nocturnal awakenings

Aims and background: The sleep-wake cycle and sleep consolidation are essential to children's growth and development.There is a paucity of studies on the sleep characteristics and the effect of electronic media on them in healthy Indian infants and toddlers.The objectives were to assess the sleep characteristics of healthy Indian infants and toddlers and to examine the impact of electronic media on them.Materials and methods: This was a cross-sectional study at a tertiary center in India, among healthy children aged 3-36 months.Those with concurrent illness (e.g., gastroenteritis, respiratory illness) were excluded.A Hindi version of the Revised Brief Infant Sleep Questionnaire (BISQ-R) was used to assess sleep patterns.Results: A total of 100 children were enrolled during the study period; their median (IQR) age was 12.1 (3.5, 18) months, with most of them being males (74%).The median (IQR) total sleep duration was 11 (10.0,13.3) hours.Electronic media exposure was noted in 83 (83%) children.Of them, 27 (32.5%)children were exposed to ≥1 hour/day.There was no significant difference in sleep duration, night awakenings, or wakefulness between media-exposed and media-unexposed groups in children.Similarly, there was no significant effect of media exposure on sleep characteristics.Conclusion: Sleep duration in infants and toddlers was below the international recommendation.A majority of children had exposure to electronic media, and one-third had exposure of at least 1 hour.Approximately three-fourths of parents didn't perceive the child's sleep problems.Clinical significance: There is an urgent need to routinely evaluate sleep characteristics in infants and toddlers and to increase awareness of sleep hygiene and media exposure among parents.

Primary insomnia is a common sleep–wake disorder characterized by impaired sleep initiation and maintenance with associated daytime dysfunction, while current pharmacological treatments are often limited by safety and tolerability concerns. This study examined the independent and combined effects of a sensory-mediated non-pharmacological intervention using Viola odorata L. and an oral botanical preparation derived from Papaver somniferum L. seeds in adults with primary insomnia. This exploratory, prospective, randomized, three-arm, component-based integrative trial enrolled 90 participants aged 18–65 years, randomized equally to Viola odorata –based Natūl therapy, Papaver somniferum seed powder, or combination therapy and treated for four weeks. Sleep outcomes—including Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), daytime dysfunction (VAS), and number of nocturnal awakenings—were assessed at baseline and post-intervention and analysed using a per-protocol framework with non-parametric methods. Recurrence rate has been assessed after three months of treatment. All three interventions were associated with significant improvements across all sleep parameters (all p < 0.001), with large within-group effect sizes (r ≈ 0.86 – 0.89). Between-group comparisons of change scores demonstrated significantly greater improvements with combination therapy compared with either monotherapy (η 2 ≈ 0.21–0.26). Viola odorata –based Natūl monotherapy produced improvements comparable to oral Papaver somniferum therapy for most outcomes. No clinically meaningful safety concerns were observed. Sensory-mediated therapy using Viola odorata L. and oral administration of Papaver somniferum L. seeds are effective in the management of primary insomnia, with combination therapy providing additive sustained with less recurrence rate and supporting a graded, personalized integrative treatment approach.

بی‌خوابی اولیه یکی از اختلالات شایع چرخه خواب–بیداری است که با اختلال در شروع و تداوم خواب و همچنین اختلال عملکرد روزانه همراه است، در حالی که درمان‌های دارویی فعلی اغلب به دلیل نگرانی‌های ایمنی و تحمل‌پذیری محدودیت دارند. این مطالعه اثرات مستقل و ترکیبی یک مداخله غیر دارویی مبتنی بر تحریک حسی با استفاده از Viola odorata L. و یک فرآورده گیاهی خوراکی مشتق از دانه‌های Papaver somniferum L. را در بزرگسالان مبتلا به بی‌خوابی اولیه بررسی کرد. این کارآزمایی اکتشافی، آینده‌نگر، تصادفی‌سازی‌شده، سه‌گروهی و مبتنی بر مؤلفه، ۹۰ شرکت‌کننده ۱۸ تا ۶۵ ساله را به طور مساوی به درمان Natūl مبتنی بر Viola odorata، پودر دانه Papaver somniferum یا درمان ترکیبی تخصیص داد و به مدت چهار هفته درمان شدند. پیامدهای خواب شامل شاخص شدت بی‌خوابی (ISI)، شاخص کیفیت خواب پیتسبورگ (PSQI)، اختلال عملکرد روزانه (VAS) و تعداد بیداری‌های شبانه در ابتدا و پس از مداخله ارزیابی و با استفاده از چارچوب per-protocol و روش‌های ناپارامتریک تحلیل شد. نرخ عود سه ماه پس از درمان ارزیابی گردید. هر سه مداخله با بهبود معنادار در تمامی شاخص‌های خواب همراه بودند (همه p < ۰٫۰۰۱)، با اندازه اثر بزرگ درون‌گروهی (r ≈ ۰٫۸۶ – ۰٫۸۹). مقایسه بین‌گروهی تغییر نمرات نشان داد که درمان ترکیبی نسبت به هر یک از مونوتراپی‌ها بهبود معنادار بیشتری ایجاد کرد (η۲ ≈ ۰٫۲۱–۰٫۲۶). مونوتراپی Natūl مبتنی بر Viola odorata بهبودی مشابه با درمان خوراکی Papaver somniferum را در اکثر پیامدها ایجاد کرد. هیچ نگرانی بالینی قابل توجهی از نظر ایمنی مشاهده نشد. درمان مبتنی بر تحریک حسی با Viola odorata L. و مصرف خوراکی دانه‌های Papaver somniferum L. در مدیریت بی‌خوابی اولیه مؤثر است و درمان ترکیبی با کاهش نرخ عود، اثربخشی افزاینده و پایدار را فراهم می‌کند و از رویکرد درمانی یکپارچه، تدریجی و شخصی‌سازی‌شده حمایت می‌کند.