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\"Learn simple yoga techniques--poses, meditations, and breathwork--to sleep better and longer, from master yoga teacher trainer and author, Mark Stephens\"-- Provided by publisher.

Poor sleep is a modifiable risk factor for multiple disorders. Frontline treatments (e.g. cognitive-behavioral therapy for insomnia) have limitations, prompting a search for alternative approaches. Here, we compare manualized Mindfulness-Based Therapy for Insomnia (MBTI) with a Sleep Hygiene, Education, and Exercise Program (SHEEP) in improving subjective and objective sleep outcomes in older adults. We conducted a single-site, parallel-arm trial, with blinded assessments collected at baseline, post-intervention and 6-months follow-up. We randomized 127 participants aged 50-80, with a Pittsburgh Sleep Quality Index (PSQI) score ⩾5, to either MBTI ( = 65) or SHEEP ( = 62), both 2 hr weekly group sessions lasting 8 weeks. Primary outcomes included PSQI and Insomnia Severity Index, and actigraphy- and polysomnography-measured sleep onset latency (SOL) and wake after sleep onset (WASO). Intention-to-treat analysis showed reductions in insomnia severity in both groups [MBTI: Cohen's effect size = -1.27, 95% confidence interval (CI) -1.61 to -0.89; SHEEP: = -0.69, 95% CI -0.96 to -0.43], with significantly greater improvement in MBTI. Sleep quality improved equivalently in both groups (MBTI: = -1.19; SHEEP: = -1.02). No significant interaction effects were observed in objective sleep measures. However, only MBTI had reduced WASO (MBTI: = -0.30; SHEEP: = 0.02), SOL (MBTI: = -0.25; SHEEP: = -0.09), and WASO (MBTI: = -0.26; SHEEP ( = -0.18). There was no change in SOL . No participants withdrew because of adverse effects. MBTI is effective at improving subjective and objective sleep quality in older adults, and could be a valid alternative for persons who have failed or do not have access to standard frontline therapies.

\"With our hectic everyday schedules, increasing anxiety, and addiction to disruptive phone and computer screens, getting the necessary shuteye can be a challenge. And when we don't, we suffer the consequences, from weight gain to grumpiness. For the many people seeking a simple, natural sleep aid, melatonin has come to the rescue. Melatonin takes a deep dive into the workings of this essential hormone, which regulates sleep and the body's circadian rhythm. Learn about its effects on the body, how to harness its benefits, and how to take supplements safely. Twenty recipes for snacks and elixirs containing foods that encourage the body to produce melatonin, along with a section featuring 30 ideas for calming bedtime rituals and routines, offer the guidance you'll need to finally catch some zzz's.\"--Amazon.com.

Background Sleep disorder is common among hospitalized patients and also has a high prevalence after traumatic brain injury. Sleep disorder can have serious detrimental effects on disease recovery. One of the simple and non-invasive methods to improve the sleep quality of these patients is use of complementary medicine interventions and aromatherapy massage is one of these methods that may help to improve their sleep quality. Therefore, this study explored the effect of aromatherapy massage with mint and sweet almond oils on the sleep quality of patients with traumatic brain injury in intensive care units. Methods This study was a randomized clinical trial. In this study, 60 patients admitted to the intensive care unit were assigned to the intervention and sham therapy groups. The hands and feet of patients in the intervention group were massaged for 20 min with a combination of mint and sweet almond oils for three consecutive days. In the sham therapy group, hands and feet of patients were massaged with Vaseline. Both groups completed demographic questionnaire and Richards-Campbell Sleep Questionnaire (RCSQ) before and after the intervention. Data were analyzed using SPSS ver. 22 via central tendency and dispersion indices (frequency, percentage, average, and standard deviation), the chi-square test, independent t-test, and paired t-test with a significance level of 0.05. Results Aromatherapy massage significantly increased the sleep quality of traumatic brain injury patients in intensive care units, meaning that the mean score of sleep quality in the intervention group compared to the sham therapy group after the intervention showed a significant increase. ( P  < 0.05). Conclusions According to the results of this study, the use of aromatherapy with a combination of mint oil and sweet almonds increases the sleep quality of traumatized patients admitted to intensive care units. Using a combination of mint oil and sweet almond oil to increase the sleep quality of patients similar to the research community can be helpful. Clinical trial registration number IRCT20151107024919N12

The authors present their professional insights and techniques for resolving insomnia by employing the Guided Mindfulness with Acceptance Treatment for Insomnia (or GMATI) program.

Background The hypothalamus has been recognized as a core structure in the sleep-wake cycle. However, whether the neuroplasticity of the hypothalamus is involved in the acupuncture treatment of insomnia remains elusive. Methods We recruited 42 patients with chronic insomnia disorder (CID) and 23 matched healthy controls (HCs), with CID patients randomly assigned to receive real acupuncture (RA) or sham acupuncture (SA) for four weeks. Insomnia severity was evaluated using the Pittsburgh Sleep Quality Index (PSQI) score, and the resting-state functional connectivity (rsFC) of the hypothalamus was assessed via functional magnetic resonance imaging (fMRI). Results In the cross-sectional investigation, CID patients showed increased rsFC between the medial hypothalamus (MH) and left lateral orbital frontal cortex (LOFC), and bilateral medial orbital frontal cortex (MOFC) compared to HCs. In the longitudinal experiment, PSQI scores significantly decreased in the RA group ( p  = 0.03) but not in the SA group. Interestingly, the increased MH-LOFC connectivity was found to be reduced following RA treatment. In addition, the altered rsFC of MH-LOFC significantly correlated with clinical improvement in the RA group ( r = -0.692, p  = 0.006). Conclusion This randomized neuroimaging study provides preliminary evidence that acupuncture may improve insomnia symptoms by restoring circuits associated with hypothalamic subregions. Trial registration This trial has been registered on the Chinese Clinical Trial Registry ( www.chictr.org.cn ) with the identifier (ChiCTR1800017092). Registered date: 11/07/2018.

Background Insomnia disorder (ID) is one of the most common sleep problems, usually accompanied by anxiety and depression symptoms. Functional magnetic resonance imaging (fMRI) study suggests that both poor sleep quality and negative emotion are linked to the dysregulation of brain network related to emotion processing in ID patients. Acupuncture therapy has been proven effective in improving sleep quality and mood of ID patients, but the involved neurobiological mechanism remains unclear. We aimed to investigate the modulation effect of acupuncture on resting-state functional connectivity (rsFC) of the emotional network (EN) in patients experiencing insomnia. Methods A total of 30 healthy controls (HCs) and 60 ID patients were enrolled in this study. Sixty ID patients were randomly assigned to real and sham acupuncture groups and attended resting-state fMRI scans before and after 4 weeks of acupuncture treatment. HCs completed an MRI/fMRI scan at baseline. The rsFC values within EN were calculated, and Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Pittsburgh Sleep Quality Index (PSQI), Hyperarousal Scale (HAS), and actigraphy data were collected for clinical efficacy evaluation. Results Resting-state FC analysis showed abnormalities in rsFC centered on the thalamus and dorsolateral prefrontal cortex within EN of ID patients compared to HCs. After real acupuncture treatment, rsFC of the anterior cingulate cortex, hippocampus, and amygdala were increased compared with the sham acupuncture group ( p  < 0.05, FDR corrected). In real acupuncture group, the rsFC value was decreased between left amygdala and left thalamus after 4 weeks of treatment compared with baseline. A trend of correlation was found that the increased rsFC value between the right amygdala and left hippocampus was positively correlated with the decreased HAMA scores across all ID patients, and the decreased left amygdala rsFC value with the left thalamus was negatively correlated with the increased sleep efficiency in the real acupuncture group. Conclusion Our findings showed that real acupuncture could produce a positive effect on modulating rsFC within network related to emotion processing in ID patients, which may illustrate the central mechanism underlying acupuncture for insomnia in improving sleep quality and emotion regulation. Trial registration http://www.chictr.org.cn ., ChiCTR1800015282, 20/03/2018.

Purpose Sleep disturbance is a prevalent problem for cancer survivors and effective behavioral treatments are not widely used for this population. This study evaluated home-based sleep interventions based on cognitive behavioral therapy for insomnia (CBT-I). Methods This phase II randomized controlled trial evaluated two manualized interventions over 7 weeks. The intervention group received sleep hygiene information, stimulus control, sleep restriction, and a bedtime imagery audio recording. The control group was similar, but without sleep restriction and used audio recordings of bedtime short stories instead of imagery. Eligibility included adult cancer survivors who had trouble falling asleep or falling back to sleep on 3 of 7 days. Patients with diagnoses of sleep or mental health disorders were excluded. The primary endpoint was change in time to fall asleep or falling back to sleep after awakening, from baseline to week 7. Two-sample T tests evaluated differences between arms for this endpoint. Results Ninety-three of 168 planned participants were enrolled from 20 institutions. The study closed early for poor accrual. Baseline time to sleep was 45 min and 52 min for the intervention and control group, respectively. At 7 weeks, both groups improved, the intervention group to 26 min and control group to 30 min, a non-significant difference between groups ( p  = 0.85). Secondary outcomes improved in both groups with no significant differences between arms. Conclusions Improvement in sleep outcomes in both arms was consistent with other CBT-I interventions delivered through alternative approaches to provider-delivered therapy. More research on optimal scalable delivery of CBT-I is needed. Clinical relevance This study supports the effectiveness of CBT-I based behavioral interventions for sleep but also the need for better delivery methods to improve uptake and effect size. Trial registration ClinicalTrials.gov identifier: NCT00993928

Objective Insomnia disorder with depressive symptoms (IDDS) represents a significant clinical phenotype, with a bidirectional relationship where insomnia both contributes to and results from depression. This study aimed to assess the efficacy and safety of combining zolpidem with Shugan Jieyu in treating IDDS. Methods In a double-blind, randomized trial, 60 IDDS patients were assigned to zolpidem plus Shugan Jieyu (ZS) or zolpidem plus placebo (ZP) for 8 weeks, with 59 completing the study. Assessments included the Insomnia Severity Index (ISI), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7 (GAD-7), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), polysomnography (PSG), and sleep diary. Mixed-model repeated-measures (MMRM) analysis was performed to assess the least squares means difference (LSMD) among the groups after 4 and 8 weeks of treatment. Subgroup analysis was performed on patients with sleep fragmentation (WASO ≥ 30 min). Results Both groups showed significant improvements in ISI, PSQI, ESS, GAD-7, and PHQ-9, with no between-group differences. For the primary outcome (ISI), the between-group difference at week 8 was − 1.68 points (95% CI: -4.49 to 1.14; p  = 0.238), corresponding to a small effect size (Cohen’s d = 0.42). ZS significantly reduced WASO and increased TST at 8 weeks, whereas ZP showed no significant changes in these measures within the group. ZS reduced subjective sleep latency (sSL) significantly more than ZP at weeks 4 (LSMD − 12.21 min, 95% CI -22.54 to -1.87; p  = 0.021; d = 0.23) and 8 (LSMD − 12.17 min, 95% CI -21.99 to -2.35; p  = 0.016; d = 0.25). In the sleep fragmentation subgroup, ZS improved sSL and subjective sleep efficiency (sSE). Both treatments were well-tolerated. Conclusion Compared with taking zolpidem alone, the combination of zolpidem with Shugan Jieyu did not significantly improve insomnia, but showed preliminary non-objective signals in improving patients’ perception of falling asleep, particularly in patients with sleep fragmentation. Trial registration The study is registered in the ClinicalTrials.gov (NCT05764798). Date registered: 30 November 2022.

Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed psychiatric disorders in childhood. A wide variety of treatments have been used for the management of ADHD. We aimed to compare the efficacy and safety of pharmacological, psychological and complementary and alternative medicine interventions for the treatment of ADHD in children and adolescents. We performed a systematic review with network meta-analyses. Randomised controlled trials (≥ 3 weeks follow-up) were identified from published and unpublished sources through searches in PubMed and the Cochrane Library (up to April 7, 2016). Interventions of interest were pharmacological (stimulants, non-stimulants, antidepressants, antipsychotics, and other unlicensed drugs), psychological (behavioural, cognitive training and neurofeedback) and complementary and alternative medicine (dietary therapy, fatty acids, amino acids, minerals, herbal therapy, homeopathy, and physical activity). The primary outcomes were efficacy (treatment response) and acceptability (all-cause discontinuation). Secondary outcomes included discontinuation due to adverse events (tolerability), as well as serious adverse events and specific adverse events. Random-effects Bayesian network meta-analyses were conducted to obtain estimates as odds ratios (ORs) with 95% credibility intervals. We analysed interventions by class and individually. 190 randomised trials (52 different interventions grouped in 32 therapeutic classes) that enrolled 26114 participants with ADHD were included in complex networks. At the class level, behavioural therapy (alone or in combination with stimulants), stimulants, and non-stimulant seemed significantly more efficacious than placebo. Behavioural therapy in combination with stimulants seemed superior to stimulants or non-stimulants. Stimulants seemed superior to behavioural therapy, cognitive training and non-stimulants. Behavioural therapy, stimulants and their combination showed the best profile of acceptability. Stimulants and non-stimulants seemed well tolerated. Among medications, methylphenidate, amphetamine, atomoxetine, guanfacine and clonidine seemed significantly more efficacious than placebo. Methylphenidate and amphetamine seemed more efficacious than atomoxetine and guanfacine. Methylphenidate and clonidine seemed better accepted than placebo and atomoxetine. Most of the efficacious pharmacological treatments were associated with harms (anorexia, weight loss and insomnia), but an increased risk of serious adverse events was not observed. There is lack of evidence for cognitive training, neurofeedback, antidepressants, antipsychotics, dietary therapy, fatty acids, and other complementary and alternative medicine. Overall findings were limited by the clinical and methodological heterogeneity, small sample sizes of trials, short-term follow-up, and the absence of high-quality evidence; consequently, results should be interpreted with caution. Clinical differences may exist between the pharmacological and non-pharmacological treatment used for the management of ADHD. Uncertainties about therapies and the balance between benefits, costs and potential harms should be considered before starting treatment. There is an urgent need for high-quality randomised trials of the multiple treatments for ADHD in children and adolescents. PROSPERO, number CRD42014015008.