The majority of patients with insomnia are treated with hypnotic agents. In the present study, we evaluated the side-effect profile of an orexin receptor antagonist and γ-aminobutyric acid A (GABA_A) receptor agonist on physical/cognitive functions upon forced awakening. This double-blind, randomized, placebo-controlled, cross-over study was conducted on 30 healthy male subjects. Fifteen minutes before bedtime, the subjects took a pill of suvorexant (20 mg), brotizolam (0.25 mg), or placebo and were forced awake 90 min thereafter. Physical- and cognitive-function tests were performed before taking the pill, after forced awakening, and the next morning. Polysomnographic recordings revealed that the efficacies of the hypnotic agents in prolonging total sleep time (∼30 min) and increasing sleep efficiency (∼6%) were comparable. When the subjects were allowed to go back to sleep after the forced awakening, the sleep latency was shorter under the influence of hypnotic agents (∼2 min) compared to the placebo trial (24 min), and the rapid eye movement latency was significantly shorter under suvorexant (98.8, 81.7, and 48.8 min for placebo, brotizolam, and suvorexant, respectively). Although brotizolam significantly impaired the overall physical/cognitive performance (sum of z score) compared with placebo upon forced awakening, there was no significant difference in the total z score of performance between suvorexant and placebo. Notably, the score for static balance with the eyes open was higher under suvorexant compared to brotizolam administration. The energy expenditure was lower under suvorexant and brotizolam compared with the placebo. The effect size of brotizolam (d = 0.24) to reduce the energy expenditure was larger than that of suvorexant (d < 0.01). Significance Insomnia is a common symptom representing an important health burden. Widely prescribed hypnotic agents enhance the function of γ-aminobutyric acid (GABA), a major inhibitory neurotransmitter. The ability to arouse and respond to unexpected stimuli is a feature of normal sleep, and one of the concerns of this class of hypnotic agents is that patients may become physically and/or cognitively impaired while the drug is in effect. As a new approach for the treatment of insomnia, orexin receptor antagonists have been recently approved, which specifically inhibit the orexin-mediated wake-promoting system, supposedly without affecting the whole brain. We found that, compared with the GABA receptor agonist brotizolam, the orexin receptor antagonist suvorexant induced less impairment in body balance after taking the medicine.

[Purpose] To examine the associations of exercise habits, particularly exercising in a group, with physical and cognitive functions in community-dwelling older adults. [Participants and Methods] A total of 615 older adults participated in this cross-sectional study. We conducted three physical performance tests (grip strength, five times sit-to-stand, and 5-meter walk tests) and the Five-Cog test (attention, memory, visuospatial, language, and reasoning). We investigated exercise habits using questionnaires and classified the participants into three groups as follows: those who did not exercise (n=86), those who exercised alone (n=168), and those who exercised in a group (n=362). To clarify the associations of exercise habits with physical and cognitive functions, we used the analysis of covariance with adjustment for potential confounders. [Results] The participants who exercised in a group had better lower limb strength than those who exercised alone and better scores for all the variables than the non-exercisers. Furthermore, those who exercised in a group scored significantly higher on the attention, memory, visuospatial, and overall cognitive function tests than those who exercised alone. [Conclusion] Our results highlight the importance of the social aspects associated with exercising, such as the presence of exercise peers, to improve the physical and cognitive health of older adults.

Background: The association of working from home (WFH) with physical activity (PA) and sedentary behavior (SB) has been explored; however, this association during periods without stringent measures to combat coronavirus disease 2019 is undercharacterized. Particularly, few studies have evaluated the potential effect modification on its associations. Therefore, this study aimed to investigate the associations of WFH frequency with accelerometer-measured PA and SB, along with its effect modifiers, among Japanese white-collar workers during the later pandemic period. Methods: A cross-sectional study involving 1133 white-collar workers residing in the Tokyo metropolitan area was conducted between April 2022 and March 2023. WFH frequency was evaluated through a self-report questionnaire, while SB and PA during weekdays were measured using a triaxial accelerometer. Linear regression models adjusting for potential confounders were used to examine the association of WFH frequency with PA and SB. Results: Regardless of activity intensity, individuals who worked at home, even for 1 to 2 days per week, demonstrated lower levels of PA and higher levels of SB as compared with those who did not (P < .05). For example, difference between never and ≥5 days per week WFH was approximately 70 minutes/day for total PA and about 4000 steps/day for step counts. Associations between WFH and decreased PA were more pronounced in workers who were older, female, less educated, in sales and service work, nonregular staff, and precontemplating changes in exercise and eating habits. Conclusions: We report that WFH was associated with decreased PA and increased SB in Japanese white-collar workers with pronounced associated in several subgroups.

We clarified the effect of exercising with others on the risks of incident functional disability and all-cause mortality among community-dwelling adults. We used an inventory mail survey with a five-year follow-up for 1520 independently living older adults (mean age: 73.4 ± 6.3 years) in Kasama City, Japan. Subjects responded to a self-reported questionnaire in June 2014. Exercise habits and the presence of exercise partners were assessed. Subjects were classified into three groups: Non-exercise, exercising alone, and exercising with others. Follow-up information and date of incident functional disability and death during the five-year follow-up were collected from the database. To compare the association between exercise habits and functional disability and mortality, Cox regression analysis was conducted. Compared with the non-exercise group, exercising with others had significantly lower hazard ratios (HRs) for functional disability (0.59, 95% confidence interval (CI) 0.40–0.88) and mortality (0.40, 95% CI 0.24–0.66) in the covariate models. Compared with exercising alone, exercising with others decreased the HRs for incident functional disability (0.53, 95% CI: 0.36–0.80) and mortality (0.50, 95% CI 0.29–0.85) rates in the unadjusted model; these associations were not significant in the covariate models. Exercising with others can contribute to functional disability prevention and longevity.

Background: The COVID-19 pandemic may have reduced opportunities for engaging in physical activity (PA) and increased sedentary behavior (SB) among workers. However, most previous studies used self-reported assessments. This study aimed to examine the changes in accelerometer-measured PA and SB from before to after COVID-19 outbreak among Japanese workers.Methods: This one-year longitudinal study used data from the annual health check-ups of workers who lived in the Tokyo metropolitan area. Baseline and follow-up data were collected from June to November, 2019 and June to November, 2020, respectively. Participants were asked to wear the accelerometer on their hip during awake hours for at least 10 days in both the surveys. Before the analysis, considering the difference in wearing time, time spent in PA and SB were converted to the percentage of wearing time. To investigate the changes in PA or SB from before to during COVID-19 outbreak, paired t-tests were performed.Results: Of the 757 eligible participants, 536 were included in the analysis (70.8%). Participants’ mean age was 53.3 years; 69.6% were female; and most were full-time employees. Time spent in PA decreased, regardless of weekdays or weekends, although changes on the weekends were not significant. Conversely, time spent in SB increased on both weekdays and weekends in 2020. These changes corresponded to approximately 10 minutes per day increase/decrease in PA/SB.Conclusion: Objectively measured PA decreased and SB increased by approximately 10 minutes per day after the COVID-19 outbreak among Japanese workers.