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We spend about one-third of our life either sleeping or attempting to do so

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Foreword
We spend about one-third of our life either sleeping or attempting to do so. Sleep is not only comforting, but is
also essential for our normal cognitive functioning and for our survival. Yet sleep can be disturbed or abnormal
in up to one-quarter of the US population. The field of sleep medicine has developed dramatically in the past
few years. To reflect these advances, we are proud to introduce the present two volumes, which are a novelty in
several respects. It is the first time that two Handbook volumes have been dedicated entirely to sleep and its dis-
orders. Readers will find in these two volumes considerable emphasis on recent developments in the field. There is
a new focus on diagnostic techniques, particularly imaging. Fresh attention is given to genetics and clinical aspects
of sleep. Finally, there is extensive coverage of management and of new therapeutic strategies for sleep disorders.
The volumes were edited by Pasquale Montagna and Sudhansu Chokroverty. As series editors, we reviewed
all the chapters and made suggestions for improvement, but we are delighted that the volume editors and chapter
authors produced such scholarly and comprehensive accounts of different aspects of sleep and its disorders.
Hence we hope that these volumes will appeal to clinicians and neuroscientists alike. Significant new advances,
particularly in terms of diagnosis and therapy, lead to new insights that demand a critical appraisal. Our goal is
to provide basic researchers with the foundations for new approaches to the study of these disorders, and clin-
icians with a state-of-the-art reference that summarizes the clinical features and management of the many neu-
rological manifestations of sleep disorders. In addition to the print form, the Handbook series is now available
electronically on Elsevier’s Science Direct site. This should make it even more accessible to readers and should
facilitate searches for specific information.
We are grateful to the two volume editors and to the numerous authors who contributed their time and expertise
to summarize developments in their field and helped put together these outstanding volumes. As always, we are
grateful to the team at Elsevier and in particular to Mr. Michael Parkinson, Ms. Caroline Cockrell, and Mr. Timothy
Horne for their unfailing and expert assistance in the development and production of these volumes.
Michael J. Aminoff
Franc¸ois Boller
Dick F. Swaab
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... Melatonin acts as a Fornaro et al. Sleep Medicine xxx (xxxx) [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] chronotherapeutic on the thalamus and hypothalamus, influencing sleep onset through the MT1-2 receptors [55]. The hypothalamic VLPO is crucial to sleep promotion: sleep-active GABAergic and galaninergic neurons project inhibiting firings towards LH and ARAS nuclei, reducing cortex arousal and inducing sleep [56]. ...
... Sleep Medicine xxx (xxxx) [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Regarding selective serotonin reuptake inhibitors (SSRIs), they all worsen sleep quality as per their pharmacological action. Paroxetine is the most sedative SSRI due to its anticholinergic properties [149] and could cause sleepiness (possibly promoting sleep), notwithstanding its detrimental effects on sleep architecture [150]. ...
... Sleep is a physiological and behavioral state characterized by a lack of consciousness and voluntary movement and considered a period of rest and recovery in which humans spend about one third of their lives (Aminoff et al., 2011). It is a physiologically complex state that is essential for wellbeing, health, and even survival, as can be demonstrated by the ultimately lethal effects of sleep deprivation (Everson et al., 1989). ...
Method
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... On average, about a third of human life is spent sleeping [83]. Maintaining proper sleep hygiene is important for glucose homeostasis [84], and overall metabolic health [85]. ...
Preprint
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Type II diabetes (T2D) is a multifaceted metabolic disease influenced by various factors (genetic, epigenetic, environmental, and other). An alarming surge in T2D prevalence is estimated, reaching 700 million cases by 2045 worldwide. This review explores the complex interactions of multiple risk factors throughout life and offers a new perspective on T2D. Genetic and epigenetic influences are described in detail. Prenatal factors, such as exposure to undernutrition and maternal overfeeding, induce lasting epigenetic changes, affecting T2D susceptibility. Furthermore, birthweight is a crude proxy for perinatal programming, with low and high birthweights associated with increased T2D risk. Often overlooked, the early postnatal period also significantly contributes to perinatal programming. Neonatal over-nutrition and feeding choices exert lasting effects on DNA methylation and metabolic outcomes later in life. Stress during this period further exacerbates T2D susceptibility. In continuation, childhood behaviors which are influenced by prior periods contribute substantially to T2D risk. Adverse childhood experiences amplify the risk of many diseases, including T2D. Sleep hygiene throughout life plays a role in metabolic health, influencing insulin resistance and appetite regulation. In adulthood, obesity remains a prominent predictor of T2D, with chronic stress contributing to weight gain and unhealthy lifestyle. This review proposes a novel perspective, considering T2D pathophysiology as a nonlinear process governed by numerous factors and their interactions throughout life. The inherent unpredictability suggests a need for personalized interventions tailored to specific risk profiles, emphasizing the importance of understanding gene-environment interactions and embracing a holistic view of T2D pathogenesis.
... Sleep is one of the essential aspects of life, People spend one-third of their lives sleeping [1] . Therefore, there is a growing public health concern regarding sleep difficulties [2] . ...
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Background: sleep quality is essential for maintaining good mental and physical well-being and various factors influence sleep quality. However, there is limited research about sleep quality among the general population in Egypt, especially in rural areas. Our study aimed to assess sleep quality and its associated factors among rural Egyptian adults. Methods: We conducted a community-based cross-sectional study in Minia, Egypt, in 2023. A randomly selected rural area was chosen. During data collection, a systematic random sample was used and 325 adults (above 18 years) were interviewed. Socio-demographic and health-related data were collected. The Pittsburgh Sleep Quality Index scale (PSQI) was utilized to assess sleep quality and anthropometric measurements were also taken. Independent predictors of poor sleep quality were identified using a multivariate binary logistic regression model. Results: Over 44% of the participants had poor sleep quality. The most prevalent abnormal sleep domains were sleep latency (43.3%) followed by sleep disturbance (40.3%). Factors such as gender, family income, chronic disease, and health perception were associated with poor sleep. However, multiple regression analyses revealed that only fair (OR: 2.55; 95% CI: 1.13-5.75) and bad health perceptions (OR: 4.27; 95% CI: 1.59-11.43) were significant predictors for poor sleep quality. Conclusion: A sizeable proportion of rural adults suffer from poor sleep quality. It is crucial to prioritize regular screening for poor sleep and develop educational programs in rural communities to enhance sleep quality. Keywords Sleep Quality , Pittsburgh Sleep Quality Index (PSQI),Prevalence risk factors , rural
... S leep is fundamental to overall health and longevity, with the average person spending about one-third of their life sleeping. 1 Adequate sleep is critical for optimal cognition, memory consolidation, mood regulation, metabolism, appetite regulation, and immune and hormone functioning. According to the American Academy of Sleep Medicine and the Sleep Research Society, adults should sleep at least 7 hours per night on a regular basis "to promote optimal health." 2 Yet, between 2013 and 2020, only about 65% of adults in the United States were meeting this amount. ...
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Alzheimer’s disease (AD) affects more women than men, with women throughout the menopausal transition potentially being the most under researched and at-risk group. Sleep disruptions, which are an established risk factor for AD, increase in prevalence with normal aging and are exacerbated in women during menopause. Sex differences showing more disrupted sleep patterns and increased AD pathology in women and female animal models have been established in literature, with much emphasis placed on loss of circulating gonadal hormones with age. Interestingly, increases in gonadotropins such as follicle stimulating hormone are emerging to be a major contributor to AD pathogenesis and may also play a role in sleep disruption, perhaps in combination with other lesser studied hormones. Several sleep influencing regions of the brain appear to be affected early in AD progression and some may exhibit sexual dimorphisms that may contribute to increased sleep disruptions in women with age. Additionally, some of the most common sleep disorders, as well as multiple health conditions that impair sleep quality, are more prevalent and more severe in women. These conditions are often comorbid with AD and have bi-directional relationships that contribute synergistically to cognitive decline and neuropathology. The association during aging of increased sleep disruption and sleep disorders, dramatic hormonal changes during and after menopause, and increased AD pathology may be interacting and contributing factors that lead to the increased number of women living with AD.
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Sleep constitutes a significant portion of human life, with individuals spending approximately one-third of their existence either sleeping or attempting to do so. 1 Sleep is critical not only for its comforting effects but also for maintaining normal cognitive functioning and human survival. The phenomenon of sleep is complex, with the body unresponsive to cognitive impulses from external stimuli whilst the brain continues to function within various learning and memory-related regions. The time spent sleeping is vital for retaining memory, as it helps to stabilize and improve associations between synapses and various areas of the brain. Sleep is divided into two distinct stages, namely rapid-eye movement (REM) sleep and non-rapid-eye movement (NREM) sleep. Slow-wave sleep, the fourth stage of NREM sleep, is the deepest stage of sleep and promotes muscle and mental health restoration, as well as memory consolidation. 2 Acquisition, consolidation, and review are the three primary phases of learning and memory. Acquisition refers to the influx of new information into the brain, consolidation to the preservation of memory, and review to the ability to retrieve stored information. Consolidation of memories can only occur during sleep, according to numerous studies, and it does so through the neural networks that control memory. Additionally, different brainwave patterns are associated with forming different types of memories.
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Objective. To examine the association between insomnia and obesity in Mexican adults aged 50 and older. Materials and methods. We used data from the Mexican Health and Aging Study (2015-2018). Self-reported insomnia was measured using the modified insomnia severity index with scores ranging from zero to six. Obesity was categorized using body mass index (BMI ≥ 30 kg/m2). We used generalized estimating equations to assess the association between insomnia and obesity over three years. Results. Insomnia was associated with obesity (odds ratio [OR]: 1.06, 95% confidence interval [CI]: 1.01,1.11), among those with no obesity at baseline. Among those with obesity, insomnia was not associated with changes in BMI. Lastly, obesity was not associated with changes in insomnia symptoms. Conclusion. This work highlights the association between insomnia and obesity among older Mexican adults and demonstrates the importance of further studies on the effects of insomnia within this population.
Chapter
The high prevalence of sleep-disorderd breathing and overnight oxygen desaturation not only in adults but also in an increasing percentage of children requires clinical attention and competence by the physicians. The American Academy of Sleep Medicine defines obstructive sleep apnea syndrome (OSAS) as an individual having five or more obstructed breathing events per hour during sleep together with certain clinical signs and symptoms (The Report of an American Academy of Sleep Medicine Task Force, Sleep 22:667–689, 1999). Continuous positive airway pressure (CPAP) is considered the standard treatment for OSAS. This therapeutic practice is supported by scientific evidence. CPAP is provided by a system that produces a constant flow of air at a preset pressure and is applied through a nasal mask, fitted to individual patients. Positive pressure is created in the upper respiratory airways, increasing its internal diameter and thereby preventing its collapse during sleep, but its effectiveness depends on patient tolerance of the device. The data on the acceptability or efficacy of several methods of respiratory support are not always univocal and coinciding. The aim of the ventilatory support therapy is to warrant a constant and normal O2 level. Optimal management of nocturnal desaturation remains challenging; therefore, it is key to determine the appropriate and suitable device and to monitor if nightly ventilatory therapy is being followed and carried out properly.KeywordsSleep apneaContinuous positive airway pressureOximetryRhinomanometryNightly monitor
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