Sleep disorders represent multifaceted pathophysiological conditions beyond simple sleep duration or quality disruptions. They are frequently associated with neuropsychiatric symptoms, cognitive decline, and systemic health deterioration. Among them, insomnia and obstructive sleep apnea (OSA) are highly prevalent and chronic, with established links to reduced quality of life and an increased risk of neurodegenerative diseases. This review summarized recent findings from neuroimaging studies that used quantitative cerebral blood flow (CBF) techniques, including arterial spin labeling (ASL) and single-photon emission computed tomography (SPECT), to examine functional brain changes associated with these disorders. Both insomnia and OSA consistently showed perfusion abnormalities in regions such as the prefrontal cortex, cingulate cortex, and hippocampus—areas that are critical for the sleep-arousal cycle, emotional regulation, and cognitive control. These alterations may reflect underlying mechanisms that include hemodynamic dysregulation, impaired metabolic regulation, and reduced connectivity in large-scale brain networks.Collectively, the evidence suggested that sleep disorders should be understood not merely as disturbances of sleep architecture, but as conditions involving cerebral hemodynamic dysregulation. Brain perfusion metrics thus hold clinical promise as sensitive biomarkers for early diagnosis, risk stratification, and treatment monitoring in sleep disorders and support the development of precision-guided interventions based on quantitative neuroimaging.

Objectives: This study is a retrospective chart review of outpatients who were prescribed prolonged-release melatonin at a university hospital in Korea between January 5, 2015, and January 20, 2020. Methods: Descriptive statistics were conducted for all prescription cases as well as by primary diagnosis. Differences according to sex, age, and final clinical improvement were also examined. In addition, separate analyses were performed for cases where prolonged-release melatonin was prescribed as monotherapy. Results: A total of 1,764 cases were analyzed. Prescriptions were more common in females, with a mean age of 66.24 years.The most frequent primary diagnosis was insomnia. At the initial visit, symptom severity ranged from mild to moderate, and at the final visit, patients were generally minimally improved. A total of 866 cases involved prolonged-release melatonin prescribed as monotherapy, with a higher proportion of male patients. The initial symptom severity in these cases was milder than that of the overall prescription cases. Conclusion These findings suggest the practical clinical utility of prolonged-release melatonin.

Objectives: Eveningness predominates in adolescence. Morningness has been reported to be associated with mental toughness via resilience. Morningness could be related to healthy sleep habits and a good personality. Methods: Sleep-related behaviors, such as weekend oversleep, social jetlag, and daytime sunlight exposure between 10:00 and 15:00, were evaluated using sleep-related questionnaires. Morningness-eveningness questionnaire, insomnia severity index, Epworth sleepiness scale, hospital anxiety and depression scale and defense style questionnaire were used. This study includes 1,610 high school students. Results: Multiple linear regression analysis revealed that morningness is predicted by male sex (β=0.115, t=4.769, p<0.001) and greater adaptive (β=0.092, t=3.506, p<0.001) and self-suppressive defense styles (β=0.072, t=2.192, p=0.029) and lesser immature defense styles (β=-0.163, t=-4.782, p<0.001) after controlling for age, sleep quality, depression, anxiety. Morningness is also predicted by greater sublimation (β=0.09, t=3.541, p<0.001) and reaction formation (β=0.112, t=4.488, p<0.001) and lesser consumption (β=-0.062, t=-2.501, p=0.012), passive aggression (β=-0.101, t=-3.747, p<0.001) and withdrawal (β=-0.084, t=-2.955, p=0.003), and male sex (β=0.117, t=4.896, p<0.001) after controlling for age, sleep quality, depression, and anxiety. Conclusion Morniness in adolescence may be related to a positive personality. Promoting morningness might be related to healthy development in personality.

Objectives: Both shift work and restless legs syndrome (RLS) are common and can disrupt sleep and mood. However, the effects of shift work on RLS remain unclear. The current study aims to explore the prevalence, severity, and related sleep and mood symptoms of RLS in shift workers (SWs) compared to non-shift workers (Non-SWs). Methods: This study recruited 4,562 SWs (age 36.98±9.84, 2,150 males and 2,422 females) and 2,093 NSWs (age 37.79±9.73, 999 males and 1,094 females). All participants completed online self-report questionnaires regarding RLS, sleep, and depression. The presence of RLS was screened using a single standard question for rapid screening of RLS. The severity of RLS was assessed using the International Restless Legs Syndrome Rating Scale (iRLS). Additionally, the Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), and short-term Center for Epidemiologic Studies Depression Scale (CES-D) were used to assess daytime sleepiness, insomnia, and depressive symptoms, respectively. Results: Of participants, 1,255 (27.45%) of SWs and 548 (26.18%) of Non-SWs were screened as having RLS, with no significant differences in the prevalence of RLS between the groups. However, among those with RLS, SWs with RLS showed higher iRLS scores compared to Non-SWs with RLS after controlling for age and sex (SWs: 9.55±7.26, NSWs: 6.75±6.05, F=64.15, p<0.01). In addition, SWs with RLS exhibited higher ISI scores (F=46.09, p<0.01), higher ESS scores (F=4.80, p=0.03), and higher CES-D scores (F=33.50, p<0.01) than Non-SWs with RLS. Conclusion Although there was no significant difference in RLS prevalence between SWs and Non-SWs, SWs with RLS exhibited more severe RLS symptoms and RLS-related symptoms, such as insomnia, sleepiness, and depression, compared to NSWs with RLS. The current study suggests that shift work may exacerbate RLS severity and RLS-related sleep and mood symptoms, although it may not be associated with the onset of RLS.

Public health and safety professionals, including firefighters, police officers, and emergency medical personnel, serve as critical pillars of public safety and societal well-being. These professions require navigating environments characterized by ‘brittleness’, ‘anxiety’, ‘nonlinearity’, and ‘incomprehensibility’—conditions that lead to chronic physical and psychological stress. This stress significantly elevates the risk of mental health disorders such as post-traumatic stress disorder, anxiety disorders, mood disorders, and sleep disturbances, while also increasing the likelihood of human errors driven by cognitive lapses. Such challenges extend beyond individual health, undermining organizational efficiency and ultimately jeopardizing public safety and societal welfare. Existing mental health management systems predominantly depend on reactive interventions, which are insufficient to meet the dynamic and unpredictable demands of high-risk occupational environments. As a proactive alternative, this paper introduces the concept of ‘Mind Vital Signs,’ an innovative framework that expands the traditional concept of vital signs into the mental health domain. Mind Vital Signs integrates physiological indicators—including heart rate variability, physical activity, respiratory rates, and sleep patterns—with psychological and behavioral data such as ecological momentary assessments and life logs. By employing real-time monitoring and advanced analytics, this multidimensional system facilitates early detection of mental health risks and supports targeted and timely preventive interventions. The implementation of Mind Vital Signs not only bolsters individual resilience and organizational stability but also enhances operational efficiency and strengthens public safety and societal well-being. Future research should prioritize clinical validation and policy development to ensure the effective integration and scalability of Mind Vital Signs in high-risk occupational settings.

Objectives: Eveningness predominates in adolescence. Morningness has been reported to be associated with mental toughness via resilience. Morningness could be related to healthy sleep habits and a good personality. Methods: Sleep-related behaviors, such as weekend oversleep, social jetlag, and daytime sunlight exposure between 10:00 and 15:00, were evaluated using sleep-related questionnaires. Morningness-eveningness questionnaire, insomnia severity index, Epworth sleepiness scale, hospital anxiety and depression scale and defense style questionnaire were used. This study includes 1,610 high school students. Results: Multiple linear regression analysis revealed that morningness is predicted by male sex (β=0.115, t=4.769, p<0.001) and greater adaptive (β=0.092, t=3.506, p<0.001) and self-suppressive defense styles (β=0.072, t=2.192, p=0.029) and lesser immature defense styles (β=-0.163, t=-4.782, p<0.001) after controlling for age, sleep quality, depression, anxiety. Morningness is also predicted by greater sublimation (β=0.09, t=3.541, p<0.001) and reaction formation (β=0.112, t=4.488, p<0.001) and lesser consumption (β=-0.062, t=-2.501, p=0.012), passive aggression (β=-0.101, t=-3.747, p<0.001) and withdrawal (β=-0.084, t=-2.955, p=0.003), and male sex (β=0.117, t=4.896, p<0.001) after controlling for age, sleep quality, depression, and anxiety. Conclusion Morniness in adolescence may be related to a positive personality. Promoting morningness might be related to healthy development in personality.

Objectives: Both shift work and restless legs syndrome (RLS) are common and can disrupt sleep and mood. However, the effects of shift work on RLS remain unclear. The current study aims to explore the prevalence, severity, and related sleep and mood symptoms of RLS in shift workers (SWs) compared to non-shift workers (Non-SWs). Methods: This study recruited 4,562 SWs (age 36.98±9.84, 2,150 males and 2,422 females) and 2,093 NSWs (age 37.79±9.73, 999 males and 1,094 females). All participants completed online self-report questionnaires regarding RLS, sleep, and depression. The presence of RLS was screened using a single standard question for rapid screening of RLS. The severity of RLS was assessed using the International Restless Legs Syndrome Rating Scale (iRLS). Additionally, the Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), and short-term Center for Epidemiologic Studies Depression Scale (CES-D) were used to assess daytime sleepiness, insomnia, and depressive symptoms, respectively. Results: Of participants, 1,255 (27.45%) of SWs and 548 (26.18%) of Non-SWs were screened as having RLS, with no significant differences in the prevalence of RLS between the groups. However, among those with RLS, SWs with RLS showed higher iRLS scores compared to Non-SWs with RLS after controlling for age and sex (SWs: 9.55±7.26, NSWs: 6.75±6.05, F=64.15, p<0.01). In addition, SWs with RLS exhibited higher ISI scores (F=46.09, p<0.01), higher ESS scores (F=4.80, p=0.03), and higher CES-D scores (F=33.50, p<0.01) than Non-SWs with RLS. Conclusion Although there was no significant difference in RLS prevalence between SWs and Non-SWs, SWs with RLS exhibited more severe RLS symptoms and RLS-related symptoms, such as insomnia, sleepiness, and depression, compared to NSWs with RLS. The current study suggests that shift work may exacerbate RLS severity and RLS-related sleep and mood symptoms, although it may not be associated with the onset of RLS.

Public health and safety professionals, including firefighters, police officers, and emergency medical personnel, serve as critical pillars of public safety and societal well-being. These professions require navigating environments characterized by ‘brittleness’, ‘anxiety’, ‘nonlinearity’, and ‘incomprehensibility’—conditions that lead to chronic physical and psychological stress. This stress significantly elevates the risk of mental health disorders such as post-traumatic stress disorder, anxiety disorders, mood disorders, and sleep disturbances, while also increasing the likelihood of human errors driven by cognitive lapses. Such challenges extend beyond individual health, undermining organizational efficiency and ultimately jeopardizing public safety and societal welfare. Existing mental health management systems predominantly depend on reactive interventions, which are insufficient to meet the dynamic and unpredictable demands of high-risk occupational environments. As a proactive alternative, this paper introduces the concept of ‘Mind Vital Signs,’ an innovative framework that expands the traditional concept of vital signs into the mental health domain. Mind Vital Signs integrates physiological indicators—including heart rate variability, physical activity, respiratory rates, and sleep patterns—with psychological and behavioral data such as ecological momentary assessments and life logs. By employing real-time monitoring and advanced analytics, this multidimensional system facilitates early detection of mental health risks and supports targeted and timely preventive interventions. The implementation of Mind Vital Signs not only bolsters individual resilience and organizational stability but also enhances operational efficiency and strengthens public safety and societal well-being. Future research should prioritize clinical validation and policy development to ensure the effective integration and scalability of Mind Vital Signs in high-risk occupational settings.

Objectives: Eveningness predominates in adolescence. Morningness has been reported to be associated with mental toughness via resilience. Morningness could be related to healthy sleep habits and a good personality. Methods: Sleep-related behaviors, such as weekend oversleep, social jetlag, and daytime sunlight exposure between 10:00 and 15:00, were evaluated using sleep-related questionnaires. Morningness-eveningness questionnaire, insomnia severity index, Epworth sleepiness scale, hospital anxiety and depression scale and defense style questionnaire were used. This study includes 1,610 high school students. Results: Multiple linear regression analysis revealed that morningness is predicted by male sex (β=0.115, t=4.769, p<0.001) and greater adaptive (β=0.092, t=3.506, p<0.001) and self-suppressive defense styles (β=0.072, t=2.192, p=0.029) and lesser immature defense styles (β=-0.163, t=-4.782, p<0.001) after controlling for age, sleep quality, depression, anxiety. Morningness is also predicted by greater sublimation (β=0.09, t=3.541, p<0.001) and reaction formation (β=0.112, t=4.488, p<0.001) and lesser consumption (β=-0.062, t=-2.501, p=0.012), passive aggression (β=-0.101, t=-3.747, p<0.001) and withdrawal (β=-0.084, t=-2.955, p=0.003), and male sex (β=0.117, t=4.896, p<0.001) after controlling for age, sleep quality, depression, and anxiety. Conclusion Morniness in adolescence may be related to a positive personality. Promoting morningness might be related to healthy development in personality.

Objectives: Both shift work and restless legs syndrome (RLS) are common and can disrupt sleep and mood. However, the effects of shift work on RLS remain unclear. The current study aims to explore the prevalence, severity, and related sleep and mood symptoms of RLS in shift workers (SWs) compared to non-shift workers (Non-SWs). Methods: This study recruited 4,562 SWs (age 36.98±9.84, 2,150 males and 2,422 females) and 2,093 NSWs (age 37.79±9.73, 999 males and 1,094 females). All participants completed online self-report questionnaires regarding RLS, sleep, and depression. The presence of RLS was screened using a single standard question for rapid screening of RLS. The severity of RLS was assessed using the International Restless Legs Syndrome Rating Scale (iRLS). Additionally, the Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), and short-term Center for Epidemiologic Studies Depression Scale (CES-D) were used to assess daytime sleepiness, insomnia, and depressive symptoms, respectively. Results: Of participants, 1,255 (27.45%) of SWs and 548 (26.18%) of Non-SWs were screened as having RLS, with no significant differences in the prevalence of RLS between the groups. However, among those with RLS, SWs with RLS showed higher iRLS scores compared to Non-SWs with RLS after controlling for age and sex (SWs: 9.55±7.26, NSWs: 6.75±6.05, F=64.15, p<0.01). In addition, SWs with RLS exhibited higher ISI scores (F=46.09, p<0.01), higher ESS scores (F=4.80, p=0.03), and higher CES-D scores (F=33.50, p<0.01) than Non-SWs with RLS. Conclusion Although there was no significant difference in RLS prevalence between SWs and Non-SWs, SWs with RLS exhibited more severe RLS symptoms and RLS-related symptoms, such as insomnia, sleepiness, and depression, compared to NSWs with RLS. The current study suggests that shift work may exacerbate RLS severity and RLS-related sleep and mood symptoms, although it may not be associated with the onset of RLS.