Nocturia, defined as waking to void during sleep hours, is common in adolescents, causing sleep disruption and daytime fatigue. While numerous studies have found nocturia associated with systolic blood pressure (BP) hypertension in adults, diastolic (D) BP has greater relative importance in youth. Little is known about the hemodynamic profile of the hypertension–nocturia link in adolescents. Accordingly, we evaluated relationships between nocturia severity and brachial artery systolic and DBPs in each arm, as well as central aortic pressures using applanation tonometry. We studied 100 adolescents, 10–18 years, from pediatric clinics. Nocturnal urinary indices were obtained from voiding diaries. Results: In total, 45% reported nocturia. Nocturia severity was correlated with left and right arm brachial SBP, higher of two arms, and central SBP (r = 0.27, p = 0.007). Brachial SBP was also correlated with nocturnal urine volume (NUV) (r = 0.31, p = 0.001) and production rate (NUP) (r = 0.32, p = 0.001). DBP showed no significant correlations. After adjusting for BMI and sex, brachial SBP remained independently associated with nocturia severity. The median first uninterrupted sleep period was 171 min (25–75%ile; 94, 300). In adolescents, SBP is associated with nocturia severity, NUV, and NUP. Nocturia typically occurs during the first half of nighttime, suggesting an impact on deep sleep.
Background: Sleep is a crucial regulator for physiological and psychological balance, and sleep disturbances have been associated with the hypothalamic–pituitary–adrenal (HPA) axis. Cortisol exhibits a circadian rhythm and plays a central role in stress response and metabolic regulation. Salivary cortisol has been widely used as a non-invasive biomarker for sleep quality, but its reflection remains unclear. This scoping review aims to systematically map and evaluate the existing literature on the relationship between salivary cortisol and sleep outcomes. Methods: Medline, Scopus, and Cochrane databases were applied to identify relevant studies. Database searches combined specific terms from three concept groups: cortisol, sleep quality, and biomarkers. This protocol follows the JBI guidelines. To be incorporated, records pertaining to any type of study design that mentions the use of salivary cortisol and the analysis of sleep quality were considered. Finally, 1067 studies were imported. Among those, 31 studies met eligibility criteria and were extracted. Result: The results indicated the trend in the use of salivary cortisol as a sleep quality biomarker; the study shows limited consistency as a biomarker. Its relationship with sleep outcomes is highly dependent on methodological factors and contextual influences. Conclusions: Overall, salivary cortisol may reflect broader stress-related physiological processes rather than sleep quality directly.
Sleep and nutrition are closely interconnected through behavioral, metabolic, and circadian pathways, yet the strength of evidence varies considerably across dietary exposures. This narrative review synthesizes current evidence on nutrients, foods, dietary patterns, chrononutrition, caffeine and alcohol in relation to sleep, while also considering the effects of insufficient sleep on dietary intake and metabolic health. The relevant literature was identified through searches of PubMed/MEDLINE, Scopus, and Web of Science, supplemented by examination of reference lists and targeted searches. Higher-quality dietary patterns, particularly Mediterranean-style diets, are generally associated with more favorable sleep characteristics, although predominantly observational evidence limits causal interpretation. Intervention studies of individual foods and supplements have reported benefits for selected sleep outcomes, but findings remain heterogeneous and are often based on small samples. Evidence for meal timing and time-restricted eating is similarly inconsistent and does not support a single eating schedule for improving sleep. In contrast, caffeine and alcohol have relatively well-established sleep-disrupting effects. Insufficient sleep can also alter dietary intake, energy balance, glucose regulation, and adiposity, highlighting the bidirectional nature of these relationships. Nutritional approaches may complement broader strategies for sleep and health, but current evidence does not support specific foods, supplements, or eating schedules as stand-alone treatments for sleep problems.
Ambulatory blood pressure (BP) and heart rate (HR) monitoring (ABPM) was performed to investigate the involvement of biological clocks in vascular aging cross-sectionally in 625 citizens (368 women, aged 23–79 years) and longitudinally in 15 citizens (12 women; mean age of 59.3 years) who underwent repeat ABPM after 6.3 years. Vascular aging, estimated by systolic BP (SBP) and pulse pressure (PP), increased with age (p < 0.0001), with a steeper increase at night than during the daytime (0.3362 vs. 0.2765 mmHg/year). Day-to-day variability in morning and evening home SBP also increased with age (p = 0.0127 and 0.0137, respectively). An intensified biological clock mode emerged nonlinearly with age and may protect against early vascular aging. Variance transposition, defined as a shift in the dominant biological rhythm from the circadian to another rhythm, also occurred nonlinearly with age. Circadian-to-circasemidian and circadian-to-circaseptan HR variance transpositions were more frequent in younger subjects and preceded circadian acrophase advance, whereas BP variance transposition predominated in older subjects. Subjects with a normal circadian period (23.5–24.5 h) exhibited less frequent HR, SBP, and DBP variance transposition. In conclusion, SBP and PP increased first at night, whereas reinforced biological clocks improved BP profiles and slowed or even reversed vascular aging.
Background: Obstructive sleep apnea (OSA) is a heterogeneous disorder influenced by both anatomical collapsibility and non-anatomical factors, such as neuromuscular response. Identifying these traits through simplified clinical surrogates is crucial for personalized precision medicine. Methods: This exploratory retrospective study evaluated 207 home polygraphy recordings of Italian patients to assess sleep-stage-specific Apnea–Hypopnea Index (REM vs. NREM AHI) as a clinical surrogate indicator of the balance between anatomical collapsibility and neuromuscular compensation. Patients were stratified by severity into simple snorers (AHI < 5 events/h), mild OSA (AHI 5–15 events/h), and severe OSA (AHI > 30 events/h). REM and NREM AHI values were compared and correlated with Apnea Index (AI), Hypopnea Index (HI), body mass index (BMI), and cumulative nocturnal desaturation indices (CT < 90% and T < 90 min). Results: In non-severe patients (simple snorers and mild OSA), REM AHI was significantly higher than NREM AHI (REM/NREM ratio > 1), suggesting relative neuromuscular protection during NREM sleep. Conversely, in severe OSA patients, the REM/NREM ratio progressively decreased and approached unity, with NREM AHI prevailing. Furthermore, NREM predominance was significantly associated with a higher AI and a worse cumulative desaturation indicating a globally more severe disease. Conclusions: A predominance of REM AHI characterizes milder OSA presentations with effective NREM muscular compensation, whereas NREM predominance aligns with an anatomically dominant, severe phenotype. Decomposing AHI into REM and NREM components provides a practical, readily available clinical surrogate to estimate the anatomy–neuromuscular balance and guide PALM-oriented personalized treatments.
