Association Among Melatonin Dysregulation, Sleep Disorders, and Sepsis-Associated Delirium: A Prospective Cohort Study with Mediation Analysis
Zhao L, Cui Q, Dong S, Yan Q, Yang F, Shi H, Wang Y, Liu J and Li Y
Association Among Melatonin Dysregulation, Sleep Disorders, and Sepsis-Associated Delirium: A Prospective Cohort Study with Mediation Analysis
Zhao L, Cui Q, Dong S, Yan Q, Yang F, Shi H, Wang Y, Liu J and Li Y
Sepsis-associated delirium (SAD) is a life-threatening complication in the intensive care unit (ICU). Although sleep disturbances are common in sepsis, their relationship with SAD remains poorly understood. We investigated the link between sleep disturbances, melatonin dysregulation, and SAD.
Factors associated with fatigue in children with enthesitis/spondylitis-related juvenile idiopathic arthritis: an exploratory cross-sectional study
Zhang M, Xing Y, He X, Guo G and Chen N
Factors associated with fatigue in children with enthesitis/spondylitis-related juvenile idiopathic arthritis: an exploratory cross-sectional study
Zhang M, Xing Y, He X, Guo G and Chen N
Enthesitis/spondylitis-related juvenile idiopathic arthritis (ESR-JIA) is a subtype of JIA characterized by peripheral arthritis and enthesitis, with possible axial skeleton involvement. Fatigue is a common and challenging symptom in JIA, often persisting despite pharmacological treatment, and may be particularly pronounced in ESR-JIA. It can impair physical and psychological well-being, daily activities, and academic performance. However, factors associated with fatigue in children with ESR-JIA remain poorly understood.
Use of the PROMIS and Neuro-QoL to Evaluate Health-Related Quality of Life following Unilateral Subthalamic Deep Brain Stimulation for Parkinson's Disease
Brinkerhoff SA, Robinson F, Martin RC, Morales S, Gonzalez CL, Hurt CP, Wade M, Cutter G, Uswatte G, Walker HC and Del Bene VA
Use of the PROMIS and Neuro-QoL to Evaluate Health-Related Quality of Life following Unilateral Subthalamic Deep Brain Stimulation for Parkinson's Disease
Brinkerhoff SA, Robinson F, Martin RC, Morales S, Gonzalez CL, Hurt CP, Wade M, Cutter G, Uswatte G, Walker HC and Del Bene VA
Subthalamic nucleus deep brain stimulation (STN DBS) improves Parkinson's disease (PD)-related motor symptoms, but how STN DBS impacts various aspects of patient-perceived health-related quality of life (HRQoL) is less clear. The Patient-Reported Outcome Measurement Instrument (PROMIS) and Quality of Life in Neurological Disorders (Neuro-QoL), National Institutes of Health computer adaptive inventories, are T-scored to a normative reference sample, and assesses 16 domains of a patient's HRQoL.
Dose-response associations between physical fitness components and anxiety in Chinese university students: A focus on cardiorespiratory fitness and vital capacity
Gao M, Yin H, Gao C and Wang H
Dose-response associations between physical fitness components and anxiety in Chinese university students: A focus on cardiorespiratory fitness and vital capacity
Gao M, Yin H, Gao C and Wang H
Despite the mental health benefits of physical activity, the specific dose-response relationship between objectively measured physical fitness (especially cardiorespiratory fitness and lung capacity) and anxiety in youth is unclear. The purpose of this study is to explore the association between these indicators in Chinese college students. A cross-sectional analysis of 3878 undergraduate students was conducted. Anxiety was assessed using the generalized anxiety disorder 7-item scale (a score of ≥10 was positive). Objective measurement of cardiopulmonary function, muscle strength, flexibility and vital capacity, and according to national standards, excellent, good, pass, fail 4 grades. After controlling for demographics and health behaviors, adjusted odds ratios (aOR) and 95% confidence intervals (CIs) for anxiety were calculated by multivariate logistic regression and analyzed graphically. The prevalence of anxiety was 24.9%. Cardiopulmonary function and muscle strength showed a clear negative dose-response relationship: compared with the excellent grade, the failing grade had the highest cardiopulmonary function related anxiety ratio (aOR = 2.15, 95% CI: 1.50-3.08), followed by muscle strength (aOR = 1.75, 95% CI: 1.18-2.60). There was a significant nonlinear association between spirometry and anxiety, with only a significantly higher risk of passing grade (aOR = 1.85, 95% CI: 1.35-2.53). Comprehensive effect analysis showed that students who failed both heart, lung and muscle had the highest risk. Among the behavioral factors, poor sleep quality (aOR = 2.85) and frequent staying up late (aOR = 1.65) were most strongly associated with anxiety. This study demonstrates a significant negative dose-response association between higher levels of cardiorespiratory fitness and muscle strength and lower odds of anxiety in college students, while vital capacity shows a complex nonlinear relationship. Improving these physical fitness components may be a feasible strategy associated with lower anxiety risk, although causality cannot be inferred from the cross-sectional design.
Interparental conflict and children's sleep quality in the chinese family context: the serial mediating roles of emotional insecurity and subjective well-being
Hou H, Guan Y and Luo T
Interparental conflict and children's sleep quality in the chinese family context: the serial mediating roles of emotional insecurity and subjective well-being
Hou H, Guan Y and Luo T
Sleep problems in children are an important risk factor for cognitive, emotional, and behavioral development. Previous studies have shown that interparental conflict is closely associated with poorer sleep quality in children. However, the internal psychological variables involved in this association, particularly how they may be understood within the Chinese family context, remain insufficiently examined. Based on a sample of Chinese children, this study examined the association between interparental conflict and poorer sleep quality in children, and it tested the mediating pathways of emotional insecurity and subjective well-being(SWB).
The prevalence of obstructive sleep apnea-hypopnea syndrome in patients with cystic fibrosis: An updated systematic review and meta-analysismeta-analysis
Zeng J, Yu H, Liu J, Jiang J, Li J and He J
The prevalence of obstructive sleep apnea-hypopnea syndrome in patients with cystic fibrosis: An updated systematic review and meta-analysismeta-analysis
Zeng J, Yu H, Liu J, Jiang J, Li J and He J
This research aimed to evaluate the prevalence of obstructive sleep apnea-hypopnea syndrome (OSAHS) in individuals with cystic fibrosis (CF) and to examine its relationship with sleep monitoring parameters and pulmonary function.
Combined percutaneous auricular vagus nerve stimulation and ultrasound-guided phrenic nerve block for persistent hiccups: A case report
Luo Q, Wu G, Shi C, Guo Z, Wang J, Wang R and Xu X
Combined percutaneous auricular vagus nerve stimulation and ultrasound-guided phrenic nerve block for persistent hiccups: A case report
Luo Q, Wu G, Shi C, Guo Z, Wang J, Wang R and Xu X
Persistent hiccups lasting more than 48 hours are rare but can markedly impair quality of life. Conventional therapies are often limited by transient efficacy, side effects, invasiveness, highlighting the need for safer and more effective options.
Clinical characteristics of patients with Alzheimer's disease and caregiver burden, mental health, and sleep quality: A cross-sectional comparative study in psychiatric hospitals and nursing homes
Chen K, Deng Y, Yan D, Wang J and Ding Y
Clinical characteristics of patients with Alzheimer's disease and caregiver burden, mental health, and sleep quality: A cross-sectional comparative study in psychiatric hospitals and nursing homes
Chen K, Deng Y, Yan D, Wang J and Ding Y
As Alzheimer's disease (AD) care shifts to institutions, differences between psychiatric hospitals and nursing homes remain unclear. We compared AD patients and professional caregivers across these settings and explored institution-specific links between caregiver burden, mental health, and sleep quality. A cross-sectional study (January to November 2024) enrolled 121 AD patients and 123 caregivers from 2 psychiatric hospitals and 2 nursing homes in Shanghai. Assessments used standardized scales. Analyses included nonparametric tests, χ2 tests, Spearman correlations, and stepwise regression. Post hoc power was adequate for moderate-to-large effects. AD patients in psychiatric hospitals are more severe, and caregivers face greater burden and psychological risk. Tailored, institution-specific mental health interventions are needed. Psychiatric hospital patients had poorer cognition and greater functional dependence (P < .001). Hospital caregivers reported higher burden, depression, anxiety, and worse sleep in specific domains (P < .05; effect sizes r = 0.18-0.47). Burden correlated positively with depression, anxiety, and poor sleep (r = 0.397-0.458). In the total sample, anxiety and poor sleep predicted burden (adjusted R2 = 0.285). In psychiatric hospitals, sleep quality was the dominant predictor (β = 0.483). In nursing homes, anxiety and workload predicted burden (adjusted R2 = 0.418); sleep quality was a negative predictor (β = -0.222), likely from floor effects and adaptive coping.
Postoperative symptom cluster classification and its association with health-related quality of life in knee osteoarthritis patients after total knee arthroplasty: An observational study
Zhou L, Chen X, Zhang Q and Chen T
Postoperative symptom cluster classification and its association with health-related quality of life in knee osteoarthritis patients after total knee arthroplasty: An observational study
Zhou L, Chen X, Zhang Q and Chen T
Total knee arthroplasty (TKA) is an effective surgical treatment for advanced knee osteoarthritis (KOA). However, the classification of postoperative symptom clusters and their impact on quality of life (QoL) remain underexplored. This study aims to categorize symptom clusters in KOA patients after TKA using latent class analysis (LCA) and to analyze the relationship between symptom clusters and QoL. Standardized questionnaires were used to assess postoperative symptoms, including pain, swelling, anxiety, depression, and sleep disorders. LCA was employed to classify patients into high-symptom (C1), low-symptom (C2), and high-swelling (C3) groups. Multivariate unordered multinomial logistic regression was applied to analyze the association between symptom clusters and clinical variables. Differences in SF-12 health survey total scores and dimensional scores among symptom clusters were also compared. A total of 365 KOA patients who underwent TKA were analyzed (from 389 valid respondents; valid response rate 93.8%). LCA identified 3 distinct symptom clusters: C1 (high-symptom group, n = 59; 16.2%), C2 (low-symptom group, n = 186; 51.0%), and C3 (high-swelling group, n = 120; 32.9%). Key factors differentiating the high-symptom group from the low-symptom group included BMI, first joint surgery, and swelling severity (P < .05). On the SF-12, the total score of C1 (50.38 ± 12.96) was significantly lower than that of C2 (56.63 ± 9.56, P = .003) and C3 (57.42 ± 10.85, P = .004). The mental dimension score was significantly lower in C1 (55.22 ± 13.72) than in C2 (63.17 ± 11.33, P < .001) and C3 (63.61 ± 12.23, P < .001). Postoperative symptom cluster classification is an effective tool for assessing the symptom profile of KOA patients after TKA. Significant differences in QoL were found across symptom clusters, with the high-symptom and high-swelling groups showing lower quality of life, particularly in mental health. This study provides data support for individualized management of postoperative symptoms in KOA patients, highlighting the importance of comprehensive symptom assessment in postoperative care.
Sleep in Trans and Non-Binary Individuals: A Question of Gender?
van Egmond LT, Wilhelm A, Majani NN and Derntl B
Sleep in Trans and Non-Binary Individuals: A Question of Gender?
van Egmond LT, Wilhelm A, Majani NN and Derntl B
Sleep problems are increasingly prevalent in society. One group that is disproportionately affected includes transgender and non-binary individuals, whose sex assigned at birth does not match their identified gender. This mismatch can lead to gender minority stress and increases the risk of mental disorders. However, research on sleep in this population remains extremely limited, especially when considering potential effects of gender-affirming care, including gender-affirming hormone therapy. Therefore, we conducted an anonymous, Germany-wide online study with 469 trans and non-binary individuals to investigate sleep quality and insomnia severity using standardised questionnaires, accounting for structural and psychosocial factors. Poor sleep quality and subclinical insomnia were highly prevalent, at levels two to four times higher than published cisgender population benchmarks. Sleep quality and insomnia severity scores were worse in non-binary individuals than in trans women. Transition options did not significantly impact sleep quality and insomnia severity scores, whereas psychosocial factors explained substantially more variance than structural variables or gender identity alone. Additionally, people using feminising hormone treatment had lower insomnia severity scores than those not using hormone treatment. Trans women woke up significantly more often due to nocturia, whereas trans men and non-binary individuals had more sleep initiation problems. Non-binary individuals used sleep medication significantly more often than binary trans individuals. Over 30% of the participants experienced frequent sleep maintenance problems. This cross-sectional study found alarming rates of poor sleep and insomnia among trans and non-binary individuals. Future studies should further investigate and address potential moderating factors underlying poor sleep in this population.
