Clinical Research Directory

Endocrine Disruption, Menopause, and Poor Sleep in wOmen With Type 2 Diabetes: Effects on Cardiovascular Health

EMPOWER aims to determine the overall effect of menopause and sleep disruption on cardiac remodeling in women with type 2 diabetes.

Sleep Hygiene During Ramadan

Ramadan fasting often disrupts sleep patterns, which can affect alertness and physical performance in student-athletes. This study tested whether a brief sleep education program designed for Ramadan could help improve sleep quality and maintain performance. Sixty-four male sport-science students who planned to fast during Ramadan were randomly assigned to one of two groups. The first group received a 45-minute educational session about sleep hygiene specifically adapted to Ramadan practices (timing of sleep around evening and pre-dawn meals, managing light exposure, limiting caffeine and screen time before bed). They also received weekly text message reminders and completed short weekly checklists about their sleep habits. The second group continued their usual routines without any intervention. Participants wore activity monitors on their wrist to track sleep throughout the study. They also completed computerized tests of attention and reaction time, as well as physical performance tests (jumping, handgrip strength, agility) before Ramadan and during the final week of fasting. The researchers found that students who received the sleep education maintained better sleep duration and quality during Ramadan compared to those who did not receive the program. They also showed better attention, faster reaction times, and better preservation of physical performance. This suggests that simple, culturally-adapted sleep education can help student-athletes maintain their health and performance during Ramadan.

Impact on Prognosis of Increased Sleep Quality Obtained by Personalized Night-time Nursing Care in Critically Ill Patients

Sleep disturbances are common among intensive care unit (ICU) patients and have been associated with difficult weaning from invasive mechanical ventilation, with an increased risk of endotracheal intubation. Other studies have reported associations between sleep disturbances and prolonged ICU length of stay or the occurrence of delirium. Among the factors contributing to sleep impairment, nighttime care interventions have been identified as a major cause. The management of sleep disorders in the ICU remains complex and often disappointing, and no pharmacological treatment is currently formally recommended. Very recently, a considerable improvement of sleep quantity (+50%) and quality (doubling of deep sleep quantity) has been reported by reorganizing nighttime nursing care according to patients' sleep cycles, using a sleep monitoring medical device. The objective of this study is to quantify the impact of a better sleep on prognosis. Sleep will be improved using sleep-guided nursing care during nighttime thanks to a real-time sleep monitor (Sleepscan°). The primary endpoint is the proportion of patients requiring invasive mechanical ventilation or who have died at day 7 after inclusion. The main secondary outcomes include the duration of ICU stay, the number of delirium free-days, the score at a discomfort scale, the score at a post-traumatic stress disorder scale at ICU discharge. Intensive care unit-related costs will be assessed. A multi-sites, prospective, randomized, open-label, superiority trial with two parallel arms will be conducted. Awake and conscious patients without continuous sedation, regardless of ventilatory support, with no indication for urgent intubation (\<12 hours) and with an expected ICU length of stay greater than 48 hours will be included. The intervention will consist of sleep-guided nighttime nursing care using the Sleepscan monitor from 7:00 p.m. to 7:00 a.m., every night until ICU discharge or day 7. Sleep-guided nursing care consist in postponing non urgent care (such as temperature measurement…) and avoiding entering the room when patients are asleep. Otherwise, when patients are awake, instructions are to go for all care, to cluster and anticipate nursing care and perform comfort care. In the control group, sleep will also be recorded using the same device but the tablet will not display the patient's sleep (or awake) status, and nighttime nursing care will be performed according to usual practice and independently of patients' sleep cycles. Based on our preliminary data and previous studies, it has been estimated that 230 patients per group will be required to detect a reduction in the proportion of patients intubated or deceased at day 7 from 20% in the control group to 10% in the intervention group. The intention-to-treat analysis population will include all randomized patients. Demonstrating an improvement in patient prognosis through enhanced sleep quality would represent a major advancement for intensive care medicine. Reducing the need for invasive mechanical ventilation may lead to shorter ICU stays, lower mortality, fewer post-ICU complications, and reduced hospital costs. Demonstrating an improvement in patient prognosis through enhanced sleep quality would represent a major advancement for intensive care medicine. Reducing the need for invasive mechanical ventilation and the incidence of delirium may lead to shorter ICU stays, lower mortality, fewer post-ICU complications, and reduced hospital costs.