The objective of this study is to determine the effects of 12 weeks of lavender aromatherapy on self-reported sleep and heart rate variability (HRV) in the midlife women with insomnia. Sixty-seven women aged 45-55 years, with a CPSQI (Chinese version of Pittsburgh Sleep Quality Index) greater than 5, were recruited from communities in Taiwan. The experimental group (n = 34) received lavender inhalation, 20 min each time, twice per week, for 12 weeks, with a total of 24 times. The control group (n = 33) received health education program for sleep hygiene with no intervention. The study of HRV was analyzed by timeand frequency-domain methods. Significant decrease in mean heart rate (HR) and increases in SDNN (standard deviation of the normal-to-normal (NN) intervals), RMSDD (square root of the mean squared differences of successive NN intervals), and HF (high frequency) of spectral powers analysis after lavender inhalation were observed in the 4th and 12th weeks of aromatherapy. The total CPSQI score of study subjects was significantly decreased in the experimental group (P < 0.001), while no significant difference was observed across the same time period (P = 0.776) in the control group. Resting HR and HRV measurements at baseline 1 month and 3 months after allocation showed no significant difference between the experimental and control groups. The study demonstrated that lavender inhalation may have a persistent short-term effect on HRV with an increase in parasympathetic modulation. Women receiving aromatherapy experienced a significant improvement in sleep quality after intervention. However, lavender aromatherapy does not appear to confer benefit on HRV in the long-term followup.

Nonalcoholic fatty liver disease (NAFLD) is highly prevalent globally and includes chronic liver diseases ranging from simple steatosis to nonalcoholic steatohepatitis (NASH). The neutrophil-to-albumin ratio (NPAR) is a cost-effective, readily available biomarker of inflammation used to assess cancer and cardiovascular disease prognosis, and it may be of predictive value in NAFLD. This study was to evaluate the associations between the NPAR, the neutrophil-to-lymphocyte ratio (NLR), and the presence of NAFLD or advanced liver fibrosis, and to assess the predictive value of the NPAR in NAFLD in a nationally representative database. This population-based, cross-sectional, retrospective study analyzed the secondary data of adults with NAFLD or advanced liver fibrosis extracted from the National Health and Nutrition Examination Survey (NHANES) database 2017–2018. NHANES participants with complete information of vibration-controlled transient elastography (VCTE) and controlled attenuation parameter (CAP) were enrolled. A logistic regression analysis was used to determine the associations between the variables in the participants with and without NAFLD or advanced liver fibrosis. The mean values of the lymphocyte counts, neutrophil counts, NPAR, aspartate aminotransaminase (AST), alanine aminotransaminase (ALT), total cholesterol, triglycerides, and HbA1c were significantly higher in the participants with NAFLD than in those without NAFLD or advanced liver fibrosis. The mean blood albumin levels of the subjects without NAFLD or advancing fibrosis were considerably greater than those of the individuals with these conditions. The mean values of the NLR, NPAR, AST, ALT, triglycerides, lymphocyte count, neutrophil count, and HbA1c were significantly higher in patients with advanced fibrosis than in those without advanced fibrosis. A multivariate analysis showed that per unit increases in both the NLR and NPAR were significantly associated with an increased risk of developing NAFLD, while neither the NLR nor NPAR was significantly associated with higher odds of advanced fibrosis. In conclusion, the novel biomarker NPAR demonstrates a good association with NAFLD, along with participants’ clinical characteristics, in a nationwide population. The NPAR may serve as a biomarker for NAFLD and help clinicians refine the diagnosis and treatment of chronic liver disease.

IntroductionSleep disorders are commonly encountered in modern populations. This cross-sectional study aimed to investigate the associations between triglyceride glucose (TyG) index and poor sleep patterns in non-diabetic adults.MethodsData of non-diabetic adults aged 20–70 years were extracted from the US National Health and Nutrition Examination Survey database 2005–2016. Pregnant women, individuals with diabetes and cancer history, and individuals lacking complete data on sleep patterns or parameters for calculating TyG index were excluded. Poor sleep pattern was defined as having two or more following conditions: (1) abnormal sleep duration, defined as less than 7 h or longer than 9 h; (2) self-reported trouble sleeping; and (3) physician-confirmed sleep disorders. Associations between poor sleep patterns, TyG index, and an additional index incorporating body mass index (BMI), TyGBMI, and other study variables were determined by univariable and multivariable logistic regression analysis.ResultsAmong 9,390 included participants, 1,422 had poor sleep patterns and 7,968 did not. The individuals with poor sleep patterns had a higher mean TyG index, were older, had higher BMI, and had higher proportions of hypertension and history of CVD than those without poor sleep pattern (all p &lt; 0.001). Multivariable analysis showed no significant association between poor sleep pattern and TyG index. However, among the components of poor sleep pattern, TyG index in the highest quartile (Q4) was significantly associated with trouble sleeping [adjusted OR (aOR): 1.46, 95%CI: 1.04–2.03) as compared with the lowest TyG quartile (Q1). In addition, TyG-BMI in Q4 was indepently associated with increased likelihood for poor sleep patterns (aOR: 2.18, 95%CI: 1.61–2.95), trouble sleeping (aOR: 1.76, 95%CI: 1.30–2.39), abnormal sleep duration (aOR: 1.41, 95%CI: 1.12–1.78), and sleep disorders (aOR: 3.11, 95%CI: 2.08–4.64) as compared to Q1.DiscussionAmong US adults without diabetes, elevated TyG index is correlated with self-reported trouble sleeping, independent of BMI. Future studies should build upon this preliminary work and examine these associations longitudinally and through treatment trials.