Objective To evaluate the association between objective short sleep duration in patients with insomnia and changes in blood parameters related to hypothalamic-pituitary-adrenal (HPA) axis activity.Method A cross-sectional pilot study was conducted in 30 middle-aged adults with chronic insomnia who were divided into 2 groups according to polysomnography (PSG) total sleep time (TST) (TST > 5h and < 5h). All patients underwent subjective analysis of sleep quality, anthropometric measurements, PSG, and determination off asting blood parameters.Results The results revealed lower sleep efficiency and higher sleep latency for those with a TST < 5h. The subjective sleep quality was worse in the TST < 5h. Significantly, higher glucose and cortisol levels were observed with a TST < 5h. Glucose, cortisol and ACTH levels were inversely correlated with the PSG total sleep time.Conclusion Patients with insomnia with objective short sleep duration had HPA-associated endocrine and metabolic imbalances chronically linked to increases in cardiovascular risk observed with this more severe insomnia phenotype.

This clinical guideline supported by the Brazilian Sleep Association comprises a brief history of the development of Brazilian sleep physiotherapy, outlines the role of the physiotherapist as part of a sleep health team, and describes the clinical guidelines in respect of the management of some sleep disorders by the physiotherapist (including sleep breathing disorders, i.e., obstructive sleep apnea, central sleep apnea, upper airway resistance syndrome, hypoventilation syndromes and overlap syndrome, and pediatric sleep breathing disorders; sleep bruxism; circadian rhythms disturbances; insomnia; and Willis-Ekbom disease/periodic limb movement disorder. This clinical practice guideline reflects the state of the art at the time of publication and will be reviewed and updated as new information becomes available.

Objective To systematically review the effects (benefits and harms) of different types of physical exercise on insomnia outcomes in adult populations with no mood disorders. Objective and subjective sleep outcomes and related mismatches were analyzed. Methods Systematic review and meta-analysis. Quality of evidence was also examined. Results Six studies including 295 participants with insomnia diagnosis were selected. Yoga, Tai Chi, resistance exercise and aerobic exercise were used in protocols with different duration, intensity and frequency. Studies involved different populations,

Poor sleep quality is associated with unhealthy dietary choices and worse body composition among night-shift workers and women during the climacteric period. This study aimed to evaluate the effect of exogenous melatonin administration on the dietary intake and body composition in healthcare workers exposed to fixed-shift work during the climacteric period. A phase II randomized, double-blind, placebo-controlled clinical trial of climacteric women working fixed morning, afternoon, or night shifts was conducted. Baseline data collection included sociodemographic information, sleep parameters, dietary intake, and body composition using bioelectrical impedance. Participants received either 0.3 mg of melatonin or a placebo for three months. Baseline total caloric and carbohydrate intake was higher among night-shift workers than afternoon-shift workers, though afternoon-shift workers a had higher body weight and fat percentage. Post-intervention, caloric intake differences dissipated due to reduced intake among night-shift workers and increased intake among afternoon-shift workers, independent of melatonin or placebo administration. However, differences in body composition persisted. Postmenopausal participants showed reduced fat mass, while premenopausal participants experienced an increase, regardless of intervention. The results suggest that physiological nighttime melatonin doses, administered on non-consecutive nights for three months, were ineffective for changing dietary intake or body composition.

Sleep disturbances and mood changes are common during the climacteric, often linked to hormonal fluctuations caused by reduced ovarian function. Evidence suggests that long‐term melatonin administration may improve the quality of life in climacteric women. This study aimed to evaluate the effects of exogenous melatonin on climacteric symptoms, sleep quality, and reproductive hormones in women working fixed shifts. A randomized clinical trial was conducted with 46 nurses working fixed shifts at a hospital in São Paulo: morning (7:00–13:00, n = 16; intervention = 7, placebo = 9), afternoon (13:00–19:00, n = 15; intervention = 8, placebo = 7), and night (19:00–7:00, n = 15; intervention = 7, placebo = 8). Participants were randomly assigned to receive either 0.3 mg of melatonin or placebo. For night shift workers, melatonin was administered only on nights off, when they were sleeping at home; the same procedure was applied to morning and afternoon workers. Data collection included sociodemographic information, self‐reported sleep quality, and menopausal symptoms. Blood samples were collected at home to measure luteinizing hormone (LH), follicle‐stimulating hormone (FSH), estradiol, and progesterone before and after the intervention. A significant main effect of melatonin was observed, with a 15.8% reduction in climacteric symptoms compared with placebo ( p = 0.01), independent of age or sleep duration, while no significant interaction with work shift was detected. Sleep quality improved by 35.33% on days off in the intervention group ( p < 0.001), with morning shift workers showing a 32.46% improvement ( p < 0.05). No significant changes were observed in reproductive hormone levels or total sleep duration. Exogenous melatonin effectively alleviates climacteric symptoms and improves sleep quality on days off, particularly among day‐shift workers, without affecting reproductive hormone concentrations or total sleep duration. Trial Registration: RBR‐10whktxm (UTN: U1111‐1305‐6221). Registered on 13 August 2025, retrospectively registered.