A Comprehensive Review of Auditory and Non-Auditory Effects of Noise on Human Health.

OBJECTIVE: Excessive noise is unpleasant and induces several physiological and psychological effects. Noise pollution is a potential threat to humans, particularly those continuously exposed for extended periods throughout the day over many years. This review aims to examine the various auditory and non-auditory outcomes associated with prolonged exposure to noise pollution. MATERIALS AND METHODS: The review utilized a combination of relevant keywords to search the electronic databases. After screening based on the applied selection criteria for title, abstract, and full text, 44 articles were finally selected for critical review. RESULTS: We identified and analyzed research findings related to noise-induced hearing loss, tinnitus, and sleep disturbances along with non-auditory issues such as annoyance, cognitive impairments, and mental stress associated with cardiovascular disorders. Furthermore, the existing studies were compared and collated to highlight the unique challenges and significance of noise pollution as a distinctive environmental concern and to explore the ongoing efforts in its research and prevention, including the early detection and potential reversal of noise-induced hearing loss. CONCLUSION: The fundamental health consequences of noise pollution underscore the need for extensive research encompassing emerging noise sources and technologies to establish a health management system tailored to address noise-related health concerns and reduce noise exposure risk among populations. Finally, further research is warranted to ensure improved measurement of noise exposure and related health outcomes, especially in the context of occupational noise.

Eating Disorders and Sleep Disturbance as Determinants of Metabolic Control in Adolescents with Type 1 Diabetes.

This cross-sectional study examined the effect of sleep disturbance and eating disorders on metabolic control in adolescents with Type 1 Diabetes. The study was conducted with adolescents with T1DM treated at a university hospital in Turkey between October 2023 and January 2024. The study sample consisted of 120 adolescents with T1DM between the ages of 10-18. Data were collected online using the Adolescent Information Form, Dutch Eating Behavior Questionnaire (DEBQ), and DSM-5 Sleep Disorder Scale (SDS). Mean, percentage, and regression analyses were used to analyze the data. Ethics committee, institutional permission and written permission from the adolescents with Type 1 Diabetes and their parents were obtained for the study. In the current study, sleep disturbance and eating disorders explained 38.5% and 40.2% of HbA1c, respectively, and were found to have a significant effect (respectively: F = 73.737, p ≤ .001; F = 19.353, p ≤ .001). This study provides evidence that eating disorders and sleep disturbance explain approximately half of HbA1c. The results of the study revealed that sleep disturbance and eating disorders were significant predictors of metabolic control in adolescents with type 1 diabetes.

Sleep Disturbance Caused by Step Changes in Railway Noise Exposure and Earthquakes.

Kyushu Shinkansen and conventional railway lines run parallel in the areas 5 km north of Kumamoto Station (northern area) and 12 km south of the station (southern area). Following the operation of the Kyushu Shinkansen Line in 2011, the adjacent conventional railway line in the north was elevated, a new station was operated in the south, and large earthquakes struck the Kumamoto area from March to April 2016. Sleep disturbances were compared before and after the interventions and earthquakes based on noise source (Shinkansen and conventional railways), area (northern and southern), and house type (detached and apartment) through socio-acoustic surveys from 2011 to 2017. The Shinkansen railway caused significantly less sleep disturbances in detached houses in the north after compared to before the earthquakes, presumably due to more frequent closures of bedroom windows in northern detached houses following the earthquakes. The Shinkansen railway caused significantly more sleep disturbances in apartments in the south after compared to before the earthquakes, presumably because the Shinkansen slowed down immediately after the earthquakes and returned to normal speed during the survey, suddenly increasing the noise exposure. There was no significant difference in the other six cases investigated. Overall, the interventions may not have caused significant differences in sleep disturbances. This article expands on the congress paper by Morihara et al. presented in the "Community Response to Noise" session at the 52nd International Congress and Exhibition on Noise Control Engineering in Makuhari, Japan, organized by the International Institute of Noise Control Engineering.

Novel electrical therapy to improve sleep disturbance in patients with autoimmune rheumatic diseases.

OBJECTIVES: Sleep disturbance is common in autoimmune rheumatism diseases (ARD) and it plays an important role in activating disease and affects the quality of life. This study aims to evaluate the efficacy and acceptability of the novel electrical therapy on sleep disturbance in ARD patients and its effect on immunologic factors. METHODS: A total of 51 ARD patients (26 treatment group and 25 control group) with sleep disturbance were enrolled in this study. Sleep parameters and immunological indicators (serum level of 12 cytokines and immune function) were collected. The novel electrical therapy was prescribed for 15-30 min 3-6 times a day. The Pittsburg Sleep Index (PSQI) was assessed before and after 3 months' treatment by Mi Energy equipment. Immune function and serum levels of cytokines of all participants at baseline and after treatment were tested with flow cytometry and flow immunofluorescence, respectively. Correlation analysis was used to analyze the relationship between sleep disturbance and immunologic factors. Multiple linear regression analysis was employed to investigate the risk of sleep disturbance in ARD. RESULTS: The global score of PSQI (Baseline: 12.81 ± 4.07, After novel electrical therapy: 4.88 ± 2.76) was effectively improved after 3 months of adjuvant therapy by electrical therapy. We also found that serum levels of IL-8 and IL-1ß statistically significantly decreased after novel electrical therapy. This adjuvant therapy can also significantly decrease the percentage of CD4 + CD8 + T cell, effector memory CD8 + T cell, Memory CD8 + T cell, Th17 cell, and plasma cell and significantly can increase the percentage of naïve CD8 + T cell, Th2 cell, and Tfh2 cell. Nevertheless, all serum level of 12 cytokines and the percentage of immune cells did not correlate with the PSQI global score except the Tc17 cell. Furthermore, age is an independent risk factor influencing PSQI scores (OR = 1.15, p < 0.05) in patients with autoimmune diseases through multiple linear regression analysis. CONCLUSIONS: Novel electrical therapy can effectively improve sleep disturbance in patients with ARD. It can also change the serum level of some cytokines (IL-8 and IL-1ß) and percentage of immune cells (CD4 + CD8 + T cell, effector memory CD8 + T cell, Memory CD8 + T cell, Th17 cell, naïve CD8 + T cell, Th2 cell, Tfh2 cell, and plasma cell).

Sleep disturbances are associated with greater healthcare utilization in children with autism spectrum disorder.

BACKGROUND: Sleep disturbances are frequently reported in children with autism spectrum disorder (ASD) and are associated with the severity of co-occurring symptoms. This study's aim was to examine the extent of healthcare utilization and clinical outcomes associated with sleep disturbances in children with ASD. STUDY DESIGN: A retrospective, cross-sectional study of 541 children with ASD from the Azrieli National Center for Autism and Neurodevelopment Research (ANCAN) whose parents completed the Children's Sleep Habits Questionnaire (CSHQ). Children with a total CSHQ score ≥ 48 were defined as having sleep disturbances. Sociodemographic characteristics, ASD diagnostic measures, chronic co-occurring conditions, medication usage, hospitalizations, visits to the emergency room (ER), and visits to specialists were compared in ASD children with and without sleep disturbances. Multivariate logistic regression models were then used to assess the independent association of sleep disturbances with clinical characteristics and healthcare utilization. RESULTS: Of the 541 children with ASD, 257 (47.5%) had sleep disturbances. Children with sleep disturbances exhibited higher rates of multiple (≥ 3) co-occurring conditions (19.1% vs. 12.7%; p = 0.0414) and prescribed medications (45.5% vs. 32.7%; p = 0.0031) than other children. Finally, ASD children with sleep disturbances were 1.72 and 2.71 times more likely to visit the ER and be hospitalized than their counterparts (aOR = 1.72; 99%CI = 1.01-2.95; and aOR = 2.71; 99%CI = 1.10-6.67, respectively). CONCLUSIONS: Our findings suggest that sleep disturbances are associated with greater healthcare utilization among children with ASD. Further studies could examine whether treating sleep disturbances in children with ASD yields additional clinical benefits beyond improvements in sleep.

Different Doses of Dexmedetomidine Reduce Postoperative Sleep Disturbance Incidence in Patients under General Anesthesia by Elevating Serum Neurotransmitter Levels.

Postoperative sleep disturbance is a common issue that affects recovery in patients undergoing general anesthesia. Dexmedetomidine (Dex) has a potential role in improving postoperative sleep quality. We evaluated the effects of different doses of Dex on postoperative sleep disturbance and serum neurotransmitters in patients undergoing radical gastrectomy under general anesthesia. Patients were assigned to the control, NS, and Dex (Dex-L/M/H) groups based on different treatment doses [0.2, 0.4, and 0.6 µg/(kg · h)]. The Athens Insomnia Scale (AIS) and ELISA kits were used to assess sleep disturbance and serum neurotransmitter (GABA, 5-HT, NE) levels before surgery and on postoperative days one, four, and seven. The effects of different doses on postoperative sleep disturbance incidence and serum neurotransmitter levels were analyzed by the Fisher exact test and one-way and repeated-measures ANOVA. Patients had no differences in gender, age, body mass index, operation time, and bleeding volume. Different Dex doses reduced the postoperative AIS score of patients under general anesthesia, improved their sleep, and increased serum levels of 5-HT, NE, and GABA. Furthermore, the effects were dose-dependent within the range of safe clinical use. Specifically, Dex at doses of 0.2, 0.4, and 0.6 µg/(kg · h) reduced postoperative AIS score, elevated serum neurotransmitter levels, and reduced postoperative sleep disturbance incidence. Collectively, Dex has a potential preventive effect on postoperative sleep disturbance in patients undergoing general anesthesia for radical gastrectomy. The optimal dose of Dex is between 0.2 and 0.6 µg/(kg · h), which significantly reduces the incidence of postoperative sleep disturbance and increases serum neurotransmitter levels.

Effects of Cognitive Behavioural Therapy on Mental Health and Sleep in Acute Kidney Injury Patients with Ureteral Calculi in the Emergency Department: A Retrospective Study.

BACKGROUND: Acute kidney injury (AKI) resulting from ureteral stones in the emergency department is typically accompanied with anxiety and sleep issues in patients, which can have adverse effects on their mental health and quality of life. Cognitive behavioural therapy (CBT) is helpful in improving mental health and sleep. This work aims to analyse the effects of CBT on mental health and sleep of AKI patients caused by ureteral calculi in the emergency department. METHODS: The clinical data of patients with AKI caused by ureteral calculi in the emergency department of our hospital from February 2021 to February 2023 were retrospectively analyzed. The patients were divided into the control group (routine nursing) and observation group (cognitive behavioural nursing) according to the different nursing methods of data recording. Propensity Score Matching (PSM) was used to balance the confounding factors of the two groups. After matching, the State Trait Anxiety Inventory (STAI), Insomnia Severity Index (ISI), Mishel Uncertainty in Illness Scale-Adult (MUIS) and 36-Item Short-Form Health Survey (SF-36) were compared between the two groups. RESULTS: After matching at a ratio of 1:1, 130 patients were included in the observation group and the control group, with 65 cases in each group. No significant difference was observed in STAI, ISI, MUIS and SF-36 scores between the two groups before nursing (p > 0.05). After nursing, the STAI, ISI and MUIS scores of the observation group were lower than those of the control group (p < 0.05). Furthermore, the SF-36 score of the observation group was higher than that of the control group (p < 0.05). CONCLUSIONS: Cognitive behavioural nursing for patients with AKI caused by ureteral calculi in the emergency department may help in retrieving patients' anxiety, reducing the severity of disease uncertainty and insomnia, improving the quality of life of patients and providing theoretical reference for clinical practice.

The Effect of Aromatherapy with Lavender Essential Oil on the Sleep and Fatigue Level of Patients with Multiple Sclerosis in Turkey: A Randomized Controlled Trial.

BACKGROUND: Fatigue is a common problem in patients with multiple sclerosis (MS) and is one of the most serious symptoms of the disease. Although many factors play a role in the etiology of fatigue in patients with MS, it has been reported that fatigue is caused by irregular or disrupted sleep patterns. AIM: The purpose of the study was to examine the effects of lavender oil aromatherapy on the sleep and fatigue of MS patients. METHODS: The study was designed as a randomized controlled trial and was conducted in Turkey. The data of the study were collected using the Patient Description Form, Fatigue Severity Scale, and Pittsburgh Sleep Quality Index. RESULTS: The mean FSS score in the experimental group was 6.86 ± 0.94 before the procedure and 3.42 ± 0.85 after the procedure, the mean PSQI score was 9.45 ± 1.23 before the procedure and 6.68 ± 2.87 after the procedure, and the difference in the mean scores between the two groups was found to be statistically significant (P < 0.001). CONCLUSION: The results showed that aromatherapy with lavender essential oil has significant impacts on fatigue and sleep in MS patients. Lavender essential oil aromatherapy can be used by nurses as an independent nursing practice. It is an inexpensive, noninvasive, and reliable technique to manage fatigue in individuals with MS.

The Frequency of Neuropsychiatric Sequelae After Traumatic Brain Injury in the Global South: A systematic review and meta-analysis.

This study aimed to assess the prevalence of neuropsychiatric sequelae following traumatic brain injury (TBI) among the Western Asian, South Asian and African regions of the global south. All studies on psychiatric disturbances or cognitive impairment following TBI conducted (until August 2021) in the 83 countries that constitute the aforementioned regions were reviewed; 6 databases were selected for the literature search. After evaluating the articles using the Joanna Briggs Institute guidelines, the random effects model was used to estimate the prevalence of depression, anxiety, post-traumatic stress disorder (PTSD), TBI-related sleep disturbance (TBI-SD), obsessive-compulsive disorder (OCD) and cognitive impairment. Of 56 non-duplicated studies identified in the initial search, 27 were eligible for systematic review and 23 for meta-analysis. The pooled prevalence of depression in 1,882 samples was 35.35%, that of anxiety in 1,211 samples was 28.64%, that of PTSD in 426 samples was 19.94%, that of OCD in 313 samples was 19.48%, that of TBI-SD in 562 samples was 26.67% and that of cognitive impairment in 941 samples was 49.10%. To date, this is the first critical review to examine the spectrum of post-TBI neuropsychiatric sequelae in the specified regions. Although existing studies lack homogeneous data due to variability in the diagnostic tools and outcome measures utilised, the reported prevalence rates are significant and comparable to statistics from the global north.

Effect of Music Therapy on the Psychological Well-Being of Maintenance Hemodialysis Patients: A Retrospective Study.

OBJECTIVE: This study aimed to evaluate the management effect of music therapy on the psychological health of patients undergoing maintenance hemodialysis (MHD), with focus on improving levels of depression, anxiety and stress. METHODS: A retrospective analysis of clinical data was conducted for 218 patients with sleep disorders accompanied by hemodialysis (HD) from January 2020 to December 2023. The subjects were categorized into a control group comprising 122 cases and an observational group comprising 96 cases. The observation group received music therapy in addition to routine management for 3 months. The psychological health status of patients was assessed using the Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), and Hemodialysis Stressor Scale (HSS), among other indicators. t Tests, χ2 test and Wilcoxon test were performed. RESULTS: After 3 months, the SDS and SAS scores of the observation group were significantly lower than those of the control group (P < 0.05). The scores for the "psychological stressors," "physiological stressors" and "social stressors" dimensions of HSS were also significantly lower in the observation group compared with those in the control group (P < 0.05). The overall satisfaction rate of the observation group was significantly higher than that of the control group (96.88% vs. 88.52%, P = 0.022). CONCLUSION: Music therapy exerted a positive effect on improving the psychological health of HD patients, particularly in reducing stress levels. This study provides clinical evidence for music therapy as a low-cost and effective adjunctive treatment.

Actigraph-based quantification of sleep in children with dystonia undergoing deep brain stimulation.

OBJECTIVE: Dystonia is among the most common pediatric movement disorders and can manifest with a range of debilitating symptoms, including sleep disruptions. The duration and quality of sleep are strongly associated with quality of life in these individuals and could serve as biomarkers of dystonia severity and the efficacy of interventions such as deep brain stimulation (DBS). Thus, this study investigated sleep duration and its relationship to disease severity and DBS response in pediatric dystonia. METHODS: Actigraphs (wearable three-axis accelerometers) were used to record multiday sleep data in 22 children with dystonia, including 6 patients before and after DBS implantation, and age- and sex- matched healthy controls. Data were preprocessed, and metrics of sleep duration and quality were extracted. Repeated-measures statistical analyses were used. RESULTS: Children with dystonia slept less than typically developing children (p = 0.009), and shorter sleep duration showed trending correlation with worse dystonia severity (r = -0.421, p = 0.073). Of 4 patients who underwent DBS and had good-quality data, 1 demonstrated significantly improved sleep (p < 0.001) postoperatively. Reduction in dystonia severity strongly correlated with increased sleep duration after DBS implantation (r = -0.965, p = 0.035). CONCLUSIONS: Sleep disturbances are an underrecognized marker of pediatric dystonia severity, as well as the effectiveness of interventions such as DBS. They can serve as objective biomarkers of disease burden and symptom progression after treatment.

Acupuncture and Sleep Quality Among Patients With Parkinson Disease: A Randomized Clinical Trial.

Importance: Poor sleep quality greatly impairs quality of life and accelerates deterioration in patients with Parkinson disease (PD), but current remedies remain limited. Acupuncture, used as an adjunctive therapy with anti-Parkinson medications, has shown positive effects in patients with PD. However, high-quality clinical evidence to support the effectiveness of acupuncture for patients with PD and poor sleep quality is lacking. Objective: To assess the safety and efficacy of real acupuncture (RA) vs sham acupuncture (SA) as an adjunctive therapy for patients with PD who have poor sleep quality. Design, Setting, and Participants: This single-center randomized clinical trial was performed at The First Affiliated Hospital of Guangzhou University of Chinese Medicine in China from February 18, 2022, to February 18, 2023. Patients with PD and sleep complaints were recruited and randomized (1:1) to receive RA or SA treatment for 4 weeks. Data analysis was performed from April 12 to August 17, 2023. Intervention: Treatment with RA or SA for 4 weeks. Main Outcomes and Measures: The main outcome was the change in Parkinson Disease Sleep Scale (PDSS) scores measured at baseline, after 4 weeks of treatment, and at 8 weeks of follow-up. Results: Of the 83 participants enrolled, 78 (94.0%) completed the intervention and were included in the analysis. Their mean (SD) age was 64.1 (7.9) years; 41 (52.6%) were men and 37 (47.4%) were women. A significant increase in PDSS scores from baseline was observed for both the RA group (29.65 [95% CI, 24.65-34.65]; P < .001) and the SA group (10.47 [95% CI, 5.35-15.60]; P < .001). Compared with the SA group, the RA group had a significant increase in PDSS scores after 4 weeks of treatment (19.75 [95% CI, 11.02-28.49]; P < .001) and at 8 weeks of follow-up (20.24 [95% CI, 11.51-28.98]; P < .001). Conclusions and Relevance: In this randomized clinical trial, acupuncture proved beneficial in improving sleep quality and quality of life among patients with PD. These findings suggest that the therapeutic effects of acupuncture could continue for up to 4 weeks. Trial Registration: Chinese Clinical Trial Registry Identifier: ChiCTR2200060655.

Health-related quality of life by veterans RAND 12 and healthcare resource utilization in cancer patients with sleep disorders: insights from the Medical Expenditure Panel Survey.

PURPOSE: This study aims to investigate the joint effects of cancer and sleep disorders on the health-related quality of life (HRQoL), healthcare resource utilization, and expenditures among US adults. METHODS: Utilizing the 2018-2019 Medical Expenditure Panel Survey (MEPS) database, a sample of 25,274 participants was categorized into four groups based on cancer and sleep disorder status. HRQoL was assessed using the VR-12 questionnaire. Generalized linear model (GLM) with a log-linear regression model combined gamma distribution was applied for the analysis of healthcare expenditure data. RESULTS: Individuals with both cancer and sleep disorders (C+/S+) exhibited notably lower physical health (PCS) and mental health (MCS) scores-1.45 and 1.87 points lower, respectively. They also showed significantly increased clinic visits (2.12 times), outpatient visits (3.59 times), emergency visits (1.69 times), and total medical expenditures (2.08 times) compared to those without cancer or sleep disorders (C-/S-). In contrast, individuals with sleep disorders alone (C-/S+) had the highest number of prescription drug usage (2.26 times) and home health care days (1.76 times) compared to the reference group (C-/S-). CONCLUSIONS: Regardless of cancer presence, individuals with sleep disorders consistently reported compromised HRQoL. Furthermore, those with cancer and sleep disorders experienced heightened healthcare resource utilization, underscoring the considerable impact of sleep disorders on overall quality of life. IMPLICATIONS FOR CANCER SURVIVORS: The findings of this study address the importance of sleep disorders among cancer patients and their potential implications for cancer care. Healthcare professionals should prioritize screening, education, and tailored interventions to support sleep health in this population.

Preoperative decreased physical activity is associated with greater postoperative pain: the mediating role of preoperative sleep disturbance.

PURPOSE: Engagement in physical activity (PA) is often associated with better sleep quality and less pain severity among patients diagnosed with breast cancer. However, less research has focused on whether patients' PA prior to breast surgery, including their perceived decrease in PA level, is associated with worse preoperative sleep quality, and subsequently, greater postoperative pain. This longitudinal study investigated whether patients' preoperative PA was associated with their postoperative pain. We also explored whether preoperative sleep disturbance partially mediated the relationship between preoperative PA and postoperative pain. METHODS: Prior to breast surgery, patients self-reported both their overall level of PA and whether they perceived a decrease in their PA since the diagnosis/onset of treatment for cancer. Patients also completed a measure of preoperative sleep disturbance. Two weeks after surgery, patients completed a measure of postoperative surgical-area pain severity. RESULTS: Our results showed that preoperatively perceiving a decrease in PA level was significantly associated with greater preoperative sleep disturbance and postoperative pain. A mediation analysis revealed that the association between preoperative decreased PA and postoperative pain was partially mediated by preoperative sleep disturbance. Notably, patients' overall preoperative level of PA was not related to preoperative sleep disturbance or postoperative pain. CONCLUSION: These findings suggest that maintaining, or even increasing, PA after diagnosis/treatment may be more important than the absolute amount of PA that women engage in during the preoperative period. Potentially, some patients with breast cancer may benefit from a preoperative intervention focused on both maintaining PA and bolstering sleep quality.

Health-Related Quality of Life in Danish Cancer Survivors Referred to a Late Effects Clinic: A Prospective Cohort Study.

PURPOSE: The Region of Southern Denmark has recently established four late effects clinics to help cancer survivors suffering from complex and severe late effects. This study aimed to capture and analyze the full range of physical, mental, and psychosocial issues using patient-reported outcomes. Moreover, we aimed to describe demographic data and the type and severity of the late effects. METHODS: A prospective cohort study was conducted among cancer survivors referred to a late effects clinic. Before their first appointment, patients completed the European Organization for Research and Treatment of Cancer Quality of Life cancer survivorship core questionnaire (EORTC QLQ-SURV100). We compared mean scores of the EORTC QLQ-SURV100 scales that were comparable to the scales/items from the EORTC QLQ-C30 questionnaire with norm data for the Danish population and EORTC reference values. RESULTS: All patients referred to the clinic within its first 2 years were included (n = 247). The mean age was 57 [23-85] years and 74% were females. The most common cancer diagnoses was breast cancer (39%). The five most commonly reported late effects were fatigue (66%), pain (51%), cognitive impairment (53%), sleep problems (42%), and neuropathy (40%). A total of 236 of the patients entering the clinic completed QLQ-SURV100. They reported significantly worse mean scores on all scales compared to the Danish norm population and EORTC reference values for pretreatment cancer patients, p < 0.001. Effect sizes were moderate or large for all scales. INTERPRETATION: In this study, we collected demographic data and described the late effects presented by the patents referred to the clinic. Moreover, we captured and analyzed the full range of physical, mental, and psychosocial issues using QLQ-SURV100. Patients referred to the Late Effects Clinic (LEC) had a number of late effects and reported a significantly lower health-related quality of life compared to the general Danish population and patients who have just been diagnosed with cancer, suggesting the aim of helping patients suffering from late effects gain a better quality of life is in dire need.

Relationship between pruritus and sleep in participants with primary biliary cholangitis in the Phase 2b GLIMMER trial.

BACKGROUND: Cholestatic pruritus and fatigue are debilitating conditions associated with primary biliary cholangitis (PBC) and can significantly impact patients' quality of life. Pruritus in PBC often worsens at night and patients frequently report sleep disturbance, which contributes to cognitive symptoms and fatigue. Linerixibat is an ileal bile acid transporter inhibitor in clinical development for the treatment of pruritus associated with PBC and was recently assessed versus placebo in the Phase 2b GLIMMER trial. This post-hoc analysis assesses the relationship between pruritus severity and sleep disturbance in participants of GLIMMER regardless of treatment group. METHODS: GLIMMER (NCT02966834), a multicenter, double-blind, randomized, placebo-controlled trial, recruited 147 patients with PBC and moderate-to-severe pruritus. Following 4 weeks single-blind placebo, patients (randomized 3:1) received linerixibat or placebo for 12 weeks (to Week 16). Participants graded their itch (twice daily) and its interference with sleep (once daily) in an electronic diary using a 0-10 numerical rating scale (NRS). Weekly and monthly itch scores were calculated as the mean of the worst daily itch score over the respective time period. At study visits, participants completed the 5-D itch scale and the PBC-40 quality of life questionnaire, both of which contain an item specific to itch-related sleep disturbance. The impact of pruritus on sleep was assessed post hoc through correlations between the changes in NRS, 5-D itch, and PBC-40. RESULTS: Strong correlations were found between change from baseline in weekly itch and sleep NRS scores (r = 0.88 [95% confidence interval (CI): 0.83; 0.91]) at the end of treatment (Week 16), as well as in monthly itch and sleep NRS scores (r = 0.84 [95% CI: 0.80; 0.87]). Patients with improved weekly pruritus score severity category demonstrated reduced perceived sleep interference on average. Itch responders (≥2-point improvement in weekly itch score from baseline) displayed larger improvements in weekly sleep NRS score, 5-D itch, and PBC-40 sleep items, than itch non-responders (<2-point improvement). CONCLUSIONS: A strong correlation exists between changes in pruritus severity and sleep interference in patients with PBC; pruritus reduction could generate concomitant improvement in sleep.

Effects of yoga interventions on the fatigue-pain-sleep disturbance symptom cluster in breast cancer patients: A systematic review.

OBJECTIVE: This systematic review aimed to evaluate the effectiveness of yoga intervention on the fatigue-pain-sleep disturbance symptom cluster in breast cancer patients. METHODS: Ten electronic databases (Medline, Embase, PubMed, Cochrane Central Register of Controlled Trials, CINAHL, Web of Science, Scopus, British Nursing Index, China National Knowledge Infrastructure, and Wan Fang database) were searched to identify randomized controlled trials from inception to October 2023. Two independent reviewers evaluated study eligibility, extracted data, and assessed the risk of bias using the Cochrane Risk of Bias tool. The findings were synthesized narratively. This systematic review has been registered (PROSPERO ID: CRD42023391269). RESULTS: A total of 1389 studies were identified, and 18 studies were included in this systematic review. Two studies reported significant alleviation of fatigue-pain-sleep disturbance symptoms, and two studies indicated a significant reduction in fatigue-sleep disturbance symptoms compared to the control group. Commonly employed yoga contents included breathing exercise and posture practice. The effective intervention components encompassed the combination of in-person sessions and home-based sessions delivery mode, with intervention sessions lasting 50-120 min each and dosages ranging from once per week to twice daily, spanning 6-16 weeks. CONCLUSIONS: Yoga intervention can be beneficial in alleviating the fatigue-pain-sleep disturbance symptom cluster in breast cancer patients. Future research should be tailored to design yoga interventions addressing different treatment stages and preferences of breast cancer patients.

Validity and reliability of the Swedish version of the Children's Sleep Habits Questionnaire (CSHQ-SWE).

BACKGROUND: To translate and culturally adapt the Children's Sleep Habits Questionnaire (CSHQ) to a Swedish version, CSHQ-SWE, and to assess its validity and reliability for use with children with attention deficit hyperactivity disorder (ADHD). METHODS: A total of 84 children with ADHD (51 boys and 33 girls; 6-12 years) and parents (7 men and 77 women; 28-51 years) were included in the study. CSHQ was translated and culturally adapted to Swedish, and assessed for concurrent validity with sleep actigraphy (analyzed by Kendall's Tau) and for reliability by internal consistency (analyzed by McDonald's Omega H). Face and content validity was evaluated by parents (n = 4) and healthcare professionals (n = 6) qualitatively (comprehensiveness, relevance, and comprehensibility assessed by interviews and analyzed by thematic analysis) and quantitatively (analyzed by content validity ratio and content validity index for 33 items and four non-scored inquiries). RESULTS: Parent-reported sleep problems (CSHQ-SWE total score) were moderately correlated with less "Sleep Efficiency" (Tau = -0.305; p < 0.001) measured by sleep actigraphy. Parent-reported problems with "Sleep Onset Delay" was moderately correlated with measured time for "Sleep Onset Latency" (Tau = 0.433; p < 0.001). Parent-reported problems with "Night Wakings" were weakly correlated with measured time for "Wake After Sleep Onset" (Tau = 0.282; p < 0.001). Parents estimation of "Total daily sleep duration" was moderately correlated with measured "Total Sleep Time" (Tau = 0.386; p < 0.001). Five of the seven subscales reached an acceptable level for internal consistency (McDonald's Omega H > 0.700). Comprehensiveness, relevance, and comprehensibility of CSHQ-SWE were satisfactory overall. Content validity ratio was 0.80 to 1.00 for six items, 0.00 to 0.60 for 22 items, and < 0.00 for nine items. Content validity index was 0.22. CONCLUSIONS: CSHQ-SWE demonstrated acceptable concurrent validity with objectively measured sleep and internal consistency, whereas the overall results of face and content validity assessment varied. The instrument needs to be further evaluated regarding construct validity, responsiveness, test-retest reliability, and its generalization to other populations.