Poor sleep quality is predictive for higher pain levels in patients with chronic scrotal pain, regardless of body perception, biological rhythm, anxiety, and depression.

OBJECTIVES: To investigate the association between pain and sleep quality, anxiety, depression, body perception, and biological rhythm in chronic scrotal pain (CSP). MATERIAL AND METHODS: This cross-sectional study of 140 CSP patients was conducted between January and October 2023. The patients were separated into groups according to the Visual Analogue Scale (VAS) score as group 1 (score<3, n=27), group 2 (score: 3-6, n=84), and group 3 (score>6, n=29). In addition to demographic data, the points were recorded from the Body Image Scale (BIS), Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN), Hospital Anxiety and Depression Scale (HADS), and the Pittsburgh Sleep Quality Index (PSQI). RESULTS: The median (IQR) age of patients was 33 (20) years and the median (IQR) duration of pain was 5 (9) months. Group 3 patients had more anxiety (24.1% vs. group 1: 22.2%; group 2: 8.3%; P=0.03) and depression (55.2% vs. group 1: 40.7%; group 2: 29.8%; P=0.04) symptoms. No statistical differences were determined between the groups according to the BIS (P=0.54). The median (IQR) total BRIAN score was higher in group 3 than group 1 [37 (11) vs. 33 (13), P=0.03]. Higher rates of poor sleep quality were determined in group 3 patients according to the PSQI (75.9% vs. group 1: 48.1%; group 2: 51.2%; P=0.04). The VAS score was found to be positively associated with pain duration, total BRIAN score and PSQI score (r=0.31, P<0.001; r=0.17, P=0.04; r=0.23, P=0.006, respectively). The PSQI score was found to be an independent predictor for a higher VAS score (HR: 1.14, P=0.01). CONCLUSION: The results of this study suggest that poor sleep quality may influence the perceived intensity of pain. LEVEL OF EVIDENCE: II.

[Athletes' sleep]. / Le sommeil des athlètes.

Sport and sleep are linked: practising sport favours good sleep, and sufficient sleep favours performance. Sleep deprivation increases the risk of injury and slows recovery from injury.

Violent video gaming among French adolescents: Impact on mental health by gender.

BACKGROUND: Nowadays, video games are very popular among teenagers. This popularity generates concerns, whether in the media, among families or among the scientific community, who wonder about their potential harmful effects. The aim of this study was to assess the association between different types of use of video games (absence of use, use of violent video games, use of non-violent video games) and mental health and aggression. METHODS: Data was drawn from a French cross-sectional study entitled "Portrait d'Adolescents" which included 15,235 adolescents using anonymous self-administered questionnaires. We defined three groups of use of video games (absence of use, use of violent video games, use of non-violent video games) and explored the association with mental health indicators among boys and girls. RESULTS: The group categorized as "non-gamers" consisted of 1288 adolescents (8.5%), while the "non-violent video gamers" group comprised 8380 adolescents (55.5%) and the "violent video gamers" group included 5430 participants (36%). Among adolescent boys, there was no observed association between responses to mental health-related questions and the type of video game playing. However, in the "violent video gamers" group, a higher percentage of boys (6.8%) reported engaging in self-harm behaviors (p=0.001). In contrast, in the "non-violent video gamers" group, a lower proportion of boys (9.4%) reported participating in dangerous games (p<0.0001). For girls, the "violent video gamers" group exhibited a higher proportion of responses indicating poorer mental health across all explored items: 22.8% reported a history of suicide attempts (p<0.0001), 22.3% reported depression (p<0.0001), 17.8% reported self harm (p<0.0001), and 11.2% reported participating in dangerous game (p<0.0001). CONCLUSION: Violent video games appear to be associated with varying behaviors depending on the gender of adolescents, and notably contribute to much poorer mental health among adolescent girls.

[Therapeutic aid to improve sleep]. / Aide thérapeutique à l'amélioration du sommeil.

At a medical-psychological center, a therapeutic program based on relaxation and mindfulness meditation sessions is offered to people suffering from chronic insomnia referred by the center's psychiatrists, psychologists and advanced practice nurse. This treatment, which can be complementary to ongoing medication, is an alternative to pharmacological approaches.

Adormecimento psíquico e despertar do inconsciente na adolescência: uma aposta na palavra / Le sommeil psychique et l'éveil de l'inconscient à l'adolescence: un pari sur la parole / Psychic numbness and awakening of the unconscious in adolescence: betting on the word

Este artigo apresenta uma reflexão sobre os efeitos do contexto da cultura digital para a adolescência. Abordamos a adolescência na teoria psicanalítica desde as concepções freudianas até as elaborações contemporâneas. Retomamos a infância como fase constitutiva do sujeito e suas implicações para a adolescência para destacar os impasses experienciados pelos adolescentes na cultura digital. Destacamos os conceitos de saber, Outro e objeto como articulatórios para a compreensão da adolescência na contemporaneidade. Consideramos que o estatuto do saber sofreu transformações decorrentes da aliança entre o capitalismo e a digitalização e que essas transformações trazem implicações para o laço social, configurando o que chamamos de adormecimento psíquico. Por fim, apontamos a conversação de orientação psicanalítica como uma possibilidade no enfrentamento dos desafios que a cultura digital apresenta

Cet article présente une réflexion sur les effets du contexte de la culture numérique sur l'adolescence. Nous analysons l'adolescence dans la théorie psychanalytique à partir des conceptions freudiennes jusqu'aux élaborations contemporaines. Nous revenons sur l'enfance en tant que phase constitutive du sujet et ses implications pour l'adolescence afin de mettre en évidence les impasses vécues par les adolescents dans la culture numérique. Nous mettrons en évidence les concepts de connaissance, d'Autre et d'objet comme des articulations fondamentales pour la compréhension de l'adolescence à l'époque contemporaine. Nous considérons que le statut du savoir a subi des transformations résultant de l'alliance entre capitalisme et numérisation et que ces transformations ont des implications sur le lien social, configurant ce que nous appelons le sommeil psychique. Enfin, nous indiquons la conversation psychanalytique comme une possibilité pour faire face aux défis que présente la culture numérique.

This article presents a reflection on the effects of digital culture on adolescence. We analyze adolescence in psychoanalytic theory from Freudian conceptions to contemporary elaborations. We return to childhood as a constitutive phase of the subject and its implications for adolescence in order to highlight the impasses experienced by adolescents in the digital culture. We highlight the concepts of knowledge, Other and object as articulations for the understanding of adolescence nowadays. We consider that the status of knowledge has undergone transformations resulting from the alliance between capitalism and digitalization and that these transformations have implications for the social bond, configuring what we call psychic numbness. Finally, we point out the psychoanalytic conversation as a possibility in facing the challenges that digital culture presents.

[Use of murine models for the study of obstructive sleep apnea syndrome in Down syndrome]. / Utilisation des modèles murins pour l'étude du syndrome d'apnées obstructives du sommeil dans le syndrome de Down.

Down syndrome (DS), or trisomy 21, is a genetic disorder caused by the presence of an extra copy of chromosome 21, leading to various characteristic physical features as well as developmental and cognitive delays. Obstructive sleep apnea syndrome (OSAS) is a common disorder in both adult and pediatric patients with DS. Several characteristics of DS may contribute to the development or worsening of OSAS. Numerous murine models of DS exist. A number of studies have explored apneas and the risk of upper airway obstruction in these models, but up until now, only in adulthood.

[Insomnia: definitions, epidemiology and changes with age]. / Insomnie : définitions, épidémiologie et évolution avec l'âge.

INSOMNIA: DEFINITIONS, EPIDEMIOLOGY AND CHANGES WITH AGE. Chronic insomnia is a disorder defined as a subjective complaint relating to the quality and/or quantity of sleep associated with daytime impact, and which must be present 3 nights per week for a period of at least 3 months. This is a common sleep problem in the general population and represents a significant proportion of reasons for consultation in the general practice. It requires early identification at all ages of life to allow the establishment of adequate care, which will have the benefit of both improving the quality of life of these patients in the short term and preventing the consequences of chronic insomnia.

[Primary open angle glaucoma and sleep apnea syndrome: A review of the literature]. / Glaucome primitif à angle ouvert et syndrome d'apnée du sommeil : une revue de la littérature.

The relationship between glaucoma and Obstructive Sleep Apnea Syndrome (OSAS) has long been discussed, with conflicting study findings. OSAS appears in the most recent studies to be more of an aggravating factor than an independent risk factor for glaucoma. Patients with OSAS may develop a more rapid progression of primary open-angle glaucoma (POAG). OSAS may damage the optic nerve not only by increasing the intraocular pressure (IOP) but also by altering the blood supply to the optic nerve as shown by more recent work with OCT-Angiography. Although the systemic benefits of Continuous Positive Airway Pressure (CPAP) have been demonstrated, few studies have evaluated its effect on the optic nerve. CPAP might act on glaucomatous neuropathy by improving the blood supply to the optic nerve. The study of this mechanism of action might provide new insights into the relationship between OSAS and glaucoma.

Mobile app measuring sleep and behaviors: A trial in adolescents with addiction.

INTRODUCTION: The smartphones generalisation allows the development of attractive "real-life" monitoring tools for care and research enabling the measurement of addictive behaviours and comorbidities such as sleep disorders. The study objective was to assess the interest of a mobile app collecting such information among adolescents with addictive behaviours in order to enhance the availability of behavioural data in consultation. METHODS: An open label randomised pilot study was held along two parallel arms. The patients randomised to the intervention group (n=18) used a mobile app to provide daily data for 15 days relating to their sleep and their behaviour (addictive behaviours with or without substances). The patients in the control group (n=18) used a paper diary allowing the collection of the same data, only the medium differed. RESULTS: The patients' median age was 16 years [15.0-16.5]. A median of 67% and 10% of the expected information was completed respectively in the intervention and control groups during the 15 days of follow-up and could be used in consultation (P=0.08). The patient's knowledge, attitudes, intentions to change, behaviour change and seeking help related to the use of the diaries appeared higher in the intervention group (20.5/30) than in the control group (11/20). CONCLUSION: This study described the high patient compliance with the data collection by means of the app. The diary app seems to have been more impactful for patients than the paper diary. This app could represent an important tool to improve the therapeutic alliance and care due to a better knowledge of the behaviours on the part of the clinician but also a better awareness of the patients themselves.

From co-regulation to self-regulation: Maternal soothing strategies and self-efficacy in relation to maternal reports of infant regulation at 3 and 7 months.

This study, conducted in Germany, examines the role of maternal soothing strategies to explain the association of maternal self-efficacy with infant regulation (crying and sleeping behavior). Questionnaire data of 150 mothers, living in Germany, with mixed ethnic and educational backgrounds were collected when infants were 3 and 7 months old. Two types of maternal soothing strategies were distinguished: close soothing, involving close physical and emotional contact, and distant soothing, involving physical and emotional distancing from the infant. A cross-sectional SEM at 3 months indicated that maternal self-efficacy is associated with reported infant regulation through distant soothing strategies. Low maternal self-efficacy was associated with frequent maternal use of distant soothing, which in turn was related to reported infant regulation problems, that is, non-soothability and greater crying frequency. Frequent use of close soothing was associated with reported infant sleeping behavior, that is, frequent night-time awakenings. A longitudinal SEM further indicated that the effects of close soothing persisted at least until the infants' age of 7 months. The study showed how low maternal self-efficacy, increased use of distant soothing, and reported early infant regulation problems are intertwined and that, due to their persisting positive effect on infant soothability, close soothing better supports infant development.

Este estudio examina el papel de las estrategias calmantes maternas para explicar la asociación entre auto efectividad materna y la regulación del infante (comportamiento de llanto y de dormir). Información de cuestionario de N = 150 madres de trasfondos étnicos y educativos mixtos se recogió cuando los infantes tenían tres y siete meses de nacidos. Dos tipos de estrategias calmantes maternas se identificaron: estrategia calmante cercana, la cual trata del contacto físico y emocional cercano, y estrategia calmante distante, la cual trata del distanciamiento físico y emocional con el infante. Un estudio de Modelo de Ecuación Estructural (SEM) transversal a los tres meses indicó que la auto efectividad materna se asocia con la reportada regulación del infante a través de estrategias calmantes distantes. La baja auto efectividad materna se asoció con el frecuente uso materno de estrategias calmantes distantes, lo cual a su vez se relacionó con los reportados problemas de regulación del infante, tales como el no calmarse y la mayor frecuencia del llanto. El uso frecuente de estrategias calmante cercanas se asoció con el reportado comportamiento de dormir del infante, tal como el frecuente despertar nocturno. Un estudio de tipo SEM longitudinal indicó más allá que los efectos de las estrategias calmantes cercanas persistían por lo menos hasta que los infantes tenían siete meses de edad. El estudio mostró cómo la baja auto efectividad materna, el uso incrementado de estrategias calmantes distantes, así como los reportados tempranos problemas de regulación del infante están entremezclados y que, debido a su persistente efecto positivo en calmar al infante, las estrategias calmantes cercanas apoyan mejor el desarrollo del infante.

Cette étude examine le rôle des stratégies maternelles d'apaisement pour expliquer le lien de l'auto-efficacité maternelle avec la régulation du nourrisson (pleurs et comportement du sommeil). Des données d'une questionnaire de N = 150 mères issues de milieux ethniques et éducationnels différents ont été recueillies quand les nourrissons avaient trois et sept mois. Deux types de stratégies maternelles d'apaisement ont été distingués: l'apaisement proche, avec un contact physique et émotionnel proche, et l'apaisement distant, avec une distanciation physique et émotionnelle du nourrisson. Une coupe transversale SEM à trois mois a indiqué que l'auto-efficacité maternelle est liée à la régulation infantile signalée au travers de stratégies d'apaisement distantes. Une auto-efficacité maternelle faible était liée à l'utilisation maternelle fréquente de stratégies d'apaisement, qui à son tour était liée aux problèmes signalés de régulation du nourrisson, comme par exemple le fait de ne pas pouvoir être apaisé ou une fréquence de pleurs plus grande. L'utilisation fréquente de stratégies d'apaisement proche était liée au comportement de sommeil du nourrisson signalé, comme par exemple des réveils nocturnes fréquents. Un SEM longitudinal a de surcroit indiqué que les effets de stratégies d'apaisement proches persistaient au moins jusqu'à l'âge de sept mois des nourrissons. L'étude a montré comment l'auto-efficacité maternelle faible, une utilisation accrue de stratégies d'apaisement distant et les problèmes signalés de régulation précoce des nourrissons sont imbriqués et que, du fait de leur effet positif persistant sur l'apaisement du nourrisson, les stratégies d'apaisement proches soutiennent mieux le développement du nourrisson.

[Sleep in a performance artist: Eight days and seven nights sitting inside a metal sculpture]. / Le sommeil d'un performeur de l'extrême. Dormir huit jours et sept nuits, assis, sans bouger, enfermé dans une sculpture.

Sleep in extreme situations has been little studied. The artist Abraham Poincheval (AP) is known for his performances in confined spaces. For his show at the Perrotin Gallery in Paris, he was enclosed for 8days and 7nights in a metal sculpture of his body in a seated position, with his head facing a work by Hans Hartung at the end of a cone system placed in front of his eyes which occluded all other visual stimuli. The interior of the metal structure was not padded and there was no head support. His sleep and internal temperature were continuously recorded using polysomnography (Grael, Compumedics) and an orally swallowed temperature sensitive capsule (Bodycap) with temperature sampling every 2min. AP slept an average of 355.1min/24h, composed of light slow-wave sleep (N1: 47.1min, N2: 192.2min), deep slow-wave sleep (N3: 100.4min), and REM sleep 4,3 % (15.4min). Sleep, although mostly nocturnal, was split into periods of no more than 20min. Deep sleep was therefore remarkably resistant to the uncomfortable experimental conditions, while REM sleep was markedly impaired, lasting only a few short minutes and followed by rapid awakening. This is probably due to the head position within the sculpture which was unsupported, so REM sleep with its inherent muscle atonia led to involuntary head flexion and was impossible to sustain for long. The thermal minimum was between 5:17 a.m. and 6:35 a.m. The amplitude of the core temperature decreased by more than 30 % between the beginning and the end of the protocol. Despite the immobility induced by the confined experimental conditions, there was no desynchronization of circadian rhythms. The sleep time was surprisingly long given the conditions, and slow-wave sleep was relatively preserved with an amount typically found in normal subjects while REM sleep was markedly impaired. Slow-wave sleep is clearly preserved underlying its central role in physical and mental homeostasis. REM sleep is clearly more fragile. The reduction in REM sleep linked to position has been found in a study of sleep in the sitting position in airplanes where loss of muscle tonus in the neck fragments REM sleep. Techniques for selective REM sleep deprivation also use muscle atonia: one of the initial techniques of selective REM sleep deprivation relied on muscle atonia in REM causing a cat to fall from a small perch into water. In man, the lack of head support is clearly a source of REM fragmentation. However in the case of this study, we cannot exclude an effect of other factors, notably the meditative techniques used by the performer to maintain attention on the painting, described as a dream state punctuated by visual hallucinations. Surprisingly, despite physical isolation within the sculpture, AP's biological rhythms remained stable. However, the conditions were not those of complete isolation: noise, the presence of the public in the gallery who occasionally talked to AP through the sculpture, and variations in light during the day were all temporal cues. In addition, a heatwave during the performance raised the temperature in the room with reduced total sleep time on the hottest night. Although the phase of the circadian rhythm measured by the internal temperature did not change, the amplitude fell which is compatible with reduced physical activity. In conclusion, under physically constraining and uncomfortable sleep conditions, deep sleep is maintained while REM sleep is starkly reduced. From a homeostatic point of view, this means that over a short period of time, in a survival situation, energy recovery through deep slow-wave sleep takes priority over REM sleep.

Evaluation of sleep and therapeutic education needs of military with PTSD.

Sleep disorders in post-traumatic stress disorder (PTSD) are both diagnostic (nocturnal reliving) and prognostic. Poor sleep worsens the daytime symptomatology of PTSD and makes it resistant to treatment. However, no specific treatment is codified in France to treat these sleep disorders although sleep therapies (cognitive behavioural therapy for insomnia, psychoeducation and relaxation) have proven for years to be effective in treating insomnia. Therapeutic sessions can be part of a therapeutic patient education program, which is a model for the management of chronic pathologies. It allows for an improvement in a patient's quality of life and enhanced medication compliance. We therefore carried out an inventory of sleep disorders of patients with PTSD. First, we collected data by means of sleep diaries concerning the population's sleep disorders at home. Then we assessed the population's expectations and needs regarding its management of sleep, thanks to a semi-qualitative interview. The data from sleep diaries, which was consistent with the literature, showed that our patients suffered from severe sleep disorders that strongly impact their daily lives, with 87% of patients having an increased sleep onset latency, and 88% having nightmares. We observed a strong demand from patients for specific support for these symptoms, 91% expressing an interest in a TPE program targeting sleep disorders. Thanks to the data collected, the emerging themes for a future therapeutic patient education program targeting sleep disorders of soldiers with PTSD are: sleep hygiene; management of nocturnal awakenings, including nightmares; and psychotropic drugs.

[Male infertility, environment and lifestyle]. / Infertilité masculine, environnement et mode de vie.

BACKGROUND: Since the 1970s, there has been a quantitative and qualitative decline in sperm parameters. The main hypothesis to explain such a rapid evolution is the involvement of environmental and behavioral phenomena. METHODS: A bibliographic search limited to English and French literature in men published before 7/2023 was carried out on the links between fertility and pollution, xenobiotics, tobacco, narcotics, cannabis, alcohol, weight, sport, sedentary lifestyle, sleep and anabolics. RESULTS: Profound changes in lifestyle have occurred over the past 50 years: reduced sleep time, sedentary lifestyle, dietary changes, tobacco consumption, use of narcotics and anabolics. These changes have a proven impact on spermogram parameters, and should be corrected in an effort to optimize reproductive health. Other environmental parameters: pollution, exposure to heavy metals, exposure to xenobiotics, phthalates and pesticides… will be more difficult to exclude from patients' daily lives, but deserve to be taken more into account. CONCLUSION: This review should help the urologist to assess and counsel patients in order to improve their reproductive health. These factors should be routinely investigated in infertile men.

[Evaluation of the risk of obstructive sleep apnea in patients awaiting general anesthesia in Burkina Faso]. / Évaluation du risque du syndrome d'apnées hypopnées obstructives du sommeil chez des patients en attente d'une anesthésie générale au Burkina Faso.

INTRODUCTION: General anaesthesia and surgery increase morbidity and mortality in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) who are not known to have OSAHS and therefore not treated before surgery. The objective of this study is to evaluate the risk of OSAHS using the STOP-BANG questionnaire (SBQ) in patients undergoing general anaesthesia in Burkina Faso. MATERIAL AND METHOD: This is a cross-sectional study concerning patients having received pre-anaesthetic consultation from 1st July 2020 to 30th June 2021. Risk of OSAHS is considered "medium to high" when the risk of obstructive sleep apnea is medium or high on SBQ. RESULTS: Our population consisted in 599 persons. A medium to high risk of OSAHS was found in 11.18%. The ASA score and the Mallampati scale were independently associated with moderate to high risk of OSAHS (P<0.001; P<0.001). ASA score of I and Mallampati class of I decreased the risk of OSAHS by 17 and 45% respectively (P=0.012; P=0.031). CONCLUSION: The risk of OSAHS in this population is comparable to that of the general population. Confirmation of OSAHS by ventilatory polygraphy or polysomnography would help to achieve further precision.

Mental health and sleep quality of low-income mothers of one-year-olds during the COVID-19 pandemic.

The COVID-19 pandemic and subsequent social restrictions created an unprecedented context for families raising young children. Although studies have documented detrimental effects of the pandemic on maternal well-being, less is known about how the pandemic specifically impacted low-income mothers. We examined depression, anxiety, and sleep quality among low-income mothers of one-year-olds during the early months of the pandemic using data from the Baby's First Years study. Focusing on the control group (n = 547), we compared mothers interviewed before March 14th, 2020 (n = 342) to mothers interviewed between March 14th and June 30th, 2020 (n = 205) to determine whether the pandemic was associated with differences in mental health and sleep quality. Mothers were recruited from four cities in the United States, and most of the sample identified as Hispanic (42.2%) or Black, non-Hispanic (38.6%). We found that mothers interviewed during the pandemic reported better mental health and sleep quality. While we cannot speak to longer-term impacts of the pandemic, it is possible low-income mothers experienced relief from daily stressors during the initial shelter-in-place orders, which may have led to improvements in well-being. These results have implications for understanding how complex life stressors influence mental health and sleep quality among low-income mothers raising young children.

La pandemia del COVID-19 y las subsecuentes restricciones sociales crearon un contexto sin precedentes para las familias que estaban criando niños pequeños. Aunque los estudios han documentado los efectos perjudiciales de la pandemia sobre el bienestar materno, menos se conoce acerca de cómo la pandemia específicamente tuvo un impacto sobre madres de bajos recursos económicos. Examinamos la depresión, ansiedad y calidad del sueño entre madres de bajos recursos económicos de niños de un año de edad durante los primeros meses de la pandemia usando datos del estudio Primeros Años del Bebé. Enfocándonos en el grupo de control (n = 547), comparamos las madres entrevistadas antes del 14 de marzo de 2020 (n = 342) con madres entrevistadas entre el 14 de marzo y el 30 de junio de 2020 (n = 205) para determinar si la pandemia se asociaba con diferencias en salud mental y calidad del sueño. A las madres se les reclutó en cuatro ciudades de Estados Unidos y la mayor parte del grupo muestra se identificaron como Hispanas (42.2%) o Negras no Hispanas (38.6%). Encontramos que las madres entrevistadas durante la pandemia reportaron mejor salud mental y calidad del sueño. A pesar de que no podemos hablar sobre el impacto a largo plazo de la pandemia, es posible que las madres de bajos recursos económicos experimentaran alivio en los factores diarios de estrés durante el inicial mandato de quedarse en su casa, lo cual pudiera haber llevado a mejoras en el bienestar. Estos resultados tienen implicaciones para comprender cómo los complejos factores de estrés influyen en la salud mental y la calidad del sueño entre madres de bajos recursos económicos que crían a niños pequeños.

La pandémie du COVID-19 et les restrictions sociales qui en ont découlé ont créé un contexte sans précédent pour les familles élevant de jeunes enfants. Bien que des études aient documenté des effets préjudiciables de la pandémie sur le bien-être maternel, on en sait moins sur la manière dont la pandémie a spécifiquement impacté les mères de milieux défavorisés. Nous avons examiné la dépression, l'anxiété, et la qualité du sommeil chez des mères de milieux défavorisés avec un enfant d'un an durant les premiers mois de la pandémie, en utilisant des données de l'étude Baby's First Years. Nous concentrant sur le groupe de contrôle (n = 547), nous avons comparé des mères interviewées avant le 14 mars 2020 (n = 342) à des mères interviewées entre le 14 mars et le 30 juin 2020 (n = 205) afin de déterminer si la pandémie était liée à des différences en santé mentale et en qualité de sommeil. Les mères ont été recrutées dans quatre villes des Etats-Unis et la plupart de l'échantillon s'identifiait comme Hispanique (42,2%) ou Noires, non hispaniques (38,6%). Nous avons trouvé que les mères interviewées Durant la pandémie faisaient état d'une meilleure santé mentale et d'une meilleure qualité de sommeil. Bien que nous ne puissions pas parler des impacts de la pandémie à long terme, il est possible que les mères de milieux défavorisés aient fait l'expérience d'un soulagement des facteurs de stress quotidiens durant la période initiale de confinement, ce qui pourrait avoir mené à des améliorations dans le bien-être. Ces résultats ont des implications pour la compréhension de la manière dont des facteurs de stress complexes influencent la santé mentale et la qualité du sommeil chez les mères de milieux défavorisés élevant de jeunes enfants.

[Lung manifestations of sickle-cell disease]. / Manifestations respiratoires de la drépanocytose.

Sickle-cell disease is an autosomal recessive genetic disorder of hemoglobin that causes systemic damage. Hypoxia is the main actor of sickle-cell disease. It initiates acutely the pathogenic cascade leading to tissue damages that in turn induce chronic hypoxia. Lung lesions represent the major risk of morbidity and mortality. Management of sickle-cell disease requires a tight collaboration between hematologists, intensivists and chest physicians. Recurrent episodes of thrombosis and hemolysis characterize the disease. New therapeutic protocols, associating hydroxyurea, transfusion program and stem cell transplantation in severe cases allow a prolonged survival until the fifth decade. However, recurrent pain, crisis, frequent hospital admissions due to infection, anemia or acute chest syndrome and chronic complications leading to organ deficiencies degrade the patients' quality of life. In low-income countries where the majority of sickle-cell patients are living, the disease is still associated with a high mortality in childhood. This paper focuses on acute chest syndrome and chronic lung manifestations.

The effectiveness of lucid dreaming therapy in patients with nightmares: A systematic review.

OBJECTIVES: Nightmares can be defined as "an unpleasant dream with anxiety and oppression". They represent a symptom possibly leading to serious psychiatric and physical consequences. It occurs to 2% to 8% of the general population. Lucid dreaming therapy (LDT) is an interesting upcoming psychotherapy for the treatment of nightmares. The aim of this study was to evaluate the efficacy of LDT in the treatment of nightmares in adults and children. METHODS: We performed a systematic review of the literature, based on the Cochrane organisation's methodology. We explored the PubMed, Cochrane library, PsycINFO via Ovid and Embase databases and clinical trial registries (CTR), namely clinicaltrials.gov, EU clinical trials and the WHO clinical trials registry platform. RESULTS: Four randomized controlled trials (RCT), 2 case series and 5 case reports were included. Most of the included studies found LDT effective in reducing nightmare frequency among adults with chronic and recurring nightmares. We did not identify any reports in children. CONCLUSIONS: Despite a limited internal validity for the included studies, these first results are encouraging. Nonetheless, larger and more rigorous studies would allow to better assess the utility of LDT for nightmares.

The low dopamine hypothesis: A plausible mechanism underpinning residual urine, overactive bladder and nocturia (RON) syndrome in older patients.

INTRODUCTION: Aging is associated with a combination of several lower urinary tract (LUT) signs and symptoms, including residual urine, overactive bladder and nocturia. One of the mechanisms of this LUT dysfunction that has not been discussed in dept so far is the role of dopamine (DA). METHODS: In this narrative review, we explore the dopaminergic hypothesis in the development of this combination of LUT signs and symptoms in older adults. RESULTS: DA is one of the neurotransmitters whose regulation and production is disrupted in aging. In synucleinopathies, altered DAergic activity is associated with the occurrence of LUTS and sleep disorders. Projections of DAergic neurons are involved in the regulation of sleep, diuresis, and bladder activity. The low dopamine hypothesis could explain the genesis of a set of LUT signs and symptoms commonly seen in this population, including elevated residual urine, Overactive bladder syndrome and Nocturia (discussed as the RON syndrome). This presentation is however also common in older patients without synucleinopathies or neurological disorders and therefore we hypothesise that altered DAergic activity because of pathological aging, and selective destruction of DAergic neurons, could underpin the presentation of this triad of LUT dysfunction in the older population. CONCLUSION: The concept of RON syndrome helps to better understand this common phenotypic presentation in clinical practice, and therefore serves as a useful platform to diagnose and treat LUTS in older adults. Besides recognizing the synucleinopathy "red flag" symptoms, this set of multi-causal LUT signs and symptoms highlights the inevitable need for combination therapy, a challenge in older people with their comorbidities and concomitant medications.

[Sleepiness among adolescents: etiology and multiple consequences]. / La somnolence chez les adolescents: étiologie et conséquences multiples.

Over the past century a dramatic decline in sleep duration among adolescents, such as more than one hour of sleep loss per night, has been reported. A debt in sleep duration could lead to sleep deprivation, a major risk factor associated with daytime sleepiness. Sleepiness refers to the inability to maintain an adequate level of alertness during the day which may result in more or less being able to control falling asleep at inappropriate times. This literature review updates on sleepiness regarding its characteristics, etiology and consequences on adolescents. Studies revealed that from 25 % to 78 % of adolescents had reported sleepiness. Its manifestations may include heavy lids, yawns, difficulties to concentrate and emotional irritability. In addition, while it is recommended that adolescents under 18 years-old should sleep from eight to ten hours a night, only 63 % of them actually do so. The etiology of sleep deprivation and sleepiness in this population can be explained by various biological and societal factors. First, the sleep-wake cycle of adolescents shows a biological shift from the beginning of pubertal maturation, described as a perfect storm. It refers to a social jetlag by going to sleep and waking up later and accumulating a sleep debt during weekdays which they try to reimburse during weekends. This phenomenon can be explained by physiological changes such as a slower accumulation of sleep pressure. In addition to this perfect storm, environmental and societal factors contribute to the social jetlag and reduce sleep duration in adolescents. Screen exposure before bedtime can delay sleep and wake onset, which is a risk factor for sleeping debt. Substance use such as caffeine, cigarettes or electronic vaporizer, ADHD or freely available medication, alcohol, cannabis use or drug consumption could further disrupt sleep-wake cycle by stimulating, depressing or otherwise disrupting the central nervous system. Early, before 8:30 am, class start times have been associated with chronic sleep deprivation, higher level of sleepiness and delayed melatonin peak secretion. Adolescents working or doing extracurricular occupations for more than 20hours a week are more at risk for reduced sleep duration and sleepiness. Parental supervision about sleep during the weekdays were associated with more appropriate bedtime. Adolescents from low socio-demographic characteristics and from minority ethnic groups have reported displaying a shorter sleep duration. Finally, sleep disorders of a physiological origin such as narcolepsy, sleep apnea or restless legs syndrome, may explain the sleep deprivation and sleepiness. Sleep deprivation and sleepiness in adolescents have consequences on their health. Cognitive functioning, such as problem solving, attention or memory, as well as school performance, can be compromised by sleep deprivation and sleepiness. At the psychological level, adolescents reporting sleepiness are more prone to display mental health problems: associations were found between sleepiness and subjective perception of depression, anxiety, somatic complaints as well as with antisocial behaviors. Finally, 68 % of 16 year-old adolescents reported they drove a car, and the reported sleepiness could lead to road accidents due to reduced attentional functioning, reaction time and decision-making abilities. In the United-States, from 7 % to 16.5 % of deadly accidents were related to driving while drowsy. Highlighting etiology and problems associated with sleep deprivation and sleepiness in adolescents could guide researchers and clinicians towards the development of possible interventions. Public health measures and knowledge transfer programs regarding modifiable psychosocial and societal factors associated with sleep-wake bioregulation could increase awareness in parents as well as in political and societal decision makers.

[Quantitative survey on French teenagers' sleep: Insomnia, anxiety-depression and circadian rhythms]. / Enquête quantitative sur le sommeil d'adolescents tout-venant français : insomnie, anxiété-dépression et rythmes circadiens.

INTRODUCTION: Insomnia is a sleep disorder that particularly affects teenagers. Its psychic and physical consequences are major and make it a public health priority. The main purpose of the study was to provide contemporary data on adolescent sleep and to explore the intrications between insomnia and mood disorders while investigating the chronotype responsibility. METHOD: A battery of questionnaires was offered to 1,036 French teenagers, enrolled in secondary school, aged between 12 and 20 years old and living in urban areas for middle school students and in rural areas for high school students. It was mainly composed of the Insomnia Severity Index (ISI), the Hospital Anxiety and Depression Scale (HADS) and the - Morningness-Eveningness Questionnaire (MEQ). The authorities responsible for ethics and professional conduct have issued a favorable opinion. RESULTS: This study demonstrated that anxiety, depression, gender and age were factors linked to insomnia, reaffirming a female predisposition and asserting a high school entry effect (especially at 15 years old). The results also indicated that a tendency to vesperality increased the risk and the level of insomnia, thus evoking the responsibility of circadian typologies in this sleep disorder. CONCLUSION: This study underlines the importance of prevention and screening for insomnia when entering high school, as well as the need, in sleep disorder clinics and in psychotherapy, to deal with individual circadian rhythms, their consequences and organizational choices in the sleep/wakefulness articulation.