***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose Age-related cognitivee decline is a growing public health concern worldwide . More than a quarter of adults with cognitive impairment experience sleep disturbance . The objective of this pilot study was to evaluate the preliminary effects of tai chi qigong ( TCQ ) on improving the night-time sleep quality of older adults with cognitive impairment . Participants Older adults with cognitive impairment who complain of sleep disturbance . Methods A r and omized controlled trial with two groups . Fifty-two subjects were recruited from two district elderly community centers and r and omly assigned to either the  TCQ  group ( n=27 ) or the control group ( n=25 ) . The intervention group received TCQ training consisting of two 60-minute sessions each week for 2 months . The control group was advised to maintain their usual activities .  Sleep quality was measured by the Chinese Pittsburgh Sleep Quality Index . Quality of life was measured by Short-form 12 , cognitive functions measured by mini-mental state examination , and subjective memory deficits measured by the memory inventory for Chinese . Results Data were collected at baseline , 2 months , and 6 months . Significant results were noted at 6 months in the Chinese Pittsburgh Sleep Quality Index global score ( P=0.004 ) , sleep duration ( P=0.003 ) , habitual sleep efficiency ( P=0.002 ) , and the Short-form 12 mental health component ( P<0.001 ) . The TCQ participants reported better sleep quality and a better ( quality of life ) mental health component than the control group . Conclusion TCQ can be considered a useful nonpharmacological approach for improving sleep quality in older adults with cognitive impairment . Clinical trial registration CUHK_CCT00448 ( https://www2.ccrb.cuhk.edu.hk/registry/public/287 ) Objective The practice of yoga has been proven to have positive effects on reducing  insomnia . Studies have also shown its effects on reducing climacteric symptoms . To date , however , no studies that evaluate the effects of yoga on postmenopausal women with a diagnosis of insomnia in a r and omized clinical trial have been conducted . The aim of this study was to evaluate the effect of yoga practice on the physical and mental health and climacteric symptoms of postmenopausal women with a diagnosis of insomnia . Methods Postmenopausal women not undergoing hormone therapy , who were 50 to 65 years old , who had an apnea-hypopnea index less than 15 , and who had a diagnosis of insomnia were r and omly assigned to one of three groups , as follows : control , passive stretching , and yoga . Question naires were administered before and 4 months after the intervention to evaluate quality of life , anxiety and depression symptoms , climacteric symptoms , insomnia severity , daytime sleepiness , and stress . The volunteers also underwent polysomnography .  The study lasted 4 months . Results There were 44 volunteers at the end of the study . When compared with the control group , the yoga group had significantly lower posttreatment scores for climacteric symptoms and insomnia severity and higher scores for quality of life and resistance phase of stress . The reduction in insomnia severity in the yoga group was significantly higher than that in the control and passive-stretching groups . Conclusions This study showed that a specific sequence of yoga might be effective in reducing insomnia and menopausal symptoms as well as improving quality of life in postmenopausal women with insomnia Background — Few prospect i ve studies have investigated  insomnia  in relation to risk for coronary heart disease . We assessed insomnia symptoms and risk of acute myocardial infa rct ion ( AMI ) in a large , population -based study . Methods and Results — A total of 52 610 men and women were followed up for a first AMI , and 2368 incident AMIs occurred during 11.4 years of follow-up , either identified at hospitals or by the National Cause of Death Registry . In our analyses , we adjusted for age , sex , marital status , education , shift work , blood pressure , lipids , diabetes mellitus , body mass index , physical activity , smoking , and alcohol consumption . Difficulties initiating and maintaining sleep and having a feeling of nonrestorative sleep were associated with a moderate increase in AMI risk . The multiadjusted hazard ratios for AMI were 1.45 ( 95 % confidence interval 1.18–1.80 ) for people with difficulties initiating sleep almost every night , 1.30 ( 1.01–1.68 ) for those with difficulties maintaining sleep almost every night , and 1.27 ( 1.03–1.57 ) for those with a feeling of nonrestorative sleep more than once a week compared with people who never experienced these sleep difficulties . When we combined the symptoms , a dose-dependent association was seen between the number of insomnia symptoms and AMI risk ( P for trend 0.003 ) . Alternative multivariable models and different sensitivity analyses suggest that the results were robust , especially concerning difficulties initiating sleep . Conclusions — Insomnia is associated with a moderately increased risk for AMI Purpose The aim of this study was to determine the effect of one night 's sleep deprivation on anaerobic performance and Reaction time of subjects in the morning of the following day . Methods Eighteen male college student athletes were studied twice in a balanced , r and omized design . Subjects were measured for peak power , mean power and Reaction time . Results The performance showed no significant difference in both tests of anaerobic power ( peak power , mean power ) over the sleep deprivation period ( P= 0.3 ; P= 0.4 respectively ) , but reaction time differed significantly from baseline ( P=0.003 ) . Results support the hypothesis that sleep serves a function of cognitive restitution , particularly in the maintenance of attentional mechanisms . In the light of the above considerations . Conclusions It was concluded that short-term sleep deprivation is not effective on anaerobic performance , but adversely affects cognitive function such as Reaction Time OBJECTIVES The aims of this study were to compare the effects of acute morning or evening exercise on nocturnal sleep  in individuals with two subjective insomnia symptoms : difficulty in initiating sleep ( DIS ) , and early morning awakening ( EMA ) , separately for the first vs the second halves of the night . METHODS Older individuals ( 55 - 65 years old ) with DIS ( N = 15 ) or EMA ( N = 15 ) and age- and sex-matched controls ( N = 13 ) participated in this non-r and omized crossover study . Participants were assigned to two exercise conditions ( morning exercise and evening exercise ) in counterbalanced order following the baseline condition with a two-week interval between conditions . A single session of aerobic step exercise was performed during each exercise condition . Nocturnal polysomnography was carried out to evaluate objective sleep quality . Patient global impression of change scale scores for nocturnal sleep were obtained to subjectively evaluate the different groups . RESULTS Acute physical exercise did not improve subjective sleep quality .  Morning exercise decreased the number of stage shifts over the whole night . The arousal index and the number of stage shifts were decreased especially during the second half of the night in all groups . Furthermore , morning exercise decreased the number of wake stages during the second half of the night in the DIS group , but not in the EMA group . CONCLUSIONS Acute morning exercise can improve nocturnal sleep quality in individuals with difficulty initiating sleep , especially during the later part of the night Purpose 1 ) To determine the effect of a home-based walking exercise program on the sleep quality and quality of life of cancer patients , as well as 2 ) to determine if enhanced sleep quality was associated with improvement in quality of life over time . Methods This is a prospect i ve , longitudinal , two-armed , r and omized clinical trial . Participants were recruited from oncology outpatient clinics in two university-based medical centers and were allocated to either usual care ( n = 35 ) or a home-based walking exercise intervention for 8 weeks ( n = 36 ) . Measurements included the Taiwanese version of the Pittsburgh Sleep Quality Index , the Medical Outcomes Study Short Form-36 , the Taiwanese Version Ratings of the Perceived Exertion Scale , and a walking exercise log . This study was analyzed on an intention-to-treat basis . Effects of the walking exercise program  on sleep quality and quality of life were analyzed by the generalized estimating equation method . Results Patients in the exercise group reported significant improvements in sleep quality ( β = −3.54 , p < 0.01 ) and the mental health dimension of quality of life ( β = 10.48 , p < 0.01 ) . Among patients who exercised , enhanced sleep quality also corresponded with reduced bodily pain ( β = 0.98 , p = 0.04 ) and improvements over time in the mental health dimension of quality of life ( β = −3.87 , p < 0.01 ) . Conclusions A home-based walking exercise program can be easily incorporated into care for cancer patients who are suffering from sleep disturbances Insomnia with objective short sleep duration appears to be a biologically more severe phenotype of the disorder . No longitudinal study to date has examined the association of this type of insomnia with incident hypertension using polysomnography . From a r and om , general population sample of 1741 adults of the Penn State Cohort , 1395 were followed-up after 7.5 years , and 786 did not have hypertension at baseline . Hypertension was determined by a self-report of receiving treatment for high blood pressure . Chronic insomnia was defined as a complaint of insomnia lasting ≥1 year , whereas poor sleep was defined as moderate-to-severe sleep difficulties . All of the subjects underwent 8-hour polysomnography  . Sleep-disordered breathing ( SDB ) was defined as an obstructive apnea/hypopnea index ≥5 . We used the median polysomnographic percentage of sleep time to define short sleep duration ( ie , < 6 hours ) . We controlled for sex , race , age , caffeine , cigarettes and alcohol consumption , depression , sleep-disordered breathing , diabetes mellitus , obesity , and blood pressure in our analyses . Compared with normal sleepers who slept ≥6 hours , the highest risk for incident hypertension was in chronic insomniacs with short sleep duration ( odds ratio , 3.8 [ 95 % CI , 1.6–9.0 ] ) . The risk for incident hypertension in poor sleepers with short sleep duration was significantly increased but became marginally significant after controlling for obesity ( odds ratio , 1.6 [ 95 % CI , 0.9–2.8 ] ) . Chronic insomnia with short sleep duration is associated with an increased risk for incident hypertension in a degree comparable to sleep-disordered breathing . Objective short sleep duration in insomnia may serve as a useful predictor of the biological severity of the disorder Background Exercise has been found to be associated with improved sleep quality . However , most of the evidence is based on resistance exercise , walking , or gym-based aerobic activity . Purpose This study aim ed to examine the effects of an 8-week aquatic exercise program on objective ly measured sleep parameters among older adults with mild sleep impairment . Methods A total of 67 eligible older adults with sleep impairment were selected and r and omized to exercise and control groups , and 63 participants completed the study . The program involved 2 × 60-min sessions of aquatic exercise for 8 weeks . Participants wore wrist actigraphs to assess seven parameters of sleep for 1 week before and after the intervention . Mixed- design analysis of variance ( ANOVA ) was used to assess the differences between groups in each of the sleep parameters . Results No significant group differences on demographic variables , life satisfaction , percentage of body fat , fitness , seated blood pressure , and any parameter of sleep were found at baseline . Significant group × time interaction effects were found in sleep onset latency , F(1,58 ) = 6.921 , p = .011 , partial eta squared = .011 , and in sleep efficiency , F(1 , 61 ) = 16.909 , p < 0.001 , partial eta squared = .217 . The exercise group reported significantly less time on sleep onset latency ( mean difference = 7.9 min ) and greater sleep efficiency ( mean difference = 5.9 % ) than the control group at posttest . There was no significant difference between groups in change of total sleep time , wake after sleep onset , activity counts , or number and length of awakenings . Conclusions An 8-week aquatic exercise has significant benefits on some sleep parameters , including less time for sleep onset latency and better sleep efficiency in older adults with mild sleep impairment Abstract Objectives . This 2013 up date of the practice guidelines for the biological treatment of unipolar depressive disorders was developed by an international Task Force of the World Federation of Societies of Biological Psychiatry ( WFSBP ) . The goal has been to systematic ally review all available evidence pertaining to the treatment of unipolar depressive disorders , and to produce a series of practice recommendations that are clinical ly and scientifically meaningful based on the available evidence . The guidelines are intended for use by all physicians seeing and treating patients with these conditions . Methods . The 2013 up date was conducted by a systematic up date literature search and appraisal . All recommendations were approved by the Guidelines Task Force . Results . This first part of the guidelines ( Part 1 ) covers disease definition , classification , epidemiology , and course of unipolar depressive disorders , as well as the management of the acute and continuation phase treatment . It is primarily concerned with the biological treatment ( including antidepressants , other psychopharmacological medications , electroconvulsive therapy , light therapy , adjunctive and novel therapeutic strategies ) of adults . Conclusions . To date , there is a variety of evidence -based antidepressant treatment options available . Nevertheless there is still a substantial proportion of patients not achieving full remission . In addition , somatic and psychiat 
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Discussion Our findings suggest that exercise can improve sleep quality without notable adverse effects .