How do sleepwear and bedding fibre types affect sleep quality: A systematic review.

Sleepwear and bedding materials can affect sleep quality by influencing the skin and body temperature and thermal comfort. This review systematically evaluates the impact of sleepwear or bedding of different fibre types on sleep quality. A systematic search was conducted in six data bases plus Google Scholar and manual searches. Original articles that compared human sleep quality between at least two fibre types of bedding or sleepwear were included, resulting in nine eligible articles included in the review. The fibre types included cotton, polyester, wool, and blended materials for sleepwear; cotton, duck down, goose down, polyester and wool for duvet; and linen and a combination of cotton and polyester for bedding. The interplay between fibre materials and sleep quality is complex. Blended sleepwear demonstrated potential benefits for specific populations. Wool sleepwear showed benefits for sleep onset in adults (cool conditions) and in older adults (warm conditions). Linen bedsheets improved sleep quality under warm conditions in young adults. Goose down-filled duvets increased slow-wave sleep under cool conditions in young adults. However, a systematic comparison of fibre types is challenging due to the diverse nature of the studies evaluating sleep quality. Further research employing standardised methodologies with standard fibre samples in different populations and in different temperature conditions is imperative to elucidate comprehensively the effects of fibre choices on sleep quality. Despite the limitations and heterogeneity of the included studies, this analysis offers valuable insights for individuals seeking to optimise their sleep experiences and for manufacturers developing sleep-related products.

A Qualitative Exploration Of Experiences And Perceptions In Recent Parents Screening Positive For Perinatal Depression In Karachi, Pakistan.

The narrative review was planned to qualitatively analyse the experiences, factors and context of parents screening positive for perinatal depression in Karachi. Semi structured in-depth interviews were conducted to explore the experiences and perceptions of participants during pregnancy, birth and 10-12 weeks after birth. Seven men and 20 women participated in the in-depth interviews. Factors in the perinatal period that affected new parents included sleep disturbances, emotional stressors linked to preference for a male child, a lack of social support, financial burdens of perinatal care, personal frustrations caused by an inability to comprehend the signs and symptoms of perinatal depression, denial to admit challenging issues concerning mental health and social disapproval with expressing mental health issues. There is an imminent need for appropriate initiatives to raise awareness about perinatal depression, and the provision of adequate perinatal mental health services for Pakistani women and men.

Mandibular Advancement Device Therapy in Japanese Rugby Athletes with Poor Sleep Quality and Obstructive Sleep Apnea.

Obstructive sleep apnea (OSA) may contribute to poor sleep quality. This study assessed subjective sleep quality, the Respiratory Event Index (REI), reaction times, and the therapeutic effects of a custom-made mandibular advancement device (MAD) in male Japanese elite rugby athletes. The Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and level III sleep test (REI and minimum oxygen saturation [SpO2 min]) were used to evaluate sleep quality. MAD therapy was used daily for 3 weeks. A telephone-based reaction time test of kinetic vision (the ability to identify moving objects) was recorded within 15 min of waking and over 5 days of pre- and post-MAD therapy. Differences in variables were evaluated using paired t-tests. Of the 42 players (mean age, 26.3 ± 3.7 years; mean body mass index, 28.7 ± 3.2 kg/m2) included in this study, 29 (69.0%) had poor sleep quality (PSQI > 5.5), and 27 were diagnosed with OSA (64.3%) (mild = 16/moderate = 9/severe = 2). Six were treated with MAD therapy, which significantly improved the REI (p < 0.01), SpO2 min (p < 0.001), ESS score (p < 0.001), reaction times (p < 0.01), and sleep quality. A significant reduction in reaction times suggests that OSA treatment can improve kinetic vision. Future studies should systematically evaluate the impact of sleep-disordered breathing on kinetic vision in athletes.

Risk factors of paternal postnatal depression in Pakistan: Findings from an urban sample.

Paternal postnatal depression is an emerging public health concern, with negative outcomes for men, their partners, and the newborn. There is a dearth of data on paternal postnatal depression in lower-middle-income countries like Pakistan. This study aimed to identify risk factors of postnatal depression in Pakistani men. Men who consented to this cross-sectional study completed a questionnaire that included sociodemographic information and Urdu translated versions of the Edinburgh Postnatal Depression Scale (EPDS) and the Pittsburgh Sleep Quality Index, 10-12 weeks postpartum. Descriptive analyses for the sociodemographic variables were calculated. Univariate analyses were conducted to calculate the relative risk and 95% confidence interval of the independent variables with an EPDS score of >10. Multivariate binary logistic regression models were performed for risk factors of paternal postnatal depression. Fifty-one questionnaires were analyzed and 23.5% of the participants scored more than 10 on the EPDS. Spouse's EPDS score > 12, and own sleep disturbance were risk factors of paternal postnatal depression in Pakistani men. There is an imminent need to incorporate fathers in the existing and future perinatal mental health programs in Pakistan.

Improving Nasal Airflow with a Novel Nasal Breathing Stent.

Nasal obstruction requires close attention, as it is a risk factor for obstructive sleep apnea (OSA). This study evaluated airflow rates of our newly designed nasal breathing stent (NBS) compared with those of existing nasal dilators in 10 adult men. We hypothesized that the NBS would expand the nasal passage more than the other nasal dilators by means of airflow measurements. We compared airflow measurements between the NBS and three existing appliances and no appliance. Velocity measurements were recorded by analyzing 499 videographic images when each appliance was placed next to a steam generator at 0, 5, and 10 mm from the outlet port for airflow visualization. The peak nasal inspiratory flow (PNIF) rate was measured using an inspiratory flow meter. The NBS resulted in significantly higher airflow velocity measurements at all distances from the outlet port and a higher PNIF rate than the other appliances. Thus, the NBS offers a significantly decreased resistance to air movement compared with other appliances. Future in-depth investigations are required to demonstrate the use of NBS as a nasal dilator in conjunction with continuous positive airway pressure/oral appliance treatments in patients with OSA.

Perinatal depression in Pakistan: A systematic review and meta-analysis.

OBJECTIVE: To estimate the prevalence and associated risk factors of perinatal depression in Pakistan. METHODS: We conducted a systematic search of Medline, PsycINFO, CINAHL, EMBASE, and Global health, up through May 31, 2019. Studies reporting on the prevalence of perinatal depression in Pakistan with or without associated risks factors were included. RESULTS: Forty-three studies reporting data from 17 544 women met the eligibility criteria and were included. Overall, the pooled prevalence of antenatal depression was 37% (95% CI: 30-44), while that of postnatal depression was 30% (95% CI: 25-36). The prevalence of perinatal depression in women residing in urban areas and those living in rural settings was not significantly different. The most frequently reported risk factors for antenatal depression were intimate partner violence and poor relationship with spouse, and that reported for postnatal depression was low-income level. An unintended pregnancy was significantly associated with perinatal depression in Pakistan. CONCLUSIONS: We identified variability in prevalence rate of perinatal depression in Pakistan. It is difficult to gauge the true magnitude of this problem potentially due to differing risk factors between the antenatal and postnatal periods and the lack of uniformity of data collection protocols and procedures. The high prevalence rates of 30%-37% compared to global estimates suggest policy makers and stakeholders should direct additional resources toward improving perinatal mental health in Pakistan.

Assessment of Screening for Nasal Obstruction among Sleep Dentistry Outpatients with Obstructive Sleep Apnea.

Oral appliances (OA), a common treatment modality for obstructive sleep apnea (OSA), are not suitable for patients with nasal obstruction. Rhinomanometry, the gold standard technique to assess nasal airway resistance, is not readily available in sleep dentistry clinics. We demonstrate the use of a portable lightweight peak nasal inspiratory flow (PNIF) rate meter to objectively assess nasal airflow and utilized the Nasal Obstruction Symptom Evaluation (NOSE) scale to subjectively assess nasal obstruction in 97 patients with OSA and 105 healthy controls. We examined the correlations between the following variables between the groups: demographics, body mass index, PNIF, NOSE scale scores, apnea-hypopnea index (AHI), minimum SpO2 (SpO2min), Mallampati classification, and Epworth Sleepiness Scale (ESS) scores. Patients with OSA had significantly lower PNIF values and higher NOSE scores than controls. In the patient group, PNIF was not significantly correlated with AHI, SpO2min, Mallampati classification, or NOSE or ESS scores. Lower PNIF values and higher NOSE scores suggested impaired nasal airflow in the OSA group. As daytime PNIF measurement bears no relationship to AHI, this cannot be used alone in predicting the suitability of treatment for OSA with OA but can be used as an adjunct for making clinical decisions.

Hyperventilation-Aided Recovery for Extra Repetitions on Bench Press and Leg Press.

Sakamoto, A, Naito, H, and Chow, CM. Hyperventilation-aided recovery for extra repetitions on bench press and leg press. J Strength Cond Res 34(5): 1274-1284, 2020-Hyperventilation (HV)-induced alkalosis, an ergogenic strategy, improved repeated pedaling sprint performance through enhanced H removal. However, it did not confer beneficial effects on other forms of exercises. This study investigated the benefits of HV-aided recovery on lifting repetitions and joint velocity during resistance training involving multiple joints and both concentric and eccentric contractions. Eleven power-trained men (mean ± SD age: 22.5 ± 4.3 years, training experience: 8.3 ± 3.6 years) performed 6 sets each of bench press and leg press at 80% 1 repetition maximum. Each set was continued until failure, with a 5-minute recovery between sets. In protocol A, HV was implemented for 30 seconds before the first, third, and fifth sets of each exercise (HV-aided recovery), whereas spontaneous breathing continued throughout the recovery before the second, fourth, and sixth sets (control recovery). In protocol B, the order of the HV and control recoveries was reversed. For both protocols, reductions in repetitions (range: -4.7% to -22.5%) and velocity (range: -23.1% to -37.7%) were consistently observed after control recovery (p < 0.05), whereas HV-aided recovery resulted in increased repetitions (range: +21.3% to +55.7%) and velocity (range: +6.3% to +15.3%) (p < 0.05) or no reductions in these measures from the previous set. The total repetitions performed across 6 sets (protocols A and B combined) were greater after the HV-aided than control recovery (p ≤ 0.001) in bench press (44 ± 10 vs. 36 ± 10 reps, increased by 27.1 ± 24.1%) and leg press (64 ± 9 vs. 50 ± 15 reps, increased by 35.2 ± 29.5%). Hyperventilation-aided recovery may boost the effectiveness of resistance training through increased training volume and lifting velocity.

Does the Proximity of Meals to Bedtime Influence the Sleep of Young Adults? A Cross-Sectional Survey of University Students.

Avoiding food before bedtime is a widely accepted sleep hygiene practice, yet few studies have assessed meal timing as a risk factor for disrupted sleep. This study examined the relationship between evening meal timing and sleep quality in young adults. A total of N = 793 participants (26% male) aged between 18 and 29 years responded to an online survey, which captured sociodemographic information, lifestyle variables, and sleep characteristics. Meal timing was defined as meals more than 3 h before or within 3 h of bedtime. The outcomes were as follows: one or more nocturnal awakenings, sleep onset latency of >30 min, and sleep duration of ≤6 h. Logistic regression analyses showed that eating within 3 h of bedtime was positively associated with nocturnal awakening (OR = 1.61, 95% CI = 1.15-2.27) but not long sleep onset latency (1.24; 0.89-1.73) or short sleep duration (0.79; 0.49-1.26). The relationship remained significant after adjusting for potential confounders of ethnicity and body mass index (OR = 1.43, 95% CI = 1.00-2.04). Meal timing appears to be a modifiable risk factor for nocturnal awakenings and disrupted sleep. However, this is a preliminary cross-sectional study and highlights the need for additional research on the influence of the timing of food intake on sleep.

Sleep and Wellbeing, Now and in the Future.

The processes of sleeping, eating and moving, in concert with cognition and learning, support health and life [...].

Cognitive effects of video games in older adults and their moderators: a systematic review with meta-analysis and meta-regression.

The growing interest in preserving cognition through video games in the ageing population is evidenced by its wealth of literature. However, there has been a lack of consensus on video games efficacy and even limited understanding on the factors moderating its effectiveness. The present review sought to evaluate video game effects, relative to no-game control condition, on cognitive functions in older adults. The functions included processing speed, attention, delayed memory, reasoning, and executive functions (inhibition, shifting and updating memory). Personal and methodological moderators were explored to explain the variability in cognitive effects using meta-regression. Through a systematic literature search of online databases, 27 intervention studies were eligible, with a total of 1126 participants, for analysis. Using random-effect models, small but significant training effects were found on updating memory but none were detected in other cognitive functions. The heterogeneity across studies was in general high for all cognitive functions and was partially accounted for, in all cognitive functions except for inhibition and updating, by different moderators such as the proportion of females, outcome measure parameters, training intensity, and game type. The findings highlight limited effects of video games on cognitive functions that were largely influenced by factors related to study design.

The impact of sleepwear fiber type on sleep quality under warm ambient conditions.

BACKGROUND: Sleep disturbance in adults with no health concerns is often linked to the thermal environment. This study assesses the impact on sleep quality of sleepwear made from fibers with different thermal insulation and hygral properties. This randomized cross-over study investigated the effects on sleep quality of sleepwear made from cotton, polyester and Merino wool in adults aged 50-70 years, at an ambient temperature of 30 °C and a relative humidity of 50%. METHODS: Thirty-six healthy participants completed four nights of sleep study with polysomnography. Participants were categorized by body mass index as <25 kg·m-2 or ≥25 kg·m-2, age as <65 years or ≥65 years, and by Pittsburgh Sleep Quality Index (PSQI) as poor sleepers (PSQI≥5) or good sleepers (PSQI<5). RESULTS: Small, but statistically significant sleep benefits were observed for wool over cotton and polyester sleepwear for multiple sleep parameters, while neither cotton nor polyester was responsible for any statistically significant sleep benefit over the 11 sleep parameters examined. The key findings were: 1) A significant sleepwear effect was observed for sleep onset latency (SOL), p=0.04. 2) For older participants, sleeping in wool significantly reduced SOL (12.4 mins) compared with cotton (26.7 mins, p=0.001) or polyester (21.6 mins, p=0.001). 3) A statistically significant effect was found for sleep fragmentation index (p=0.01) in which wool sleepwear (12.1 no·h- 1) was lower than polyester (13.7 no·h- 1) (p=0.005), but not different to cotton (13.3 no·h- 1). 4) Poor sleepers had less wakefulness when sleeping in wool compared to cotton (p=0.047). 5) And Poor sleepers had higher rapid eye movement sleep latency in polyester than in cotton (p=0.037) or in wool (p=0.036). CONCLUSION: Statistically significant benefits for wool sleepwear were observed on average for all participants and, in particular, for the older and poorer sleepers. There were no significant differences in any sleep variables between sleepwear types for the BMI sub-group.

Obstructive sleep apnea treatment with a twopiece mandibular advancement device with an elastic retention band in combination with orofacial myofunctional therapy: a case report.

Two-piece mandibular advancement devices (MAD) are considered more comfortable than monoblock devices, and they are commonly used for the treatment of obstructive sleep apnea (OSA). However, they are not without limitations, especially in patients with nasal obstruction/malocclusion. Here, we discuss the case of a 37-year-old woman with mandibular regression and severe OSA, for whom a standard twopiece MAD was not adequetely effective. However, her sleep apnea improved with concurrent treatment with lip-muscle training (orofacial myofunctional therapy, OMFT) and a two-piece oral appliance (OA) supplemented with an elastic retention band (ERB). The OMFT improved lip muscle strength. In particular, the ERB restricted mouth opening. The application of OMFT together with an OA and ERB was a good option for this patient. Future clinical trials should include a three-arm study involving the OMFT (with measurement of lip-closure force, reflecting the degree of mouth opening), the two-piece OA with an ERB, and combined treatment.

Dynamic changes in electroencephalogram spectral power with varying apnea duration in older adults.

Sleep apnea elicits brain and physiological changes and its duration varies across the night. This study investigates the changes in the relative powers in electroencephalogram (EEG) frequency bands before and at apnea termination and as a function of apnea duration. The analysis was performed on 30 sleep records (375 apnea events) of older adults diagnosed with sleep apnea. Power spectral analysis centered on two 10-s EEG epochs, before apnea termination (BAT) and after apnea termination (AAT), for each apnea event. The relative power changes in EEG frequency bands were compared with changes in apnea duration, defined as Short (between 10 and 20 s), Moderate (between 20 and 30 s) and Long (between 30 and 40 s). A significant reduction in EEG relative powers for lower frequency bands of alpha and sigma were observed for the Long compared to the Moderate and Short apnea duration groups at BAT, and reduction in relative theta, alpha and sigma powers for the Long compared to the Moderate and Short groups at AAT. The proportion of apnea events showed a significantly decreased trend with increased apnea duration for non-rapid eye movement sleep but not rapid eye movement sleep. The proportion of central apnea events decreased with increased apnea duration, but not obstructive episodes. The findings suggest EEG arousal occurred both before and at apnea termination and these transient arousals were associated with a reduction in relative EEG powers of the low-frequency bands: theta, alpha and sigma. The clinical implication is that these transient EEG arousals, without awakenings, are protective of sleep. Further studies with large datasets and different age groups are recommended.

The effects of multi-stage exercise with and without concurrent cognitive performance on cardiorespiratory and cerebral haemodynamic responses.

INTRODUCTION: Studies of cerebral haemodynamics have shown changes with increased exercise intensity, but the patterns have been highly variable and reliable associations with cognitive performance have not been identified. The aim of this study was to examine whether exercise-induced changes in oxygenated haemoglobin (O2Hb) led to changes in concomitant cognitive performance. METHODS: This study examined cardiorespiratory and cerebral haemodynamics during multi-stage exercise from rest to exhaustion, with (Ex + C) and without (Ex) concurrent cognitive performance (Go/No-go task). RESULTS: The presence of the cognitive task affected both cardiorespiratory and cerebral haemodynamics. The patterns in the cerebral haemodynamics during Ex and Ex + C diverged above the respiratory compensation threshold (RCT), but differences were significant only at 100% [Formula: see text], displaying increased deoxygenated haemoglobin (HHb), decreased difference between oxygenated and deoxygenated haemoglobin (HbDiff), and decreased cerebral oxygenation (COx) during Ex + C. More complex haemodynamic trends against intensity during Ex + C suggested that the presence of a cognitive task increases cerebral metabolic demand at high exercise intensities. The levels of O2Hb, HHb, HbDiff and total haemoglobin increased most steeply at intensities around the RCT during both Ex and Ex + C, but these changes were not accompanied by improved cognitive performance. CONCLUSION: The primary hypothesis, that cognitive performance would match changes in O2Hb, was not supported. Small variations in reaction time and response accuracy across exercise intensities were not significant, suggesting that cognitive performance is unaffected by intense short-duration exercise. Our results add further evidence that exercise-induced changes in cerebral haemodynamics do not affect cognitive performance.

Effects of Hyperventilation on Repeated Pedaling Sprint Performance: Short vs. Long Intervention Duration.

Sakamoto, A, Naito, H, and Chow, C-M. Effects of hyperventilation on repeated pedaling sprint performance: short vs. long intervention duration. J Strength Cond Res 32(1): 170-180, 2018-Previously, hyperventilation (HV)-induced respiratory alkalosis, implemented during the last 30 seconds of each 60-second recovery that separated repeated pedaling sprints, has been shown to attenuate performance decrement. The present study investigated whether the ergogenic effects of HV would hold if the HV duration was shortened or extended. Seventeen power-trained athletes performed 10 seconds × 10 sets of standing pedaling sprints on a cycle ergometer, with a 60-second interset recovery and the load (kp) set at 0.075 × body mass, under 3 breathing conditions: control, HV of 15 seconds (HVshort), and HV of 45 seconds (HVlong). Subjects breathed spontaneously during each 60-second recovery for the control condition. Under HVshort and HVlong conditions, subjects hyperventilated at 60 breaths·min with near-maximum tidal volume during the last 15 or 45 seconds, respectively, of each recovery period. Peak and mean pedaling power outputs (POpeak and POmean) were documented for each sprint set to compare performance decrements between conditions. No significant condition effect or condition × time interaction was found for POpeak and POmean. The lack of ergogenic effects with HVlong may be ascribed to a complex interaction between the positive (augmented buffering effects) and negative effects of HV (decreased aerobic energy metabolism and exaggerated discomfort sensation of increased ventilatory work). For HVshort, the implemented duration may have been too short to yield positive physiological effects. A practical implication is that ergogenic effects may be impaired when HV is too short or too long, with the duration of around 30 seconds being the target for this exercise type.

Calibration and validation processes for relative humidity measurement by a Hygrochron iButton.

Accurate relative humidity (RH) measurement is demanded in studies of thermal comfort. Thermal discomfort occurs when the near-to-skin temperature or RH is outside of the thermal comfort zone. The Hygrochron, a small wireless device which measures both temperature and RH, would be suitable and convenient in exercise or sleep studies. However, the RH measurement has not been validated. This paper has three parts. Part 1: In evaluating the sensor surface for RH detection, four Hygrochrons were placed on a wet paper towel. Two were placed on the towel with the protruding surface facing up and the other two facing down. The results showed that the Hygrochron with the protruding side was the sensor surface for detecting RH. Part 2: Twenty-seven Hygrochrons were calibrated in a humidity calibration chamber at a RH range from 40 to 90% at a constant temperature from 32 to 37°C. The mean bias was -1.08% between the Hygrochrons and the calibration chamber. The Hygrochron overestimated RH at the lower range (40-60%) and underestimated RH at the higher range (80-90%). The application of individual regression equations to each Hygrochron improved accuracy and reduced the mean bias to -0.002%. However, one Hygrochron showed outlier values that may be due to a manufacturing defect. Part 3: The reproducibility of Hygrochron for RH measurements was tested twice at the same condition of 35°C over a three-month interval. The intra-class coefficient was 0.996 to 1.000 with non-significant differences in the mean RH between test and re-test results (p=0.159). Hygrochrons are valid for RH measurements which show high reproducibility. It is recommended that Hygrochrons be calibrated over a range of desired RH and temperature prior to use to improve accuracy and detect any manufacturing defects.

Lip muscle training improves obstructive sleep apnea and objective sleep: a case report.

The present study assessed the potential of lip muscle training for improving sleep. A patient with heavy snoring, daytime sleepiness and dry mouth underwent lip muscle training. Lip closure force LCFmax increased by 67.3% and LCFmin by 152% post-training. AHI decreased from 12.2 to 3.9 events/h by reducing hypopneic episodes. TST, sleep stage N3 and REM sleep increased, and WASO, sleep stage N1, and AI decreased. The patient switched from mouth to nose breathing during sleep and stopped snoring. Improved LCF, by moving the tongue into the anterior-superior oral cavity, may increase upper airway space and reduce the hypopnea index.

Defining the rest interval associated with the main sleep period in actigraph scoring.

Actigraphy is increasingly used for sleep monitoring. However, there is a lack of standardized methodology for data processing and analysis, which often makes between study comparisons difficult, if not impossible, and thus open to flawed interpretation. This study evaluated a manual method for detection of the rest interval in actigraph data collected with Actiwatch 2. The rest interval (time in bed), defined as the bedtime and rise time and set by proprietary software, is an essential requirement for the estimation of sleep indices. This study manually and systematically detected the rest interval of 187 nights of recording from seven healthy males and three females, aged 13.5±0.7 (mean ± standard deviation) years. Data were analyzed for agreement between software default algorithm and manual scoring. Inter-rater reliability in manual scoring was also tested between two scorers. Data showed consistency between default settings and manual scorers for bedtime and rise time, but only moderate agreement for the rest interval duration and poor agreement for activity level at bedtime and rise time. Manual detection of rest intervals between scorers showed a high degree of agreement for all parameters (intraclass correlations range 0.864 to 0.995). The findings demonstrate that the default algorithm on occasions was unable to detect rest intervals or set the exact interval. Participant issues and inter-scorer issues also made difficult the detection of rest intervals. These findings have led to a manual detection protocol to define bedtime and rise time, supplemented with an event diary.