In France, a previous study estimated that 11% of households were infested by bed bugs between 2017 and 2022. In response to a potential resurgence of cases in 2023 and the anticipated tourist influx for the Paris 2024 Olympic Games, two complementary studies were commissioned by the french Directorate General for Health (DGS).The aim was to update incidence data in general practice and to assess the proportion of infestation in the general population, focusing on its psychological impact (PH-4 questions) and consequences on daily life (Sheehan Disability Scale).Over the period from April 2024 to March 2025, 219 general practitioners (GPs) in mainland France weekly reported potential bed bug infestation cases. In addition, GPs were asked to send photographs of reported cases whenever possible. An entomologist and a dermatologist then conducted a consensus assessment to determine the relevance of the visual evidence and the coherence of the associated case description. The study in the general population surveyed all participants in an online cohort using a questionnaire to assess infestations and their impact on daily life.129 cases were reported in general practice. Of the 57 cases reviewed by the two experts, 41 (72%) were classified as probable. Almost all cases (98%) reported an exacerbation of avoidance behaviors. 4,176 participants responded to the questionnaire in the general population from which 57 (1,4%) reported an infestation during the study period. The impact on daily life was relatively significant in both cohorts (36% in general practice ; 45% in general population).Preliminary data suggests that the number of bed bug-related consultations appears to have decreased since 2020, and the Paris 2024 Olympic Games period has not led to an increase in cases. The relatively high proportion of cases exhibiting a 'moderate to severe' impact on daily life in both parts of the study appears consistent with findings reported in the literature.Our finding suggest that the sustained media attention reflects the profound psychological burden and the significant impairment of daily life caused by infestations, rather than a quantifiable increase in bed bug incidence across the country.

Fewer than 1% of patients with insomnia in Germany gain access to guideline‑recommended care, Cognitive Behavioural Therapy for Insomnia (CBT‑I), often only after prolonged delays.To illuminate what happens along the patient journey in the interim, this survey aimed to identify gaps in care, unmet needs, and potential levers to optimise provision in European primary care using Germany as a case example.A standardised online survey was conducted between August and September 2024 among adults with insomnia and healthcare professionals. Patients were recruited via a digital health application they were currently using (XXX); healthcare professionals were recruited via newsletters.A total of 523 patients participated; 47.8% reported insomnia for more than five years. Before their first medical consultation, 92.2% had self‑initiated measures to address sleep problems, including over‑the‑counter sleep medications (69.3%), relaxation techniques (65.2%), and sleep‑hygiene practices (51.9%). In 59.9% of cases, patients sought medical support specifically due to sleep problems; 40.1% raised sleep in the context of other complaints. In 56% of cases, the first medical consultation occurred only after several years. Consultation resulted in a prescription for a sleep medication in 37.4% of cases; 14.1% reported regular use. Most respondents rated the possibility of discontinuing such medication as important. At the time of the survey, 40.5% had not received a formal insomnia diagnosis. Among 34 healthcare professionals, only 21.9% reported routinely diagnosing insomnia when sleep problems are present. Reported reasons included insufficient recognition of insomnia as a distinct disorder, knowledge gaps among clinicians, and low prioritisation in routine practice. Patient‑side factors (limited problem awareness, widespread self‑medication) and structural barriers (restricted therapy availability, limited sleep‑medicine expertise) were also cited.Despite long‑standing symptoms, formal diagnosis is frequently absent, indicating deficits in patient awareness and systemic/structural weaknesses in care.Strengthening professional awareness, expanding guideline‑concordant therapy provision, and targeted patient education are essential to improve the patient journey in European primary care.

With the accelerating aging of the population, abnormal sleep duration has become increasingly common among middle-aged and older adults. However, the mechanisms by which diabetes and sarcopenia, two highly prevalent chronic conditions, individually and in combination affect sleep health are not yet fully understood.To investigate the impact of sarcopenia and its comorbid status with diabetes on the risk of abnormal sleep duration in middle-aged and older adults.Using longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020, we included participants aged ≥45 years (n=4,936) and ≥60 years (n=2,061) with normal sleep at baseline. Cox proportional hazards models were employed to analyze the associations of sarcopenia (diagnosed according to AWGS 2019 criteria) and its various combined states with diabetes (diagnosed based on fasting plasma glucose) with the subsequent incidence of abnormal sleep duration (nighttime sleep duration 8 h).Sarcopenia was significantly associated with an increased risk of abnormal sleep duration (HR=1.204, 95% CI: 1.023–1.417), particularly with long sleep duration (>8 h; HR=1.566, 95% CI: 1.192–2.057). The highest risk was observed in the group with comorbid diabetes and sarcopenia (HR=1.515, 95% CI: 1.059–2.167), with incidence rates of 49.3% in 2013, rising sharply to 80.0% in 2020. The risks were also significantly elevated in groups with prediabetes and sarcopenia (HR=1.423, 95% CI: 1.096-1.847) and with non-diabetes and sarcopenia (HR=1.279, 95% CI: 1.113-1.468).These findings suggest that the management of sarcopenia in the elderly should extend beyond physical function to include sleep health monitoring. Early combined interventions targeting prediabetes or possible sarcopenia may be an effective strategy for preventing abnormal sleep duration.Sarcopenia is an independent risk factor for abnormal sleep duration. When comorbid with diabetes, especially prediabetes, the risk shows a further synergistic increase. Early identification and combined management of both conditions are crucial for improving sleep health in middle-aged and older adults.

In primary care, patients frequently present with symptoms suggestive of obstructive sleep apnoea (OSA), but access to laboratory polysomnography (PSG) is limited and waiting times can delay treatment decisions. Scalable home-based tools could support GP-led triage and referral prioritisation, provided diagnostic performance remains consistent across common patient profiles such as sex, age and body mass index (BMI).To evaluate whether a chest-worn smartphone-based home sleep test maintains consistent performance across sex, age bands and BMI for moderate-to-severe sleep apnoea detection, and to report agreement for AHI severity classification versus PSG.Post-hoc subgroup analysis of the XXX multicentre study per-protocol population (adults; N=432; 9 European centres). PSG (central adjudication) was the reference. Four-class AHI severity agreement used quadratic-weighted kappa. For AHI≥15 events·h⁻¹, overall performance was reported first as a benchmark, then subgroup sensitivity/specificity were examined by sex, age band and BMI.Overall severity agreement was high (weighted κ=0.878). For AHI≥15, sensitivity was 0.91, specificity 0.91, AUC 0.96 and Cohen’s κ 0.81. Sex-stratified sensitivity/specificity were 0.918/0.868 in males (N=243) and 0.891/0.932 in females (N=189). BMI-stratified sensitivity/specificity were 0.893/0.944 in normal-weight (N=140), 0.859/0.872 in overweight (N=155) and 0.963/0.884 in obese (N=136). Age-stratified sensitivity/specificity were 0.938/0.929 (18–29; N=61), 0.904/0.900 (50–59; N=111), 0.912/0.880 (60–69; N=62), 0.909/0.500 (70–79; N=24; two PSG-negative) and 1.000/1.000 (≥80; N=4). Subgroup estimates were consistent with the overall benchmark.Across sex and BMI strata—including obesity—estimates were close to the benchmark, supporting consistent GP-led screening and triage across common primary-care profiles. The low specificity in ages 70–79 should be interpreted cautiously because it is driven by only 2 PSG-negative cases. Limitations include a referral-cohort setting and small older subgroups.In a large multicentre PSG study, a smartphone-based home sleep test showed high agreement for AHI severity classification and consistent subgroup performance for moderate-to-severe sleep apnoea detection, supporting use for primary care triage.   MeSH Terms : Sleep Apnea Syndromes  Polysomnography  Primary Health Care Gatekeeping Smartphon

While insomnia, depression and anxiety disorders are most frequently diagnosed and treated in primary care, the longitudinal relationship between these phenomena remains elusive for this setting.The aim of the present study was to quantify the association of registered insomnia with subsequent depression or anxiety in primary care.A matched population-based cohort study was conducted using International Classification of Primary Care (ICPC) and Anatomical Therapeutic Classification (ATC) codes extracted from medical records of 84 XXX general practices. Patients without documented psychological or social problems, aged 18 to 65 years, with a registered insomnia diagnosis (ICPC: P06) or prescribed sleep medication (ATC: N05CD, N05CF, N05CH) were matched 1:1 to healthy controls on gender, year of birth, and general practice. Controls could be used more than once. The primary outcome measure was depression (ICPC: P03, P76, P76.02) or anxiety (ICPC: P01, P74, P74.01, P74.02) registration up to five years after the insomnia diagnosis.Patients with insomnia between 1 January 2010 and 1 January 2015 (n = 1,535) and the control group (n = 1,502) were followed for five years after the insomnia diagnosis. Patients with insomnia had a higher risk of depression or anxiety (odds ratio (OR) = 1.53, 95% confidence interval (CI) [1.18 – 1.98]).The present study identifies insomnia as a potential marker for early detection of depression and anxiety in primary care. In addition, treating insomnia accurately in this setting might reduce depression and anxiety incidences, as insomnia can be effectively and safely treated with Cognitive Behavioural Therapy for Insomnia (CBT-I), with more durable effects than sleep medication.Patients with an insomnia diagnosis in primary care were at higher risk to develop depression or anxiety compared to healthy controls. Implementing prevention strategies that increase vigilance and improve insomnia treatment in primary care could reduce incidences of depression and anxiety on a population level.

Chronic insomnia raise issues by its complexity, and lack of access to non-drugs solutions. Alternative therapeutics are still expected, and light therapy appears as one of them : by its impact on sleep mechanisms, and its limited side effects. Our hypothesis was that light therapy could improve sleep quality of chronic insomniac.INSOLUX study aimed to evaluate active versus placebo light therapy on objective sleep efficiency of a large panel of insomniac patients. Secondary objectives were about other objective and subjective sleep parameters, as well as alertness and mood.This randomized, double-blind controled trial was conducted by 40 GPs of 3 regions of France. They included 239 patients suffering from any type of chronic insomnia, with and without sleeping pills treatment. After 2 weeks of baseline, they were asked to use light glasses for 20 minutes in the morning, during 4 weeks : bright white blue enriched light of 2000 lux for active group, and dim red light of 150 lux for placebo group. A 2-weeks follow-up period completed the protocol. They wore an actimeter during the whole period, completed daily a sleep diary, and periodically questionnaires about mood, sleep quality, seasonality and chronotype. Analyses were conducted in intention to treat.Preliminary results show that the two groups are comparable for age, gender, use of sleeping pills, and associated conditions. No objective improvement of sleep parameters was observed on the whole population, on actimetry nor on sleep diary. Improvement of global sleep quality and mood was observed in both groups. There was a significant improvement of anxiety level in the active group compared to the placebo group at the end of the treatment and follow-up.These results do not show any objective effect on the quality of sleep in patients with insomnia in general. We hypothesize that certain types of insomnia (with difficulty falling asleep and/or waking up during the night) may respond better to light therapy than others.Further analyses are planned to test this hypothesis and to take into account certain factors that may influence these results : seasonality, chronotype, changes in hypnotic use, exposure to natural light.

Sleep disturbances, including insomnia and obstructive sleep apnea, are highly prevalent yet under-recognized contributors to morbidity in primary care populations. The growing burden of non-communicable diseases (NCDs) and evidence linking inadequate sleep with cardiometabolic, neurocognitive, and psychiatric disorders position sleep health as a core domain of preventive medicine. (1) To elucidate the mechanisms of sleep regulation and physiology relevant to clinical practice. (2) To characterize the spectrum and epidemiology of common sleep disorders encountered in primary care. (3) To evaluate the clinical impact of evidence-based sleep hygiene interventions.Key scientific literature and multi-center epidemiological studies are reviewed to synthesize current knowledge on sleep architecture, diagnostic criteria for major sleep disorders, and validated screening tools, e.g., Pittsburgh Sleep Quality Index. Data is contextualized, focusing on the intersection of lifestyle factors contributing to disordered sleep.Insufficient and poor-quality sleep are independently associated with increased risks of hypertension, type 2 diabetes, obesity, depression, and cognitive decline. Evidence-based interventions—most notably regular sleep-wake schedules, targeted reduction of late caffeine and screen exposure, and optimizing sleep environment—demonstrate measurable improvements in subjective sleep quality, daytime functioning, and health outcomes across patient cohorts.​                 Early identification and intervention for sleep disturbances are both feasible and impactful in the primary care context. The use of brief, validated questionnaires, coupled with practical sleep hygiene advice, can be systematically embedded into chronic disease management. Addressing sleep health in PHC is likely to yield synergistic benefits for metabolic, mental, and cardiovascular health, warranting its prioritization among preventive service strategies.Strengthening sleep literacy among physicians is essential to improving patient care and population health. Integrating sleep assessment and management into routine practice empowers clinicians to address a frequently overlooked, yet highly modifiable, determinant of disease burden in primary care.