Search Results (1,209)

Background/Objectives: Although the protective effects of zinc against COVID-19 are documented, its impact on COVID-19 vaccine immunogenicity remains unknown. Methods: We conducted a prospective study involving a cohort of 79 Japanese individuals (aged 21–56 years; comprising three subcohorts) and measured their serum zinc levels pre-vaccination and anti-SARS-CoV-2 IgM/IgG levels pre- and post-vaccination over 4 months. Results: Serum zinc concentrations ranged between 74–140 and 64–113 μg/dL in male and female individuals, respectively, with one male and 11 female participants exhibiting subclinical zinc deficiency (60–80 μg/dL). Mixed models for antibody titers, accounting for the subcohorts, repeat measurements, and covariates (e.g., vaccine type, sex, age, height, steroid use, medical history, smoking and drinking habits, perceived stress, and sleep disturbances) showed positive effects of zinc on IgM (p = 0.012) and IgG (p = 0.013) in 45 female individuals with 255 observations. However, a similar association was not found in the 34 male participants with 162 observations. This discrepancy may be attributed to one participant being included in the subcohort with frequent repeat measurements (10 repeats in 4 months). COVID-19 mRNA vaccine immunogenicity was enhanced in the participants with high baseline blood zinc levels within the reference range. Conclusions: Our findings underscore the relevance of maintaining adequate zinc levels before vaccination, which can be achieved through a balanced diet and healthy lifestyle choices. Full article

Anxiety-induced sleep disturbance is a common phenomenon that affects the overall well-being and quality of life of school-going adolescents. Nonetheless, evidence on anxiety-induced sleep disturbance among adolescents in Benin is scarce. This study examined the gender differences in the prevalence and correlates of anxiety-induced sleep disturbance among in-school adolescents in the Republic of Benin. We conducted a secondary analysis of Benin’s 2016 Global School-Based Health Survey dataset involving 2496 in-school adolescents aged 13 years and above. The proportion of male and female students who reported anxiety-induced sleep disturbance was computed. The multivariable binary logistic regression analysis was conducted to determine the factors associated with anxiety-induced sleep disturbance. Adjusted odds ratios (aOR) were estimated with corresponding confidence intervals at a 0.05 significance level. The overall prevalence of anxiety-induced sleep disturbance among adolescents was 21.3%. The prevalence of anxiety-induced sleep disturbance was 22.4% and 19.9% among the male and female participants, respectively. Among male in-school adolescents, hunger (aOR = 0.51, 95% CI = 0.37–0.71), loneliness (aOR = 0.29, 95% CI = 0.20–0.41), suicide ideation (aOR = 0.37, 95% CI = 0.22–0.61), suicide attempt (aOR = 1.79, 95% CI = 1.12–2.87), ever having sex (aOR = 0.66, 95% CI = 0.48–0.91), and having understanding parents (aOR = 0.64, 95% CI = 0.47–0.87) were significantly associated with anxiety-induced sleep disturbance. On the other hand, hunger (aOR = 0.63, 95% CI = 0.42–0.94), loneliness (aOR = 0.42, 95% CI = 0.28–0.61), and suicide ideation (aOR = 0.52, 95% CI = 0.33–0.83) were significantly associated with anxiety-induced sleep disturbance among the female in-school adolescents. The prevalence of anxiety-induced sleep disturbance among in-school adolescents in Benin poses a great concern for their mental health and well-being. Collaborative efforts between schools, parents, and healthcare professionals should focus on culturally appropriate, gender-specific factors that may contribute to a reduction in anxiety-induced sleep disturbance among in-school adolescents in Benin. Full article

Background: The involvement of the circadian system in the etiology and treatment of Parkinson’s disease (PD) is becoming an increasingly important topic. The prodromal symptoms of PD include insomnia, fatigue, depression and sleep disturbance which herald the onset of the primary symptoms of bradykinesia, tremor and rigidity while robbing patients of their quality of life. Light treatment (LT) has been implemented for modifying circadian function in PD but few studies have examined its use in a protracted term that characterizes PD itself. Methods: The present exploratory study monitors the effect of LT over a 10 year course of PD in the context of ongoing circadian function. Results: Improvement in circadian based symptoms were seen soon after LT commenced and continued for the duration of the study. Improvement in motor function was more subtle and was not distinguishable until 1.2 years after commencing treatment. Improvement in most motor and prodromal symptoms remained in steady state for the duration of the study as long as patients were compliant with daily use. Conclusions: The sequence of improvement in prodromal symptoms and motor function seen here parallels the slow, incremental repair process mimicking the protracted degenerative sequelae of PD that extends over decades. This process also emulates the slow incremental improvement characterizing the reparative course seen with circadian symptoms in other disorders that improve with LT. Recent findings from epidemiological work suggest that early disruption of circadian rhythmicity is associated with increased risk of PD and the present findings are consistent with that hypothesis. It is concluded that intervening in circadian function with LT presents a minimally invasive method that is compatible with internal timing that slows the degenerative process of PD. Full article

Background: Maternal sleep disturbance is a risk factor for adverse outcomes like preterm birth. However, the association of maternal sleep quality and duration with the risk of the infant being small for gestational age (SGA) remains inconclusive, and the specific critical window of vulnerability has yet to be clearly identified. Therefore, this study aims to investigate the effect of maternal sleep quality and duration on the risk of having an SGA infant and to identify the critical window for this association. Methods: One thousand six hundred and seventy-seven participants from the Shenzhen Birth Cohort Study were included. Maternal sleep duration and quality during pregnancy were assessed using the Pittsburgh Sleep Quality Index (PSQI) in early (<19 weeks), mid- (24–28 weeks), and late (32–38 weeks) pregnancy. Multivariate logistic regression analyses were used to examine the association of an SGA infant with sleep duration and quality, along with their specific effects across the different pregnancy stages. Results: The pregnant women with short sleep duration (≤7 h/day) in the early stage of pregnancy appeared to have a higher risk of having an SGA infant (aOR = 1.93, 95% CI = 1.32~2.79). Additionally, poor sleep quality combined with short sleep duration was associated with an even higher risk of having an SGA infant (aOR = 2.08, 95% CI = 1.32~3.23). However, this association was observed only during early pregnancy. Conclusions: The women with short sleep duration were associated with SGA risk, and the early stage of pregnancy might be a particularly sensitive period for this relationship. Addressing maternal sleep problems during pregnancy as part of antenatal care is crucial for reducing the likelihood of having an SGA infant and improving the overall birth outcomes. Full article

Background/Objectives: Sleep disturbance is often observed in the context of chronic pain. We hypothesize that, by providing an immersive Virtual Reality (VR) experience with a serious game to chronic pain patients an hour before bedtime, attention can be diverted from the pain condition, consequently leading to improved sleep quality. The aim is to evaluate the efficacy of VR compared to usual care in reducing the number of awakenings during the night and increasing sleep efficiency in patients suffering from painful diabetic polyneuropathy (PDPN). Methods: Eight patients with PDPN were randomized to either two weeks of VR or two weeks of usual care, followed by a cross-over. The primary outcome measurements were sleep efficiency and number of awakenings during the night. As secondary outcomes, self-reported sleep quality, insomnia, pain catastrophizing, anxiety, depression, pain intensity, side effects and impression of change were evaluated. Results: Data of seven patients were analysed. Actigraphy data, self-reported sleep quality, insomnia, pain catastrophizing, anxiety, depression and pain intensity scores did not differ between usual care and VR. As for impression of change, more patients improved after VR compared to usual care (V = 21, p = 0.03). Conclusions: A 2-week period of pain neuroscience education through VR did not result in increased sleep efficiency or fewer awakenings compared to usual care in patients with PDPN. These pilot results indicate that patients subjectively experience an improvement, yet this is not substantiated by either self-reported or objective measurements. Full article

Background: Degenerative cervical myelopathy is a progressive neurological disorder that is commonly encountered in clinical practice and its incidence is expected to increase alongside the aging population. Given the importance of early and accurate diagnosis in this patient population, this narrative review aims to provide a repository of up-to-date information regarding pertinent patient history, physical exam findings, and potential alternate diagnoses. Methods: The PubMed database was queried for publications from 1 January 2019 to 19 March 2024. The search terms utilized are as follows: cervical myelopathy”, “cervical spondylotic myelopathy”, “degenerative cervical myelopathy”, “epidemiology”, “prevalence”, “incidence”, “etiology”, “diagnosis”, “differential”, “symptoms”, “clinical presentation”, and “atypical symptoms”. The resultant articles were reviewed for relevance and redundancy and are presented within the following categories: Natural History, Epidemiology, Clinical Presentation, Diagnosis, and Management. Results: Myelopathy patients often present with subtle and non-specific symptoms such as sleep disturbances, increased falls, and difficulty driving, which can lead to underdiagnosis and misdiagnosis. Failing to diagnose degenerative cervical myelopathy in a timely manner can result in progressive and irreparable neurological damage. Although many nonoperative treatment modalities are available, surgical decompression is ultimately recommended in most cases to limit further deterioration in neurological function and optimize long-term patient outcomes. Conclusions: A thorough clinical history and physical examination remain the most important diagnostic tools to avoid misdiagnosis and implement early treatment in this patient population. Full article

Background: Myasthenia gravis (MG) is an autoimmune neuromuscular disease characterized by fatigue and muscle weakness. Previous research has noted a high incidence of psychological problems, particularly anxiety and depression, as well as alterations in sleep quality among patients with MG. The aim of this study was to assess depression, anxiety, sleep problems, and fatigue in individuals with MG and to analyze the relationships among these variables, as well as to determine the influence of corticosteroid use and thymectomy. Methods: The sample consisted of 72 participants, 42 belonging to the clinical group with MG and 30 healthy participants to the control group. The instruments used were Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), and Fatigue Severity Scale (FSS). Results: The results showed that MG patients exhibited higher levels of fatigue, anxiety, depression, and poorer sleep quality compared to the control group (p < 0.05). Significant differences in sleep quality and anxiety levels were observed between thymectomized and non-thymectomized patients. Additionally, a positive correlation was found between anxiety symptoms and sleep quality. Conclusions: The study demonstrated the presence of anxious and depressive symptoms in patients with MG, as well as poorer sleep quality and increased fatigue, suggesting that MG affects not only neuromuscular function but also the psychological well-being of patients. Full article

Background: Posterior fossa syndrome (PFS), also known as cerebellar mutism syndrome, occurs in about 25% of pediatric patients undergoing resection of a posterior cranial fossa medulloblastoma. It is characterized primarily by mutism or reduced/impaired speech and may include variable symptoms such as motor dysfunction (apraxia, ataxia, hypotonia), supranuclear cranial nerve palsies, neurocognitive changes, and emotional lability. Long-term multidisciplinary rehabilitation is typically required, with recovery taking approximately six months, though many children experience long-term residual deficits. Neuropathic pain associated with PFS is rarely reported in pediatric patients, and evidence for its management is limited. Methods: This case report describes a 10-year-old boy who developed PFS following incomplete resection of a medulloblastoma. Clinical presentation included mutism, irritability, emotional lability, sleep disturbances, and neuropathic pain localized at the C5 level. The patient was treated with a combination of gabapentin, diazepam, and baclofen. Results: The combined pharmacological approach resulted in successful management of the patient’s neuropathic pain and other symptoms associated with PFS, improving his overall condition. Conclusions: This case highlights the potential effectiveness of a multimodal pharmacological regimen for treating neuropathic pain and associated symptoms in pediatric patients with PFS. Further research is needed to explore optimal treatment strategies for this rare but challenging complication. Full article

Post-Coronavirus Disease 2019 (post-COVID-19) syndrome represents a cluster of persistent symptoms following Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection that can severely affect quality of life. The pathogenic mechanisms and epidemiology in different regions are still under evaluation. To assess the outcomes of post-COVID-19 syndrome, we performed a questionnaire-based, cross-sectional study in previously infected individuals. Out of 549 respondents, (male:female ratio: 0.32), 29.5% had persistent symptoms at 3 months, 23.5% had persistent symptoms at 6 months, and 18.3% had persistent symptoms at 12 months after the initial infection. The most common symptoms included fatigue (8.7%), sleep disturbances (7.1%), and cognitive impairment (6.4%). The risk of developing post-COVID-19 syndrome increased for those with more symptoms in the acute phase (OR 4.24, p < 0.001) and those experiencing reinfections (OR 2.405, p < 0.001), while SARS-CoV-2 vaccination halved the risk (OR = 0.489, p = 0.004). Individuals with post-COVID-19 syndrome had a 5.7-fold higher risk of being diagnosed with a new chronic condition, with 44% reporting cardiovascular disease, and a 6.8-fold higher likelihood of needing medical care or leave. Affected individuals reported significant impairments in mobility, pain/discomfort, and anxiety/depression, with 20.7% needing to adjust their work schedules. Overall, patients with post-COVID-19 syndrome require ongoing monitoring and rehabilitation, and further socio-economic impact studies are needed. Full article

The classical function of the mineralocorticoid receptor (MR) is to maintain electrolytic homeostasis and control extracellular volume and blood pressure. The MR is expressed in the central nervous system (CNS) and is involved in the regulation of the hypothalamic–pituitary–adrenal (HPA) axis as well as sleep physiology, playing a role in the non-rapid eye movement (NREM) phase of sleep. Some patients with psychiatric disorders have very poor sleep quality, and a relationship between MR dysregulation and this disorder has been found in them. In addition, the MR is involved in the regulation of the renal peripheral clock. One of the most common comorbidities observed in patients with chronic kidney disease (CKD) is poor sleep quality. Patients with CKD experience sleep disturbances, including reduced sleep duration, sleep fragmentation, and insomnia. To date, no studies have specifically investigated the relationship between MR activation and CKD-associated sleep disturbances. However, in this review, we analyzed the environment that occurs in CKD and proposed two MR-related mechanisms that may be responsible for these sleep disturbances: the circadian clock disruption and the high levels of MR agonist observed in CKD. Full article

COSMOS-France is the French part of the COSMOS project, an international prospective cohort study that investigates whether the use of mobile phones and other wireless technologies is associated with health effects and symptoms (cancers, cardiovascular diseases, neurologic pathologies, tinnitus, headaches, or sleep and mood disturbances). Here, we provide the first descriptive results of COSMOS-France, a cohort nested in the general population-based cohort of adults named Constances. Methods: A total of 39,284 Constances volunteers were invited to participate in the COSMOS-France study during the pilot (2017) and main recruitment phase (2019). Participants were asked to complete detailed questionnaires on their mobile phone use, health conditions, and personal characteristics. We examined the association between mobile phone use, including usage for calls and Voice over Internet Protocol (VoIP), cordless phone use, and Wi-Fi usage with age, sex, education, smoking status, body mass index (BMI), and handedness. Results: The participation rate was 48.4%, resulting in 18,502 questionnaires in the analyzed dataset. Mobile phone use was reported by 96.1% (N = 17,782). Users reported typically calling 5–29 min per week (37.1%, N = 6600), making one to four calls per day (52.9%, N = 9408), using one phone (83.9%, N = 14,921) and not sharing it (80.4% N = 14,295), mostly using the phone on the side of the head of their dominant hand (59.1%, N = 10,300), not using loudspeakers or hands-free kits, and not using VoIP (84.9% N = 15,088). Individuals’ age and sex modified this picture, sometimes markedly. Education and smoking status were associated with ever use and call duration, but neither BMI nor handedness was. Cordless phone use was reported by 66.0% of the population, and Wi-Fi use was reported by 88.4%. Conclusion: In this cross-sectional presentation of contemporary mobile phone usage in France, age and sex were important determinants of use patterns. Full article

Background: The impact of prolonged digital device exposure on physical and mental health in children has been widely investigated by the scientific community. Additionally, the lockdown periods due to the COVID-19 pandemic further exposed children to screen time for e-learning activities. The aim of this systematic review (PROSPERO Registration: CRD42022315596) was to evaluate the effect of digital device exposure on children’s health. The impact of the COVID-19 pandemic was additionally explored to verify the further exposure of children due to the e-learning environment. Methods: Available online databases (PubMed, Google Scholar, Semantic Scholar, BASE, Scopus, Web of Science, and SPORTDiscus) were searched for study selection. The PICO model was followed by including a target population of children aged 2 to 12 years, exposed or not to any type of digital devices, while evaluating changes in both physical and mental health outcomes. The quality assessment was conducted by using the Joanna Briggs Institute (JBI) Critical Appraisal Tool. Synthesis without meta-analysis (SWiM) guidelines were followed to provide data synthesis. Results: Forty studies with a total sample of 75,540 children were included in this systematic review. The study design was mainly cross-sectional (n = 28) and of moderate quality (n = 33). Overall, the quality score was reduced due to recall, selection, and detection biases; blinding procedures influenced the quality score of controlled trials, and outcome validity reduced the quality score of cohort studies. Digital device exposure affected physical activity engagement and adiposity parameters; sleep and behavioral problems emerged in children overexposed to digital devices. Ocular conditions were also reported and associated with higher screen exposure. Home confinement during COVID-19 further increased digital device exposure with additional negative effects. Conclusions: The prolonged use of digital devices has a significant negative impact on children aged 2 to 12, leading to decreased physical activity, sleep disturbances, behavioral issues, lower academic performance, socioemotional challenges, and eye strain, particularly following extended online learning during lockdowns. Full article

Background: Patients with head and neck cancer often experience impaired sleep. Moreover, the treatment may negatively affect sleep quality. The aim of this observational study was to evaluate the sleep quality after treatment for head and neck cancer, and its relationship with quality of life and psychological distress. Methods: A total of 151 patients who underwent treatment for head and neck cancer at our department were included in the study. Quality of life, sleep quality, risk of sleep apnea, sleepiness, pain, and psychological distress were assessed by means of specific questionnaires. Results: The median follow-up was 30 months. Poor sleep quality was observed in 55.6% of the cases. An association between PSQI global sleep quality and EORTC global health status was found. The DT, HADS anxiety, and HADS depression scores were associated to PSQI global score, sleep quality, sleep latency, sleep disturbances, and daytime dysfunction. Conclusions: Sleep disturbances, particularly OSA and insomnia, are frequent in HNC patients, and significantly impact their quality of life and psychological well-being. Given the effect of sleep on overall well-being, addressing sleep disorders should be a priority in the care of HNC patients. Full article

Background/Objectives: Major depressive disorder is a significant public health concern linked to factors such as a low-quality diet, a sedentary lifestyle, and poor sleep quality, all of which contribute to its development; nevertheless, the existing literature lacks a comprehensive framework to effectively integrate these interrelated influences. Methods: To address this gap, we conducted a questionnaire-based study involving 411 individuals aged 18 to 74 and employed a weighted complex network model to clarify the associations among nutritional factors, physical activity levels, psychological parameters, and sleep profiles and depression. In addition to constructing networks that encompass distinct subgroups based on general context, sex differences (female vs. male), and four age categories, our network was designed with a clearly defined target: the score from the Beck Depression Inventory. Results: In all networks studied, psychological parameters (e.g., tension, depression, hostility, fatigue, confusion, and total mood disturbance) emerged as the most influential nodes in relation to the targeted node (Eigenvector centrality of approximately 0.30). Additionally, sleep quality was identified as the next most relevant parameter for the general network (Eigenvector = 0.25), while nutritional factors—particularly carbohydrates—demonstrated greater prestige within the male network (Eigenvector = 0.06). Nutritional parameters had a stronger influence on depressive symptoms among individuals aged 29–39 years (Eigenvectors = 0.09, 0.09, and 0.14 for energy, carbohydrates, and fat, respectively). Conclusions: This novel approach allowed for a clearer visualization of how the studied parameters impact depressive symptoms, revealing significant differences when certain aspects are examined independently across distinct groups. Full article

Objective: To investigate the long-term effects of intravenous neridronate treatment in patients with complex regional pain syndrome type 1 (CRPS) in a real-life setting. Methods: We conducted a retrospective study on consecutive CRPS patients treated at our hospital from February 2018 to July 2023. All were treated within three months of the onset of CRPS symptoms. The Patient-Reported Outcomes Measurement Information System 29-Item Health Profile (PROMIS-29) version 2.1 was administered. The main outcome of interest was the evolution of the PROMIS-29 scores from baseline to the last follow-up visit. Patients were categorized as “complete responders” or “non-complete responders”. The association of clinical and demographic variables with a complete response was analyzed using chi-square tests and univariate logistic regression. Results: Thirty-six patients were included, with a median follow-up time of 4.8 years. A significant improvement was noted in the mean numerical pain rating scale (from 6.4 ± 1.9 to 3.1 ± 2.4, p < 0.001), as well as across all PROMIS-29 domains. Physical function improved from 34.2 ± 4.9 to 49.2 ± 9.9, p < 0.001; anxiety from 58.0 ± 6.7 to 49.6 ± 6.9, p < 0.001; depression from 55.3 ± 6.3 to 47.7 ± 6.6, p < 0.001; fatigue from 55.7 ± 7.7 to 50.9 ± 8.7, p < 0.001; sleep disturbance from 53.8 ± 6.8 to 51.3 ± 6.6, p = 0.034; social roles and activities from 41.8 ± 5.2 to 51.8 ± 8.9, p < 0.001; and pain interference from 64.1 ± 5.9 to 52.4 ± 9.9, p < 0.001. The likelihood of achieving a complete response was associated with the male sex, foot or ankle injuries (compared to hand and wrist injuries), and a younger age. No association was found with the type of inciting event or with the body mass index. Conclusions: Our real-life data indicate that early treatment with neridronate leads to substantial benefits in patients affected by CRPS type 1. The strongest responses are seen in young patients, males, and those with lower limb involvement. Full article