5; p=0.076), walking (80.7% ± 14.2; p=0.326), or resistance training (85.3% ± 12.5; p=0.072). Core focused exercises had significantly lower adherence (58% ± 35.7; p<0.001). Training significantly increased leg press maximal strength (10.7% ± 6.7, p=0.023) and peak oxygen consumption (9.7% ± 22.4%, p=0.013). No significant difference occurred in any other variable tested. CONCLUSIONS: Feasibility estimates were lower than expected but the high adherence promoted improvements in strength and cardiorespiratory function during mCRPC treatment but did not translate into functional improvements. These preliminary findings suggest home-based interventions are promising, but limited supervision or advanced disease may limit completion of training protocol.

ObjectiveTo evaluate the therapeutic efficacy of Shexiang Baoxin Pill combined with exercise in heart failure patients with preserved ejection fraction (HFpEF).MethodsSixty patients with HFpEF were randomly divided into group A (n=20), receiving Shexiang Baoxin Pill combined with home-based exercise training based on conventional drugs for 12 weeks; group B (n=20), receiving conventional drugs combined with home-based exercise training for 12 weeks; and group C (n=20), receiving conventional drug treatment only. Peak oxygen uptake (peakVO2), anaerobic threshold (AT), 6-min walking test (6MWT), Pittsburgh Sleep Quality Index (PSQI), and SF-36 questionnaire (SF-36) results before and after treatment were compared among groups.ResultsAfter the 12-week intervention, patients in group C showed significant declines in peakVO2, AT, 6MWT, PSQI, and SF-36 compared with pre-treatment (P<0.01), while groups A and B both showed significant improvements in peakVO2, AT, 6MWT, PSQI, and SF-36 results compared with pre-treatment (P<0.01). Compared with group C, patients in groups A and B showed significant improvements in peakVO2, AT, 6MWT, PSQI, and SF-36 (P<0.01). In addition, patients in group A showed more significant improvements in physical function, role-physical, vitality, and mental health scores on the SF-36 questionnaire, and PSQI scores than those in group B (P<0.01).ConclusionsExercise training improved exercise tolerance, sleep quality and quality of life (QoL) in patients with HFpEF. Notably, Shexiang Baoxin Pill played an active role in sleep quality and QoL of patients with HFpEF. (The trial was registered in the Chinese Clinical Trial Registry (No. ChiCTR2100054322))

Background This study investigated the relationship between sleep quality and circadian rhythm chronotype with uncontrolled hypertension. Methods This cross-sectional study was conducted on 170 patients. Sleep quality is classified into two groups: good sleep quality and poor sleep quality. Circadian rhythm has three chronotypes: morning, intermediate, and evening. Results Of a total of 170 patients, 84 (49.4%) patients were male. The total mean age was 62.8 (±12). The Uncontrolled hypertension odds ratio in patients with poor sleep quality was 18.47 (CI= (5.1, 67); P-value = 0.001). Patients with intermediate rhythms were more likely to have uncontrolled hypertension (OR:4.18, CI= (1.7, 10.5); P-value = 0.002). In the multiple logistic regression model, male gender increased the odds of uncontrolled hypertension in patients with poor sleep quality or intermediate circadian rhythm (OR: 17, CI;(3.7, 78.9); OR:6.83, CI:(2.3, 20.3) respectively). Conclusion Poor sleep quality and intermedia circadian rhythm were related to uncontrolled hypertension..

Circadian and age-related modulation of thermoreception and temperature regulation: mechanisms and functional implications

Non-peptide oxytocin receptor ligands and hamster circadian wheel running rhythms

A Home-Based Exercise Program to Improve Function, Fatigue, and Sleep Quality in Patients With Stage IV Lung and Colorectal Cancer: A Randomized Controlled Trial

DOAJ is a unique and extensive index of diverse open access journals from around the world, driven by a growing community, committed to ensuring quality content is freely available online for everyone.