A systematic review and network meta-analysis of randomized controlled trials evaluating the evidence base of melatonin, light exposure, exercise, and complementary and alternative medicine for patients with insomnia disorder

Insomnia is a prevalent disorder and it leads to relevant impairment in health-related quality of life. Recent clinical guidelines pointed out that Cognitive-Behavior Therapy for Insomnia (CBT-I) should be considered as first-line intervention. Nevertheless, many other interventions are commonly used by patients or have been proposed as effective for insomnia. These include melatonin, light exposure, exercise, and complementary and alternative medicine. Evaluation of comparable effectiveness of these interventions with first-line intervention for insomnia is however still lacking. We conducted a systematic review and network meta-analysis on the effects of these interventions. PubMed, PsycInfo, PsycArticles, MEDLINE, and CINAHL were systematically searched and 40 studies were included in the systematic review, while 36 were entered into the meta-analysis. Eight network meta-analyses were conducted. Findings support effectiveness of melatonin in improving sleep-onset difficulties and of meditative movement therapies for self-report sleep efficiency and severity of the insomnia disorder. Some support was observed for exercise, hypnotherapy, and transcranial magnetic resonance, but the number of studies for these interventions is still too small. None of the considered interventions received superior evidence to CBT-I, which should be more widely disseminated in primary care

Exploring the Thermodynamics of a Universal Fermi Gas

From sand piles to electrons in metals, one of the greatest challenges in modern physics is to understand the behavior of an ensemble of strongly interacting particles. A class of quantum many-body systems such as neutron matter and cold Fermi gases share the same universal thermodynamic properties when interactions reach the maximum effective value allowed by quantum mechanics, the so-called unitary limit [1,2]. It is then possible to simulate some astrophysical phenomena inside the highly controlled environment of an atomic physics laboratory. Previous work on the thermodynamics of a two-component Fermi gas led to thermodynamic quantities averaged over the trap [3-5], making it difficult to compare with many-body theories developed for uniform gases. Here we develop a general method that provides for the first time the equation of state of a uniform gas, as well as a detailed comparison with existing theories [6,14]. The precision of our equation of state leads to new physical insights on the unitary gas. For the unpolarized gas, we prove that the low-temperature thermodynamics of the strongly interacting normal phase is well described by Fermi liquid theory and we localize the superfluid transition. For a spin-polarized system, our equation of state at zero temperature has a 2% accuracy and it extends the work of [15] on the phase diagram to a new regime of precision. We show in particular that, despite strong correlations, the normal phase behaves as a mixture of two ideal gases: a Fermi gas of bare majority atoms and a non-interacting gas of dressed quasi-particles, the fermionic polarons [10,16-18].Comment: 8 pages, 5 figure

Large atom number dual-species magneto-optical trap for fermionic 6Li and 40K atoms

We present the design, implementation and characterization of a dual-species magneto-optical trap (MOT) for fermionic 6Li and 40K atoms with large atom numbers. The MOT simultaneously contains 5.2x10^9 6Li-atoms and 8.0x10^9 40K-atoms, which are continuously loaded by a Zeeman slower for 6Li and a 2D-MOT for 40K. The atom sources induce capture rates of 1.2x10^9 6Li-atoms/s and 1.4x10^9 40K-atoms/s. Trap losses due to light-induced interspecies collisions of ~65% were observed and could be minimized to ~10% by using low magnetic field gradients and low light powers in the repumping light of both atomic species. The described system represents the starting point for the production of a large-atom number quantum degenerate Fermi-Fermi mixture

Ultra-cold Polarized Fermi Gases

Recent experiments with ultra-cold atoms have demonstrated the possibility of realizing experimentally fermionic superfluids with imbalanced spin populations. We discuss how these developments have shed a new light on a half- century old open problem in condensed matter physics, and raised new interrogations of their own.Comment: 27 pages; 8 figures; Published in Report in Rep. Prog. Phys. 73 112401 (2010

Sleep and cognitive performance:cross-sectional associations from the UK Biobank

Objective: The relationship between insomnia symptoms and cognitive performance is unclear, particularly at the population level. We conducted the largest examination of this association to date through analysis of the UK Biobank, a large population-based sample of adults aged 40-69 yrs. We also sought to determine associations between cognitive performance and self-reported chronotype, sleep medication use, and sleep duration. Methods: This cross-sectional, population-based study involved 477,529 participants, comprising 133,314 with frequent insomnia symptoms (age: 57.4 ± 7.7 yrs; 62.1% female) and 344,215 controls without (age: 56.1 ± 8.2 yrs; 52.0% female). Cognitive performance was assessed through a touchscreen test battery probing reasoning, basic reaction time, numeric memory, visual memory and prospective memory. Adjusted models included relevant demographic, clinical and sleep variables. Results: Frequent insomnia symptoms were associated with cognitive impairment in unadjusted models, however these effects were reversed after full adjustment, leaving those with frequent insomnia symptoms showing statistically better cognitive performance over those without. Relative to intermediate chronotype, evening chronotype was associated with superior task performance, while morning chronotype was associated with the poorest performance. Sleep medication use and both long (>9hrs) and short (<7hrs) sleep duration were associated with impaired performance. Conclusions: Our results suggest that after adjustment for potential confounding variables, frequent insomnia symptoms may be associated with a small statistical advantage, which is unlikely to be clinically meaningful, on simple neurocognitive tasks. Further work is required to examine mechanistic underpinnings of an apparent evening chronotype advantage in cognitive performance, as well as impairment associated with morning chronotype, sleep medication use, and sleep duration extremes

Genome-wide association analysis of self-reported daytime sleepiness identifies 42 loci that suggest biological subtypes

This is the final version. Available from the publisher via the DOI in this record.UK Biobank Sleep Traits GWAS summary statistics are available at the Sleep Disorder Knowledge Portal (SDKP) website (http://www.sleepdisordergenetics.org). All other data are contained within the article and its supplementary information or available upon request.Excessive daytime sleepiness (EDS) affects 10–20% of the population and is associated with substantial functional deficits. Here, we identify 42 loci for self-reported daytime sleepiness in GWAS of 452,071 individuals from the UK Biobank, with enrichment for genes expressed in brain tissues and in neuronal transmission pathways. We confirm the aggregate effect of a genetic risk score of 42 SNPs on daytime sleepiness in independent Scandinavian cohorts and on other sleep disorders (restless legs syndrome, insomnia) and sleep traits (duration, chronotype, accelerometer-derived sleep efficiency and daytime naps or inactivity). However, individual daytime sleepiness signals vary in their associations with objective short vs long sleep, and with markers of sleep continuity. The 42 sleepiness variants primarily cluster into two predominant composite biological subtypes - sleep propensity and sleep fragmentation. Shared genetic links are also seen with obesity, coronary heart disease, psychiatric diseases, cognitive traits and reproductive ageing.Medical Research Council (MRC

The therapeutic potential of attentional bias modification training for insomnia: study protocol for a randomised controlled trial.

The efficacy of attentional bias modification (ABM) as a treatment for anxiety and depression has been extensively studied with promising results. Despite some evidence of sleep-related attentional biases in insomnia, only a small number of studies, yielding mixed results, have examined the application of ABM in insomnia. This study specifically aims to determine whether ABM can reduce (i) the presence of an attentional bias for sleep-related threatening words; (ii) insomnia symptom severity; (iii) sleep onset latency; and (iv) pre-sleep cognitive arousal amongst individuals with insomnia compared to a non-treatment control group of individuals with insomnia. We propose a randomised controlled trial of 90 individuals from the general population who meet the criteria for Insomnia Disorder. Following an initial examination for the presence of a sleep-related attentional bias using the dot-probe paradigm, participants will be randomised to an online attentional bias modification training condition, or to a standard attentional bias task (non-treatment) control condition. Both conditions will be delivered online by a web platform. All participants allocated to the non-treatment control group will be offered ABM training once the study is complete. The primary outcome will be the attentional bias indices of vigilance and disengagement and self-reported insomnia symptoms, sleep onset latency and pre-sleep cognitive arousal. Attentional bias and insomnia symptoms will be assessed at baseline (day 1) and post-treatment (2 days after the final training session: day 9). Insomnia symptoms will be again assessed at follow-up (day 16). Secondary outcomes include examining whether sleep associated monitoring and worry are related to a sleep-related attentional bias in insomnia, and whether such reports reduce following ABM. All main analyses will be carried out on completion of follow-up assessments. The trial is supported by the Department of Psychology, Sociology and Politics at Sheffield Hallam University. This study will extend the research base examining the efficacy of attentional bias modification for insomnia. ISRCTN ( ISRCTN11643569 , registered on 5 June 2018)

Production of a dual-species Bose-Einstein condensate of Rb and Cs atoms

We report the simultaneous production of Bose-Einstein condensates (BECs) of $^{87}$Rb and $^{133}$Cs atoms in separate optical traps. The two samples are mixed during laser cooling and loading but are separated by $400 \mu$m for the final stage of evaporative cooling. This is done to avoid considerable interspecies three-body recombination, which causes heating and evaporative loss. We characterize the BEC production process, discuss limitations, and outline the use of the dual-species BEC in future experiments to produce rovibronic ground state molecules, including a scheme facilitated by the superfluid-to-Mott-insulator (SF-MI) phase transition