Magnesium Glycinate (Sleep)

INTRODUCTION: Caffeine is the most widely consumed psychoactive stimulant worldwide and acts primarily through antagonism of adenosine A1 and A2A receptors, thereby reducing sleep pressure and promoting wakefulness. Although its alerting and performance-enhancing effects are well established, its influence on sleep-related electroencephalography (EEG) has been investigated across diverse paradigms with substantial methodological heterogeneity. This systematic and mechanistic review aimed to synthesize human evidence on how caffeine affects sleep architecture, quantitative sleep EEG, and neurophysiological markers of sleep homeostasis, and to interpret these findings within current models of adenosine-mediated sleep-wake regulation. MATERIALS AND METHODS: A systematic search of PubMed/MEDLINE, Web of Science, Scopus, Embase, PsycINFO, ResearchGate, and Google Scholar was conducted for studies published between January 1980 and January 2026, with the final search performed on 10 January 2026. Eligible studies were original human investigations examining caffeine exposure or administration and reporting sleep-related EEG outcomes, including polysomnographic sleep staging, spectral EEG analyses, or other EEG-derived sleep metrics. Two reviewers independently screened records and assessed eligibility, with disagreements resolved by consensus. Data on study design, participant characteristics, caffeine interventions, EEG methodology, and outcomes were extracted using a predefined form. Risk of bias was evaluated using the RoB 2 and ROBINS-I tools. Owing to marked heterogeneity across studies, findings were synthesized narratively within a mechanistic interpretive framework. RESULTS: Thirty-two studies were included. Across highly heterogeneous paradigms-including acute bedtime or evening dosing, daytime or repeated caffeine use before nocturnal sleep, administration during prolonged wakefulness followed by recovery sleep, withdrawal protocols, and ambulatory/home EEG monitoring-the most consistent finding was suppression of low-frequency NREM EEG activity, particularly slow-wave activity and the lowest delta frequencies. Caffeine frequently increased faster EEG activi

BACKGROUND: Auriculotherapy has been used extensively for insomnia in traditional Chinese medicine due to its high effectiveness and few adverse effects. However, there are several auriculotherapy approaches, and it's still uncertain which is best for treating primary insomnia (PI). The purpose of this study is to determine the best auriculotherapy strategy for treating PI. METHODS: A comprehensive search was conducted across 8 databases to identify randomized controlled trials investigating the use of auriculotherapy for the treatment of PI. The search period spanned from database inception through July 28, 2025. The observation group received either single or combined auriculotherapy, while the control group was given another type of auriculotherapy, oral eszopiclone, sham stimulation, or usual care. The primary outcome was the Pittsburgh Sleep Quality Index, and the secondary outcome was safety assessments. Methodological quality was assessed with the Cochrane Risk of Bias Tool (version 5.1.0). Data analysis was done using Stata 16.0 and Review Manager 5.4. RESULTS: A total of 25 studies were included, covering 11 distinct auriculotherapies, and 2106 patients with PI diagnoses were included. The results of the traditional comparison showed that both auricular acupressure and transcutaneous auricular vagus nerve stimulation were more effective than the control group at lowering Pittsburgh Sleep Quality Index scores. According to the findings of the network meta-analysis, 11 auriculotherapies were more effective than sham stimulation or usual care at treating PI. According to the surface under the cumulative ranking curve values, the following are the top 5 interventions, in order of probability: Auricular bloodletting + auricular acupressure (85.8%), auricular massage + auricular scraping + auricular acupressure (85.5%), auricular scraping + auricular acupressure (84.8%), auricular needle-embedding + auricular acupressure (71.2%), and auricular acupuncture + auricular acupressure (67.5%). CONCLUSION: The most effective auriculotherapy regimens for PI are auricular bloodletting + auricular acupressure and auricular massage + auricular scraping + auricular acupr

INTRODUCTION: Long-distance relationships (LDRs) reduce opportunities for physical intimacy, often prompting individuals to seek alternative sexual activities such as masturbation. Although common, its influence on sexual satisfaction, sexual health, psychological well-being, and relational stability in LDRs remains understudied. Moreover, cultural and population differences shape diverse meanings and perspectives on masturbation. OBJECTIVES: We employed a systematic review approach to explore the role of masturbation within long-distance relationships. Specifically, this review aims to examine how masturbation is associated with sexual, relational, and psychological outcomes and how these perspectives vary across cultural contexts. METHODS: A systematic review was conducted following the PRISMA guidelines, compiling both quantitative and qualitative studies on masturbation as an alternative sexual activity in LDRs as well as its implications for sexual satisfaction, relationship satisfaction, and psychological well-being. RESULTS: Fourteen studies were eligible for further analysis in which men reported higher frequencies of masturbation compared to women, with significant increases observed in the context of long-distance relationships and during COVID-19 quarantine periods. Men were mainly motivated by biological release, orgasm, and stress reduction, often with pornography, whereas women reported broader motives such as relaxation, better sleep, stress relief, and emotional closeness. The effects on sexual satisfaction were mixed: masturbation was reported to be associated with greater body awareness, self-esteem, and relational harmony, yet excessive frequency was linked to lower satisfaction and arousal. Mutual, technology-mediated practices helped maintain intimacy, while excessive solitary use undermined relationship quality. From a sexual health perspective, moderate masturbation may be associated with indirect benefits through improved body awareness, whereas frequent use was linked to poorer experiences. Psychologically, it served as a coping strategy for sleep and stress, but excessive engagement increased anxiety and reduced emotional well-being. CO

BACKGROUND: Chronic obstructive pulmonary disease (COPD) features poor sleep quality due to nocturnal dyspnea and psychological distress, leading to increased hospital admissions and reduced quality of life. Considering patient preference and existing evidence, non-pharmacological intervention, i.e. cognitive behavioral therapy for insomnia (CBT-I), on sleep for COPD patients had its potential efficacy. However, current guidelines do not include sleep management as standard care, and there is a lack of comprehensive reviews on this topic. This systematic review hence evaluated the effectiveness of non-pharmacological treatments for poor sleep in COPD patients. METHODS: Literature identification was conducted through MEDLINE, CINHAL PLUS, AMED and ScienceDirect under PRISMA guidance. Randomized controlled trials, cohort studies and cross-sectional studies regarding poor sleep quality among COPD population were retrieved. Abstract, title and full text screening were performed by the author and assessed by a second reviewer. Risk of bias and quality appraisal was done with JBI scale. RESULTS: 12 articles (783 patients) were identified, including 9 randomized controlled trials, 1 cohort study and 2 cross-sectional studies. The risk of bias (quality) was ranked: low (high) for 3, moderate (moderate) for 7 and high (low) for 2. Several interventions were identified (number of study): CBT-I (2) and cognitive behavioral therapy (1), pulmonary rehabilitation (PR) (2), progressive muscle relaxation technique (PMRT) (2), non-invasive ventilation (NIV) (3), relaxation exercise (RE) (1) and therapeutic touch (TT) (1). Significant improvement in sleep quality was reported in PMRT, TT and RE. CONCLUSION: PMRT, TT and RE showed improvement in sleep quality in COPD patients yet unable to rank their effectiveness as heterogeneous outcome measures across studies. No substantial evidence was capable to demonstrate effectiveness of CBT-I, CBT, PR and NIV to explicit COPD patients. Moreover, future research including combination of non-pharmacological treatments is needed. © 2026. The Author(s).

BACKGROUND: Sleep disorders are increasingly linked to glymphatic dysfunction, but whether this impairment is universal across different sleep pathologies remains unclear. OBJECTIVE: This meta-analysis examined whether glymphatic dysfunction, assessed via the diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) index, may represent a shared neural feature across a spectrum of sleep disorders. METHODS: We systematically searched PubMed, EMBASE, and the Cochrane Library from inception to December 31, 2025, for observational studies comparing DTI-ALPS index between patients with sleep disorders and healthy controls. Data were synthesized from 19 studies (n = 2,315) using a random-effects model to calculate standardized mean differences (SMDs). Methodological quality was assessed with the Newcastle-Ottawa Scale. Subgroup analyses, meta-regression, sensitivity analyses, and publication bias assessment were performed. RESULTS: The pooled analysis revealed significant global glymphatic impairment in patients with sleep disorders (SMD = -1.60, 95% CI [-2.65, -0.54], p = 0.003), indicating global glymphatic dysfunction. However, heterogeneity was extremely high (I2 = 94.7%). Disorder-specific analyses showed pronounced deficits in obstructive sleep apnea (SMD = -0.92, p < 0.001) and idiopathic REM sleep behavior disorder (SMD = -0.63, p = 0.004), as well as in PSQI-defined poor sleep (SMD = -0.50, p < 0.001). Results for insomnia and narcolepsy were non-significant and highly heterogeneous. Meta-regression identified no significant moderators; publication bias was detected (p = 0.01). CONCLUSION: Glymphatic dysfunction, as assessed by DTI-ALPS, is consistently observed across several sleep disorders, suggesting a potential shared pathway. However, extreme heterogeneity limits interpretability of the pooled effect, and cross-sectional data preclude causal inference.

OBJECTIVE: This study assesses the impact of varying adherence to American College of Sports Medicine (ACSM) guidelines on quality of life and symptom burden in lung cancer patients. METHODS: A systematic search was performed across PubMed, Embase, Web of Science, and Cochrane Library to identify RCTs of exercise in lung cancer. Interventions were classified by adherence to ACSM guidelines for subsequent subgroup analyses. Meta-analyses used random-effects models to pool standardized mean differences (SMDs) and 95% confidence intervals (CIs). Study quality was assessed using the revised Cochrane Risk of Bias tool for randomized trials (RoB 2), and publication bias was evaluated using Begg's and Egger's tests. RESULTS: A total of 32 studies were analyzed, of which 18 demonstrated high adherence to the ACSM guidelines. Meta-analysis demonstrated that exercise interventions significantly improved quality of life (SMD = 0.44, 95% CI: 0.18, 0.70, p < 0.001), with a greater effect in the high-adherence group compared with the low or uncertain adherence group (SMD = 0.75 vs. 0.20, p = 0.03). Exercise also significantly alleviated fatigue (SMD = -0.50, 95% CI: -0.81, -0.20, p = 0.001), with more pronounced improvements in the high-adherence group (SMD = -0.77 vs. -0.11, p = 0.004). In addition, exercise significantly reduced anxiety (SMD = -0.63, 95% CI: -1.00, -0.26, p < 0.001) and depression (SMD = -0.67, 95% CI: -0.97, -0.38, p < 0.001); however, no significant differences were observed between adherence subgroups. Pain was also relieved (SMD = -0.81, 95% CI: -1.49, -0.12, p = 0.02), with a greater effect in the high-adherence group (SMD = -1.46 vs. 0.02, p = 0.01). Overall evidence shows no clear sleep improvement (SMD = -0.12, 95% CI: -0.37, 0.12, p = 0.32), despite borderline significance in the high-adherence subgroup (p = 0.05) and near-significant subgroup differences (p = 0.06). CONCLUSIONS: Exercise interventions with high adherence to the ACSM guidelines may be more effective in improving quality of life, fatigue, and pain. However, improvements in anxiety and depression do not appear to be dependent on adherence. No significant improvement was observed in s

BackgroundEndometriosis is a hormone-driven systemic inflammatory condition characterized by endometrial-like lesions which grow throughout the body affecting up to 15% of women worldwide with symptoms including chronic pain, infertility, and persistent fatigue. Many patients report a reduction in their quality of life, potentially driven in part by poor sleep quality. Despite this low sleep quality is not a commonly recognized symptom of endometriosis.ObjectiveWe aimed to examine the association between endometriosis and poor sleep quality.DesignWe conducted a systematic literature review and mixed-effects meta-analysis to evaluate the association between endometriosis and sleep quality.Data sources and methodsSix studies identified through PubMed and Embase met inclusion criteria and were assessed for quality. Between-group standardized mean differences (SMD) were pooled, and sensitivity analyses and meta-regressions were performed to evaluate the influence of between-study heterogeneity.ResultsPooling of all studies produced a standardized mean difference of 0.69 (95% CI: 0.28,1.09) with high heterogeneity (I2 = 94% p<0.01), which equates to a 2.44 (95%CI: 0.99; 3.85) point increase on the Pittsburg Sleep Quality Index (indicating poorer overall sleep quality) for endometriosis patients compared to healthy controls. This association persisted during sensitivity analyses.ConclusionThis observed association may be driven by a pain-sleep quality feedback loop or by the inflammation and hormonal imbalances of endometriosis. While there are several limitations to interpreting these results, including differences in control selections and adjustments for potential confounders between included studies, it is the first quantitative evaluation of the association between endometriosis and poor sleep quality across populations. Since sleep quality predicts chronic pain patterns, future research and patient treatment plans should focus on potential interventions to improve the sleep quality of endometriosis patients experience to reduce the societal and personal burdens of this disease. Plain Language Summary: Endometriosis is a chronic condition where tissue similar to

AIMS/BACKGROUND: Obstructive sleep apnea (OSA) and intermittent maternal hypoxia during pregnancy have been hypothesised to impact fetal heart rate (FHR). To evidence this possible link, we performed a systematic review of the current evidence about maternal OSA and FHR alteration. METHODS: The following databases were analysed from the inception to June 2024: Cochrane Library, PubMed-Medline, EMBASE, Web of Science, and Google Scholar. We included studies with pregnant women affected by OSA, and FHR assessed via cardiotocography or fetal electrocardiography. Studies without polysomnography or home sleep testing, cross-over designs, or non-English publications were excluded. RESULTS: 168 studies were screened, and six were included. Five were prospective observational studies, and one was a case report. Maternal age showed a value from 26.6 ± 7.1 to 34.8 ± 3.3 years, and gestational age ranged from 32.1 ± 3.4 to 39.4 ± 1.0 weeks. The body mass index (BMI) values ranged between 27.5 ± 7.2 and 55 kg/m2. Polysomnography was the primary diagnostic tool for OSA in most studies; one study utilised a home sleep test. Apnea/hypopnea episodes frequency varied from 8.4 to 159 events per hour. Findings about the FHR alterations were discordant: three studies did not report an association, other three observed FHR changes linked to maternal respiratory events. CONCLUSION: Our systematic review evidenced a significant variability about the maternal OSA impact on fetal heart rate. The study's results were contradictory. These inconsistencies also derive from different study designs, sample sizes, and outcomes analysed. Further studies are necessary to evidence the real impact of the OSA on the fetal cardiac response. SYSTEMATIC REVIEW REGISTRATION: PROSPERO (CRD42024533801). © 2026 The Author(s). Published by IMR Press.

BACKGROUND: Primary insomnia (PI) is a chronic sleep disorder with a complex pathogenesis, and various treatment options are available. In recent years, multiple acupoint stimulation therapies have gained increasing attention as non-pharmacological interventions. This systematic review and network meta-analysis aimed to assess the comparative efficacy of different acupoint stimulation therapies for PI. METHODS: We searched eight Chinese and English databases and six trial registries from inception to September 22, 2024. Outcomes included total effective rate (TER), Pittsburgh Sleep Quality Index (PSQI) with its six subcomponents, and the change in PSQI scores (ΔPSQI) from baseline to post-treatment. A random-effects model was used for the network meta-analysis. Risk of bias and certainty of evidence were assessed using the ROB2 tool and CINeMA framework. The PROSPERO registration number is CRD42025640547. RESULTS: A total of 95 RCTs involving 7,628 patients were included, comparing 14 acupoint stimulation therapies and involving 108 major acupoints. Body acupuncture combined with electroacupuncture ranked highest in improving the TER (SUCRA: 0.874), while moxibustion combined with tuina was most effective in reducing the total PSQI score (0.966). Moxibustion alone demonstrated the greatest improvement in the PSQI score difference (0.933). Electroacupuncture combined with auricular acupressure showed superior effectiveness in improving all six PSQI subcomponents. The most frequently used acupuncture points were Shenmen (HT 7, 62.1%), Baihui (GV 20, 56.3%), and Anmian (EX-HN 22, 45.8%), while the most commonly used ear points included Shenmen (TF4, 17.4%), Xin (CO15, 14.2%), and Pizhixia (AT4, 11.1%). Cluster analysis identified eight prevalent patterns of point compatibility. CONCLUSIONS: The tolerability and long-term efficacy of different acupoint stimulation therapies for primary insomnia remain unclear. These findings support individualized treatment and acupoint compatibility, laying the groundwork for optimizing intervention protocols and exploring neuroimmune mechanisms. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD4202564054

BACKGROUND: Sleep is a crucial physiological process that significantly influences recovery among hospitalized postoperative surgical patients, including those treated in intensive care units and general surgical wards. Reliable and valid instruments for assessing sleep quality are essential for guiding clinical decision-making and improving patient outcomes. However, the psychometric properties of commonly used sleep assessment tools remain inconsistent, highlighting the need for systematic evaluation. OBJECTIVE: This study aimed to conduct a COSMIN-based systematic review to examine the measurement properties of sleep quality assessment instruments used in hospitalized postoperative surgical patients. METHODS: A systematic literature search was conducted across PubMed, Scopus, Web of Science, CINAHL, and PsycINFO for studies published between 2010 and 2024. The methodological quality of each study was evaluated using the COSMIN Risk of Bias checklist, and a narrative synthesis was performed to summarize the psychometric evidence for each instrument. RESULTS: Of the 210 studies initially identified, 37 met the eligibility criteria. The Pittsburgh Sleep Quality Index (PSQI) demonstrated adequate reliability and construct validity but showed limitations related to measurement error and responsiveness. The Richards-Campbell Sleep Questionnaire (RCSQ) exhibited strong reliability and construct validity, though variability was observed in interrater agreement between nurses and patients. The Epworth Sleepiness Scale (ESS) was reliable for assessing daytime sleepiness but provided limited evidence for structural validity in postoperative contexts. The Sleep Quality Questionnaire (SQQ), Verran and Snyder-Halpern Sleep Scale (VSH), and Insomnia Clinical Evaluation (ICE) showed mixed psychometric properties, indicating the need for further validation in hospitalized postoperative populations. CONCLUSION: The PSQI and RCSQ remain the most frequently utilized sleep assessment instruments; however, their psychometric limitations warrant cautious interpretation. This review underscores the need for further research to refine, validate, and potentially develop more robust sl

BACKGROUND AND OBJECTIVES: This study examined the effects of a novel phytochemical supplement blend on markers of exercise-induced muscle damage. METHODS: In a randomised, parallel group design, 24 healthy participants (14 males) consumed 300 mg of a phytochemical blend (calcium fructoborate, turmeric and pomegranate; PB) or inert placebo for 9 days (n = 12 per condition). On day 7, participants performed 150 drop jumps to induce muscle damage. Markers of neuromuscular function, muscle soreness/pain, perceived exhaustion and sleep quality, were measured pre-exercise and 24, 48, and 72 h post-exercise; systemic markers of inflammation, muscle damage, and oxidative stress were measured on these days as well post-exercise and 2.5 h post-exercise. RESULTS: There was an interaction effect for pressure pain threshold in the vastus lateralis (p = 0.041), which was ~21% higher in PB 72 h post-exercise (p = 0.074; ds = 0.767). Perceived sleep quality was greater 72 h post-exercise in PB (p = 0.049; rrb = 0.423) and those in the PB condition reported feeling more recovered and less mentally drained post-exercise (p ≤ 0.043). There were no statistically significant between-condition differences for any markers of neuromuscular function, inflammation, oxidative stress or muscle damage (p > 0.05). CONCLUSION: In conclusion, a novel PB showed promise for attenuating muscle pain and perceived exhaustion, and improving sleep quality, in the days after muscle damaging exercise. The study protocol was pre-registered on the Open Science Framework Registry (registration number: qgw3a).

Background/Objectives: Creatine is a supplement that, beyond its physiological effects, has been shown to have positive effects on cognitive abilities. In our previous study, we showed that a single dose of 0.35 g/kg creatine induces changes in brain metabolism during sleep deprivation and reduces deterioration in cognitive performance. The present study investigates whether supplementation of a lower dose is associated with cognitive effects during sleep deprivation, focusing exclusively on cognitive performance outcomes. Methods: Twenty-nine healthy subjects performed cognitive tests at the evening baseline and 3, 5.5, and 7.5 h after receiving a single dose of creatine monohydrate (0.2 g/kg) or a placebo during a total of 21 h of sleep deprivation (SD). Results: The results show a mitigating effect of creatine on sleep deprivation-induced deterioration in logical and numerical tasks, language-related processing speed, and the Psychomotor Vigilance Test (PVT). Compared to males, females benefit more in logic, PVT and processing speed in language and logic tasks. Conclusions: Our results show that a dose of 0.2 g/kg creatine is associated with a reduced deterioration in cognitive performance during sleep deprivation. Although the effect is less pronounced than with a high dose of 0.35 g/kg, there is still an improvement of up to 12%.

BACKGROUND: Perimenopausal symptoms affect most women and often substantially impair their quality of life, whereas conventional estrogen therapy alone does not fully address clinical needs. Baoqing granules (BQG), derived from Zuo Gui Wan in Jingyue's Complete Works, were modified to target kidney Yin deficiency and have shown promising clinical efficacy, although robust randomized evidence remains limited. METHODS: The trial was registered with the Chinese Clinical Trial Registry (ChiCTR2300073338; http://www.chictr.org.cn). In this randomized, double-blind, placebo-controlled clinical trial, eligible perimenopausal women received either Femoston plus placebo or Femoston plus BQG for four weeks, followed by a four-week follow-up. The primary outcomes were the Modified Kupperman Menopausal Index (Modified KMI) and traditional Chinese medicine (TCM) syndrome scores. Secondary outcomes included the Menopause-Specific Quality of Life Questionnaire (MENQOL), Pittsburgh Sleep Quality Index (PSQI), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and serum levels of sex hormones and lipids. Safety was evaluated through hepatic and renal function tests and adverse-event monitoring. RESULTS: Both groups showed significant improvements from baseline; however, participants in the BQG group experienced greater short-term improvements that persisted at week 8 in Modified KMI, TCM syndrome scores, MENQOL, and PSQI, while differences in SAS and SDS became significant only at follow-up. Hormone and lipid profiles showed no overall between-group differences, although exploratory subgroup analyses suggested higher estradiol and lower follicle-stimulating hormone levels in postmenopausal women receiving BQG. Liver and kidney functions remained within normal ranges, and only one mild adverse event was reported. CONCLUSION: In this 8-week study, BQG as an adjunct to Femoston was associated with additional short-term improvements in multidimensional perimenopausal symptoms, with acceptable tolerability. These findings support the potential role of BQG as a complementary therapy; however, longer-term studies are needed to confirm the durability of benefit and lon

BACKGROUND: Stress, sleep deprivation, and burnout are significant safety risks for acute care surgeons, negatively impacting performance, well-being, and clinical outcomes. OBJECTIVE: This pilot randomized controlled trial aimed to measure neurophysiological effects of prescribed music (PM) and self-selected music (SSM) on surgeon stress, burnout, and neurophysiological responses using a multimodal protocol that integrated functional magnetic resonance imaging (fMRI), wearable biosensor monitoring, and psychological self-assessments. METHODS: Full-time attending surgeons at a quaternary care hospital were invited to participate in a 3-armed trial (1:1:1 block allocation). Intervention groups were instructed to listen to 30 minutes (minimum 15 minutes) of either PM or SSM daily at bedtime for 6 weeks, reflecting real-world conditions. PM comprised original compositions based on elements promoting perceived relaxation from a prior study. The control arm avoided music in the 30 minutes before bed. Allocation was concealed from the recruiting investigator; the fMRI technicians, the statistician, and lead investigators were blinded until analyses were completed. Functional connectivity patterns were measured using fMRI at baseline and 6 weeks while participants listened to simulated intensive care unit noise, PM, and SSM. Secondary outcomes included continuous actigraphy for sleep quality and self-reported anxiety, sleep quality, and burnout using validated scales (State-Trait Anxiety Inventory, Pittsburgh Sleep Quality Index, and Maslach Burnout Inventory). RESULTS: A total of 22 surgeons were assessed; demands of fMRI and data collection schedule led 3 to decline and 2 (allocated to PM) not to finish baseline measures; 6 PM, 5 SSM, and 6 controls received allocated intervention; 2 PM participants were withdrawn for nonadherence and missing follow-up data and 1 control missed follow-up collection due to scheduling (final analysis set after missing data: PM: n=4, SSM: n=5, control: n=5). One control participant experienced transient vertigo in fMRI. Trends in fMRI data indicated that both intervention groups experienced less negative emotional arousal and anxiety, w

BACKGROUND: High-impact chronic pain (HICP) involves substantial interference in functioning, affects 8.5% of the population, and leads to higher health care costs relative to low-impact chronic pain (LICP). Behavioral interventions such as virtual reality (VR) offer scalable and accessible treatment, but testing is needed to ensure durable effectiveness in HICP. We conducted a secondary analysis of the largest real-world dataset for a therapeutic skill-based VR vs a sham VR control to test treatment efficacy in HICP vs LICP. Relative to LICP, we found significantly larger (and clinically meaningful; ie, ≥2 points) pain interference and pain intensity reductions for HICP at end of treatment and 1 year posttreatment. End-of-treatment reduction in pain interference reclassified 70% (114/163) of participants with HICP as LICP, and this improvement held at 1 year posttreatment (104/155, 67%). OBJECTIVE: This study examined the effectiveness of a 56-session skill-based VR therapy in HICP at 2 years posttreatment and compared the effects with those on LICP. METHODS: We conducted a secondary analysis of the skill-based VR sample (536/1067, 50.2%) at 2 years posttreatment from a randomized controlled trial involving an in-home chronic low back pain sample that was recruited and tested online and was diverse (female: 411/536, 77%; non-White individuals: 166/536, 31%; high school or lower educational level: 102/536, 19%; mean age 50.8 years) and had clinically severe pain at baseline (intensity=6.6; interference=6.2; 42% with severe or complete disability). Focusing on the skill-based VR participants (536/1067, 50.2%) and using a validated approach, we classified participants at baseline as either HICP (baseline Brief Pain Inventory pain interference score>7) or LICP (baseline Brief Pain Inventory pain interference score<7). Clinical effectiveness was examined using a general linear model at 2 years posttreatment relative to baseline with the primary outcomes of pain interference and pain intensity. RESULTS: Participants with HICP (192/536, 35.8%) reported superior reductions in pain interference, pain intensity, sleep disturbance, and physical disability (P<.001 in all c

BACKGROUND: Breast cancer surgery and corresponding treatments have significant residual effects on survivors of breast cancer in China. Body image distress and stigma are persistent challenges that negatively affect their quality of life. Accessible, sustainable, and cost-effective support remains scarce. OBJECTIVE: This study aimed to evaluate the effectiveness and cost-effectiveness of an app-based mindfulness breast care (MBC) program in addressing body image distress and stigma for survivors of breast cancer. METHODS: We carried out a randomized controlled trial in 2 university-affiliated hospitals in China. Survivors of breast cancer who had completed primary treatments and had mobile phone internet access were recruited and randomly assigned at a 1:1 ratio to the intervention (3-month MBC program plus routine care) or the control group (routine care alone). Under the conceptualization of mindfulness-based cognitive therapy, the MBC program was developed, including three modules: (1) Library, (2) Mindfulness Yoga, and (3) Mindfulness Practices. The primary outcomes measured were body image distress and stigma, and secondary outcomes included sleep quality, social support, and quality of life (physical and mental well-being). Assessments were conducted at baseline, 3 months (T1), and 6 months (T2). Multiple imputation was used to handle missing data and generalized estimating equations were fitted to evaluate the effectiveness. The incremental cost per quality-adjusted life year (QALY) gained was used to measure cost-effectiveness. RESULTS: A total of 192 survivors of breast cancer participated in the baseline assessment, with 155 completing the 2 follow-up surveys. The median total usage duration was 199.60 (IQR 70.90-451.31; mean 360.59, SD 511.72) minutes, and total login frequency was 39.50 (IQR 19.00-86.50; mean 57.02, SD 50.26) times. The reduction in body image distress at T2 (adjusted mean difference -1.91; 95% CI -3.40 to -0.42; P=.01; d=-0.31), the reduction in stigma at T1 (adjusted mean difference -5.83; 95% CI -8.46 to -3.20; P<.001; d=-0.61) and T2 (adjusted mean difference -7.79; 95% CI -10.62 to -4.97; P<.001; d=-0.82), and the improvement i

BACKGROUND: Methamphetamine (MA) addiction is a chronic relapsing disorder that impairs physical health, induces mental distress (e.g., anxiety), and triggers abnormal inflammatory and neurotransmitter responses, all contributing to high relapse rates. Mindfulness and yoga interventions may alleviate psychological distress and improve physical well-being in substance users; however, few studies have systematically investigated their comprehensive effects on physical function, inflammatory markers, neurotransmitter balance, and relapse intention in MA addicts, leaving a gap in non-pharmacological interventions for this population. OBJECTIVE: This randomized controlled trial aimed to investigate the effects of a 24-week yoga intervention integrated with mindfulness components on multiple health outcomes among individuals with methamphetamine use disorder, ncluding physical function (assessed by Functional Movement Screening [FMS], reaction time, sleep quality, subjective fatigue, and creatine kinase [CK]), anxiety, inflammatory response (tumor necrosis factor-α [TNF-α], interleukin-6 [IL-6], and interleukin-10 [IL-10]), heart rate variability (HRV), relapse-related neurotransmitters (dopamine [DA], serotonin [5-HT], and norepinephrine [NE]), and relapse intention. METHODS: Eighty MA addicts meeting DSM-5 criteria were randomly assigned to an experimental group (n = 41; 40-min mindfulness yoga sessions, three times weekly for 24 weeks) or a control group (n = 39; no additional intervention). Assessments were conducted at baseline and post-intervention for all outcomes, with additional measurements at 4 and 12 weeks for fatigue, CK, and inflammatory markers. RESULTS: Following the 24-week intervention, the experimental group demonstrated significant improvements in sleep quality (PSQI score reduced from 14.32 to 8.41), anxiety levels (BAI score decreased), FMS total score (increased from 9.24 to 12.12), and reaction time (improved from 0.59 s to 0.48 s) compared to baseline and controls (p < 0.01). Relapse intention (OCDS score reduced from 29.12 to 18.45) and NE levels significantly decreased, while DA and 5-HT levels significantly increased (p < 0.01). The experim

BACKGROUND: Evidence suggests that transcranial direct current stimulation (tDCS) combined with repetitive transcranial magnetic stimulation (rTMS) is more effective than either modality alone. However, the underlying neural mechanisms remain unclear. OBJECTIVE: To explore the effects of combined tDCS-rTMS on cortical functional networks and neural regulation processes in chronic insomnia. METHODS: In this randomised, double-blind, sham-controlled trial, 111 adults with chronic insomnia were allocated to real tDCS+real rTMS or sham tDCS+real rTMS. Participants received 20 weekday sessions over 4 weeks. Of these, 106 completed treatment and 103 provided functional near-infrared spectroscopy (fNIRS) data meeting predefined quality criteria. fNIRS measured oxygenated haemoglobin (Oxy-Hb) responses in prefrontal and temporal regions during a verbal fluency task (VFT) before and after treatment. The primary outcome was haemodynamic activation; secondary outcomes were functional connectivity and sleep quality. FINDINGS: Sleep quality improved in both groups, with significantly greater reduction in Pittsburgh Sleep Quality Index (PSQI) scores in the real tDCS+real rTMS group (p<0.05). No between-group differences were observed in VFT performance. However, the combined stimulation group showed significantly increased Oxy-Hb responses across multiple fronto-temporal channels, particularly in bilateral temporal regions, and greater enhancement in mean functional connectivity (p<0.05). Both interventions were well tolerated, with no serious adverse events. CONCLUSIONS: This study provides neuroimaging evidence that combined tDCS and rTMS may improve chronic insomnia by enhancing activation of fronto-temporal cortices and strengthening inter-regional functional connectivity. These findings offer objective support for the clinical efficacy of the combined stimulation protocol, link neurophysiological changes to treatment optimisation and suggest potential advantages of this approach for neuromodulation-based therapeutic strategies. CLINICAL IMPLICATIONS: These findings suggest that tDCS combined with rTMS may represent a feasible and well tolerated non-pharmacological strate

Objective: To investigate the effects of perioperative transcutaneous auricular vagus nerve stimulation (taVNS) on postoperative pain and early sleep quality in patients undergoing glaucoma surgery under general anesthesia. Methods: A total of 94 hospitalized patients scheduled for elective glaucoma surgery under general anesthesia at Beijing Tongren Hospital, Capital Medical University, from April to August 2024 were prospectively enrolled and randomly assigned using a random number table to either the taVNS group (n=47) or the sham stimulation group (s-taVNS group) (n=47). In the taVNS group, active electrical stimulation was applied to the left auricular concha area starting from 2 days before surgery, while the s-taVNS group received electrode placement without current output. Stimulation was performed twice daily for 30 min each session until the first postoperative day. The primary outcome was the incidence of moderate to severe pain within 24 hours after surgery, defined as a Numeric Rating Scale (NRS) score≥4 score. Secondary outcomes included NRS scores at different time points, use of rescue analgesics, insomnia severity index (ISI) scores. Comparisons were made between the two groups regarding the primary and secondary outcome measures. Results: The taVNS group included 27 males and 20 females, aged (56.5±11.3) years; the s-taVNS group included 26 males and 21 females, aged (58.4±9.7) years, with no significant differences in age or gender between the two groups (all P>0.05). The incidence of moderate to severe pain within 24 hours after surgery was lower in the taVNS group than in the s-taVNS group [14.9% (7/47) v. 38.3% (18/47), P=0.010]. The proportion of patients requiring acetaminophen for rescue analgesia within 24 hours postoperatively was lower in the taVNS group than in the s-taVNS group [8.5% (4/47) vs 23.4% (11/47), P=0.049]. The ISI score on the first postoperative night was lower in the taVNS group than in the s-taVNS group [(3.1±2.7) score vs (5.7±4.3) score, P=0.018]. Conclusion: Perioperative taVNS can effectively reduce the incidence of moderate to severe postoperative pain and improve early postoperative sleep quality in patients und

Sleep deprivation (SD) has been shown to impair sensory functions, including olfactory processing, which may be related to changes in brain activity. This study aims to investigate the effects of SD, short-term sleep recovery (RS), and neuromodulation interventions on the functional activity of olfactory-related brain regions. We hypothesize that these interventions could restore some of the neural activity disrupted by SD, particularly in areas associated with olfactory processing. In this study, 90 male participants first underwent a baseline sleep period of at least 8 h, followed by 36 h of sleep deprivation (SD36h). The participants were randomly assigned to four groups: control group (CON, n = 30, age 20.8 ± 1.6 years), magnetic stimulation group (MS, n = 30, age 21.3 ± 1.6 years), electrical stimulation group (ES, n = 17, age 20.3 ± 0.7 years), and combined stimulation group (CS, n = 13, age 20.8 ± 1.0 years). After SD36h, participants underwent an 8-hour restorative sleep period, before and after completing the 8-hour RS period, additionally received 30 min of MS(MS was applied over the occipital region using a rhythmic gamma magnetic-field device), ES(ES was delivered as tDCS targeting the left DLPFC, anode at F3, cathode at FP1, 2 mA), and CS. All participants underwent three resting-state functional MRI (fMRI) scans: at baseline, after sleep deprivation, and after intervention. This experiment analyzed the Amplitude of Low-Frequency Fluctuations (ALFF) and functional connectivity (FC) in olfactory-related regions. ALFF and FC were analyzed using a group (CON/MS/ES/CS) × time (baseline/SD36h/RS) repeated-measures ANOVA with FDR correction, followed by FDR-corrected post-hoc tests for significant main effects. No group × time interaction survived FDR correction for ALFF or FC. For ALFF, a main group effect was observed in Hippocampus_L and Olfactory_R, with the ES (and CS in Olfactory_R) showing lower ALFF than CON and/or MS. For time effects, ALFF in Hippocampus_L was reduced at SD36h and remained lower after RS relative to baseline, while Olfactory_L ALFF was lower after RS than baseline. For FC, main group effects were found in Hippocampus_L and Fusif

AIM: This study examined the effectiveness of oncology yoga and mindfulness-based meditation (OY and MB) intervention on sleep, fatigue, and quality of life in colorectal cancer (CRC) survivors. This study employed a sequential explanatory mixed-methods design, with a primary focus on quantitative analysis. METHODS: The study was conducted from October 2021 to February 2022, involving 90 patients. Online OY & MB sessions were held over 12 weeks. Data were collected using the Brief Fatigue Inventory, Piper Fatigue Inventory, European Quality of Life-5 Dimensions, Pittsburgh Sleep Quality Index, and a patient information form. Three focus group interviews were conducted online to collect qualitative data. RESULTS: The mean age of the patients was 50.57 Å} 10.74 years, and 50.0% were women. After the intervention, significant differences were observed in the post-test scores of Brief Fatigue (t = -5.22), Piper Fatigue (t = -3.72), Sleep Quality (t = -3.54), and Quality of Life (t = -3.41) in the intervention group (p < .001). Participants reported enhanced physical and psychological relaxation, a greater sense of well-being, and perceived benefits from the supportive group environment. CONCLUSION: Yoga and meditation may play a pivotal role in significantly ameliorating fatigue, sleep problems, and subjective conditions that adversely impact the quality of life of CRC patients. Medical challenges, technological limitations, and accessibility issues were also stated as difficulties in attending yoga and meditation practices. Cite this article as: Şengül, T., Oflaz, F., & Karadağ, A. (2026). Effects of online oncology yoga and mindfulness-based meditation on fatigue, sleep, and quality of life in colorectal cancer survivors: A mixed-methods study. Florence Nightingale Journal of Nursing, 34, 0139, doi: 10.5152/ FNJN.2026.24139.

BACKGROUND: Optimizing pain control and anesthesia stability is essential for surgical outcomes in dogs. This study evaluated the effects of preoperative tapentadol on anesthesia depth, recovery, and serotonin levels in dogs undergoing elective spaying. METHODS: Sixty-six healthy female dogs were randomly assigned to three groups: standard pain relief, tapentadol alone, or tapentadol combined with standard pain relief. Anesthesia was induced with propofol and maintained with sevoflurane. Intraoperative heart rate, blood pressure, anesthetic depth, postoperative sedation, pain scores, and plasma serotonin concentrations were recorded. RESULTS: Tapentadol-treated dogs showed deeper and more stable anesthesia during surgical stimulation, higher early postoperative sedation that resolved within two hours, and reduced postoperative serotonin levels compared with controls. All analgesic protocols maintained adequate pain control, and biochemical parameters remained within normal limits. CONCLUSIONS: Preoperative tapentadol enhances anesthetic stability, supports smoother early recovery, and modulates serotonin levels in dogs, suggesting benefits for perioperative pain management and overall surgical welfare.

Compared to polysomnography (PSG) and actigraphy, contactless consumer sleep-tracking devices (CCSTDs) are low-cost, user-friendly, and non-disruptive to sleep. This study evaluated the performance of two inexpensive, representative first-generation Chinese-made CCSTDs (the iSleep S200G and Sleep Dot B501) against PSG and actigraphy, using standardized validation protocols. The objective was to assess their feasibility as alternatives for large-scale, long-term preliminary research that does not rely on single-day high-precision sleep data. Eleven healthy young adults (mean age = 26.5 ± 4.8 years) participated in a two-night sleep laboratory study using four devices in parallel. Compared with PSG, the iSleep S200G exhibited no significant differences in TST and SE, while the Sleep Dot B501 showed no significant differences in TST, SE, SOL, and WASO. The intraclass correlation coefficient values and epoch-by-epoch agreement of the iSleep S200G and Sleep Dot B501 were as good as or better than those of actigraphy. Notably, the epoch-by-epoch agreement metric of both devices was not inferior to other consumer sleep-tracking devices already used for long-term, large-scale sleep monitoring. Therefore, even within budget constraints, first-generation CCSTDs can effectively meet the requirements for long-term, large-scale sleep monitoring without sleep stage detection. The results also provided data references for researchers using iteratively upgraded CCSTDs.

This study focuses on the production and characterization of polyvinyl alcohol (PVA)-chitosan (CS)-based nanoparticles loaded with vitamin E (VitE) and ephedrine (Ep) via electrospraying for intranasal drug delivery in narcolepsy treatment. The nanoparticles were successfully synthesized using optimized parameters (15.5 kV voltage, 0.3 mL/h flow rate, 25 G needle size, and 14 cm distance). Scanning electron microscopy (SEM) analysis confirmed the formation of spherical particles with an average size of 350-500 nm, while energy-dispersive X-ray spectroscopy (EDS) mapping revealed a homogeneous elemental distribution with oxygen (51.74%), silicon (24.48%), carbon (6.47%), zinc (6.08%), and aluminum (3.82%). Fourier-transform infrared (FTIR) spectra demonstrated the successful encapsulation of VitE and Ep through characteristic peaks at 3285 cm-1 (OH stretching), 1731 cm-1 (C=O stretching), and 1086 cm-1 (C-O-C stretching). In vitro drug release analysis indicated a controlled and sustained release profile, with cumulative VitE and Ep release reaching 78.6% and 84.3%, respectively, over 48 h in phosphate-buffered saline (PBS, pH 7.4). Antioxidant activity assessment using the DPPH assay confirmed an R2 value of 18.84 µg/mL, demonstrating significant free radical scavenging potential. The antibacterial activity, tested via the disk diffusion method, exhibited inhibition zones of 18.31 ± 5.8 mm (E. coli) and 21.51 ± 1.57 mm (S. aureus), confirming strong antimicrobial properties. These findings suggest that the developed electrosprayed PVA/CS nanoparticles loaded with VitE and Ep offer a promising intranasal delivery system with enhanced bioavailability, controlled release, antioxidant capacity, and antibacterial properties, making them a viable candidate for narcolepsy treatment.

Dementia caregiving represents a major public health challenge, with spousal caregivers assuming the greatest burden. Spouses, themselves typically older adults, provide high intensity, long-term, and largely unpaid care across all stages of cognitive decline. Despite their central role in dementia care, the health consequences experienced by spousal caregivers remain insufficiently characterized in the literature and inadequately addressed in clinical and public health practice. This structured narrative review synthesizes current evidence on the multidimensional impact of dementia caregiving on the physical, psychological, cognitive, social, and financial health of spousal caregivers. It further contextualizes these consequences within the trajectory of dementia progression, and identifies interventions, support systems, and policy considerations necessary to mitigate caregiver burden. Spousal caregivers experience disproportionate burden due to continuous, escalating responsibilities that often mirror the progressive deterioration of their partners. Emotional burdens, including uncertainty during pre-diagnostic stages, role strain, conflict, loss of intimacy, and anticipatory grief. Physically, spouses endure musculoskeletal strain, sleep disruption, poor nutrition, and heightened frailty risk. Psychologically, spousal caregivers exhibit elevated rates of depression, anxiety, loneliness, and stress-related disorders. Socially, caregivers experience substantial isolation, stigma, and erosion of social networks. Financial hardship, including early retirement, reduced employment, and uncompensated care hours, further exacerbate stress. Evidence suggests that chronic caregiving stress contributes to biological changes such as immune dysregulation, inflammation, acceleration, aging, and potential cognitive decline in caregivers themselves. Caregiver burden influences patient outcomes as evidenced by increased emergency department use, falls, and earlier institutionalization in persons with dementia whose caregiver is subjected to a high burden. Current care models rarely include routine, caregiver assessment or structured guidance following diagnosis, resulting in

Background: Gastroesophageal reflux disease (GERD) is a common digestive disorder with a substantial impact on quality of life. Emerging evidence suggests that dietary patterns and lifestyle behaviors are associated with the occurrence and severity of GERD symptoms; however, integrated data from Romania remain limited. Objective: The aim of this study was to evaluate associations between pro- and anti-inflammatory dietary patterns, lifestyle-related behavioral factors, and the presence and severity of gastroesophageal reflux symptoms in an adult Romanian population. Methods: A national cross-sectional observational study was conducted using a self-administered online questionnaire. All participants included in the study reported a prior diagnosis of gastroesophageal reflux disease (GERD), and participant classification was based exclusively on current symptomatology assessed using the GERD-Q score. Therefore, comparisons were not performed between patients and a healthy population, but rather between individuals at different stages of clinical expression of the same condition, characterized by a fluctuating course. The instrument included standardized GERD-Q items for symptom assessment, together with questions regarding dietary intake and lifestyle behaviors. Pro-inflammatory (PRO), anti-inflammatory (ANTI), and combined (PRO-ANTI) dietary scores were established. Statistical analyses included comparative and correlational tests as well as multivariable logistic regression models. Results: Among the 340 participants included in the study, 72.4% reported symptoms consistent with GERD according to the GERD-Q score. A higher pro-inflammatory dietary score was significantly associated with GERD, with participants in the highest PRO category showing more than a fourfold higher likelihood of GERD in multivariable analyses. Consumption of spicy foods and carbonated beverages was associated with an increased risk of GERD in univariate analyses; however, these associations did not remain significant in multivariable models. Late meals (defined as consumption of one's last meal of the day less than two hours before bedtime) were independently associated with GERD. Combin

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol-associated liver disease (MetALD), and related fibrosis are increasingly prevalent conditions. The relation of the American Heart Association's (AHA) cardiovascular health (CVH) metric Life's Essential 8 (LE8) with MASLD, MetALD, and hepatic fibrosis remains unclear. We aimed to investigate the associations of CVH with MASLD, MetALD, and hepatic fibrosis. Methods: We defined significant hepatic fibrosis as a liver stiffness ≥8.2 kPa measured by vibration-controlled transient elastography. MASLD was defined as steatosis (controlled attenuation parameter of ≥274 dB/m) with ≥1 cardiometabolic risk factor and mild alcohol intake (≤140 g/week [women]; ≤210 g/week [men]). MetALD was defined as steatosis with ≥1 cardiometabolic risk factor and moderate alcohol intake (141-350 g/week [women]; 211-420 g/week [men]). Data from 2962 participants in the Framingham Heart Study (mean age 59 years, 57% women) were used in multivariable-adjusted logistic regression models, accounting for demographic and clinical covariates to relate CVH and liver outcomes. Results: Our study included 2704 participants with mild and 258 with moderate alcohol use. MASLD and MetALD prevalence was 34% and 40%, respectively, and 9% had significant hepatic fibrosis. Each 10-point increase in LE4 score (composite of diet, sleep health, physical activity, and smoking) was associated with 16% lower odds of MASLD (Odds Ratio [OR] 0.84; 95% CI: 0.80-0.90; p < 0.001) but not MetALD. Each 10-point increase in LE8 score was associated with 17% lower odds of hepatic fibrosis (OR 0.83; 95% CI: 0.78-0.89; p < 0.001). Conclusions: Better CVH is related to lower odds of MASLD and significant hepatic fibrosis.

BACKGROUND: Childhood obesity is a major public health concern associated with adverse metabolic outcomes later in life. Despite increased awareness, unhealthy lifestyle behaviors-including suboptimal diet quality, physical inactivity, insufficient sleep, and unfavorable body composition-remain prevalent in pediatric populations. Effective, child-centered educational tools for early prevention are still limited. METHODS: We developed the Lifestyle Tridimensional Pyramid, an educational model integrating nutrition, physical activity, and sleep within a single, three-dimensional framework. The model also addresses body composition by emphasizing the balance between skeletal muscle and adipose tissue and the interdependence of lifestyle behaviors. This narrative review is supported by an umbrella review of 17 systematic reviews and meta-analyses published between 2010 and 2025, synthesizing evidence on lifestyle behaviors of pediatric obesity. RESULTS: High- to moderate-quality evidence indicates that adherence to Mediterranean-style dietary patterns, regular moderate-to-vigorous physical activity, adequate sleep duration, and a healthier body composition might prevent the development of obesity and improved cardiometabolic profiles in children and adolescents. The pyramid provides a structured, visually accessible tool to support lifestyle counseling in pediatric outpatient settings and is adaptable to school- and community-based health promotion. CONCLUSIONS: Although prospective validation studies are warranted, the Lifestyle Tridimensional Pyramid represents a practical, evidence-informed framework to support integrated lifestyle education and improve primary and secondary prevention of pediatric obesity.

Fibromyalgia is a complex, heterogeneous and often disabling syndrome that seriously affects the quality of life of patients. It is characterized by chronic widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive impairment. Its pathophysiology remains poorly understood, and conventional treatments often offer limited efficacy while carrying significant side effects, highlighting the urgent need for alternative therapeutics strategies. We report a retrospective case series evaluating a novel protocol that combines low frequency Pulsed Electromagnetic Field (PEMF) therapy, medical ozone insufflation, and targeted nutritional supplementation in three patients with refractory fibromyalgia who had previously shown inadequate response to conventional treatments. Following the intervention, patients experienced substantial pain relief and significant improvement in quality of life, which were sustained at the 30-day follow-up assessment. These findings suggest that the combination of PEMF and ozone therapy may induce durable physiological benefits, presenting a promising complementary strategy for managing refractory fibromyalgia.

The National Heart, Lung, and Blood Institute-sponsored workshop, "Maternal and Perinatal Nutritional Programming of Lung Health and Disease in Childhood and Early Adulthood: Research Gaps and Opportunities," was convened (October 24-25, 2024) to explore how nutrition before, during, and after pregnancy influences lung development and respiratory health across the lifespan. The workshop focused on identifying critical knowledge gaps, mechanistic pathways, and intervention opportunities. Presentations spanned maternal dietary patterns, specific nutrient supplementation, gestational weight gain, and the role of maternal obesity in offspring wheeze and asthma. The role of early postnatal nutrition, particularly human milk for preterm infants at risk for bronchopulmonary dysplasia, was emphasized. Emerging areas included circadian rhythms and the maternal and infant microbiome, metabolome, and epigenome in mediating nutrition-related respiratory outcomes. Research needs included randomized trials of dietary interventions, mechanistic studies to elucidate biological pathways, and implementation strategies to integrate nutritional interventions into practice. Vulnerable populations were emphasized, including preterm infants and families experiencing food insecurity. Participants emphasized the need for a coordinated research agenda to inform future interventions that could improve outcomes across generations.