Differential diagnosis and prognosis of delayed neuropsychiatric sequelae after acute carbon monoxide poisoning in a patient with schizophrenia: A case report.

Background: Delayed neuropsychiatric sequelae (DNS) is a syndrome that appears days to weeks after acute carbon monoxide (CO) poisoning. DNS shows various neuropsychiatric symptoms, such as mental deterioration and parkinsonism. Case Presentation: Our case was a 37-year-old male with schizophrenia. He attempted suicide by CO poisoning and was brought to our emergency department (Day 0). He was ventilated with normobaric oxygen therapy for 3 days and moved to the psychiatric ward with clear consciousness. We restarted antipsychotics, and he gradually presented akinesia and rigidity. Additionally, around Day 32, he showed disorganized behaviors, mental deterioration, incontinence, and gait disturbance. Brain magnetic resonance imaging (MRI) showed slightly abnormal findings on Day 35. Although we suspected DNS on the clinical course and the MRI findings, catatonia and side-effects of antipsychotics were also considered. Finally, electroencephalography (EEG) on Day 38 with apparent abnormalities, including diffuse slow waves, resulted in our diagnosis of DNS, and he underwent hyperbaric oxygen therapy. His condition was dramatically improved, and his diffuse slow waves on EEG disappeared on Day 83. We also followed his clinical presentations and brain MRI until 33 months. Throughout the whole follow-up, his cognition, movement, and psychiatric symptoms remained stable. However, his brain MRI showed progressive atrophy in bilateral frontal lobes and increasing white matter lesions throughout the whole course. Conclusion: EEG, as well as brain MRI, may be crucial in the differential diagnosis of DNS in patients with complex conditions involving medications and severe mental illnesses.

Increased digital media use is associated with sleep problems among university students: A study during the COVID-19 pandemic in Japan.

This retrospective cohort study investigates the association between the incidence of sleep problems and changes in digital media use among university students during the COVID-19 pandemic. It used data from annual health check-ups performed at a Japanese university in 2019 and 2020. Students undergoing these check-ups were identified to respond to questions about sleep problems, digital media use, breakfast and exercise habits, and stress. In total, 3,869 students were included in the analysis. The association between the incidence of sleep problems in 2020 and the changes in digital media use between 2019 and 2020 was assessed using logistic regression models. The rate of long digital media use (≥ 2 hours) in 2019 was 42.6%, while in 2020 it was 53.6%. Incidence of sleep problems was observed in 244 students (6.3%) in 2020. There were 786 students (20.3%) who used digital media for ≤ 2 h in 2019 and ≥ 2 h in 2020. From the sample, 66 students (8.4%) reported incidence of sleep problems in 2020. Additionally, those respondents who specifically reported increased digital media use between 2019 and 2020 (increased use) where at greater risk (OR: 1.76; 95% CI: 1.21, 2.55) of reporting sleep problems in 2020, even after controlling for other study variables. Thus, this study provides evidence that the incidence of sleep problems has had a significant association with an increase in digital media use among university students throughout the COVID-19 pandemic. These findings highlight the importance of ensuring appropriate digital media use among students for improved quality of sleep.

Association of weekday-to-weekend sleep differences and stress response among a Japanese working population: a cross-sectional study.

OBJECTIVES: To investigate the relationship between differences in weekday-to-weekend sleep habits and stress responses in a working population. METHODS: This cross-sectional study used data from university workers on sleep habits, differences in sleep duration between weekdays and weekends, and each midpoint of the sleep phase on weekdays and weekends. Social jetlag was defined as the difference in the midpoint of the sleep phase between weekdays and weekends. In addition, the Brief Job Stress Questionnaire assessed stress responses and stress-related factors. To examine sleep-related factors affecting stress responses, regression analysis was performed with adjustments for age, sex, and stress-related factors. RESULTS: Analyzed were 2,739 participants. Sleep duration differences obtained by subtracting sleep duration on weekdays from that on weekends, social jetlag, and weekday sleep duration were significantly associated with an increased risk of stress responses in a univariate linear regression model. Adjusting for age, sex, job stressors, and stressor buffering factors did not change this trend. However, when additionally adjusting for all sleep parameters, only sleep duration differences and weekday sleep duration were significantly associated with stress responses (ß 0.67 [95% CI 0.24, 1.10], p = 0.002), (-0.66 [-1.20, -0.13], p = 0.015). CONCLUSIONS: This study provided further evidence that weekday sleep duration and weekday-to-weekend sleep duration differences were independently associated with stress responses even when considering stress-related factors. However, social jetlag was not clearly associated with stress responses. Our findings highlighted the necessity of securing sufficient sleep for stress management and mental health promotion in a working population.