Sleep is a critical but frequently disrupted part of hospital care, affecting patient recovery, length of stay, and physical and mental health. This review examines recent evidence (2022–2026) on why inpatient sleep is disrupted and how interventions can mitigate disturbance across different patient groups and hospital settings. Findings span five domains: environmental factors such as noise and light, hospital infrastructure and room configuration, patient-related factors including pain and anxiety, care routines, and interventions. Recent high-quality trials and meta-analyses increasingly support nonpharmacological strategies - including environmental modification, care-routine restructuring, and sensory therapies - while evidence for pharmacological agents such as melatonin remains weak outside specific contexts. This review highlights the multifactorial nature of sleep disruption in hospital settings. Prioritizing patient sleep through evidence-based, sustainable strategies can support faster recovery, reduce complications, and improve overall care quality, yet poor sleep remains pervasive. Current evidence supports system-level interventions (workflow restructuring, environmental redesign) and low-cost measures (earplugs, sleep masks, physical therapy) to improve sleep related outcomes including delirium, pain, and length of stay.
Research on Autism in eating disorders (EDs) has historically focused on anorexia nervosa (AN), with comparatively limited attention given to binge-type EDs such as bulimia nervosa (BN) and binge eating disorder (BED). This review summarises emerging evidence on Autism in binge-type EDs and highlights key clinical and research implications. Emerging evidence suggests that Autism is over-represented in BN and BED, although prevalence appears lower than in AN and research remains methodologically limited. Recent studies suggest that affective and reward-related processes, alongside sensory differences, may contribute to binge-type presentations. Co-occurring ADHD appears particularly relevant and may complicate recognition, clinical presentation, and treatment. Autism also remains under-recognised in binge-type EDs by ED services, where existing adaptations remain largely derived from AN models. Current AN-centric models may inadequately capture Neurodivergence in binge-type EDs. More transdiagnostic, mechanism-informed research and treatment approaches are needed.
Despite Cognitive Behavioral Therapy (CBT) remaining the frontline treatment for Internet Gaming Disorder (IGD), the therapeutic potential of yoga and mindfulness-based interventions (YBIs/MBIs) remains incompletely synthesized. This narrative review evaluates their efficacy in reducing IGD symptoms and associated psychosocial outcomes, while identifying underlying therapeutic mechanisms and research gaps. Across the literature, mindfulness meditation consistently outperformed Progressive Muscle Relaxation in reducing IGD severity, supported by neuroimaging evidence of improved prefrontal–striatal connectivity. Mindfulness-Oriented Recovery Enhancement produced durable symptom reductions at three-month follow-up, while integrated yoga modules yielded broad improvements across IGD symptoms, psychological distress, and attentional control in adolescents. YBIs/MBIs demonstrate meaningful potential as adjunctive IGD treatments, particularly when integrated with CBT, with notable cultural adaptability across school and clinical settings. Future research should prioritize multi-site RCTs, standardized outcome batteries, and extended follow-up to establish standalone efficacy.
As children move from being a minor to 18 and over as adults, the decision-making power shifts from the parent to the now adult child. That is unless legal guardianship is sought. One of the first encounters parents begin to really process the ramifications of this change is at school during individualized education program (IEP) transition planning meetings which begin for students with disabilities as early as 14 years in some states and school systems and required by federal law to occur by 16 years old. Local education agencies, or school districts, are required to inform students and parents of the shift in responsibilities when the child reaches the age of majority of 18 years old. This paper provides alternatives to guardianship and explores ways in which healthcare providers can support their patients who may be exploring decision-making options at 18 years old. Teachers and other school personnel often provide information that encourages parents to seek guardianship, pushing yet another student into the school-to-guardianship pipeline. Guardianship is not always the best option, yet it is often recommended, especially for transition-aged youth and young adults with significant disabilities. Healthcare providers are sometimes part of these school meetings, but more often, medical professionals provide assessment results to inform an individual’s need for guardianship to the courts. Healthcare providers should comprehend the different ways in which individuals with significant disabilities make decisions upon reaching adulthood. This knowledge should include a clear understanding of the implications and consequences of a court taking away partial or full legal decision-making capabilities from a young adult with a significant disability.
Growing evidence suggests that adverse childhood experiences (ACE) increase the risk for reproductive mood disorders (RMD), i.e. premenstrual syndrome, premenstrual dysphoric disorder, postpartum and perimenopausal depression, and might be associated with symptom severity in these disorders. However, evidence for the specific impact of ACE subtypes remains scarce. This review investigates whether certain ACE subtypes are more prevalent among women with RMDs, whether women exposed to ACE have a higher risk to develop such disorders and if the degree of exposure is associated with the symptom severity. We conducted a literature search across electronic data bases and reviewed a final selection of 16 studies that differentiated between ACE subtypes. The findings indicate that emotional abuse tends to be the subtype most clearly associated with these disorders. While emotional abuse was consistently linked to adverse outcomes, the complexities of ACE co-occurrence and the potential differing impacts of other subtypes such as different forms of abuse and neglect are underscored. The review highlights the variability in study populations, methodologies, and assessment tools. The interplay between hormonal fluctuations and emotional dysregulation is discussed as potential mediators in the development of RMDs, suggesting that emotional abuse may exacerbate sensitivity to hormonal changes. Future research is called for to clarify subtype-specific mechanisms, age-related effects, and genetic predispositions to hormonal sensitivity following ACE. Overall, this article contributes to the understanding of how ACE subtypes intersect with the etiology of RMDs in women, emphasizing the need for tailored approaches in research and clinical interventions.
