AIM:Despite being one of the most disabling symptoms of post-traumatic stress disorder (PTSD)-disrupting sleep continuity, reinforcing hyperarousal, and worsening psychiatric comorbidity-the physiological signature of Trauma-related nightmares (TRNs) under naturalistic sleep conditions remains poorly characterized. METHODS:We used home-based, multi-sensor devices from the SOMMEPT cohort to assess whether TRNs display distinct autonomic dynamics before and after awakening. TRN awakenings were self-marked with the wristband button and validated through electroencephalography (EEG) inspection by a psychiatrist and a sleep physician. Each TRN event (N = 412) was matched 1:1 to three control conditions: spontaneous awakenings in 60 healthy military participants, awakenings in 34 military PTSD patients without TRNs, and non-nightmare awakenings from 74 military PTSD patients with TRNs. Pre-awakening autonomic activity was analyzed over 10 min, and post-awakening reactivity over a 2-min window using nonparametric statistics with cluster-based permutation correction. RESULTS:TRNs were associated with heightened sudomotor activity and reduced vagal heart rate variability compared with spontaneous awakenings in healthy controls; differences were weaker versus PTSD patients without TRNs or non-TRN awakenings. Phasic Electrodermal activity (EDA) showed earlier peaks and prolonged recovery, while movement was lower before TRN-related awakenings. Post-awakening, TRNs elicited an abrupt surge: heart rate accelerated within ~40 s and normalized by ~2 min; tonic EDA remained elevated, phasic EDA bursts were longer, slower to recover, and motor activity rose during the first ~80 s. CONCLUSIONS:TRNs display a distinctive autonomic pattern with pre-awakening sudomotor buildup and post-awakening cardiovascular-electrodermal surges, supporting biomarker-based detection and targeted intervention. TRIAL REGISTRATION:ClinicalTrials.gov Identifier: NCT04581850.

IntroductionSleep deprivation is known to induce cardiovascular responses. Several studies have shown the beneficial effect of caffeine on neurobehavioral performance during sleep deprivation, but less is known about its influence on the cardiovascular and inflammatory responses associated with sleep deprivation. The aim of this study is to evaluate the impact of acute caffeine intake on (1) peripheral blood pressures, and (2) heart rate, and cutaneous vascular conductance (CVC) and related biomarkers of endothelial activation, during total sleep deprivation (TSD), considering habitual caffeine consumption.Methods41 subjects followed a randomized, placebo-controlled, cross-over study and underwent 2 conditions of TSD (38 h), one with caffeine intake at 09:00 and 14:00 (2.5 mg/kg), and the other with placebo intake.ResultsWe confirm that TSD increases systolic and diastolic arterial pressures (p = 0.001 and p = 0.002 for main effects respectively) and heart rate (p = 0.001), and decreases endothelium-dependent and -independent CVC (p = 0.001). Acute caffeine intake inflates the increase in arterial pressures and IL-6 levels, while it does not affect CVC and levels of E-selectin and monocyte chemotaxis protein-1 (MCP-1). Moreover, chronic caffeine consumption had significant main effects on systolic arterial pressure (p = 0.03), heart rate (p = 0.02), IL-6 levels (p = 0.02), and acetylcholine (ACh)-induced CVC (p = 0.02), and interacted with TSD on E-selectin levels and ACh-induced CVC (p = 0.02 respectively).ConclusionAcute caffeine intake provokes immuno-inflammatory and cardiovascular responses, and chronic caffeine consumption should be limited to the lowest efficient doses.Clinical Trial Registrationhttps://clinicaltrials.gov/study/NCT03859882, identifier NCT03859882.

Background and Objective Aircraft pilots can be faced with a high mental workload (MW) combined with moderate hypoxia and sleep restriction. We aimed to assess the cross-validation of a machine learning-based MW predictive model under hypoxia and/or sleep restriction. Secondly, we developed a robust predictive model using multimodal physiological parameters to improve the validity across different physiological conditions. Methods Seventeen healthy participants were randomly exposed to three 12-minute periods of increased MW (low, medium, and high) in a 4-condition crossover design: sleep restriction (SR, <3h Total Sleep Time, TST) vs. habitual sleep (HS, >6h TST), hypoxia (HY, 2h, FIO2=13.6%, ∼3,500 m) vs. normoxia (NO, FIO2=21%). MW levels were designed using the Multi-Attribute Test Battery (MATB)-II with an additional auditory Oddball-like task. Six machine learning classifiers were compared. Features selection (from EEG, ECG, respiratory and eye tracking sensors) was performed using backward Recursive Feature Elimination (RFE). Results The best models for 1-minute MW levels classification on HSNO were K-Nearest Neighbors (KNN, F1 score = 80.3±8.9%), Support Vector Machine (SVM, 77.8±10.3%) and Random Forest (RF, 75.7±9.1%). Exposure to sleep restriction and/or hypoxia decreased models’ performance (F1 <35%). KNN and RF models, in particular those including EEG and eye tracking, trained on All-Conditions performed well across conditions (F1 scores = 77.4±7.8% and 70.7±10.2%). Conclusion Our results highlight the need for training MW models under different physiological constraints and using multimodal datasets to improve robustness. (NCT05563688)

Efficient attention depends on the temporal alignment between ongoing neural activity and task-relevant sensory events. Alpha-band dynamics, and particularly individual alpha frequency (IAF), have been proposed to regulate this alignment, yet direct causal evidence linking IAF to attentional timing remains limited. Here, we used neurofeedback (NF) to test whether experimentally induced changes in parieto-occipital IAF alter the neural and behavioral dynamics of visual attention. 108 healthy adults completed five sessions of EEG-based IAF neurofeedback or an active placebo control and performed the Attention Network Test (ANT) after each session. Participants were classified as learners or non-learners based on their ability to voluntarily increase IAF. Attentional performance was assessed using response times, efficiency scores, and cue-related facilitation. Neural measures included resting IAF and task-related alpha event-related desynchronization (α-ERD) amplitude and latency as an index of the timing of cortical engagement.Compared with non-learners and placebo participants, NF learners showed faster responses, higher attentional efficiency, and stronger facilitation effects following informative cues. At the neural level, learners exhibited shorter α-ERD latencies, indicating earlier task-related recruitment of visual–parietal networks. Crucially, repeated-measures mediation analyses revealed a partial sequential pathway whereby NF-related increases in IAF predicted faster response times through reductions in α-ERD latency. These findings provide causal evidence that IAF constrains the temporal dynamics of attentional deployment by regulating the speed of alpha-band desynchronization following task-relevant cues and identifying IAF as a key functional parameter governing attentional readiness and the temporal deployment of attention by shaping the dynamics of alpha-band desynchronization.

The effect of sleep restriction (SR) on the physiological responses to normobaric hypoxia (NH) remains unknown. This study examined whether acute SR the night prior to a 5-h exposure to 3,500 m NH impacts (i) the resting ventilatory response, (ii) circulating pro- and anti-inflammatory cytokines, and (iii) their potential association. Seventeen healthy men (31 ± 7 yr; 77.1 ± 8.5 kg) were exposed to 5 h of NH (FIO2 = 13.6

Basal blood pressure (BP) is partly determined by systemic vascular resistance, which is modulated by vasoactive pathways, including gaseous messengers. Carbon monoxide (CO), continuously generated by the constitutive enzyme heme oxygenase-2 (HO-2) encoded by HMOX2, promotes vascular smooth muscle relaxation and may contribute to interindividual variability in resting BP. The functional single-nucleotide polymorphism rs4786504_T>C has been associated with higher HMOX2 expression in C-allele carriers, providing a plausible biological link between genetic variation in the HO-2/CO pathway and vascular redox signaling. We investigated this association in forty young, healthy, normotensive adults studied under controlled laboratory conditions during a 4-day sleep deprivation protocol, with repeated standardized daytime BP measurements (478 observations). Linear mixed-effects models were adjusted for major physiological and behavioral covariates. T-allele carriers (C/T + T/T) exhibited higher diastolic BP (β = +6.08 mmHg, 95%CI [1.32-10.84], p = 0.017) and mean arterial pressure (β = +5.28 mmHg, 95%CI [0.28-10.29], p = 0.046) than C/C homozygotes, with no effect on systolic BP or heart rate. The association remained consistent across sensitivity and additive genetic models. This hypothesis-generating study provides preliminary evidence in humans, albeit limited by sample size, of a link between a functional HMOX2 variant and resting BP, consistent with a possible contribution of constitutive HO-2 activity to BP regulation.

ObjectivesThis article proposes a specific program of sequences of combinations of movements (SCM) based on motor development stages (MDS) to optimize the sports performance of elite professional athletes (EPAs).DesignNarrative literature review.MethodInformation on MDS, including biomechanical, physiological, psychological skills, prevention, recovery, and training programs of EPAs, was extracted from 57 conceptually relevant references. Databases (PubMed, Scopus, Web of Science, Google Scholar) were searched using terms such as motor development, neuroplasticity, sensorimotor coordination, and sports performance.BackgroundThe literature shows consistent evidence supporting the relevance of motor development stage–derived movement patterns for athletic performance. MDS are described as sequential postural and movement patterns emerging during early neuromotor maturation. They are widely applied in neurological rehabilitation, where studies report improvements in motor control and coordination, although transfer to elite athletes remains untested. Performance-related dimensions (posture, balance, mobility, coordination) are linked to central nervous system organization and neuroplasticity. Structured developmental movement sequences may enhance sensorimotor integration and motor refinement. Biomechanical and neurocognitive evidence suggests that SCM based on MDS could improve movement quality, neuromuscular efficiency, and adaptability. Some studies also associate motor learning with psychological factors such as attention and resilience, though evidence remains indirect. Overall, SCM appears as a promising multidimensional training approach, but lacks direct experimental validation in elite sport.ConclusionsWith SCM, coaches, trainers, and scientists could design training and competition programs tailored to athletes’ individual needs, including warm-up routines, injury prevention, recovery, and adaptation to intense training and competitive situations. However, studies examining the acute and chronic effects of SCM on the biomechanical, physiological, and psychological responses of EPAs, including neuroplasticity, are needed to confirm this hypothesis and clarify its potential benefits across athletic domains.

Sleep disturbances, including insomnia and trauma‐related nightmares (TRNs), are the core symptoms of post‐traumatic stress disorder (PTSD) in military personnel. Furthermore these nocturnal manifestations are directly related to the persistence of daytime PTSD symptoms and are known to exacerbate comorbid conditions such as depression, suicidality, and daytime impairments. This prospective study examined the variability of PTSD‐related sleep disruptions and its relationship to symptom severity using ecological recordings over several nights. One hundred thirty PTSD‐diagnosed service members and 65 healthy military controls recorded sleep data at home for five nights using a polysomnographic headband to measure total sleep time (TST), sleep onset latency (SOL), wake after sleep onset (WASO), sleep efficiency index (SEI), and sleep stages. PTSD severity and comorbid symptoms were assessed by clinical evaluations. Compared to controls, PTSD participants had higher SOL and WASO (+14.1 min and +9.1 min, p < 0.001, respectively), reduced SEI (−6.6%, p < 0.001), and lower N3 and rapid eye movement (REM) sleep durations. In addition, night‐to‐night variability (NNV) in SOL and WASO was higher in the PTSD group. The sleep fragmentation index (FI)—and more specifically non‐REM (NREM) sleep fragmentation—was significantly correlated with PTSD severity, particularly the intrusive and avoidance symptoms clusters in the PCL‐5 score. The results highlight the need for customized multinight assessments to study sleep variability in military patients with combat‐related PTSD, in order to advance therapeutic strategies for military populations. Trial Registration: ClinicalTrials.gov Identifier: NCT04581850

Total sleep deprivation (TSD) alters local cold tolerance and could thus increase the risk of cold injury. We evaluated the impact of acute caffeine intake, the main countermeasure to TSD-related deleterious effects, on local cold tolerance before and after TSD. Thirty-six healthy subjects underwent two TSD protocols (i.e., continuous wakefulness), with randomized crossover intake of acute caffeine or placebo (2.5 mg/kg) administered twice during wakefulness. Before and after 33 h of TSD, finger (index and annular) temperature and skin blood flow were assessed during cold-water immersion (CWI, 5°C, 20 min) followed by 20 min of rewarming in ambient air. We showed no significant effects of TSD on mean finger temperature during CWI in the placebo condition, but a significant reduction of the minimal temperature (8.86°C ± 0.35°C vs. 8.64°C ± 0.27°C, p = 0.02). During rewarming, we showed a reduction in temperature in the placebo condition (p = 0.02 for the mean temperature and p = 0.03 for the maximal) and an increase in the skin blood flow disparity between fingers at the four points of laser speckle rewarming measurements (p = 0.03). After TSD, acute caffeine intake (vs. placebo) increased mean (+2.11°C ± 0.21°C, p = 0.01) and minimal (+0.61°C ± 0.10°C, p = 0.02) finger temperatures during CWI, and improved rewarming after CWI (mean and maximal temperatures) (+2.28°C ± 0.08°C, p = 0.01, and +2.06°C ± 0.12°C, p = 0.02, respectively). Before TSD, acute caffeine intake significantly increased (vs. placebo) mean temperatures during CWI (p = 0.03) and reduced pain from the onset (p = 0.03) to the end of CWI (p = 0.02) and the first 2 min of rewarming (p = 0.04). There was also a significant main effect of habitual daily caffeine consumption on minimal finger temperatures during CWI, which decreased significantly between 0 and 600 mg consumption (R2 = -0.43, p = 0.01), independently of the effects of day (before and after TSD) and treatment (caffeine and placebo conditions). These findings suggest that acute caffeine intake could be a protective countermeasure to local cold tolerance, particularly during TSD. However, habitual daily caffeine consumption is a factor of individual variability that should be recorded during CWI protocols. Clinical trial NCT03859882.

The ability of operators to integrate visual and auditory information places a high demand on their attention when monitoring instruments and systems. In this context, physiological constraints such as reduced oxygen levels alone or combined with restricted sleep are known to impair attention capacities. However, it is not known whether EEG markers of visual attention are affected differently from those of auditory attention in a situation combining both constraints. This study aimed to investigate the effects of prolonged moderate hypoxia exposure (4 h at fraction of inspired oxygen FiO2 = 13.6%, ≃ 3500 m), sleep restriction (3 h of time-in-bed) and their combination on the evoked potential P300 and the alpha rhythm in 17 healthy participants. We first found that visually and auditory evoked P300 amplitude were reduced by sleep restriction and the combination of hypoxia plus sleep restriction, but not by hypoxia alone, reproducing previous findings regarding sleep restriction. We also found less efficient alpha event-related desynchronization (α-ERD) and alpha inter-trial phase coherence (α-ITPC) as it has already been observed during sleep restriction, while also providing novel insights into the effects of acute moderate and prolonged hypoxia exposure. Furthermore, our results confirm that certain neural aspects of visual and auditory attentional processes are differentially affected by hypoxia and sleep restriction, and also suggest that sleep restriction plays a primary role in driving the effects observed under combined constraints.

Hypoxia (HY) and sleep deprivation have opposite effects on appetite. As HY may alter sleep, it may be informative to assess the accumulative effects of these two stressors on hunger, energy intake (EI), and food reward. Seventeen young, active, healthy males completed four 5-hr sessions in normoxia (NO) or normobaric HY (FIO2 = 13.6%, similar to 3,500 m) after a night of habitual sleep (HS; total sleep time >6 hr) or sleep restriction (SR; total sleep time <3 hr). Subjective appetite was assessed regularly using visual analogic scales and EI during an ad libitum lunch after 3.5 hr of exposure. Food reward was assessed using the Leeds Food Preference Questionnaire just before the lunch. As expected, EI was lower for the HY-HS (4.32 +/- 0.71 MJ; p = .048) and HY-SR (4.16 +/- 0.68 MJ, p = .013) sessions than the NO-HS (4.90 +/- 0.84 MJ) session without acute mountain sickness-related gastrointestinal symptoms. No significant effect of SR alone was observed (NO-SR: 4.40 +/- 0.68 MJ). Subjective appetite was not affected. Explicit liking for high-fat foods was higher with SR than HS (main effect: p = .002) and implicit wanting for high-fat foods was higher for the NO-SR, HY-HS, and HY-SR sessions than the NO-HS session (p < .006). Thus, acute SR did not modify subjective appetite or EI despite the increasing food reward for high-fat foods and did not alter the HY-induced changes of appetite or food reward.

Aircraft pilots face a high mental workload (MW) under environmental constraints induced by high altitude and sometimes sleep restriction (SR). Our aim was to assess the combined effects of hypoxia and sleep restriction on cognitive and physiological responses to different MW levels using the Multi-Attribute Test Battery (MATB)-II with an additional auditory Oddball-like task. Seventeen healthy subjects were subjected in random order to three 12-min periods of increased MW level (low, medium, and high): sleep restriction (SR, <3 h of total sleep time (TST)) vs. habitual sleep (HS, >6 h TST), hypoxia (HY, 2 h, FIO2 = 13.6%, ~3500 m vs. normoxia, NO, FIO2 = 21%). Following each MW level, participants completed the NASA-TLX subjective MW scale. Increasing MW decreases performance on the MATB-II Tracking task (p = 0.001, MW difficulty main effect) and increases NASA-TLX (p = 0.001). In the combined HY/SR condition, MATB-II performance was lower, and the NASA-TLX score was higher compared with the NO/HS condition, while no effect of hypoxia alone was observed. In the accuracy of the auditory task, there is a significant interaction between hypoxia and MW difficulty (F(2–176) = 3.14, p = 0.04), with lower values at high MW under hypoxic conditions. Breathing rate, pupil size, and amplitude of pupil dilation response (PDR) to auditory stimuli are associated with increased MW. These parameters are the best predictors of increased MW, independently of physiological constraints. Adding ECG, SpO2, or electrodermal conductance does not improve model performance. In conclusion, hypoxia and sleep restriction have an additive effect on MW. Physiological and electrophysiological responses must be taken into account when designing a MW predictive model and cross-validation.

Operational environments are characterized by a range of psycho-physiological constraints that can degrade combatants’ performance and impact on their long-term health. Neurofeedback training (NFT), a non-invasive, safe and effective means of regulating brain activity, has been shown to be effective for mental disorders, as well as for cognitive and motor capacities and aiding sports performance in healthy individuals. Its value in helping soldiers in operational condition or suffering from post-traumatic stress (PTSD) is undeniable, but relatively unexplored. The aim of this narrative review is to show the applicability of NFT to enhance cognitive performance and to treat (or manage) PTSD symptoms in the military context. It provides an overview of NFT use cases before, during or after military operations, and in the treatment of soldiers suffering from PTSD. The position of NFT within the broad spectrum of performance enhancement techniques, as well as several key factors influencing the effectiveness of NFT are discussed. Finally, suggestions for the use of NFT in the military context (pre-training environments, and during and post-deployments to combat zones or field operations), future research directions, recommendations and caveats (e.g., on transfer to operational situations, inter-individual variability in responsiveness) are offered. This review is thus expected to draw clear perspectives for both researchers and armed forces regarding NFT for cognitive performance enhancement and PTSD treatment related to the military context.

Multi-Attribute Task Battery (MATB) is a computerized flight simulator for aviation-related tasks, suitable for non-pilots and available in many versions, including open source. MATB requires the individual or simultaneous execution of 4 sub-tasks: system monitoring (SYSMON), tracking (TRACK), communications (COMM), and resource management (RESMAN). Fully customizable, the design of test duration, number of sub-tasks used, event rates, response times and overlap, create different levels of mental load. MATB can be combined with an additional auditory attention (Oddball) task, or with physiological constraints (i.e., sleep loss, exercise, hypoxia). We aimed to assess the main characteristics of MATB design for assessing the response to different workload levels. We identified and reviewed 19 articles for which the effects of low and high workload were analyzed. Although MATB has shown promise in detecting performance degradation due to increase workload, studies have yielded conflicting or unclear results regarding MATB configurations. Increased event rates, number of sub-tasks (multitasking), and overlap are associated with increased perceived workload score (ex. NASA-TLX), decreased performance (especially tracking), and neurophysiological responses, while no effect of time-on-task is observed. The median duration used for the test is 20 min (range 12–60) with a level duration of 10 min (range 4–15). To assess mental workload, the median number of stimuli is respectively 3 events/min (range 0.6–17.2) for low, and 23.5 events/min (range 9–65) for high workload level. In this review, we give some recommendations for standardization of MATB design, configuration, description and training, in order to improve reproducibility and comparison between studies, a challenge for the future researches, as human-machine interaction and digital influx increase for pilots. We also open the discussion on the possible use of MATB in the context of aeronautical/operational constraints in order to assess the effects combined with changes in mental workload levels. Thus, with appropriate levels of difficulty, MATB can be used as a suitable simulation tool to study the effects of changes on the mental workload of aircraft pilots, during different operational and physiological constraints.

Background: Caffeine is a well-known psychostimulant reputed to alleviate the deleterious effects of sleep deprivation. Nevertheless, caffeine can alter sleep duration and quality, particularly during recovery sleep. We evaluated the effects of acute caffeine intake on the duration and quality of recovery sleep following total sleep deprivation (TSD), taking into account daily caffeine consumption. Methods: Forty-one participants performed a double-blind, crossover TSD protocol (38 h of continuous wakefulness) with acute caffeine or placebo. Caffeine (2.5 mg/kg) or placebo was administered twice during continuous wakefulness (last treatment 6.5 h before bedtime for the recovery night). Polysomnographic measurements were recorded using a connected headband. Results: TSD was associated with a rebound in total sleep time (TST) on the recovery night (+110.2 ± 23.2 min, p < 0.001). Caffeine intake decreased this recovery TST (−30.2 ± 8.2 min p = 0.02) and the N3 sleep stage duration (−35.6 ± 23.2 min, p < 0.01). Caffeine intake altered recovery sleep continuity (increased number of long awakenings), stability (higher stage transition frequency), and organization (less time spent in complete sleep cycle) and decreased the delta power spectral density during NREM sleep. On the recovery night, habitual daily caffeine consumption was negatively correlated with TST in caffeine and placebo conditions and positively correlated with wake after sleep onset (WASO) duration and with the frequency of long (>2 min) awakenings in the caffeine condition only. Conclusions: Acute caffeine intake during TSD affects nighttime recovery sleep, with an interaction with daily consumption. These results may influence advice on caffeine intake for night-shift workers. (NCT03859882).

Introduction: Exposure to moderate levels of simulated hypoxia has subtle cognitive effects relative to ground level, in healthy individuals. However, there are few data on the cognitive consequences of the combination of hypoxia and partial sleep deprivation, which is a classic military or civilian operational context. In this study, we tested the hypothesis that exposure to moderate hypoxia while sleep-restricted impairs several domains of cognition, and we also assessed physiological parameters and salivary concentrations of cortisol and alpha-amylase. Method: Seventeen healthy males completed two sessions of cognitive tests (sustained attention using the PVT psychomotor vigilance task and executive functions using the Go-NoGo inhibition task and N-Back working memory task) after 30 min (T + 30 ') and 4 h (T + 240 ') of exposure in a normobaric hypoxic tent (FIO2 = 13.6 %, similar or equal to 3,500 m) (HY). This was completed after one night of sleep restriction (3 a.m. to 6 a.m. bedtime, SRHY) and one night of habitual sleep (10 p.m. to 6 a.m. bedtime, HSHY) (with cross-over randomization). The two nights sleep architecture and physiological parameters (oxygen saturation (SpO(2)) and heart rate (HR) during T + 30 ' and T + 240 ' sessions were analyzed. Salivary cortisol and alpha-amylase (sAA) concentrations were analyzed before hypoxia, after the T + 30 ' and T + 240 ' cognitive sessions, and after leaving the hypoxic tent. Results: Sustained attention (RT and number of lapses in the PVT) and executive functions (Go-NoGo and 1-Back and 2-Back parameters, as inhibition and working memory signatures) were impaired in the SRHY condition compared to HSHY. SpO(2) and HR were higher after 4 h compared with 30 min of hypoxia in the HSHY condition, while only HR was statistically higher in the SRHY condition. In SRHY, salivary AA concentration was lower and cortisol was higher than in HSHY. A significant increase in sAA concentration is observed after the cognitive session at 4 h of hypoxia exposure compared to that at 30 min, only in the SRHY condition. There are significant positive correlations between reaction time and the corresponding heart rate (a non-invasive marker of physiological stress) for the executive tasks in the two sleep conditions. This was not observed for salivary levels of sAA and cortisol, respective reliable indicators of the sympathoadrenomedullary system and the hypothalamic-pituitary adrenocortical system. Conclusion: Exposure to moderate normobaric hypoxia (similar or equal to 3500 m / similar or equal to 11,500 ft simulated) after a single night of 3-hour sleep impairs cognitive performance after 30 min and 4 h of exposure. The key determinants and/or mechanism(s) responsible for cognitive impairment when exposed to moderate hypoxia with sleep restriction, particularly on the executive function, have yet to be elucidated.

INTRODUCTION:In the military population, trauma-related nightmares (TRNs) are highly associated with deployments and combat-related events. Trauma-related nightmares are also correlated with severity, treatment resistance, and chronicity of Post-Traumatic Stress Disorder (PTSD). However, to date, no specific measure of TRNs has been validated for use in the French language. This study aimed to translate and culturally adapt the English version of the Trauma-Related Nightmare Survey into French and to evaluate the psychometric properties of the translation on veterans.MATERIALS AND METHODS:After the translation and cultural adaptation process, we evaluated the reliability and validity of the French version of the questionnaire (TRNS-FR) in a population of veterans suffering from PTSD with nightmare complaints (n = 56 patients for test-retest and n = 60 for internal consistency), recruited from five French military hospitals.RESULTS:Analyses demonstrated that TRNS-FR has good test-retest reliability (r = 0.59) and good internal consistency with PTSD symptoms, insomnia symptoms, and subjective sleep parameters assessed at home. This questionnaire provides a rapid and comprehensive assessment of sleep disturbance and a specific description of TRNs in the population of veterans with severe PTSD. Our results allowed us to propose a valid and reliable French adaptation of the questionnaire.CONCLUSION:Because sleep disturbances and TRNs require specific therapeutic management, the psychometric qualities of TRNS-FR make it a tool of choice for assessing TRNs in future clinical research settings.

Pro-inflammatory cytokines are involved in sleep-wake regulation and are associated with caffeine consumption. This is a cross-sectional study in 1023 active French workers investigating associations between self-reported sleep complaints (>3months) and total sleep time (TST) with nine single-nucleotide-polymorphisms (SNPs) including pro-inflammatory cytokines, according to caffeine con-sumption. Participants were characterized as low, moderate and high (0-50, 51-300, and >300 mg/day) caffeine consumers. After adjusting the odd ratios (OR) for age, gender, and smoking, the risk of sleep complaints was higher in subjects with genetic mutations in tumor necrosis factor alpha (TNF-a, rs 1800629) (ORa [95%CI] = 1.43 [1.07-1.92] for both G/A and A/A aggregate genotypes) or interleukin-1 beta (IL-1(3, rs1143627) (ORa = 1.61 [1.08-2.4 4] for homozygous A/A genotype), and the risk was higher when subjects carry the mutations in TNF-a plus IL-1(3 regardless of caffeine consumption. When stratified with caffeine consumption, the risk of sleep complaints was higher in TNF-a A allele carriers in high caffeine consumers, and in homozygous A/A genotype of IL-1(3 in moderate and high consumers. None of the nine SNPs influence TST, with the exception of the mutation on CYP1A2 and only when stratified with caffeine consumption. Our results also indicated more caffeine side-effects when carrying mutation on IL1(3. This study showed that polymorphisms in TNF-a and/or IL-1(3 influenced sleep complaints but did not influence total sleep time. This suggests that management of sleep complaints, which can be addressed by clinical interventions, should consider the influence of the genetic profile of pro-inflammatory cytokines.(c) 2022 Published by Elsevier B.V.