BACKGROUND & AIMS: :The aim of this study was to explore how the level of shiftwork exposure during an individual's working life might be related to subjectively reported sleep quality and timing during retirement. Telephone interviews regarding past employment and sleep timing and quality (among other variables) were conducted using a pseudo-random age-targeted sampling process. Subjective sleep quality was assessed using a telephone version of the Pittsburgh Sleep Quality Index. Timing of reported habitual bedtimes and rise-times were assessed using the Sleep Timing Questionnaire. Questions measuring morningness and subjective health were also given. Retired seniors (aged >65 years, n = 1113) were studied. Analysis was by analysis of variance, with shiftwork exposure in three bins [0 (n = 387), 1-15 (n = 371) and >15 years (n = 355)], gender (n = 634 male, 479 female) and former occupation [in two broad categories, 'managerial' (n = 437) versus 'other' (n = 676)] as factors. In retired shiftworkers, relative to retired day workers, past exposure to shiftwork was associated with higher (worse) PSQI scores by 1.0 units (1-15 years) and 0.6 units (>15 years) (main effect P = 0.005). There were also main effects of gender and former occupation (males and managerials reporting better sleep), but neither variable interacted with shiftwork exposure. The timing of current mean habitual bedtimes and rise-times (and also the variance around them) were very similar for the three shiftwork exposure groups. The shiftwork exposure effect did not appear to be mediated by either morningness or current health. Prior exposure to shiftwork would appear to be related to currently reported sleep problems during retirement.

背景与目标： ：这项研究的目的是探讨个人工作生活中的轮班暴露水平可能与主观报告的睡眠质量和退休时间有关。使用伪随机针对年龄的抽样过程，就过去的工作，睡眠时间和质量（以及其他变量）进行了电话采访。使用匹兹堡睡眠质量指数的电话版本评估主观睡眠质量。使用睡眠时间问卷评估报告的习惯就寝时间和上升时间的时间。还提出了衡量早晨和主观健康的问题。研究了退休的老年人（年龄> 65岁，n = 1113）。通过方差分析进行分析，三个班次中有轮班工作暴露[0（n = 387），1-15（n = 371）和> 15岁（n = 355）]，性别（n = 634男性，479女性）和以前的职业[分为两大类，“管理”（n = 437）与“其他”（n = 676）]作为因素。在退休的轮班工人中，相对于退休的日工，过去的轮班暴露与较高的（较差的）PSQI分数相关（1.0单位（1-15年）和0.6单位（> 15年））（主要影响P = 0.005）。性别和以前的职业也有主要影响（男性和管理人员报告了更好的睡眠），但没有变量与轮班工作发生相互作用。对于三个轮班暴露组，当前平均习惯就寝时间和上升时间（以及周围的变化）的时间安排非常相似。轮班暴露的影响似乎不是由早晨或目前的健康介导的。先前接触轮班工作似乎与目前报告的退休期间的睡眠问题有关。

BACKGROUND & AIMS: :Steier, Joerg, Nic Cade, Ben Walker, John Moxham, and Caroline Jolley. Observational study of neural respiratory drive during sleep at high altitude. High Alt Med Biol. 18:242-248, 2017. AIMS:Ventilation at altitude changes due to altered levels of pO2, pCO2 and the effect on blood pH. Nocturnal ventilation is particularly exposed to these changes. We hypothesized that an increasing neural respiratory drive (NRD) is associated with the severity of sleep-disordered breathing at altitude. METHODS:Mountaineers were studied at sea level (London, United Kingdom), and at altitude at the Aconcagua (Andes, Argentina). NRD was measured as electromyogram of the diaphragm (EMGdi) overnight by a transesophageal multi-electrode catheter; results were reported for sea level, 3,380 m, 4,370 m, and 5,570 m. RESULTS:Four healthy subjects (3 men, age 31(3)years, body mass index 23.6(0.9)kg/m2, neck circumference 37.0(2.7)cm, forced expiratory volume in 1 second 111.8(5.1)%predicted, and forced vital capacity 115.5(6.3)%predicted) were studied. No subject had significant sleep abnormalities at sea level. Time to ascent to 3,380 m was 1 day, to 4,370 m was 5 days, and the total nights at altitude were 21 days. The oxygen desaturation index (4% oxygen desaturation index [ODI] 0.8(0.4), 22.0 (7.2), 61.4 (26.9), 144.9/hour, respectively) and the EMGdi (5.2 (1.9), 12.8 (5.1), 14.1 (3.4), 18.5%, respectively) increased with the development of periodic breathing at altitude, whereas the average SpO2 declined (97.5 (1.3), 84.8 (0.5), 81.0 (4.1), 68.5%, respectively). The average EMGdi correlated well with the 4%ODI (r = 0.968, p = 0.032). CONCLUSION:NRD sleep increases at altitude in relation to the severity of periodic breathing.

背景与目标： ：斯蒂尔，约尔格，尼克·凯德，本·沃克，约翰·莫克瑟姆和卡罗琳·乔利。高原睡眠中神经呼吸驱动的观察性研究。高Alt Med生物学。 18：242-248，2017。
目的：由于pO2，pCO2水平的改变以及对血液pH值的影响，海拔高度的通风情况发生变化。夜间通气尤其容易受到这些变化的影响。我们假设增加的神经呼吸驱动（NRD）与海拔高度的睡眠呼吸障碍的严重程度有关。
方法：在海平面（英国伦敦）和阿空加瓜的海拔高度（阿根廷安第斯山脉）对登山者进行了研究。通过经食管的多电极导管将NRD测量为隔夜肌膜（EMGdi）的肌电图；报告了海平面3380 m，4370 m和5570 m的结果。
结果：四名健康受试者（3名男性，年龄31（3）岁，体重指数23.6（0.9）kg / m2，颈围37.0（2.7）cm，1秒内被测出的呼气量为111.8（5.1）％，被测出肺活量115.5（6.3）％预计）。没有受试者在海平面上有明显的睡眠异常。上升到3,380 m的时间是1天，到达4,370 m的时间是5天，海拔高度的总夜晚数是21天。氧饱和度指数（4％氧饱和度指数[ODI] 0.8（0.4），22.0（7.2），61.4（26.9），144.9 /小时）和EMGdi（5.2（1.9），12.8（5.1），14.1（ 3.4），18.5％）随高海拔周期性呼吸的发展而增加，而平均SpO2下降（分别为97.5（1.3），84.8（0.5），81.0（4.1）和68.5％）。平均EMGdi与4％ODI密切相关（r = 0.968，p = 0.032）。
结论：与定期呼吸的严重程度相比，高海拔地区的NRD睡眠增加。

BACKGROUND & AIMS: :This study evaluated the prevalence and factors associated with sleep disturbance in a large cohort of HIV-infected patients across China. A cross-sectional study was conducted among HIV-infected patients on antiretroviral therapy at 20 AIDS clinics. The Pittsburgh Sleep Quality Index was self-administered by subjects. Socio-demographic characteristics, medical history and HIV-related clinical data were collected. 4103 patients had complete data for analysis. Sleep disturbances were observed in 43.1% of patients. Associated factors in multivariable analysis included psychological factors: anxiety (odds ratio [OR], 3.13; 95% confidence interval [CI], 2.44-4.00; P < 0.001), depression (OR, 2.09; 95% CI, 1.70-2.57; P < 0.001), and both anxiety and depression (OR, 5.90; 95% CI, 4.86-7.16; P < 0.001); sociodemographic factors: MSM (OR, 1.26; 95% CI, 1.04-1.52; P = 0.018), being single (OR, 1.45; 95%CI 1.21-1.74; P < 0.001), higher education (OR, 1.25; 95% CI, 1.03-1.53; P = 0.025); and clinical factors: suboptimal adherence (OR,1.51; 95% CI,1.23-1.85; P < 0.001), regimen-switching (OR, 1.94; 95% CI, 1.12-3.35; P = 0.018), and antidepressant use (OR, 1.98; 95% CI, 1.47-2.67; P = 0.044). Prevalence of sleep disturbance is high in this large Chinese cohort. Associated factors appear related to psychological and social-demographic factors. Health workers may consider routinely assessing sleep disturbances among HIV-infected patients, especially in the first three months after HIV diagnosis, and referring for mental health services, which may positively impact adherence to treatment.

背景与目标： ：这项研究评估了中国一大批感染HIV的患者的患病率和与睡眠障碍相关的因素。在20个艾滋病诊所中，对接受HIV感染的患者进行了抗逆转录病毒治疗的横断面研究。匹兹堡睡眠质量指数由受试者自行管理。收集了社会人口统计学特征，病史和与艾滋病相关的临床数据。 4103例患者有完整的数据需要分析。在43.1％的患者中观察到睡眠障碍。多变量分析中的相关因素包括心理因素：焦虑（赔率[OR]，3.13； 95％置信区间[CI]，2.44-4.00； P <0.001），抑郁（OR，2.09； 95％CI，1.70-2.57；病历）。 P <0.001），以及焦虑和抑郁（OR，5.90； 95％CI，4.86-7.16； P <0.001）；社会人口统计学因素：MSM（OR，1.26; 95％CI，1.04-1.52; P = 0.018），单身（OR，1.45; 95％CI 1.21-1.74; P <0.001），高等教育程度（OR，1.25; 95％CI，1.03-1.53​​; P = 0.025）;临床因素：次最佳依从性（OR，1.51; 95％CI，1.23-1.85; P <0.001），方案转换（OR，1.94; 95％CI，1.12-3.35; P = 0.018），和抗抑郁药的使用（OR ，1.98； 95％CI，1.47-2.67； P ＝ 0.044）。在这个庞大的中国人群中，睡眠障碍的患病率很高。相关因素似乎与心理和社会人口统计学因素有关。卫生工作者可以考虑常规评估艾滋病毒感染患者的睡眠障碍，尤其是在艾滋病毒确诊后的前三个月，并寻求心理健康服务，这可能会对坚持治疗产生积极影响。

BACKGROUND & AIMS: :The purpose of this investigation was to evaluate the effectiveness of a behavioral treatment package to reduce chronic sleep problems in children with Angelman Syndrome. Participants were five children, 2-11 years-of-age. Parents maintained sleep diaries to record sleep and disruptive nighttime behaviors. Actigraphy was added to provide independent evaluations of sleep-wake activity. The treatment package targeted the sleep environment, the sleep-wake schedule, and parent-child interactions during sleep times. Treatment was introduced sequentially, across families, and evaluated in an interrupted time series, multiple baseline design. Data show that prior to treatment, baseline rates of nighttime disruptive behavior were stable or increasing and none of the participants were falling to sleep independently. With the introduction of treatment, all participants quickly learned to initiate sleep independently. Gradual reductions were reported in disruptive behaviors and these improvements were sustained over time. Results were replicated with two participants when treatment was withdrawn and reinstated. Changes in disruptive bedtime behaviors and in sleep onset were found to be statistically significant. Parents indicated high satisfaction with the treatment. A behavioral treatment package was found to be effective with five children with long histories of significant sleep-related behavior problems. These results suggest that behavioral treatment may be a reasonable way to address sleep problems in some children with Angelman Syndrome.

背景与目标： ：这项研究的目的是评估行为治疗方案以减少Angelman综合征患儿的慢性睡眠问题的有效性。参加者为5个年龄在2-11岁之间的儿童。父母保留睡眠日记以记录睡眠和夜间行为。增加了书法，以提供对睡眠觉醒活动的独立评估。该治疗方案针对睡眠环境，睡眠唤醒计划以及睡眠期间的亲子互动。在各个家庭中按顺序引入治疗方法，并在中断的时间序列和多个基线设计中进行评估。数据显示，在治疗之前，夜间破坏行为的基线率稳定或上升，并且没有参与者独立入睡。随着治疗的引入，所有参与者很快学会了独立开始睡眠。据报道，破坏性行为逐渐减少，并且随着时间的推移，这些改善持续存在。退出治疗并恢复治疗时，两名参与者重复了结果。发现破坏性的就寝时间行为和睡眠发作的变化在统计学上是显着的。父母对治疗表示高度满意。发现行为治疗一揽子方法对五个有悠久的重大睡眠相关行为问题病史的儿童有效。这些结果表明，行为治疗可能是解决某些Angelman综合征儿童睡眠问题的合理方法。

BACKGROUND & AIMS: :The goal of our study was to investigate different aspects of sleep, namely the sleep-wake cycle and sleep stages, in the vegetative state/unresponsive wakefulness syndrome (VS/UWS), and minimally conscious state (MCS). A 24-h polysomnography was performed in 20 patients who were in a UWS (n=10) or in a MCS (n=10) because of brain injury. The data were first tested for the presence of a sleep-wake cycle, and the observed sleep patterns were compared with standard scoring criteria. Sleep spindles, slow wave sleep, and rapid eye movement sleep were quantified and their clinical value was investigated. According to our results, an electrophysiological sleep-wake cycle was identified in five MCS and three VS/UWS patients. Sleep stages did not always match the standard scoring criteria, which therefore needed to be adapted. Sleep spindles were present more in patients who clinically improved within 6 months. Slow wave sleep was present in eight MCS and three VS/UWS patients but never in the ischemic etiology. Rapid eye movement sleep, and therefore dreaming that is a form of consciousness, was present in all MCS and three VS/UWS patients. In conclusion, the presence of alternating periods of eyes-open/eyes-closed cycles does not necessarily imply preserved electrophysiological sleep architecture in the UWS and MCS, contrary to previous definition. The investigation of sleep is a little studied yet simple and informative way to evaluate the integrity of residual brain function in patients with disorders of consciousness with possible clinical diagnostic and prognostic implications.

背景与目标： ：我们的研究目标是研究处于营养状态/无反应性清醒综合症（VS / UWS）和最低意识状态（MCS）的睡眠的不同方面，即睡眠-觉醒周期和睡眠阶段。在20例因脑损伤而处于UWS（n = 10）或MCS（n = 10）的患者中进行了24小时多导睡眠监测。首先测试数据是否存在睡眠-觉醒周期，并将观察到的睡眠模式与标准评分标准进行比较。对睡眠纺锤体，慢波睡眠和快速眼动睡眠进行了量化，并研究了它们的临床价值。根据我们的结果，在5例MCS和3例VS / UWS患者中发现了电生理睡眠-觉醒周期。睡眠阶段并不总是符合标准的评分标准，因此需要进行调整。在6个月内临床好转的患者中，睡眠纺锤体的比例更高。慢波睡眠存在于8例MCS和3例VS / UWS患者中，但从未出现在缺血性病因中。所有MCS和3名VS / UWS患者都出现了快速的眼球运动睡眠，并因此梦想成一种意识意识。总之，睁眼/闭眼周期交替周期的存在并不一定意味着在UWS和MCS中保留了电生理睡眠结构，这与先前的定义相反。对睡眠的研究是一项经过研究的简单方法，但它为评估意识障碍患者的残余脑功能的完整性提供了可能，该方法可能具有临床诊断和预后意义。

BACKGROUND & AIMS: BACKGROUND AND AIM:Little is known about the relation between gastroesophageal reflux (GER) episodes and sleep interruptions in infants. The aim of the study was to evaluate the relationship between GER and the incidence of sleep interruptions in infants. METHODS:Study patients included 24 infants (younger than 1 year) referred for multichannel intraluminal impedance and esophageal pH monitoring with simultaneous polysomnography. Exclusion criteria were a previous fundoplication and studies lasting <20 hours. Tests were clinically indicated to investigate suspicion of GER-related apnea (17, 70.8%), stridor (6, 25%), noisy breathing (2, 8.3%), and cyanotic spells (1, 4.2%). Most patients presented with significant comorbidities (19, 79.2%). RESULTS:The number of nonacid GER (NAGER) per hour was greater during sleep time than during daytime and awakening following sleep onset (median 0.27 vs 1.85 and 1.45, P<0.01). A total of 1204 (range 7-86 per infant) arousals in 24 infants was detected, 165 (13.7%) that followed GER episodes, and 43 (3.6%) that preceded GER episodes. Seven patients presented with a positive symptom association probability for arousals; 5 were exclusively because of NAGER. A positive symptom association probability for awakenings was detected in 9 patients; 4 were because of NAGER, 4 were because of AGER, and 1 was because of both NAGER and GER. Patients with awakenings related to GER presented longer mean clearance time of AGER during sleep (165.5 vs 92.8 seconds, P=0.03). CONCLUSIONS:GER was a frequent cause of interrupting sleep among our infant patients, and NAGER proved to be equally important as AGER for causing arousals and awakenings in infants.

背景与目标： 背景与目的：婴幼儿胃食管反流（GER）发作与睡眠中断之间的关系知之甚少。该研究的目的是评估GER与婴儿睡眠中断发生率之间的关系。
方法：研究患者包括24例婴儿（1岁以下），他们接受多通道腔内阻抗监测和同时进行多导睡眠监测的食管pH监测。排除标准为先前的胃底折叠术，研究持续<20小时。临床上已进行测试，以调查可疑的GER相关性呼吸暂停（17，70.8％），喘鸣（6，25％），嘈杂的呼吸（2，8.3％）和紫otic（1，4.2％）。大多数患者表现出明显的合并症（19，79.2％）。
结果：睡眠时间每小时的非酸性GER（NAGER）数量比白天和睡眠开始后的清醒时间要多（中位数为0.27 vs 1.85和1.45，P <0.01）。在24例婴儿中共检测到1204例（每个婴儿7-86范围）觉醒，GER发作后有165例（13.7％），GER发作前有43例（3.6％）。七名患者的觉醒症状关联概率为正值； 5个完全是因为NAGER。 9例患者的觉醒症状关联概率为正值； 4个是由于NAGER引起的，4个是由于AGER引起的，而1个是由于NAGER和GER​​引起的。与GER相关的觉醒患者在睡眠期间表现出更长的AGER平均清除时间（165.5 vs 92.8秒，P = 0.03）。
结论：GER是导致婴儿患者睡眠中断的常见原因，并且NAGER与AGER在引起婴儿唤醒和觉醒方面具有同等重要的作用。

BACKGROUND & AIMS: OBJECTIVE:To obtain prevalence estimates of clinical features of obstructive sleep apnoea (OSA) and identify the dimensions of the public health problem requiring further investigation for an Australian population. METHODS:The South Australian Health Omnibus Survey is an annual representative population survey of South Australians aged≥15 years, conducted via interviewer-administered questionnaire. In 2009, 3007 participants were asked the STOP-BANG instrument measure of obstructive sleep apnoea risk, which includes symptoms of loud snoring, frequent tiredness during daytime, observed apnoea, and high blood pressure (STOP), and measured body mass index, age, neck circumference and gender (BANG). Three or more positive response categorises a person at high risk for OSA. RESULTS:Snoring was reported by 49.7% of adults. Tiredness after sleep more than 3 - 4 times per week was reported by 24.8%, and during wake-time by 27.7% of adults, with 8.8% reporting having fallen asleep while driving. Over half of the surveyed men (57.1%, n=566) and 19.3% (n=269) of the women were classified at high-risk of OSA with the STOP-BANG measure. In multivariable models, high risk was associated with less education, lower income, and residence in a regional rather than metropolitan area. CONCLUSION:The high prevalence of adults at risk for OSA suggests that the capacity currently available within the healthcare system to investigate and diagnose OSA is likely to be inadequate, particularly outside urban areas. This highlights an important public health problem that requires further detailed study and trials of new models of care.

背景与目标： 目的：获得阻塞性睡眠呼吸暂停（OSA）临床特征的患病率估计值，并确定需要进一步调查的澳大利亚人群公共卫生问题的范围。
方法：《南澳大利亚健康综合调查》是对年满15岁的南澳大利亚人进行的年度代表性人口调查，通过访调员管理的问卷调查进行。 2009年，有3007名参与者被要求使用STOP-BANG仪器测量阻塞性睡眠呼吸暂停的风险，包括大声打，白天频繁疲倦，观察到的呼吸暂停和高血压（STOP）的症状，以及测得的体重指数，年龄，脖子围和性别（BANG）。三个或更多的积极反应将高OSA风险的人归类。
结果：49.7％的成年人打S。据报告，睡眠后每周疲倦超过3-4次，占24.8％；在唤醒时间，成年人中有27.7％，其中有8.8％的人在开车时睡着了。通过STOP-BANG措施将超过一半的男性（57.1％，n = 566）和19.3％（n = 269）的女性归为OSA高危人群。在多变量模型中，高风险与受教育程度较低，收入较低以及居住在区域而不是大都市地区有关。
结论：高危人群中存在OSA的高患病率表明，医疗系统中目前可用于调查和诊断OSA的能力可能不足，尤其是在城市地区以外。这突出了一个重要的公共卫生问题，需要对新的护理模式进行进一步的详细研究和试验。

BACKGROUND & AIMS: Tumor necrosis factor (TNF) is a well characterized sleep-regulatory substance. To study receptor mechanisms for the sleep-promoting effects of TNF, sleep patterns were determined in control and TNF 55 kDa receptor knock-out (TNFR-KO) mice with a B6 x 129 background after intraperitoneal injections of saline or murine TNFalpha. The TNFR-KO mice had significantly less baseline sleep than the controls. TNFalpha dose-dependently increased non-rapid eye movement sleep (NREMS) in the controls but did not influence sleep in TNFR-KO mice. Although TNFR-KO mice failed to respond to TNFalpha, they had an increase in NREMS and a decrease in rapid eye movement sleep after interleukin-1beta treatment. These results indicate that TNFalpha affects sleep via the 55 kDa receptor and provide further evidence that TNFalpha is involved in physiological sleep regulation. Current results also extend the list of species to mice in which TNFalpha and interleukin-1beta are somnogenic.

背景与目标： 肿瘤坏死因子（TNF）是一种特征良好的睡眠调节物质。为了研究TNF促进睡眠的受体机制，在腹膜内注射盐水或鼠TNFalpha后，在B6 x 129背景的对照组和TNF 55kDa受体敲除（TNFR-KO）小鼠中确定睡眠模式。 TNFR-KO小鼠的基线睡眠明显少于对照组。 TNFalpha剂量依赖性地增加了对照组的非快速眼动睡眠（NREMS），但不影响TNFR-KO小鼠的睡眠。尽管TNFR-KO小鼠对TNFα无效，但在白介素1β治疗后，它们的NREMS升高且眼球快速睡眠减少。这些结果表明TNFα通过55kDa受体影响睡眠，并提供进一步的证据证明TNFα参与生理性睡眠调节。目前的结果也将TNFα和白细胞介素-1β具有催眠作用的小鼠扩大了物种种类。

BACKGROUND & AIMS: :Drinking to intoxication is a modifiable risk factor for various health, social, and legal problems. The objective was to estimate the relative risk of intoxication by type of drinking location. Participants were 1614 university students (mean age 19.0 years) in residential halls who completed a web survey (67% response). Respondents reported their drinking for each day of the preceding week, in residential halls, pubs/bars/nightclubs, student flats/houses, and 'other' locations. An estimated blood alcohol concentration (EBAC) was computed and intoxication was defined as EBAC>0.08%. Pubs/bars/nightclubs accounted for 51% of all alcohol consumed, followed by residential halls (34%), student flats/houses (9%), and other locations (6%). Episodes resulting in intoxication comprised 61% of all drinking episodes in pubs/bars/nightclubs, 55% in student flats/houses, 53% in residential halls, and 37% in other locations. Multi-level analyses revealed positive associations between the first three location types (relative to 'other') and intoxication among women. Drinking in pubs/bars/nightclubs was associated with intoxication among men. Other significant predictors included hazardous drinking in the respondent's residential hall, pre-university drinking, and first-year status. Student intoxication is commonplace in licensed premises and residential halls. These environments are amenable to interventions to reduce the incidence of intoxication.

背景与目标： ：醉酒是各种健康，社会和法律问题的可修正风险因素。目的是根据饮酒场所的类型来估计中毒的相对风险。参加者为1614名在宿舍中的大学生（平均年龄19.0岁），他们完成了网络调查（回复率为67％）。受访者报告了前一周的每一天在居民大厅，酒吧/酒吧/夜总会，学生公寓/房屋和“其他”地点的饮酒情况。计算估计的血液酒精浓度（EBAC），并将中毒定义为EBAC> 0.08％。酒馆/酒吧/夜总会占所有酒精消费的51％，其次是宿舍（34％），学生公寓/房屋（9％）和其他场所（6％）。在酒吧/夜总会中，导致醉酒的发作占所有饮酒发作的61％，在学生公寓/房屋中占55％，在学生宿舍中占53％，在其他地方占37％。多级分析显示，前三个位置类型（相对于“其他”位置）与女性中毒之间呈正相关。在酒吧/酒吧/夜总会喝酒与男性中毒有关。其他重要的预测指标包括被调查者在住宅大厅内的有害饮酒，大学前饮酒和第一年的状态。在许可的场所和宿舍中，学生醉酒是司空见惯的。这些环境适合进行干预以减少中毒的发生率。

BACKGROUND & AIMS: BACKGROUND:The hormone melatonin plays a key role in the proper functioning of the circadian timing system (CTS). Exogenous melatonin has been shown to be beneficial in cases of CTS dysfunction and sleep disturbances. The aim of our study was to relate 24-h melatonin excretion to objective sleep measures. METHODS:A total of 67 individuals were included in the study: 29 healthy subjects (16 women, 13 men; mean age 62.4 y, range 24-86) and 38 outpatients with neuropsychiatric sleep-related disturbances (25 women, 13 men; mean age 46.5 y, range 21-69). Over two consecutive nights in the sleep laboratory, polysomnographic (PSG) recordings were made and urine samples were collected at predefined intervals. RESULTS:Our data failed to show any age-controlled partial correlation between 6-sulphatoxymelatonin (aMT6s) parameters and PSG parameters in either of the two groups. CONCLUSION:Measuring endogenous melatonin does not seem to be an adequate way to evaluate sleep quality. This could be due to the fact that the size of the pineal gland and the amount of melatonin produced vary 20-fold between individuals.

背景与目标： 背景：褪黑激素在昼夜节律计时系统（CTS）的正常运转中起着关键作用。外源性褪黑素已被证明对CTS功能障碍和睡眠障碍有益。我们研究的目的是将24小时褪黑激素排泄与客观睡眠指标联系起来。
方法：研究共纳入67位个体：29位健康受试者（16位女性，13位男性；平均年龄62.4岁，范围24-86）和38位神经精神病患者与睡眠相关的门诊患者（25位女性，13位男性；平均年龄46.5岁，范围21-69）。在睡眠实验室连续两个晚上，进行了多导睡眠图（PSG）记录，并以预定的时间间隔收集了尿液样本。
结果：我们的数据未能显示两组中的6-硫代氧黑素（aMT6s）参数和PSG参数之间存在任何年龄控制的部分相关性。
结论：测量内源性褪黑激素似乎并不是评估睡眠质量的适当方法。这可能是由于松果体的大小和褪黑激素的产生量在个体之间变化了20倍。

BACKGROUND & AIMS: The present study examined the differences of self-ratings of 4 h sleep in three statesL-WE, where the percentage of waking time and urinary epinephrine are low (< 20% waking time); H-W, where the percentage of waking time and epinephrine levels increase along the basal regression line as determined by a previous study (20-100% waking time and < 7 ng/min); H-E, where epinephrine levels increase more than expected from the basal regression line for the two parameters (> 7 ng/min). Eight healthy male subjects participated twice in a 4 h polysomnograph experiment with four types of sleep onset (total of 64 observations). In group L-WE (52 observations for eight subjects), there were no excessively negative feelings on sleep latency, sleep depth, and feelings of sleep compared with usual sleep according to the questionnaire. Subjective sleep diagrams in group L-WE were similar to polysomnographic findings. Thus, group L-WE was thought objectively and subjectively to have a good sleep state. Groups H-W (eight observations for four subjects) and H-E (four observations for two subjects) had negative feelings regarding sleep depth and feelings of sleep compared with usual sleep. Approximately half the group H-W underrated their sleep compared with objective diagrams, while all cases in group H-E remarkably underrated their sleep in the subjective diagrams. The state of remarkable adrenal medullary secretory activity seen in group H-E and that of the slightly increased activity shown in group H-W were included in poor sleep states objectively and subjectively.

背景与目标： 本研究研究了三个州L-WE的4小时睡眠自我评价的差异，其中L-WE的醒来时间和尿肾上腺素的百分比较低（醒来时间<20％）； H-W，如先前研究确定的那样，苏醒时间和肾上腺素水平的百分比沿基础回归线增加（苏醒时间为20-100％，<7 ng / min）； H-E，其中两个参数（> 7 ng / min）的肾上腺素水平增加超过基线回归线的预期。八名健康男性受试者两次参加了4小时多导睡眠图实验，其中有四种类型的睡眠发作（总共64次观察）。根据问卷调查，在L-WE组（对八个受试者的52项观察）中，与通常的睡眠相比，在睡眠潜伏期，睡眠深度和睡眠感觉上没有过度的负面感觉。 L-WE组的主观睡眠图与多导睡眠图检查结果相似。因此，客观地和主观地认为L-WE组具有良好的睡眠状态。与常规睡眠相比，H-W组（四个受试者的八个观察结果）和H-E组（两个受试者的四个观察结果）对睡眠深度和睡眠感觉有负面感觉。与客观图表相比，H-W组大约一半的人低估了他们的睡眠，而在客观图表中，H-E组的所有病例均明显低估了他们的睡眠。 H-E组所见的肾上腺髓质分泌活动显着状态和H-W组所显示的肾上腺髓质分泌活动略有增加的状态被客观地和主观地纳入了不良睡眠状态。

BACKGROUND & AIMS: :The central nervous system undergoes several dynamic changes during sleep, which are coordinated by the pons, basal forebrain areas, and other subcortical structures and are mediated by three major neurotransmitters-norepinephrine, serotonin, and acetylcholine. The neuronal populations that produce these neuromodulators constitute the central representation of the sympathetic and parasympathetic subdivisions of the autonomic nervous system. The locus coeruleus (noradrenergic) and the raphe nucleus (serotoninergic) are most active during waking and become progressively less active in the transition from non-rapid eye movement (non-REM) to rapid eye movement (REM) sleep. On the other hand, the cholinergic neurons in the dorsolateral tegmental and pedunculopontine nuclei area are active both during waking and REM sleep. Over the past decade, a number of studies have provided interesting new evidence supporting the role of sleep in sleep-dependent memory processing. These studies have been directed specifically towards the role of sleep in memory encoding, memory consolidation, brain plasticity and memory reconsolidation, and have confirmed the hypothesis that sleep contributes importantly to processes of memory and brain plasticity. It has been shown in humans that sleep triggers overnight learning on a motor-sequence memory task, while equivalent waking periods produce no such improvement. These findings have important implications for acquiring real-life skills and in clinical rehabilitation following brain trauma and stroke.

背景与目标： ：中枢神经系统在睡眠过程中会经历一些动态变化，这些变化由脑桥，基底前脑区域和其他皮质下结构协调，并由三种主要的神经递质-去甲肾上腺素，5-羟色胺和乙酰胆碱介导。产生这些神经调节剂的神经元群体构成了自主神经系统交感神经和副交感神经细分的主要代表。醒来时，蓝斑（去甲肾上腺素能）和核中核（5-羟色胺能）最活跃，并且在从非快速眼动（non-REM）到快速眼动（REM）睡眠的过渡过程中，逐渐变弱。另一方面，在清醒和快速眼动睡眠期间，背外侧被盖区和足桥骨核区域的胆碱能神经元均活跃。在过去的十年中，许多研究提供了有趣的新证据来支持睡眠在依赖于睡眠的记忆处理中的作用。这些研究专门针对睡眠在记忆编码，记忆巩固，脑可塑性和记忆重建中的作用，并证实了以下假设：睡眠在记忆和脑可塑性过程中起重要作用。在人类中已经证明，睡眠触发了对运动序列记忆任务的通宵学习，而等效的醒着时间则没有这种改善。这些发现对于获得现实生活的技能以及脑外伤和中风后的临床康复具有重要意义。

BACKGROUND & AIMS: :Sleep-disordered breathing often presents as a cardiac or psychiatric problem. Such presentation may lead to suboptimal diagnostic and therapeutic decisions. The authors present a case in which a patient's condition improved only after the primary disorder was diagnosed and properly managed.

背景与目标： ：睡眠呼吸障碍通常表现为心脏或精神疾病。这样的表现可能导致次优的诊断和治疗决策。作者介绍了一种情况，只有在诊断出原发性疾病并妥善处理后，患者的病情才会改善。

BACKGROUND & AIMS: OBJECTIVES:To examine associations between sleep duration and health outcomes among distinct groups of sexual minority adults. METHODS:Using data from the 2014 Behavioral Risk Factor Surveillance System, we compared sleep duration (very short: ≤ 5 hr; short: 6 hr; normal: 7-8 hr; and long: ≥ 9 hr per day) between cisgender straight adults and distinct groups of sexual minorities. We further examined associations between sleep duration and 10 chronic health conditions among sexual minorities. RESULTS:Of 146,893 respondents, 142,507 (96.2%) were cisgender straight, and 4,386 (3.8%) were lesbian, gay, bisexual, transgender (LGBT). Overall, 17.3% of LGBT respondents reported very short sleep per day, compared with 12.2% for cisgender straight respondents (p < 0.0001). Among LGBT populations, the prevalence of very short sleep varied significantly among distinct groups, ranging from 13.2% among transgender female to male adults to 35.5% among transgender gender nonconforming adults. Very short sleep was further associated with increased odds of having stroke (aOR = 4.1, 95% CI [2.2-7.6]), heart attack (aOR = 3.0, CI [1.6-5.8]), coronary heart disease (aOR = 3.1, 95% CI [1.5-6.2]), asthma (aOR = 1.7, 95% CI [1.1-2.4]), chronic obstructive pulmonary disease (aOR = 2.5, CI [1.5-4.0]), arthritis (aOR = 2.1, CI [1.4-3.0]), and cancer (aOR = 1.8, 95% CI [1.0-3.2]) among sexual minorities. Disparities in the prevalence of stroke, heart attack, coronary health disease, COPD, diabetes, obesity, arthritis, and cancer were found among LGBT populations. CONCLUSIONS:Sexual minorities have a higher prevalence of sleep deprivation as compared with their straight counterparts. Sleep deprivation varies by sexual identity and gender. Very short sleep duration is associated with some chronic health conditions among LGBT populations. Promotion of sleep health education and routine medical assessment of sleep disorders are critically needed for sexual minority adults.

背景与目标： 目的：研究不同性别的成年少数群体的睡眠时间与健康结局之间的关联。
方法：使用2014年行为危险因素监测系统的数据，我们比较了直食成年成年直觉成年成年人的睡眠时间（非常短：≤5小时;短：6小时;正常：7-8小时;每天：≥9小时）以及不同性别的少数群体。我们进一步研究了性少数群体的睡眠时间与10种慢性健康状况之间的关联。
结果：在146,893名受访者中，有142,507名（96.2％）为顺性别，而有4,386名（3.8％）为女同性恋，男同性恋，双性恋和变性者（LGBT）。总体而言，LGBT受访者中有17.3％的人每天睡眠时间很短，而顺性别的受访者中有12.2％的人每天睡眠时间短（p <0.0001）。在LGBT人群中，不同组别的极短睡眠发生率差异显着，从跨性别女性到男性成年人中的13.2％，到跨性别性别不合格成年人中的35.5％。睡眠时间短还与中风（aOR = 4.1，95％CI [2.2-7.6]），心脏病发作（aOR = 3.0，CI [1.6-5.8]），冠心病（aOR = 3.1， 95％CI [1.5-6.2]），哮喘（aOR = 1.7、95％CI [1.1-2.4]），慢性阻塞性肺疾病（aOR = 2.5，CI [1.5-4.0]），关节炎（aOR = 2.1，CI [1.4-3.0]）和性少数人群中的癌症（aOR = 1.8，95％CI [1.0-3.2]）。在LGBT人群中发现中风，心脏病发作，冠心病，COPD，糖尿病，肥胖症，关节炎和癌症的患病率存在​​差异。
结论：与异性恋人群相比，性少数人群的睡眠剥夺患病率更高。睡眠剥夺因性别和性别而异。极短的睡眠时间与LGBT人群中的某些慢性健康状况有关。性少数成年人迫切需要促进睡眠健康教育和睡眠障碍的常规医学评估。

BACKGROUND & AIMS: :Chronic sleep restriction is a common experience; and while it has negative physiological effects, little is known about how it affects human behavior. To date, no study has investigated whether chronic sleep restriction can influence implicit attitudes (e.g., towards a race). Here, in a randomized, counterbalanced crossover design, we subjected participants to 3 weeks of chronic sleep restriction in the lab (i.e., 3 weekly cycles of 5 nights of 4 hours of sleep per night followed by 2 nights of 8 hours of sleep) and found evidence for an increased negative implicit bias towards Arab Muslims. No indicators of an implicit bias were found in these same individuals when they were rested (during a counterbalanced 3-week period of 8 hours time in bed per night). These findings suggest that chronic sleep restriction may "unmask" implicit racial or ethnic biases that are otherwise inhibited when in a rested state. Because chronic sleep restriction is prevalent among many occupations that routinely interact with ethnic minorities in potentially high-conflict situations (e.g., police officers), it is critical to consider the role that restricted sleep may play in exacerbating negative implicit attitudes and their potential for provoking unintentional and potentially harmful behavioral consequences.

背景与目标： ：长期睡眠受限是一种常见的经历；尽管它具有负面的生理作用，但对其如何影响人类行为知之甚少。迄今为止，尚无研究调查慢性睡眠限制是否会影响内在态度（例如，对种族的态度）。在这里，在随机，平衡的分频设计中，我们在实验室中对参与者进行了3周的慢性睡眠限制（即每周3个周期，即每晚4个小时的5夜睡眠，然后是2个小时的8个小时的夜睡眠）。发现证据表明，对阿拉伯穆斯林的负面内在偏见有所增加。在这些人休息时（在平衡的3周内，每晚卧床时间为8小时），没有发现隐性偏见的迹象。这些发现表明，长期睡眠限制可能会“掩盖”内在的种族或种族偏见，而这些偏见在休息状态下会受到抑制。由于慢性睡眠限制在许多潜在的高冲突情况下通常与少数族裔互动的职业中很普遍（例如，警务人员），因此必须考虑限制睡眠可能在加剧负面的内隐态度和挑衅中扮演的角色。意外和潜在有害的行为后果。