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Tsai CT, Rajput G, Gao A, Wu Y, Wu DTY. Improving the design of patient-generated health data visualizations: design considerations from a Fitbit sleep study. J Am Med Inform Assoc 2024; 31:465-471. [PMID: 37475179 PMCID: PMC10797273 DOI: 10.1093/jamia/ocad117] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 05/11/2023] [Accepted: 06/28/2023] [Indexed: 07/22/2023] Open
Abstract
Interactive data visualization can be a viable way to discover patterns in patient-generated health data and enable health behavior changes. However, very few studies have investigated the design and usability of such data visualization. The present study aimed to (1) explore user experiences with sleep data visualizations in the Fitbit app, and (2) focus on end users' perspectives to identify areas of improvement and potential solutions. The study recruited eighteen pre-medicine college students, who wore Fitbit watches for a two-week sleep data collection period and participated in an exit semi-structured interview to share their experience. A focus group was conducted subsequently to ideate potential solutions. The qualitative analysis identified six pain points (PPs) from the interview data using affinity mapping. Four design solutions were proposed by the focus group to address these PPs and illustrated by a set of mock-ups. The study findings informed four design considerations: (1) usability, (2) transparency and explainability, (3) understandability and actionability, and (4) individualized benchmarking. Further research is needed to examine the design guidelines and best practices of sleep data visualization, to create well-designed visualizations for the general population that enables health behavior changes.
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Affiliation(s)
- Ching-Tzu Tsai
- Department of Biomedical Informatics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- School of Design, College of Design, Architecture, Art, and Planning, University of Cincinnati, Cincinnati, Ohio, USA
| | - Gargi Rajput
- Department of Biomedical Informatics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Medical Science Baccalaureate Program, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Andy Gao
- Department of Biomedical Informatics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Medical Science Baccalaureate Program, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Yue Wu
- Department of Biomedical Informatics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- School of Design, College of Design, Architecture, Art, and Planning, University of Cincinnati, Cincinnati, Ohio, USA
| | - Danny T Y Wu
- Department of Biomedical Informatics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- School of Design, College of Design, Architecture, Art, and Planning, University of Cincinnati, Cincinnati, Ohio, USA
- Medical Science Baccalaureate Program, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
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Mohan ME, Mohan MC, Prabhakaran P, Syam Das S, Krishnakumar IM, Baby Chakrapani PS. Exploring the short-term influence of a proprietary oil extract of black cumin ( Nigella sativa) on non-restorative sleep: a randomized, double-blinded, placebo-controlled actigraphy study. Front Nutr 2024; 10:1200118. [PMID: 38288065 PMCID: PMC10822901 DOI: 10.3389/fnut.2023.1200118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 12/27/2023] [Indexed: 01/31/2024] Open
Abstract
Background Nigella sativa (black cumin, or black seed) is popularly known as the seed of blessings in the Arab system of medicine. Though not widely recommended for sleep, a unique proprietary black cumin extract (BlaQmax®/ThymoDream™; BCO-5) has been shown to be helpful in the management of stress and sleep issues. Methods This randomized, double-blind, placebo-controlled trial aimed to investigate the efficacy of BCO-5 on the sleep quality of volunteers characterized with a self-reported non-restorative sleep disorder. Healthy male and female participants (n = 70), aged 18-65 years (BMI 22-28 Kg/m2) were randomized to either placebo or BCO-5 (n = 35/group). Both interventions were supplemented at 200 mg/day for seven days. Actigraphy and a validated restorative sleep questionnaire (RSQ-W) were used to monitor the influence of BCO-5 on sleep. Results Compared to placebo, BCO-5 significantly improved sleep quality, as evidenced by both intra-group and inter-group analyses of the actigraphy data. The relative improvements observed were sleep efficiency (7.8%, p < 0.001), total sleep time (19.1%, p < 0.001), sleep onset latency (35.4%; p < 0.001), and wake-after-sleep-onset (22.5%; p < 0.001) compared with placebo. BCO-5 also improved sleep by 75.3% compared to baseline (p < 0.001) and by 68.9% compared to placebo (p < 0.001), when monitored by RSQ-W. BCO-5 was well-tolerated with no reports of side effects or toxicity. Conclusion BCO-5 significantly improved non-restorative sleep in seven days, indicating its potential role as a natural sleep aid.
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Affiliation(s)
- M. E. Mohan
- Department of General Medicine, BGS Global Institute of Medical Sciences, Kengeri, India
| | - Mohind C. Mohan
- Centre for Neuroscience, Cochin University of Science and Technology, Cochin, Kerala, India
- Department of Biotechnology, Cochin University of Science and Technology, Cochin, Kerala, India
| | | | - S. Syam Das
- R&D Centre, Akay Natural Ingredients, Cochin, Kerala, India
| | | | - P. S. Baby Chakrapani
- Centre for Neuroscience, Cochin University of Science and Technology, Cochin, Kerala, India
- Department of Biotechnology, Cochin University of Science and Technology, Cochin, Kerala, India
- Centre of Excellence in Neurodegeneration and Brain Health, Cochin, Kerala, India
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Winders S, Lyon DE, Kelly DL, Weaver MT, Yi F, Rezende de Carvalho M, Stechmiller JK. Sleep, Fatigue, and Inflammatory Biomarkers in Older Adults with Chronic Venous Leg Ulcers Receiving Intensive Outpatient Wound Care. Adv Wound Care (New Rochelle) 2024. [PMID: 38062760 DOI: 10.1089/wound.2023.0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2024] Open
Abstract
Objective: Chronic venous ulcers are a relatively common and distressing condition that disproportionately affects older individuals. Along with multiple concomitant issues such as wound drainage, pain, and mobility impairments, individuals with chronic venous leg ulcers (CVLUs) commonly report sleep disturbances and fatigue; however, limited research has examined these symptoms in relation to inflammatory biomarkers in this population over the intensive wound care treatment trajectory. This study aimed at describing the symptoms of sleep and fatigue in older adults with CVLUs receiving intensive wound treatment with weekly debridement and exploring the relationships between these symptoms and tumor necrosis factor-alpha (TNF-α), c-reactive protein (CRP), and interleukin (IL)-6. Approach: Demographics, clinical characteristics, Pittsburgh Sleep Quality Index (PSQI) scores, Brief Fatigue Inventory (BFI), TNF-α, CRP, and IL-6 levels were collected from 84 older adults with CVLUs at three time points (baseline, week 4, and week 8). Data analysis included descriptive statistics and Bayesian estimation of associations. Results: Findings showed a consistent pattern of poor sleep quality and mild fatigue among these individuals. Lower IL-6 levels at week 4 and higher CRP levels at week 8 were linked to poor sleep quality. Higher CRP levels were linked to greater fatigue at baseline and week 8. Sleep and fatigue were correlated at all time points. Innovation and Conclusion: This study highlights the importance of clinicians evaluating sleep and fatigue in those with CVLUs. Further research is needed to validate circulating inflammatory biomarkers to enhance our understanding of sleep and fatigue's role in wound healing.
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Affiliation(s)
- Samantha Winders
- Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, Washington, USA
| | - Debra E Lyon
- College of Nursing Dean's Office, University of Florida College of Nursing, Gainesville, Florida, USA
| | - Debra Lynch Kelly
- College of Nursing Dean's Office, University of Florida College of Nursing, Gainesville, Florida, USA
| | - Michael T Weaver
- University of Florida, Biobehavioral Nursing Science, Gainesville, Florida, USA
| | - Fan Yi
- Department of Mathematics and Statistical Science, University of Idaho, Moscow, Idaho, USA
| | | | - Joyce K Stechmiller
- University of Florida, Biobehavioral Nursing Science, Gainesville, Florida, USA
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Ricci A, Fernandez-Mendoza J. Evidence of how the maturing sleeping brain contributes to the sleepy brain of adolescents. Sleep 2024; 47:zsad283. [PMID: 37935893 PMCID: PMC10782484 DOI: 10.1093/sleep/zsad283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Indexed: 11/09/2023] Open
Affiliation(s)
- Anna Ricci
- Department of Neurological Sciences, Robert Larner M.D. College of Medicine, University of Vermont, Burlington, VT, USA
| | - Julio Fernandez-Mendoza
- Sleep Research and Treatment Center, Department of Psychiatry and Behavioral Health, Penn State Health Milton S. Hershey Medical Center, Penn State University College of Medicine, Hershey, PA, USA
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Saintila J, Soriano-Moreno AN, Ramos-Vera C, Oblitas-Guerrero SM, Calizaya-Milla YE. Association between sleep duration and burnout in healthcare professionals: a cross-sectional survey. Front Public Health 2024; 11:1268164. [PMID: 38269387 PMCID: PMC10806404 DOI: 10.3389/fpubh.2023.1268164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 12/18/2023] [Indexed: 01/26/2024] Open
Abstract
Background Short sleep duration in healthcare professionals is a recurring concern among researchers. On the other hand, the prevalence of burnout in this population group is experiencing exponential growth. Therefore, this study aimed to explore the association between sleep duration and burnout in healthcare professionals. Methods This is a cross-sectional study. Data were collected by applying a non-probabilistic convenience sampling, considering a sample of 300 healthcare professionals from the public sector in Peru. The association between variables was explored using multivariate logistic regression. Values of p < 0.05 were considered statistically significant. Results The results of the analysis in the crude models revealed that both men and women who slept < 7 h during workdays and days off were 8.33 (95% CI = 2.68-13.99, p = 0.004) and 17.18 (95% CI = 10.50-23.87, p < 0.001) times more likely to have burnout compared to those who reported ≥7 h, respectively. After adjusting for confounding variables, the association remained statistically significant. Conclusion The findings of this study underscore the critical importance of sleep duration in the incidence of burnout among healthcare professionals. In the context of the global challenges to the mental and physical health of these professionals, our results highlight the urgent need to implement strategies at the organizational and individual level. This includes promoting a better work-life balance, and effective stress management and improved sleep quality.
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Angelillo S, Sansone V, Paduano G, Lateano L, Di Giuseppe G, Nobile CGA. The quality of sleep: evaluation among university students. Front Public Health 2024; 11:1270426. [PMID: 38259777 PMCID: PMC10800457 DOI: 10.3389/fpubh.2023.1270426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction This study explored the quality of sleep among university students in the South of Italy during the Covid-19 pandemic. Methods A cross-sectional study was conducted between March 2022 and January 2023 and involved students over the age of 18, who were invited to complete a self-administered questionnaire using an online application. Results Overall, 88% of men and 94.5% of women had Pittsburgh Sleep Quality Index (PSQI) scores of ≥5 and a mean PSQI score of 9.2 ± 3. Students with severe or extremely depression score, with sever or extremely stress score, male and who did not had Covid-19 infection were more likely to have a PSQI global score. Moreover, 62.6% of the students declared a reduction in social relations and 72.3% an increase in the use of social media during the pandemic period. The majority of respondents reported an extremely severe level of depression (68.1%), anxiety (84.4%) and stress (71.9%). Conclusion This finding indicate that a relevant percentage of students are poor sleepers with a higher overall PSQI score with depression and stress and underline the role the implementation of public health interventions to promote healthy life styles and in particular focus on the duration of long night sleep.
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Affiliation(s)
- Silvia Angelillo
- Department of Health Sciences, University of Catanzaro “Magna Gracia”, Catanzaro, Italy
| | - Vincenza Sansone
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Giovanna Paduano
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Ludovica Lateano
- Department of Health Sciences, University of Catanzaro “Magna Gracia”, Catanzaro, Italy
| | - Gabriella Di Giuseppe
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
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Bock K, Peltzer J, Liu W, Colgrove Y, Smirnova I, Siengsukon C. Sleep quality and lymphedema in breast cancer survivors: a mixed method analysis. J Cancer Surviv 2024:10.1007/s11764-023-01516-9. [PMID: 38183577 DOI: 10.1007/s11764-023-01516-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 12/17/2023] [Indexed: 01/08/2024]
Abstract
PURPOSE The purpose of this convergent mixed methods study was to assess the perceptions and characteristics of sleep in breast cancer survivors (BCSs) and elucidate perceptions of sleep among BCS with lymphedema. METHODS Participants were BCS with and without lymphedema. Both groups completed the Pittsburgh Sleep Quality Index (PSQI), PROMIS® Sleep Disturbance (8a short form), and wore an actigraph on their wrist to capture sleep/wake cycles for 7 days/nights while logging their sleep using a sleep diary. The coefficient of variation of sleep efficiency was calculated from the sleep diary to assess intraindividual variability. In addition, a subsample of BCS with lymphedema participated in a semi-structured qualitative interview. The qualitative data was analyzed separately, and the themes were applied to provide a more nuanced explanation of the quantitative outcomes. RESULTS The BCS with lymphedema (n=23) had a significant difference in PSQI (p=0.002), PROMIS® Sleep Disturbance (p=0.084), and sleep efficiency coefficient of variation (p=0.014) compared to BCS without lymphedema (n=23). There were no statistically significant differences between groups in the actigraphy results. BCS with lymphedema perceived that lymphedema management contributed to their sleep disturbance, further exacerbating their mind/body fatigue. CONCLUSION This study provides the foundation for future research to investigate the integration of sleep interventions with lymphedema management for holistic survivorship care for BCS with lymphedema. IMPLICATIONS FOR CANCER SURVIVORS An innovative sleep health intervention designed to consider the unique factors contributing to sleep disturbance in BCS with lymphedema will fill a gap in their post-cancer treatment quality of life.
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Affiliation(s)
- Karen Bock
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Jill Peltzer
- School of Nursing, University of Kansas Medical Center, Kansas City, KS, USA
| | - Wen Liu
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA
| | - Yvonne Colgrove
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA
| | - Irina Smirnova
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA
| | - Catherine Siengsukon
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA
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Shorofi SA, Dadashian P, Arbon P, Moosazadeh M. The efficacy of earplugs and eye masks for delirium severity and sleep quality in patients undergoing coronary artery bypass grafting in cardiac intensive care units: A single-blind, randomised controlled trial. Aust Crit Care 2024; 37:74-83. [PMID: 37802695 DOI: 10.1016/j.aucc.2023.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 07/31/2023] [Accepted: 08/26/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND AND PURPOSE Delirium is a neuropsychiatric syndrome with a wide range of possible causes and multiple complications in patients admitted to intensive care units. It is, therefore, necessary to seek appropriate and safe strategies to prevent and manage delirium. This study is intended to examine the efficacy of eye masks and earplugs for delirium severity and sleep quality in patients with coronary artery bypass grafting in a cardiac intensive care unit. MATERIALS AND METHODS This single-blind, randomised controlled trial was conducted on 114 patients who were consecutively enrolled and randomly assigned to either the experimental group or the control group. The experimental group received routine care plus eye masks and earplugs, and the control group received only routine care. The delirium severity and sleep quality were measured with the Neelon and Champagne confusion scale and the Verran and Snyder-Halpern sleep scale. RESULTS The mean delirium severity score differed significantly between the two groups on the second, third, and fourth postoperative days (p < 0.001). Although the trend of changes in the mean delirium severity score from the first postoperative day (before the intervention) to the second, third, and fourth postoperative days was downward in the two groups (trending towards higher delirium severity), the control group experienced greater changes than the experimental group. An intragroup analysis of delirium severity detected a statistically significant difference in both the experimental and control groups (p < 0.001). The sleep quality domains (sleep disturbance, sleep effectiveness, sleep supplementation) showed a statistically significant difference between the two groups across the three intervention days (p < 0.001). CONCLUSION The overnight use of eye masks and earplugs were found to have positive effects on sleep quality domains (sleep disturbance, sleep effectiveness, sleep supplementation) and delirium severity in coronary artery bypass grafting patients admitted to the cardiac intensive care unit for several days. It was also found that a significant interaction effect between the sleep disturbance subscale and delirium severity exists. CLINICAL TRIAL REGISTRATION NUMBER (https://en.irct.ir): IRCT20210523051370N2.
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Affiliation(s)
- Seyed Afshin Shorofi
- Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran; Adjunct Research Fellow, Flinders University, Adelaide, Australia.
| | - Pooneh Dadashian
- Student Research Committee, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Paul Arbon
- Torrens Resilience Institute, Flinders University, Adelaide, Australia
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
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Sanchez-Trigo H, Molina-Martínez E, Grimaldi-Puyana M, Sañudo B. Effects of lifestyle behaviours and depressed mood on sleep quality in young adults. A machine learning approach. Psychol Health 2024; 39:128-143. [PMID: 35475409 DOI: 10.1080/08870446.2022.2067331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 04/05/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Modern lifestyles may lead to high stress levels, frequently associated with mood disorders (e.g. depressed mood) and sleep disturbance. The objective of this study was to develop a machine learning model aimed at identifying risk factors for developing poor sleep quality in young adults. MATERIAL AND METHODS The sample consisted of 383 college-aged students (mean age ± SD: 21 ± 1 years; 61% males). Sleep quality, mood state, physical activity, number of sitting hours, and smartphone use were measured. RESULTS A decision tree algorithm distinguished participants' sleep quality with 74% accuracy using a combination of four features: depressed mood, physical activity, sitting time, and vigour. Together with depressed mood, both physical activity (>6432 metabolic equivalent tasks -METs- per week) and sedentary behaviour (sitting time greater than 7 h/day) were the primary features that could differentiate those with poor sleep quality from those with good sleep quality. CONCLUSIONS We provided a decision tree model with a sensitivity of 90.7% and a specificity of 54.3%, with an AUC of 0.725. These findings could promote improvements in prevention strategies and contribute to the development of meaningful and evidence-based intervention programs.
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Affiliation(s)
| | | | | | - Borja Sañudo
- Physical Education and Sports Department, University of Seville, Sevilla, Spain
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Aellen FM, Van der Meer J, Dietmann A, Schmidt M, Bassetti CLA, Tzovara A. Disentangling the complex landscape of sleep-wake disorders with data-driven phenotyping: A study of the Bernese center. Eur J Neurol 2024; 31:e16026. [PMID: 37531449 PMCID: PMC11235675 DOI: 10.1111/ene.16026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 07/05/2023] [Accepted: 07/31/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND AND PURPOSE The diagnosis of sleep-wake disorders (SWDs) is challenging because of the existence of only few accurate biomarkers and the frequent coexistence of multiple SWDs and/or other comorbidities. The aim of this study was to assess in a large cohort of well-characterized SWD patients the potential of a data-driven approach for the identification of SWDs. METHODS We included 6958 patients from the Bernese Sleep Registry and 300 variables/biomarkers including questionnaires, results of polysomnography/vigilance tests, and final clinical diagnoses. A pipeline, based on machine learning, was created to extract and cluster the clinical data. Our analysis was performed on three cohorts: patients with central disorders of hypersomnolence (CDHs), a full cohort of patients with SWDs, and a clean cohort without coexisting SWDs. RESULTS A first analysis focused on the cohort of patients with CDHs and revealed four patient clusters: two clusters for narcolepsy type 1 (NT1) but not for narcolepsy type 2 or idiopathic hypersomnia. In the full cohort of SWDs, nine clusters were found: four contained patients with obstructive and central sleep apnea syndrome, one with NT1, and four with intermixed SWDs. In the cohort of patients without coexisting SWDs, an additional cluster of patients with chronic insomnia disorder was identified. CONCLUSIONS This study confirms the existence of clear clusters of NT1 in CDHs, but mainly intermixed groups in the full spectrum of SWDs, with the exception of sleep apnea syndromes and NT1. New biomarkers are needed for better phenotyping and diagnosis of SWDs.
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Affiliation(s)
- Florence M. Aellen
- Institute of Computer ScienceUniversity of BernBernSwitzerland
- Center for Experimental Neurology, Department of NeurologyInselspital, Bern University Hospital and University of BernBernSwitzerland
| | - Julia Van der Meer
- Department of NeurologyInselspital, Bern University Hospital and University of BernBernSwitzerland
| | - Anelia Dietmann
- Department of NeurologyInselspital, Bern University Hospital and University of BernBernSwitzerland
| | - Markus Schmidt
- Center for Experimental Neurology, Department of NeurologyInselspital, Bern University Hospital and University of BernBernSwitzerland
| | - Claudio L. A. Bassetti
- Center for Experimental Neurology, Department of NeurologyInselspital, Bern University Hospital and University of BernBernSwitzerland
| | - Athina Tzovara
- Institute of Computer ScienceUniversity of BernBernSwitzerland
- Center for Experimental Neurology, Department of NeurologyInselspital, Bern University Hospital and University of BernBernSwitzerland
- Sleep Wake Epilepsy Center–NeuroTec, Department of NeurologyInselspital, Bern University Hospital, University of BernBernSwitzerland
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Fu Y, Yu B, Yang B, Pan J, Feng C, Jia P, Zeng H, Yang S. Association between chronotype and metabolic-associated fatty liver disease in employed adults: A longitudinal study in Southwestern China. Chronobiol Int 2023; 40:1557-1565. [PMID: 38012067 DOI: 10.1080/07420528.2023.2285316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023]
Abstract
The circadian system is an essential physiological regulator of mammals, and sleep chronotype may be associated with the risk of metabolic disorders. However, evidence regarding the role of sleep chronotype in the development of metabolic-associated fatty liver disease (MAFLD) is scarce, particularly in employed adults. We conducted a longitudinal study of 1,309 employed adults in Southwestern China with a five-year follow-up from 2017 to 2021. MAFLD was assessed by the presence of hepatic steatosis using abdominal ultrasonography, overweight/obese status, diabetes mellitus, metabolic dysregulation, or elevation of high-sensitivity C-reactive protein. Chronotype was assessed by the Morning and Evening Questionnaire-5 (MEQ-5). The logistic random effects model was applied to analyze the 5-year panel data to estimate the association between chronotype and MAFLD, and the potential effect modification of demographics on such association. The MAFLD prevalence of participants was 38.6% at baseline and showed an increasing trend during follow-up (p for trends < 0.05). Compared with morning chronotype, evening chronotype was positively associated with MAFLD (OR = 2.19, 95%CI: [1.09, 4.40]) after controlled for covariates. Age, sex, ethnicity, and educational level did not modify the association between chronotype and MAFLD. These findings suggest that improving circadian rhythms could reduce the risk of MAFLD and chronic disease burden among employed adults.
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Affiliation(s)
- Yao Fu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Bin Yu
- Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China
| | - Bo Yang
- Department of Clinical Medical College, Affiliated Hospital of Chengdu University, Chengdu, China
| | - Jia Pan
- Department of Clinical Medical College, Affiliated Hospital of Chengdu University, Chengdu, China
| | - Chuanteng Feng
- Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China
| | - Peng Jia
- School of Public Health, Wuhan University, Wuhan, China
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, China
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
| | - Honglian Zeng
- Department of Clinical Medical College, Affiliated Hospital of Chengdu University, Chengdu, China
| | - Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Department of Clinical Medical College, Affiliated Hospital of Chengdu University, Chengdu, China
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
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Baglioni C, Espie CA, Altena E, Gavriloff D, Jernelöv S, Holzinger B, Schlarb A, Riemann D. Cognitive behavioural therapy for insomnia disorder: Extending the stepped care model. J Sleep Res 2023; 32:e14016. [PMID: 37584390 DOI: 10.1111/jsr.14016] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 08/03/2023] [Indexed: 08/17/2023]
Abstract
Despite cognitive behaviour therapy for insomnia (CBT-I) being the first-line intervention for the disorder, it is often not readily available to patients in need. The stepped care model (SCM) represents an approach to facilitating efficient and wide-ranging provision of evidence-based care to those with insomnia. The SCM reflects a pyramid of therapeutics based on CBT-I gradually increasing in clinical intensity and addressing clinical complexity. By applying CBT-I through the SCM it is hoped that the treatment gap can be bridged such that not only more patients can be reached, but that clinical resource can be more effectively distributed, with patients receiving more tailored care as needed. Nevertheless, this should not be done at the risk of a lower quality of care being offered, and high-standard training for clinicians and scrutiny of non-clinician led interventions remains important. As national health laws within European countries have substantial differences, the application of the SCM as it relates to the treatment of insomnia may be challenged by contrasting interpretations. In order that the SCM is appropriately implemented: (a) only evidence-based CBT-I treatments should be promoted within the model; (b) clinicians involved in SCM should be suitably qualified to offer CBT in general, and have appropriate further training in CBT-I; (c) professionals involved in interventions not included in the SCM, but related to it, such as preventive and educational programmes, diagnostic procedures, and pharmacological treatments, should also have good knowledge of the SCM in order to promote correct allocation to the appropriate interventional step.
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Affiliation(s)
- Chiara Baglioni
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Faculty of Medicine, Freiburg, Germany
- Department of Human Sciences, Guglielmo Marconi University, Rome, Italy
| | - Colin A Espie
- Sir Jules Thorne Sleep and Circadian Neuroscience Institute, University of Oxford, Oxford, UK
| | | | - Dimitri Gavriloff
- Sir Jules Thorne Sleep and Circadian Neuroscience Institute, University of Oxford, Oxford, UK
| | - Susanna Jernelöv
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | - Angelika Schlarb
- Department of Psychology and Sports Science, University of Bielefeld, Bielefeld, Germany
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Faculty of Medicine, Freiburg, Germany
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Khalifian CE, Titone M, Wooldridge JS, Knopp K, Seibert G, Monson C, Morland L. The role of veterans' PTSD symptoms in veteran couples' insomnia. FAMILY PROCESS 2023; 62:1725-1739. [PMID: 36347178 DOI: 10.1111/famp.12835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 09/14/2022] [Accepted: 09/25/2022] [Indexed: 06/16/2023]
Abstract
Insomnia contributes to individual mental and physical health and relationship well-being. Veterans' PTSD symptoms are associated with their own insomnia. However, research has not explored whether and how veterans' PTSD symptoms are associated with their partners' insomnia. The present study examined the association between veterans' PTSD symptom severity and veterans' and partners' insomnia. Veterans (n = 192) and their partners (n = 192; total N = 384) completed baseline assessments in a PTSD treatment study for veterans with PTSD and their partners. Path analysis was used to examine the relation between veterans' PTSD symptom severity, as measured by the PTSD symptom checklist-5 (PCL-5) and veterans' and partners' insomnia, as measured by the Insomnia Severity Index (ISI). Veterans' full-scale PCL-5 was positively related to veterans' and partners' insomnia. For veterans, intrusion and arousal symptoms were positively related to their own insomnia severity, while veterans' negative alterations in cognition and mood were associated with partners' insomnia severity. In exploratory analyses, partners' depressive symptoms fully mediated the relation between veterans' negative cognitions and mood and partners' insomnia. PTSD symptoms impact both veterans' and partners' insomnia. However, different PTSD symptom clusters were related to insomnia for each partner, and the link for partners was explained by their own depression symptoms. PTSD, insomnia, and integrated treatments should consider strategies for including partners in treatment to address these interconnected problems.
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Affiliation(s)
- Chandra E Khalifian
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Madison Titone
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Jennalee S Wooldridge
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Kayla Knopp
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Gregory Seibert
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | | | - Leslie Morland
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
- National Center for PTSD -Pacific Islands division, Honolulu, Hawaii, USA
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64
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Tapia AL, Yu L, Lim A, Barnes LL, Hall MH, Butters MA, Buysse DJ, Wallace ML. Race and sex differences in the longitudinal changes in multidimensional self-reported sleep health characteristics in aging older adults. Sleep Health 2023; 9:947-958. [PMID: 37802678 PMCID: PMC10841494 DOI: 10.1016/j.sleh.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 06/28/2023] [Accepted: 08/15/2023] [Indexed: 10/08/2023]
Abstract
OBJECTIVES We examined within-individual changes in self-reported sleep health as community-dwelling older adults age as well as potential differences in these changes by self-reported sex and racial identity. METHODS Participants were from the United States and enrolled in the Rush Memory and Aging Project, Minority Aging Research Study, or Religious Orders Study (N = 3539, 20% Black, 75% female, mean 78years [range 65-103]), and they received annual, in-person clinical evaluations (median 5 visits [range 1-27]). A sleep health composite score measured the number of poor sleep characteristics among satisfaction, daytime sleepiness, efficiency, and duration. Mixed effects models estimated associations of age, race, sex, and their interactions on the composite and individual sleep measures, accounting for key confounders. RESULTS As they aged, Black participants shifted from reporting two poor sleep characteristics to one poor sleep characteristic, while White participants shifted from one poor characteristic to two. Regardless of age, sex, and race, participants reported that they "often" felt satisfied with their sleep and "sometimes" had trouble staying asleep. Females over age 85 and males of all ages reported the most daytime sleepiness, and older White participants (>age 90) reported the most difficulty falling asleep. CONCLUSIONS Although self-reported sleep characteristics were typically stable across age, identifying race and sex differences in self-reported sleep health can help guide future research to understand the mechanisms that underlie these differences.
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Affiliation(s)
- Amanda L Tapia
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Lan Yu
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Andrew Lim
- Department of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Lisa L Barnes
- Department of Neurological Sciences, Rush University, Chicago, Illinois, USA
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Meryl A Butters
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Meredith L Wallace
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Statistics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
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Full KM, Johnson DA, Kaufmann CN, Malhotra A. An Update on Sleep Duration, Obesity, and Mortality Risk in Women. Sleep Med Clin 2023; 18:415-422. [PMID: 38501514 PMCID: PMC10969361 DOI: 10.1016/j.jsmc.2023.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
Sleep health is an essential component to overall health. Because of numerous societal, economic, and biological factors, obtaining adequate sleep poses a unique challenge to aging women. Yet, women have been traditionally understudied in sleep research. An increasing body of research supports abnormal sleep duration as a risk factor for obesity, cardiovascular disease, and mortality. This review focuses specifically on 3 areas of the discussion of insufficient sleep in women: (1) the mysterious poor health of long sleepers, (2) the potential underlying mechanisms linking abnormal sleep duration and cardiometabolic health, and (3) the need to investigate multiple levels of social determinants driving sleep disparities.
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Affiliation(s)
- Kelsie M Full
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 600, Nashville, TN 37203, USA.
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, Georgia, 30322, USA
| | - Christopher N Kaufmann
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, Florida, 32603, USA
| | - Atul Malhotra
- Division of Pulmonary, Critical Care and Sleep Medicine, School of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, California, 92093, USA
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Inam M, Kianoush S, Sheikh S, Krittanawong C, Zhu D, Rifai MA, Minhas AMK, Samad Z, Khan U, Merchant A, Virani SS. The Association Between Race, Ethnicity and Sleep Quality and Duration: A National Health Interview Survey Study. Curr Probl Cardiol 2023; 48:102004. [PMID: 37506957 DOI: 10.1016/j.cpcardiol.2023.102004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Inadequate sleep duration and poor sleep quality are associated with adverse cardiovascular outcomes. METHODS Using data from the National Health Interview Survey, we compared self-reported sleep duration and quality among different groups: Whites, Chinese, Asian Indian, Filipino, and Other Asians. Outcome included Sleep duration (≥7 and <7 hours) and sleep quality (coded as a binary variable). RESULTS We included 155,203 participants. The overall prevalence of ≥7 hours of sleep was 69.5% and poor sleep quality was reported by 73.9%. Compared to Whites and Chinese, Filipinos, and Other Asians were less likely to get adequate sleep (≥7 hours). All 4 Asian groups were less likely to report poor sleep quality compared with White individuals, while Asian Indians reported poor sleep quality less frequently compared with Chinese individuals. CONCLUSION There are significant differences in sleep duration and quality between White and Asian groups, as well as within Asian subgroups. Further studies with disaggregated Asian subgroup data are needed to formally study these disparities.
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Affiliation(s)
- Maha Inam
- Research and Graduate Studies, Office of the Vice Provost, Aga Khan University, Karachi, Pakistan
| | - Sina Kianoush
- Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Sana Sheikh
- Department of Medicine, Aga Khan University, Karachi, Sindh, Pakistan
| | - Chayakrit Krittanawong
- Leon H. Charney Division of Cardiology, New York University Langone Health, New York, NY
| | - Dongshan Zhu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Mahmoud Al Rifai
- Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, United States
| | | | - Zainab Samad
- Department of Medicine, Aga Khan University, Karachi, Sindh, Pakistan; Division of Cardiology, Aga Khan University, Karachi, Sindh, Pakistan
| | - Unab Khan
- Department of Family Medicine, Aga Khan University, Karachi, Sindh, Pakistan
| | - Anwar Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Salim S Virani
- Research and Graduate Studies, Office of the Vice Provost, Aga Khan University, Karachi, Pakistan; Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX; The Texas Heart Institute, Houston, TX; Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX.
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Ahn S, Chung ML, Logan JG. Sleep Deficiency by Caregiving Status: Findings From Nationally Representative Data. West J Nurs Res 2023; 45:1120-1129. [PMID: 37902143 PMCID: PMC11298120 DOI: 10.1177/01939459231208416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
OBJECTIVE Caregiving demands may influence caregivers' sleep duration and quality, which are essential for optimal health. We aimed to examine the association between caregiving status and sleep deficiency (i.e., short sleep duration and/or poor quality) and identify factors associated with sleep deficiency among caregivers. METHODS This secondary analysis used data from 3870 adults living in the United States, obtained from the 2019 Health Information National Trends Survey. Multinomial logistic regressions were performed to examine the association between caregiving status (i.e., caregivers vs. non-caregivers) and sleep status (i.e., normal duration-good quality [optimal sleep, reference], short duration-good quality, normal duration-poor quality, and short duration-poor quality), and to identify caregiving-related factors associated with sleep deficiency in the caregiver group. RESULTS Compared to non-caregivers, caregivers were more likely to report short sleep duration (<7 hours) with good quality sleep (relative risk ratio [RRR] = 1.566, 95% CI [1.238, 1.980]) or poor quality sleep (RRR = 1.376, 95% CI [1.034, 1.832]) than the optimal sleep status. Caregivers providing care for ≥20 hours per week (vs. <20 hours) and providing care to individuals with dementia (vs. no dementia caregiving) were 2.8 times more likely to report normal sleep duration with poor sleep quality than optimal sleep (RRR = 2.796, 95% CI [1.125, 6.950]; RRR = 2.776, 95% CI [1.154, 6.675], respectively). CONCLUSION The findings of a higher risk of sleep deficiency among caregivers suggest that health care providers need to assess both caregivers' sleep duration and quality status. Interventions tailored to the caregiving context are also warranted.
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Affiliation(s)
- Soojung Ahn
- School of Nursing, Vanderbilt University, Nashville, TN, USA
| | - Misook L. Chung
- College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Jeongok G. Logan
- School of Nursing, University of Virginia, Charlottesville, VA, USA
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Wang H, Yu X, Hu J, Zheng Y, Hu J, Sun X, Ren Y, Chen Y. Effect of Electroacupuncture Versus Cognitive Behavioral Therapy for Perimenopausal Insomnia: Protocol for a Noninferiority Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e51767. [PMID: 37943587 PMCID: PMC10667986 DOI: 10.2196/51767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 10/10/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Perimenopausal insomnia (PMI) has a high global incidence, which is common in middle-aged women and is more severe than nonmenopausal insomnia. Effective treatments with fewer side effects and more consistent repeatable results are needed. Acupuncture, a therapy based on traditional Chinese medicine, is safe and may be effective for PMI. It is widely accepted in Western countries, and evidence supports the use of acupuncture as a main or supplementary therapy. Cognitive behavioral therapy is also used to improve sleep quality. It has structured sessions and has been recommended as a first-line treatment for insomnia (cognitive behavioral therapy for insomnia [CBT-I]) by the American Association of Physicians. However, few randomized controlled trials have been conducted to compare the effectiveness of these 2 therapies. This study will be performed in perimenopausal women with insomnia to determine the efficacy of electroacupuncture (EA) versus CBT-I. OBJECTIVE This study aimed to compare the preliminary effectiveness and safety of EA and CBT-I for PMI through a randomized controlled noninferiority study design. METHODS This study is designed as an assessor-blinded, noninferiority, randomized controlled trial. A total of 160 eligible participants with PMI will be randomly divided into 2 groups to receive either EA or CBT-I. Participants in the EA group will receive electroacupuncture for 8 weeks. The intervention will be delivered 3 times weekly for a total of 12 sessions and 2 times weekly for the next 4 weeks. Meanwhile, participants in the control group will undergo CBT-I (once a week) for 8 weeks. Treatment will use 7 main acupoints (GV20, DU24, EX-HN3, EX-HN18, EX-CA1, RN6, and RN4) and an extra 4 acupoints based on syndrome differentiation. The primary outcome is the Insomnia Severity Index. The secondary outcome measures are the Pittsburgh Sleep Quality Index; Menopause-Specific Quality of Life; Menopause Rating Scale; Hamilton Depression Scale; Hamilton Anxiety Scale; hot flash score; and the level of estradiol, follicle-stimulating hormone, and luteinizing hormone in serum. Sleep architecture will be assessed using polysomnograms. RESULTS Participants are currently being recruited. The first participant was enrolled in January 2023, marking the initiation of the recruitment phase. The recruitment process is expected to continue until January 2025, at which point data collection will commence. CONCLUSIONS This trial represents a pioneering effort to investigate the efficacy and safety of EA and CBT-I as interventions for PMI. It is noteworthy that this study is conducted solely within a single center and involves Chinese participants, which is a limitation. Nonetheless, the findings of this study are expected to contribute valuable insights for clinicians engaged in the management of PMI. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2300070981; https://www.chictr.org.cn/showprojEN.html?proj=194561. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51767.
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Affiliation(s)
- Huixian Wang
- Department of Acupuncture and Moxibustion, Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xintong Yu
- Acupuncture Anesthesia Clinical Research Institute, Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jing Hu
- Department of Acupuncture and Moxibustion, Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yanting Zheng
- Shanghai Yangpu Mental Health Center, Shanghai, China
| | - Jia Hu
- Shanghai Yangpu Mental Health Center, Shanghai, China
| | - Xuqiu Sun
- Acupuncture Anesthesia Clinical Research Institute, Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ying Ren
- Department of Acupuncture and Moxibustion, Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yunfei Chen
- Department of Acupuncture and Moxibustion, Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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McCall WV, Looney SW, Zulfiqar M, Ketcham E, Jones M, Mixson C, McCloud L, Miller BJ, Rosenquist PB. Daytime autonomic nervous system functions differ among adults with and without insomnia symptoms. J Clin Sleep Med 2023; 19:1885-1893. [PMID: 37421322 PMCID: PMC10620659 DOI: 10.5664/jcsm.10704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/27/2023] [Accepted: 06/27/2023] [Indexed: 07/10/2023]
Abstract
STUDY OBJECTIVES We gathered data to determine whether daytime assays of the autonomic nervous system would differ between persons with no vs modest insomnia symptoms and would correlate with the severity of insomnia symptoms in patients. METHODS This report is composed of 2 studies. Study 1 conducted pupillary light reflex (PLR) measurements in community volunteers who were not seeking medical care. Study 2 contrasted PLR and heart rate variability in a different sample of community volunteers and a comparison sample of adults seeking outpatient care for insomnia and psychiatric problems. All measurements were taken between 3 and 5 pm. RESULTS In Study 1, volunteers with modest insomnia symptom severity had a more rapid PLR average constriction velocity compared with those with no symptoms. In Study 2, lower heart rate variability, indicating higher levels of physiologic arousal, generally were in agreement with faster PLR average constriction velocity, both of which indicate higher levels of arousal. Insomnia symptom severity was highly correlated with faster average constriction velocity in the patient sample. CONCLUSIONS These studies suggest that (1) daytime measurements of the autonomic nervous system differ between persons with modest vs no insomnia symptoms and (2) insomnia symptom severity is highly correlated with PLR. Daytime measurement of autonomic nervous system activity might allow for daytime point-of-care measurement to characterize the level of physiologic arousal to define a hyperarousal subtype of insomnia disorder. CITATION McCall WV, Looney SW, Zulfiqar M, et al. Daytime autonomic nervous system functions differ among adults with and without insomnia symptoms. J Clin Sleep Med. 2023;19(11):1885-1893.
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Affiliation(s)
- William V. McCall
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Stephen W. Looney
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Maria Zulfiqar
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Evan Ketcham
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Megan Jones
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Carter Mixson
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Laryssa McCloud
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Brian J. Miller
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Peter B. Rosenquist
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia
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Zhai S, Hash J, Ward TM, Yuwen W, Sonney J. Analysis, evaluation, and reformulation of social cognitive theory: Toward parent-child shared management in sleep health. J Pediatr Nurs 2023; 73:e65-e74. [PMID: 37481389 DOI: 10.1016/j.pedn.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 07/24/2023]
Abstract
THEORETICAL PRINCIPLES Social Cognitive Theory (SCT) is a middle-range theory with triadic determinism between behavioral, environmental, and personal. SCT has been a guiding framework in health promotion research as it helps understand people's behaviors. PHENOMENA ADDRESSED Behavioral Insomnia of Childhood (BIC) is highly prevalent, affecting up to 45% of typically developing children and 80% of children with special healthcare needs. BIC leads to sleep deficiency, disrupted physical and psychological health, poor school performance, behavioral dysfunction, and negatively affects parental and family functioning. Using Fawcett's framework, we analyzed and evaluated SCT in a pediatric sleep context and propose a reformulation of SCT to better inform sleep research. RESEARCH LINKAGES SCT is individually focused and does not account for interdependence within relationships. Pediatric sleep interventions have limited long-term effects and sustainability without considering the parent-child dyadic interdependency. We advance the argument that the parent-child shared management (PCSM) perspective is beneficial for understanding pediatric sleep health. PCSM is a concept that reflects the shared responsibility and interdependence that parent and child have for managing child health. It assumes that with parents' ongoing support, children's responsibility for their health management increases over time, along with developmental progression and health-related experiences. We propose reformulating SCT by integrating PCSM in the pediatric sleep context: SCT with Shared Management (SCT-SM). The proposed SCT-SM accounts for parent-child interdependence and role transition. Shared management interventions that engage parents and children in active roles in managing sleep have potential sustainable effects in improving sleep and quality of life. (250).
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Affiliation(s)
- Shumenghui Zhai
- School of Nursing, Pacific Lutheran University, 12180 Park Ave. S, Tacoma, WA 98447, United States of America.
| | - Jonika Hash
- School of Nursing, University of Washington, 1959 NE Pacific St., Seattle, WA 98195, United States of America
| | - Teresa M Ward
- School of Medicine, University of Washington, 1959 NE Pacific St, Seattle, WA 98195, United States of America
| | - Weichao Yuwen
- School of Nursing & Healthcare Leadership, University of Washington Tacoma, 1922 Pacific Ave, Tacoma, WA 98402, United States of America
| | - Jennifer Sonney
- School of Nursing, University of Washington, 1959 NE Pacific St., Seattle, WA 98195, United States of America
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Clementi MA, Kienzler C, Yonker M, Harmon M, Simon SL. Preliminary exploration of a multidimensional sleep health composite in adolescent females with frequent migraine. Headache 2023; 63:1437-1447. [PMID: 37655667 PMCID: PMC10840896 DOI: 10.1111/head.14626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/11/2023] [Accepted: 07/17/2023] [Indexed: 09/02/2023]
Abstract
OBJECTIVE This observational study aimed to: (i) describe and explore preliminary psychometric properties of a multidimensional sleep health composite score in adolescent females with frequent migraine; and (ii) examine associations between the composite score, headache characteristics, and emotional health. BACKGROUND Sleep health is a multidimensional construct comprised of various dimensions of sleep and circadian functioning, including Regularity, Satisfaction, Alertness, Timing, Efficiency, and Duration (Ru-SATED framework). The Ru-SATED sleep health composite score may provide a holistic perspective of sleep among adolescents with frequent migraine in the context of neurobiological and psychosocial impacts on sleep unique to this developmental period. METHODS In all, 60 female adolescents (aged 12-18 years) with high-frequency episodic or chronic migraine completed wrist-worn actigraphy for 10 days and concurrent daily electronic surveys assessing headache, sleep, and emotional health. A sleep health composite score was derived from empirically supported "healthy" versus "unhealthy" ratings on the six Ru-SATED sleep dimensions. RESULTS Half of participants (27/54 [50%]) had a composite score ≥4 (i.e., at least four of the six dimensions rated as poor). Convergent validity of the composite score was acceptable (rs = 0.30-0.56, all p < 0.05). Internal consistency among the dimensions was low (α = 0.45). Multivariate multiple regression models indicated that worse sleep health was associated with greater headache-related disability (B = 0.71, p = 0.018) and anxiety (B = 0.59, p = 0.010), and trended toward significance for sadness (B = 0.35, p = 0.052). The composite score was not significantly associated with headache frequency or severity. CONCLUSIONS A multidimensional sleep health composite score may provide an alternative, more comprehensive picture of sleep disturbance among adolescent females with frequent migraine. Larger studies are needed to examine psychometric properties more rigorously and further explore the composite score as a potentially unique predictor of headache outcomes.
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Affiliation(s)
- Michelle A Clementi
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Caitlin Kienzler
- Department of Psychology, University of Colorado Denver, Denver, Colorado, USA
| | - Marcy Yonker
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Michelle Harmon
- Department of Psychology, University of Colorado Denver, Denver, Colorado, USA
| | - Stacey L Simon
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Zarhin D. Sleep as a familial and communal matter: a qualitative study of social norms around sleep health in Israel. BMC Public Health 2023; 23:2080. [PMID: 37875859 PMCID: PMC10598894 DOI: 10.1186/s12889-023-17003-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 10/16/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND A growing body of research has clarified that sleep is influenced not only by biological factors but also by social factors. While studies have shown that social norms can affect sleep behavior and sleeping arrangements, including when, where, how, and with whom people sleep, researchers still know relatively little about how social norms affect sleep health, especially among adults. The current study explores the association between social norms and sleep health in the Israeli context. METHODS Data were drawn from semi-structured, in-depth interviews with 66 Israelis-including women and men, Arabs and Jews, and religious and non-religious persons-conducted between February 2020 and February 2022. This article focuses on responses to a set of questions about the comments people make or hear from others about their sleep. Exploring how people comment on the sleep of others highlights prevalent social norms around sleep. RESULTS Findings indicate that how sleep is "done" is policed by family and community members who react to norm violations by commenting on what is perceived as "inappropriate" sleep behavior. Comments were made in jest or earnest in response to breaches of social norms regarding sleep timing, duration, continuity, and alertness/sleepiness, indicating that social norms and expectations shape each of these sleep health dimensions. CONCLUSIONS This article expands the scholarly understanding of the social determinants of sleep health. The study concludes that since individuals may opt to conform to current social norms, which are enforced by members of the family and community, interventions aimed at promoting sleep health should target not only individuals but also the family and community.
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Affiliation(s)
- Dana Zarhin
- Department of Sociology, University of Haifa, Social Science Building, Mt. Carmel, Haifa, 3190501, Israel.
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Eigl ES, Hauser T, Topalidis PI, Schabus M. On the Efficacy of a CBT-I-Based Online Program for Sleep Problems: A Randomized Controlled Trial. Clocks Sleep 2023; 5:590-603. [PMID: 37873840 PMCID: PMC10594462 DOI: 10.3390/clockssleep5040039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/02/2023] [Accepted: 10/06/2023] [Indexed: 10/25/2023] Open
Abstract
There is an urgent need for easily accessible treatment options for sleep problems to reduce the current treatment gap in receiving cognitive behavioral therapy for insomnia (CBT-I). Using a randomized controlled trial, we evaluated the efficacy of a CBT-I-based online program on sleep. Fifty-three volunteers (21-71 years; MAge = 44.6 ± 12.5; 27 female) suffering from impaired sleep were randomly allocated either to the experimental group (EG, n = 27) or to an active control group (CG, n = 26). The EG participated in a 6-week CBT-I-based online program, while the CG received psychoeducation and sleep hygiene instructions. Sleep was assessed both objectively via ambulatory polysomnography (PSG) as well as subjectively via questionnaires at three time points (baseline, pre- and post-intervention). A one-month follow-up assessment was performed using questionnaires. The EG showed small but reliable improvements from pre- to post-intervention in PSG-derived wake after sleep onset (from 58.6 min to 42.5 min; p < 0.05) and sleep efficiency (from 86.0% to 89.2%; p < 0.05). Furthermore, subjective sleep quality (assessed via Pittsburgh Sleep Quality Index) improved significantly during intervention (p = 0.011) and follow-up (p = 0.015) in the EG alone. The Insomnia Severity Index decreased from pre- to post-intervention in both groups (EG: p = 0.003, CG: p = 0.008), while it further improved during follow-up (p = 0.035) in the EG alone. We show that a CBT-I-based online program can improve sleep not only subjectively but also objectively and can be a viable alternative when face-to-face interventions are not available.
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Affiliation(s)
- Esther-Sevil Eigl
- Laboratory for Sleep, Cognition & Consciousness Research, Department of Psychology, Paris-Lodron University of Salzburg, 5020 Salzburg, Austria; (E.-S.E.)
| | - Theresa Hauser
- Laboratory for Sleep, Cognition & Consciousness Research, Department of Psychology, Paris-Lodron University of Salzburg, 5020 Salzburg, Austria; (E.-S.E.)
| | - Pavlos I. Topalidis
- Laboratory for Sleep, Cognition & Consciousness Research, Department of Psychology, Paris-Lodron University of Salzburg, 5020 Salzburg, Austria; (E.-S.E.)
| | - Manuel Schabus
- Laboratory for Sleep, Cognition & Consciousness Research, Department of Psychology, Paris-Lodron University of Salzburg, 5020 Salzburg, Austria; (E.-S.E.)
- Centre for Cognitive Neuroscience Salzburg (CCNS), Paris-Lodron University of Salzburg, 5020 Salzburg, Austria
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74
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d’Onofrio P, Jernelöv S, Rosén A, Blom K, Kaldo V, Schwarz J, Åkerstedt T. The Polysomnographical Meaning of Changed Sleep Quality-A Study of Treatment with Reduced Time in Bed. Brain Sci 2023; 13:1426. [PMID: 37891794 PMCID: PMC10605173 DOI: 10.3390/brainsci13101426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/28/2023] [Accepted: 10/04/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Reports of poor sleep are widespread, but their link with objective sleep (polysomnography-PSG) is weak in cross-sectional studies. In contrast, the purpose of this study was to investigate the association between changes in subjective and objective sleep variables using data from a study of the reduction in time in bed (TIB). METHODS One sleep recording was carried out at baseline and one at treatment week 5 (end of treatment) (N = 34). RESULTS The Karolinska Sleep Quality Index improved and was correlated with improvement in sleep efficiency (r = 0.41, p < 0.05) and reduction in TIB (r = -0.47, p < 0.01) and sleep latency (r = 0.36, p < 0.05). The restorative sleep index showed similar results. Improvements in the insomnia severity index (ISI) essentially lacked correlations with changes in the PSG variables. It was suggested that the latter may be due to the ISI representing a week of subjective sleep experience, of which a single PSG night may not be representative. CONCLUSIONS It was concluded that changes in the subjective ratings of sleep are relatively well associated with changes in the PSG-based sleep continuity variables when both describe the same sleep.
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Affiliation(s)
- Paolo d’Onofrio
- Stress Research Institute, Department of Psychology, Stockholm University, 10691 Stockholm, Sweden; (P.d.); (J.S.)
| | - Susanna Jernelöv
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, 14186 Stockholm, Sweden; (S.J.); (A.R.); (K.B.); (V.K.)
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Ann Rosén
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, 14186 Stockholm, Sweden; (S.J.); (A.R.); (K.B.); (V.K.)
| | - Kerstin Blom
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, 14186 Stockholm, Sweden; (S.J.); (A.R.); (K.B.); (V.K.)
| | - Viktor Kaldo
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, 14186 Stockholm, Sweden; (S.J.); (A.R.); (K.B.); (V.K.)
- Department of Psychology, Faculty of Health and Life Sciences, Linnaeus University, 35195 Växjö, Sweden
| | - Johanna Schwarz
- Stress Research Institute, Department of Psychology, Stockholm University, 10691 Stockholm, Sweden; (P.d.); (J.S.)
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Torbjörn Åkerstedt
- Stress Research Institute, Department of Psychology, Stockholm University, 10691 Stockholm, Sweden; (P.d.); (J.S.)
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, 17177 Stockholm, Sweden
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75
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Chen S, Li H, Wen D. Social Support and Daytime Sleepiness Among Chinese Medical Students: Mediating Roles of Loneliness and Problematic Smartphone Use. Psychol Res Behav Manag 2023; 16:4083-4093. [PMID: 37817912 PMCID: PMC10561758 DOI: 10.2147/prbm.s432400] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/25/2023] [Indexed: 10/12/2023] Open
Abstract
Background Sleep problems have become a serious threat to public health worldwide. Daytime sleepiness is an important indicator of many sleep problems, which have a significant impact on academic performance, physical and mental health, and wellbeing among medical students. We aimed to explore the factors associated with daytime sleepiness among medical students. Methods We conducted a cross-sectional survey of 466 medical students recruited via convenience sampling. Self-rated psychometric scales, including the Social Support Rate Scale, the Epworth Sleepiness Scale, the Chinese version of the UCLA loneliness scale, and the Mobile Phone Addiction Index (MPAI), were utilized to evaluate social support, daytime sleepiness, loneliness, and problematic smartphone use. A sequential mediation model was constructed with daytime sleepiness as the dependent variable, social support as the independent variable, and loneliness and problematic smartphone use as mediating variables. Age, gender, and grade were taken as covariates. Results Social support among medical students was negatively associated with loneliness, problematic smartphone use, and daytime sleepiness (p < 0.01). A sequential mediation analysis showed that loneliness (the first mediator) and problematic smartphone use (the second mediator) sequentially mediated the path from social support to daytime sleepiness among medical students (β = -0.008; 95% CI = -0.016, -0.002). Moreover, there were also significant mediating roles observed in the relationship between social support and daytime sleepiness via loneliness only (β = -0.037; 95% CI = -0.062, -0.015) and problematic smartphone use only (β = -0.022; 95% CI = -0.041, -0.008). Conclusion Social support, loneliness, and problematic smartphone use among medical students influenced their daytime sleepiness. Interventions targeting medical student loneliness and problematic smartphone use behaviors might attenuate the effects from low levels of social support and further improve daytime sleepiness.
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Affiliation(s)
- Sijian Chen
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, People’s Republic of China
- School of Nursing, China Medical University, Shenyang, People’s Republic of China
| | - Honghe Li
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, People’s Republic of China
| | - Deliang Wen
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, People’s Republic of China
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76
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Qi H, Liu R, Zhou J, Feng Y, Feng L, Feng Z, Yan F. Investigating sleep quality and sleep hygiene awareness among Chinese adults: an association and network analysis study. Sleep Breath 2023; 27:2049-2058. [PMID: 36869169 PMCID: PMC9984285 DOI: 10.1007/s11325-023-02798-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 02/07/2023] [Accepted: 02/22/2023] [Indexed: 03/05/2023]
Abstract
PURPOSE The relationships between sleep quality and sleep hygiene awareness in the Chinese population were unclear. We aimed to investigate the associations and related factors between sleep quality and sleep hygiene awareness in adults and to identify the most central domain for sleep quality using network analysis. METHODS A cross-sectional survey was conducted from April 22 to May 5, 2020. Adults (18 years old or above) who had access to smartphones were invited to participate in this survey. The Pittsburg Sleep Quality Index (PSQI) and the Sleep Hygiene Awareness and Practice Scale (SHAPS) were used to evaluate the sleep quality and sleep hygiene awareness of the participants. Propensity score matching (PSM) was used as sensitivity analysis to reduce the confounding effects. Multiple logistic regression was performed to evaluate the associations. The R packages "bootnet" and "qgraph" were used to estimate the connection and calculate the network centrality indices between good and poor sleepers. RESULTS In total, 939 respondents were included in the analysis. Of them, 48.8% (95% CI: 45.6-52.0%) were identified as poor sleepers. Participants with nervous system diseases, psychiatric diseases, and psychological problems were more likely to have poor sleep quality. The notion that using sleep medication regularly was beneficial to sleep was associated with poor sleep quality. Similarly, the notion that waking up at the same time each day disrupted sleep was also associated with poor sleep quality. The findings were consistent before and after PSM. Subjective sleep quality was the most central domain for sleep quality in good and poor sleepers. CONCLUSION Poor sleep quality was positively associated with certain sleep hygiene notions in Chinese adults. Effective measures such as self-relief, sleep hygiene education, and cognitive behavioral treatment may have been needed to improve sleep quality, especially during the COVID-19 outbreak.
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Affiliation(s)
- Han Qi
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
- Department of Epidemiology and Health Statistics, School of Public Health, and Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Rui Liu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Jia Zhou
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Yuan Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Lei Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Zizhao Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Fang Yan
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China.
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Shipman-Lacewell J, Hagiwara N, Green T, Jones H, Belgrave F, Valrie C. Sleep and Fatigue as Mediators of Racial Discrimination and Internalizing Symptoms in Black Adolescent-Caregiver Dyads. Res Child Adolesc Psychopathol 2023; 51:1407-1423. [PMID: 37227559 PMCID: PMC10543451 DOI: 10.1007/s10802-023-01069-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2023] [Indexed: 05/26/2023]
Abstract
While the association of racial discrimination and internalizing symptoms in Black individuals is well established, we still have a limited understanding of mechanisms and contextual factors influencing this association, such as sleep and the family context. The present study examined sleep and fatigue as mediators underlying the relationship between racial discrimination and internalizing symptoms within Black adolescent-caregiver dyads. Using data from a larger survey study of risk and resilience in Black adolescents (Mage= 14.36, 49.5% female) and their caregivers (Mage= 39.25, 75.9% female), we used the Actor-Partner Interdependence Model extended Mediation (APIMeM) to test associations of racial discrimination, sleep factors, and internalizing symptoms among 179 dyads. Significant actor effects revealed that sleep disturbance and fatigue independently mediated the association of racial discrimination and internalizing symptoms among adolescents and caregivers. Additionally, partner effects were found, such that adolescents' experiences of discrimination were indirectly associated with their caregivers' internalizing symptoms via caregiver fatigue. No direct or indirect effects of caregiver experiences of discrimination on adolescent outcomes were found. The findings highlight the important role sleep and fatigue play in the link between racial discrimination and internalizing symptoms among Black adolescents and adults; and the role that the family context may play in this association. Mental health and sleep interventions for Black individuals should address the impact of racial discrimination on internalizing symptoms, with an emphasis on family-focused interventions.
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Affiliation(s)
| | - Nao Hagiwara
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Tiffany Green
- Departments of Population Health Sciences and Obstetrics & Gynecology, University of Wisconsin-Madison, Madison, WI, USA
| | - Heather Jones
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Faye Belgrave
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Cecelia Valrie
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
- Institute for Inclusion, Inquiry, and Innovation, Virginia Commonwealth University, Richmond, VA, USA
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78
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Albers JD, Meertens RM, Savelberg HHCM, Köhler S, Wesselius A, Schram MT, Stehouwer CDA, de Galan BE, van Greevenbroek MMJ, van der Kallen CJH, Eussen SJPM, Bosma H, Schaper NC, Koster A. Both short and long sleep durations are associated with type 2 diabetes, independent from traditional lifestyle risk factors-The Maastricht Study. Sleep Health 2023; 9:733-741. [PMID: 37573207 DOI: 10.1016/j.sleh.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 05/17/2023] [Accepted: 06/27/2023] [Indexed: 08/14/2023]
Abstract
OBJECTIVES This study examined the cross-sectional association between sleep duration, prediabetes, and type 2 diabetes, and its independence from the traditional lifestyle risk factors diet, physical activity, smoking behavior, and alcohol consumption. METHODS Cross-sectional data from 5561 people aged 40-75 years recruited into The Maastricht Study between 2010 and 2018 were used (1:1 female:male and mean age: 60.1 years [standard deviation: 8.6]). Sleep duration was operationalized as in-bed time, algorithmically derived from activPAL3 accelerometer data (median 7 nights, IQR 1). Glucose metabolism status was determined with an oral glucose tolerance test. Multinomial logistic regression was used to assess the association of sleep duration as restricted cubic spline with prediabetes and type 2 diabetes. We adjusted for sex, age, educational level, the use of sleep medication or antidepressants, and the following lifestyle risk factors: diet quality, physical activity, smoking behavior, and alcohol consumption. RESULTS A U-shaped association between sleep duration and type 2 diabetes was found. Compared to those with a sleep duration of 8 hours, participants with a sleep duration of 5 and 12 hours had higher odds of type 2 diabetes (OR: 2.9 [95% CI 1.9 to 4.4] and OR 3.2 [2.0 to 5.2], respectively). This association remained after further adjustment for the lifestyle risk factors (OR: 2.6 [1.7 to 4.1] and OR 1.8 [1.1 to 3.1]). No such association was observed between sleep duration and prediabetes. CONCLUSIONS Both short and long sleep durations are associated positively and independently of lifestyle and cardiovascular risk factors with type 2 diabetes, but not with prediabetes.
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Affiliation(s)
- Jeroen D Albers
- Department of Social Medicine, Maastricht University, Maastricht, the Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.
| | - Ree M Meertens
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands; Department of Health Promotion, Maastricht University, Maastricht, the Netherlands
| | - Hans H C M Savelberg
- School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands; Department of Human Movement Sciences, Maastricht University, Maastricht, the Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands
| | - Anke Wesselius
- School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands; Department of Genetics & Cell Biology, Complex Genetics, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Miranda T Schram
- School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Bastiaan E de Galan
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marleen M J van Greevenbroek
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Carla J H van der Kallen
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Simone J P M Eussen
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Hans Bosma
- Department of Social Medicine, Maastricht University, Maastricht, the Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Nicolaas C Schaper
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Annemarie Koster
- Department of Social Medicine, Maastricht University, Maastricht, the Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
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Fjermestad KW, Finnbakk RR, Solbakk AK, Gravholt CH, Huster RJ. Subjective versus objective sleep in men with Klinefelter syndrome. Orphanet J Rare Dis 2023; 18:260. [PMID: 37658437 PMCID: PMC10472643 DOI: 10.1186/s13023-023-02822-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 07/10/2023] [Indexed: 09/03/2023] Open
Abstract
OBJECTIVES To investigate sleep among men with Klinefelter syndrome (KS). METHOD We compared the sleep domains latency, disturbance, and efficiency in 30 men with KS (M age = 36.7 years, SD = 10.6) to 21 age-matched non-KS controls (M age = 36.8 years, SD = 14.4). Actigraphs were used to objectively measure sleep across 7 days and nights. Participants also completed a sleep diary over the same period, and the Pittsburgh Sleep Quality Index (PSQI). RESULTS The mean correlation between the objective and subjective sleep measures was lower for the KS sample (M r = .15) than for controls (M r = .34). Sleep disturbance was significantly larger in the KS sample, as measured by actigraphy (p = .022, d = 0.71) and the PSQI (p = .037, d = 0.61). In regression models predicting sleep domains from KS status, age, educational level, vocational status, IQ, and mental health, KS status was not a significant predictor. Higher age was associated with more actigraphy-measured sleep disturbance. Higher educational level and being employed were associated with better sleep efficiency. CONCLUSIONS Sleep disturbance may be a particular problem for men with KS and should be measured with complimentary methods.
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Affiliation(s)
- K W Fjermestad
- Department of Psychology, University of Oslo, Forskningsveien 3a, 0373, Oslo, Norway.
- Frambu Resource Centre for Rare Disorders, Siggerud, Norway.
| | - R R Finnbakk
- Department of Psychology, University of Oslo, Forskningsveien 3a, 0373, Oslo, Norway
| | - A-K Solbakk
- Department of Psychology, University of Oslo, Forskningsveien 3a, 0373, Oslo, Norway
- RITMO Centre for Interdisciplinary Studies in Rhythm, Time and Motion, University of Oslo, Oslo, Norway
- Department of Neurosurgery, Oslo University Hospital, Oslo, Norway
- Department of Neuropsychology, Helgeland Hospital, Mosjøen, Norway
| | - C H Gravholt
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - R J Huster
- Department of Psychology, University of Oslo, Forskningsveien 3a, 0373, Oslo, Norway
- Sleep Unit, Department of Otorhinolaryngology/Head and Neck Surgery, Lovisenberg Diaconal Hospital, Oslo, Norway
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80
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Hibbing PR, Carlson JA, Simon SL, Melanson EL, Creasy SA. Convergent validity of time in bed estimates from activPAL and Actiwatch in free-living youth and adults. JOURNAL FOR THE MEASUREMENT OF PHYSICAL BEHAVIOUR 2023; 6:213-222. [PMID: 39026985 PMCID: PMC11257610 DOI: 10.1123/jmpb.2023-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Abstract
Actiwatch devices are often used to estimate time in bed (TIB), but recently became commercially unavailable. Thigh-worn activPAL devices could be a viable alternative. We tested convergent validity between activPAL (CREA algorithm) and Actiwatch devices. Data were from free-living samples comprising 47 youth (3-16 valid nights/participant) and 42 adults (6-26 valid nights/participant) who wore both devices concurrently. On average, activPAL predicted earlier bedtimes and later risetimes compared to Actiwatch, resulting in longer overnight intervals (by 1.49 hours/night for youth and 0.67 hours/night for adults; both p < 0.001). TIB interruptions were predicted less commonly by activPAL (mean < 2 interruptions/night for both youth and adults) than Actiwatch (mean of 24-26 interruptions/night in both groups; both p < 0.001). Overnight intervals for both devices tended to overlap for lengthy periods (mean of 7.38 hours/night for youth and 7.69 hours/night for adults). Within these overlapping periods, the devices gave matching epoch-level TIB predictions an average of 87.9% of the time for youth and 84.3% of the time for adults. Most remaining epochs (11.8% and 15.1%, respectively) were classified as TIB by activPAL but not Actiwatch. Overall, the devices had fair agreement during the overlapping periods, but limited agreement when predicting interruptions, bedtime, or risetime. Future work should assess the criterion validity of activPAL devices to understand implications for health research. The present findings demonstrate that activPAL is not interchangeable with Actiwatch, which is consistent with their differing foundations (thigh inclination for activPAL versus wrist movement for Actiwatch).
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Affiliation(s)
- Paul R. Hibbing
- Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, USA
- Center for Children’s Healthy Lifestyles & Nutrition, Children’s Mercy Kansas City, Kansas City, MO, USA
| | - Jordan A. Carlson
- Center for Children’s Healthy Lifestyles & Nutrition, Children’s Mercy Kansas City, Kansas City, MO, USA
- Department of Pediatrics, University of Missouri Kansas City, Kansas City, MO, USA
| | - Stacey L. Simon
- Division of Pulmonary Medicine University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Edward L. Melanson
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Division of Geriatric Medicine, Department of Medicine University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Eastern Colorado Veterans Affairs Geriatric Research, Education, and Clinical Center, Denver, CO, USA
| | - Seth A. Creasy
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Anschutz Health and Wellness Center University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Adjaye-Gbewonyo D, Ng AE, Jackson CL, Johnson DA. The perceived neighborhood walking environment and self-reported sleep health in a nationally representative sample of the United States. Health Place 2023; 83:103066. [PMID: 37385129 DOI: 10.1016/j.healthplace.2023.103066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 07/01/2023]
Abstract
Neighborhood environment can influence sleep health; yet, there is a lack of data on specific environment features in nationally representative samples. We used the 2020 National Health Interview Survey to determine associations between perceived built and social environment factors related to pedestrian access (walking paths, sidewalks), amenities (shops, transit stops, entertainment/services, places to relax), and unsafe walking conditions (traffic, crime) and self-reported sleep duration and disturbances. Places to relax and pedestrian access were associated with better sleep health while unsafe walking conditions were associated with worse sleep health. Access to amenities (shops, transit stops, entertainment venues) had null associations with sleep health.
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Affiliation(s)
- Dzifa Adjaye-Gbewonyo
- National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Road, Hyattsville, MD, 20782, USA.
| | - Amanda E Ng
- National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Road, Hyattsville, MD, 20782, USA.
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, 111 T.W. Alexander Drive, Research Triangle Park, NC, 27709, USA; Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, 6707 Democracy Blvd Ste 800, Bethesda, MD, 20892, USA.
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd, NE, Atlanta, GA, 30322, USA.
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Costa-López B, Lavigne-Cerván R, Collado-Valero JA, Juárez-Ruiz de Mier R, Navarro-Soria I. The Influence of Emotional Regulation and Cognitive Flexibility on Sleep Habits in Spanish Children and Adolescents through the Lens of Parents. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1390. [PMID: 37628389 PMCID: PMC10453574 DOI: 10.3390/children10081390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/04/2023] [Accepted: 08/13/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Previous research studies have suggested the importance of studying the relationship between emotional regulation and sleep habits. Some investigations have especially focused on how emotional regulation could impact sleep habits in children and adolescents. Therefore, these researchers have stated there exists a two-way direction in this relationship. OBJECTIVE This study aimed to analyze the influence of emotional regulation on sleep habits in Spanish children and adolescents and the mediating role of anxiety in this relationship. METHOD Participants were 953 Spanish parents who completed the assessment protocol according to their children and adolescents' information. RESULTS The results revealed moderate-strong correlations between emotional regulation problems and sleep habit disturbances (r = 0.375, p < 0.001), trait (r = 0.488, p < 0.001) anxiety, and state (r = 0.589, p < 0.001) anxiety. Additionally, emotional regulation showed a direct impact on sleep habits (β = 0.011, p = 0.005). Trait and state anxiety demonstrated a significant mediating role in the relationship between emotional regulation and sleep habits. CONCLUSIONS Emotional regulation may have an impact on sleep habits during childhood and adolescence, suggesting the importance of early intervention focused on the emotions management and the prevention of sleep habit disturbances.
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Affiliation(s)
- Borja Costa-López
- Department of Health Psychology, University of Alicante, 03690 Alicante, Spain;
| | - Rocío Lavigne-Cerván
- Department of Developmental and Educational Psychology, University of Malaga, 29016 Málaga, Spain; (R.L.-C.); (J.A.C.-V.); (R.J.-R.d.M.)
| | - Joshua A. Collado-Valero
- Department of Developmental and Educational Psychology, University of Malaga, 29016 Málaga, Spain; (R.L.-C.); (J.A.C.-V.); (R.J.-R.d.M.)
| | - Rocío Juárez-Ruiz de Mier
- Department of Developmental and Educational Psychology, University of Malaga, 29016 Málaga, Spain; (R.L.-C.); (J.A.C.-V.); (R.J.-R.d.M.)
| | - Ignasi Navarro-Soria
- Department of Developmental and Educational Psychology, University of Alicante, 03690 Alicante, Spain
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83
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Thangaleela S, Sivamaruthi BS, Kesika P, Mariappan S, Rashmi S, Choeisoongnern T, Sittiprapaporn P, Chaiyasut C. Neurological Insights into Sleep Disorders in Parkinson's Disease. Brain Sci 2023; 13:1202. [PMID: 37626558 PMCID: PMC10452387 DOI: 10.3390/brainsci13081202] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/07/2023] [Accepted: 08/12/2023] [Indexed: 08/27/2023] Open
Abstract
Parkinson's disease (PD) is a common multidimensional neurological disorder characterized by motor and non-motor features and is more prevalent in the elderly. Sleep disorders and cognitive disturbances are also significant characteristics of PD. Sleep is an important physiological process for normal human cognition and physical functioning. Sleep deprivation negatively impacts human physical, mental, and behavioral functions. Sleep disturbances include problems falling asleep, disturbances occurring during sleep, abnormal movements during sleep, insufficient sleep, and excessive sleep. The most recognizable and known sleep disorders, such as rapid-eye-movement behavior disorder (RBD), insomnia, excessive daytime sleepiness (EDS), restless legs syndrome (RLS), sleep-related breathing disorders (SRBDs), and circadian-rhythm-related sleep-wake disorders (CRSWDs), have been associated with PD. RBD and associated emotional disorders are common non-motor symptoms of PD. In individuals, sleep disorders and cognitive impairment are important prognostic factors for predicting progressing neurodegeneration and developing dementia conditions in PD. Studies have focused on RBD and its associated neurological changes and functional deficits in PD patients. Other risks, such as cognitive decline, anxiety, and depression, are related to RBD. Sleep-disorder diagnosis is challenging, especially in identifying the essential factors that disturb the sleep-wake cycle and the co-existence of other concomitant sleep issues, motor symptoms, and breathing disorders. Focusing on sleep patterns and their disturbances, including genetic and other neurochemical changes, helps us to better understand the central causes of sleep alterations and cognitive functions in PD patients. Relations between α-synuclein aggregation in the brain and gender differences in sleep disorders have been reported. The existing correlation between sleep disorders and levels of α-synuclein in the cerebrospinal fluid indicates the risk of progression of synucleinopathies. Multidirectional approaches are required to correlate sleep disorders and neuropsychiatric symptoms and diagnose sensitive biomarkers for neurodegeneration. The evaluation of sleep pattern disturbances and cognitive impairment may aid in the development of novel and effective treatments for PD.
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Affiliation(s)
- Subramanian Thangaleela
- Innovation Center for Holistic Health, Nutraceuticals, and Cosmeceuticals, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand; (S.T.); (B.S.S.); (P.K.)
| | - Bhagavathi Sundaram Sivamaruthi
- Innovation Center for Holistic Health, Nutraceuticals, and Cosmeceuticals, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand; (S.T.); (B.S.S.); (P.K.)
- Office of Research Administration, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Periyanaina Kesika
- Innovation Center for Holistic Health, Nutraceuticals, and Cosmeceuticals, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand; (S.T.); (B.S.S.); (P.K.)
- Office of Research Administration, Chiang Mai University, Chiang Mai 50200, Thailand
| | | | - Subramanian Rashmi
- Innovation Center for Holistic Health, Nutraceuticals, and Cosmeceuticals, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand; (S.T.); (B.S.S.); (P.K.)
| | - Thiwanya Choeisoongnern
- Neuropsychological Research Laboratory, Neuroscience Research Center, School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok 10110, Thailand
| | - Phakkharawat Sittiprapaporn
- Neuropsychological Research Laboratory, Neuroscience Research Center, School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok 10110, Thailand
| | - Chaiyavat Chaiyasut
- Innovation Center for Holistic Health, Nutraceuticals, and Cosmeceuticals, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand; (S.T.); (B.S.S.); (P.K.)
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84
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Lee S, Kim SN. The effects of acupuncture on sleep disorders and its underlying mechanism: a literature review of rodent studies. Front Neurosci 2023; 17:1243029. [PMID: 37614343 PMCID: PMC10442542 DOI: 10.3389/fnins.2023.1243029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 07/28/2023] [Indexed: 08/25/2023] Open
Abstract
Sleep is a set of physiological processes mainly under neurobiological regulation that affect several physiological systems, and sleep disorders are a condition where normal sleep patterns are disturbed. Clinical studies have confirmed the effects of acupuncture on sleep duration and quality. Although many studies have explored the therapeutic effects of acupuncture on sleep disorders, the mechanisms are unclear. We investigated the mechanism of acupuncture efficacy in a rodent model of sleep disorders and evaluated the therapeutic effects of acupuncture treatment. According to our results, sleep disorders are associated with several brain regions and neurotransmitters. Furthermore, this review showed that neurological processes, such as catecholamine and BDNF signaling pathways, can be regulated by acupuncture, which is a crucial aspect of the acupuncture mechanism in sleep disorders.
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Affiliation(s)
| | - Seung-Nam Kim
- College of Korean Medicine, Dongguk University, Goyang, Republic of Korea
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85
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Groeger JA, Hepsomali P. Social Deprivation and Ethnicity Are Associated with More Problematic Sleep in Middle-Aged and Older Adults. Clocks Sleep 2023; 5:399-413. [PMID: 37606487 PMCID: PMC10443366 DOI: 10.3390/clockssleep5030030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/17/2023] [Accepted: 07/31/2023] [Indexed: 08/23/2023] Open
Abstract
Objectives: We test the hypothesis that the incidence of sleep problems is influenced by socio-demographic variables, particularly social deprivation and ethnicity. Methods: Self-reports of sleep duration and sleep difficulties (waking in the night, sleeping in the day, difficulty waking and snoring), personal wealth (household income, property-owning, etc.), ethnic group, employment, education, as well as post-code-based Townsend Social Deprivation, were extracted from UK Biobank's cohort of c500,000 British-domiciled adults (40-70 years). Analyses contrasted the incidence of different sleep problems and a composite measure of these (the Problematic Sleep Index) across groups. Results: Almost one-third of participants reported sleeping shorter (24.7%), or longer (7.7%) than age-corrected recommended sleep durations. The incidence of shorter or longer sleep increased with social deprivation and varied with ethnicity. Snoring, waking during the night, finding it difficult to get up in the morning and sleeping in the daytime were subject to similar effects. The Problematic Sleep Index showed being younger, male, employed, home-owning, having a higher household income, having a higher level of educational achievement, and time in education were all associated with better sleep, as was living in a more affluent area and being White. Conclusions: Sleep problems in Britain show a social gradient, independently of a range of other demographic and social influences, suggesting that sleep quality differs with and between ethnic groups. These sleep inequalities suggest that the protective and recuperative effects of sleep are disproportionately distributed across society and should encourage us to consider the potential benefits of community-specific sleep interventions.
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Affiliation(s)
- John A. Groeger
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham NG1 5LT, UK
| | - Piril Hepsomali
- School of Psychology, University of Roehampton, London SW15 4JD, UK
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86
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Lyu X, Dunietz GL, O'Brien LM, Chervin RD, Koumpias A, Shedden K. Disparities in sleep-wake patterns by labor force status: Population-based findings. Chronobiol Int 2023; 40:1111-1122. [PMID: 37691398 DOI: 10.1080/07420528.2023.2253904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 06/01/2023] [Accepted: 08/25/2023] [Indexed: 09/12/2023]
Abstract
Sleep disturbances have been associated with unemployment, but variation in sleep-wake patterns by labor force status has rarely been examined. With a population-based sample, we investigated differences in sleep-wake patterns by labor force status (employed, unemployed, and not-in-the-labor-force) and potential disparities by sociodemographic variables. The analysis included 130,602 adults aged 25-60 y, who participated in the American Time Use Survey between 2003 and 2019. Individual sleep-wake pattern was extracted from time use logs in a strict 24-h period (04:00 h-03:59 h). Functional nonparametric regression models based on dimensionality reduction and neighborhood matching were applied to model the relationship between sleep-wake patterns and labor force status. Specifically, we predicted changes in intra-person sleep-wake patterns under hypothetical changes of labor force status from employed to unemployed or not-in-the-labor-force. We then studied moderations of this association by gender, race/ethnicity and educational attainment. In comparison to the employed state, unemployed and not-in-the-labor-force states were predicted to have later wake-times, later bedtimes, and higher tendency for taking midday naps. Changes in labor force status led to more apparent shifts in wake-times than in bedtimes. Additionally, sleep schedules of Hispanics and those with higher education level were more vulnerable to the change of labor force status from employed to unemployed.
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Affiliation(s)
- Xiru Lyu
- Department of Statistics, University of Michigan, Ann Arbor, Michigan, USA
- Division of Sleep Medicine, Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | - Galit Levi Dunietz
- Division of Sleep Medicine, Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | - Louise M O'Brien
- Division of Sleep Medicine, Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ronald D Chervin
- Division of Sleep Medicine, Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | - Antonios Koumpias
- Department of Social Sciences, University of Michigan, Dearborn, Michigan, USA
| | - Kerby Shedden
- Department of Statistics, University of Michigan, Ann Arbor, Michigan, USA
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87
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Park JH, Lee JD. A Customized Deep Sleep Recommender System Using Hybrid Deep Learning. SENSORS (BASEL, SWITZERLAND) 2023; 23:6670. [PMID: 37571454 PMCID: PMC10422391 DOI: 10.3390/s23156670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/16/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023]
Abstract
This paper proposes a recommendation system based on a hybrid learning approach for a personal deep sleep service, called the Customized Deep Sleep Recommender System (CDSRS). Sleep is one of the most important factors for human life in modern society. Optimal sleep contributes to increasing work efficiency and controlling overall well-being. Therefore, a sleep recommendation service is considered a necessary service for modern individuals. Accurate sleep analysis and data are required to provide such a personalized sleep service. However, given the variations in sleep patterns between individuals, there is currently no international standard for sleep. Additionally, service platforms face a cold start problem when dealing with new users. To address these challenges, this study utilizes K-means clustering analysis to define sleep patterns and employs a hybrid learning algorithm to evaluate recommendations by combining user-based and collaborative filtering methods. It also incorporates feedback top-N classification processing for user profile learning and recommendations. The behavior of the study model is as follows. Using personal information received through mobile devices and data, such as snoring, sleep time, movement, and noise collected through AI motion beds, we recommend sleep and receive user evaluations of recommended sleep. This assessment reconstructs the profile and, finally, makes recommendations using top-N classification. The experimental results were evaluated using two absolute error measurement methods: mean squared error (MSE) and mean absolute percentage error (MAPE). The research results regarding the hybrid learning methods show 13.2% fewer errors than collaborative filtering (CF) and 10.2% fewer errors than content-based filtering (CBF) on an MSE basis. According to the MAPE, the methods are 14.7% more accurate than the CF model and 9.2% better than the CBF model. These results demonstrate that CDSRS systems can provide more accurate recommendations and customized sleep services to users than CF, CBF, and combination models. As a result, CDSRS, a hybrid learning method, can better reflect a user's evaluation than traditional methods and can increase the accuracy of recommendations as the number of users increases.
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Affiliation(s)
| | - Jae-Dong Lee
- Department of Computer Science, Dankook University, 152 Jukjeon-ro Campus, Suji-gu, Yongin-si 16890, Republic of Korea;
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88
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Zhang Y. Time Spent on Private Tutoring and Sleep Patterns of Chinese Adolescents: Evidence from a National Panel Survey. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1231. [PMID: 37508728 PMCID: PMC10378598 DOI: 10.3390/children10071231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/15/2023] [Accepted: 07/16/2023] [Indexed: 07/30/2023]
Abstract
OBJECTIVE In recent decades, there has been a marked increase in private tutoring and a decline in sleep health among adolescents. This study aimed to outline the association between time spent on private tutoring and sleep patterns of Chinese adolescents. METHODS Participants were from a nationwide two-wave panel survey. We performed OLS regressions of sleep duration at wave 2 and Poisson regressions of sleep problems at wave 2 on tutoring time at wave 2, adjusting for baseline sleep duration and other covariates. Tutoring time was assessed by three items: daily hours of tutoring, daily hours of tutoring on weekdays, and daily hours of tutoring on weekends. RESULTS Overall, more time spent on private tutoring was associated with shorter sleep duration and more sleep problems. Furthermore, both weekday and weekend tutoring can have a positive effect on the number of sleep problems. With regard to sleep duration, weekend tutoring time played a negative role, while the effect of weekday tutoring time was negligible. CONCLUSION In the Chinese context, which is characterized by intense academic competition, participation in private tutoring plays a significant role in shaping students' sleep duration and sleep problems. To improve the sleep health of adolescents, the time spent on private tutoring should be carefully monitored and regulated.
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Affiliation(s)
- Yueyun Zhang
- Department of Sociology, School of Humanities, Social Sciences & Law, Harbin Institute of Technology, Harbin 150001, China
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89
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Genario R, Gil S, Oliveira-Júnior G, Leitão AE, Franco T, Dos Santos Sales RC, Ferriolli E, Busse AL, Filho WJ, Gualano B, Roschel H. Sleep quality is a predictor of muscle mass, strength, quality of life, anxiety and depression in older adults with obesity. Sci Rep 2023; 13:11256. [PMID: 37438429 DOI: 10.1038/s41598-023-37921-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 06/29/2023] [Indexed: 07/14/2023] Open
Abstract
We aimed to investigate associations between sleep quality with selected quantitative and qualitative parameters of health in older individuals with obesity. Cross-sectional assessment (n = 95 men/women; ≥ 65 years; BMI ≥ 30 kg/m2) of sleep quality, body composition, handgrip strength, quality-of-life, anxiety/depression. Mean PSQI score was 6.3. Poor sleepers (n = 49) presented lower appendicular lean mass (ALM) (16.2 vs 17.8 kg; p = 0.0273), ALM/BMI (0.47 vs 0.53 kg/BMI; p = 0.0085), fat mass (48.6 vs 46.6%; p = 0.0464), handgrip strength (19.7 vs 22.0 kgf; p = 0.0542) and handgrip/BMI (0.57 vs 0.66 kgf/BMI; p = 0.0242) than good sleepers. They also had higher anxiety (8.6 vs 5.6; p = 0.0100) and depression (4.8 vs 3.2; p = 0.0197) scores, worse health-related quality-of-life and lower scores in mental (62.8 vs 73.0; p = 0.0223) and physical (52.9 vs 67.3; p = 0.0015) domains. Adjusted models showed that PSQI was negatively associated with ALM (β = - 0.13, 95% CI - 0.25; - 0.01) and health-related quality of life on physical (β = - 2.76, 95% CI - 3.82; - 1.70) and mental (β = - 2.25, 95% CI - 3.38; - 1.12) domains, and positively associated with anxiety (β = 0.57; 95% CI 0.26; 0.87) and depression (β = 0.31; 95% CI 0.13; 0.49). Poor sleep quality associates with impaired selected quantitative and qualitative parameters of health. Additionally, sleep quality was shown as an independent predictor of ALM, health-related quality-of-life, anxiety and depression in older individuals with obesity.
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Affiliation(s)
- Rafael Genario
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Saulo Gil
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Gersiel Oliveira-Júnior
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Alice Erwig Leitão
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Tathiane Franco
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Ruan Célio Dos Santos Sales
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Eduardo Ferriolli
- Division of Internal and Geriatric Medicine, Department of Internal Medicine-Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Alexandre Leopold Busse
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Wilson Jacob Filho
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Bruno Gualano
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil.
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.
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90
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Gaiduk M, Seepold R, Martínez Madrid N, Ortega JA. Assessing the Feasibility of Replacing Subjective Questionnaire-Based Sleep Measurement with an Objective Approach Using a Smartwatch. SENSORS (BASEL, SWITZERLAND) 2023; 23:6145. [PMID: 37447992 DOI: 10.3390/s23136145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/29/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023]
Abstract
In order to ensure sufficient recovery of the human body and brain, healthy sleep is indispensable. For this purpose, appropriate therapy should be initiated at an early stage in the case of sleep disorders. For some sleep disorders (e.g., insomnia), a sleep diary is essential for diagnosis and therapy monitoring. However, subjective measurement with a sleep diary has several disadvantages, requiring regular action from the user and leading to decreased comfort and potential data loss. To automate sleep monitoring and increase user comfort, one could consider replacing a sleep diary with an automatic measurement, such as a smartwatch, which would not disturb sleep. To obtain accurate results on the evaluation of the possibility of such a replacement, a field study was conducted with a total of 166 overnight recordings, followed by an analysis of the results. In this evaluation, objective sleep measurement with a Samsung Galaxy Watch 4 was compared to a subjective approach with a sleep diary, which is a standard method in sleep medicine. The focus was on comparing four relevant sleep characteristics: falling asleep time, waking up time, total sleep time (TST), and sleep efficiency (SE). After evaluating the results, it was concluded that a smartwatch could replace subjective measurement to determine falling asleep and waking up time, considering some level of inaccuracy. In the case of SE, substitution was also proved to be possible. However, some individual recordings showed a higher discrepancy in results between the two approaches. For its part, the evaluation of the TST measurement currently does not allow us to recommend substituting the measurement method for this sleep parameter. The appropriateness of replacing sleep diary measurement with a smartwatch depends on the acceptable levels of discrepancy. We propose four levels of similarity of results, defining ranges of absolute differences between objective and subjective measurements. By considering the values in the provided table and knowing the required accuracy, it is possible to determine the suitability of substitution in each individual case. The introduction of a "similarity level" parameter increases the adaptability and reusability of study findings in individual practical cases.
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Affiliation(s)
- Maksym Gaiduk
- Department of Computer Science, HTWG Konstanz-University of Applied Sciences, 78462 Konstanz, Germany
| | - Ralf Seepold
- Department of Computer Science, HTWG Konstanz-University of Applied Sciences, 78462 Konstanz, Germany
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91
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Zolfaghari S, Cyr M, Pelletier A, Postuma RB. Effects of Season and Daylight Saving Time Shifts on Sleep Symptoms: Canadian Longitudinal Study on Aging. Neurology 2023; 101:e74-e82. [PMID: 37137725 PMCID: PMC10351306 DOI: 10.1212/wnl.0000000000207342] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 03/09/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES There has been conflicting evidence regarding the association between seasonal changes and daylight saving time (DST) and sleep disorders. This topic is of particular interest currently because the United States and Canada are considering the elimination of seasonal clock changes. The aim of this study was to compare sleep symptoms among participants who were interviewed in different seasons and before/after the transition into DST and standard time (ST). METHODS A total of 30,097 people aged 45-85 years taking part in the Canadian Longitudinal Study on Aging were studied. Participants completed a questionnaire on sleep duration, satisfaction, sleep-onset insomnia, sleep-maintenance insomnia, and hypersomnolence symptoms. Sleep disorders were compared between participants who were interviewed during different seasons and at different times of the year (DST/ST). Data were analyzed using χ2, analysis of variance, binary logistic, and linear regression tests. RESULTS Among participants interviewed in different seasons, we found no difference in dissatisfaction with sleep, sleep onset, sleep maintenance, and hypersomnolence. Those interviewed in summer had slightly shorter sleep duration compared with those in winter (6.76 ± 1.2 vs 6.84 ± 1.3 hours). Participants interviewed 1 week before vs 1 week after DST transition showed no difference in sleep symptoms, except for a 9-minute decrease in sleep duration a week after transition. However, those who were interviewed a week after transition to ST compared with a week before reported more dissatisfaction with sleep (28% vs 22.6%, adjusted odds ratio [aOR] 1.34, 95% CI 1.02-1.76), higher sleep-onset insomnia (7.1% vs 3.3%, aOR 2.26, 95% CI 1.19-4.27), higher sleep-maintenance insomnia (12.9% vs 8.2%, aOR 1.64, 95% CI 1.02-2.66), and more hypersomnolence with adequate sleep (7.3% vs 3.6%, aOR 2.08, 95% CI 1.14-3.79). DISCUSSION We found small seasonal variations in sleep duration but no difference in other sleep symptoms. The transition from DST to ST was associated with a transient increase in sleep disorders.
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Affiliation(s)
- Sheida Zolfaghari
- From the Integrated Program in Neuroscience (S.Z.), McGill University; Research Institute of the McGill University Health Centre (S.Z., A.P., R.B.P.); Faculty of Medicine and Health Sciences (M.C.), McGill University; Centre for Advanced Research in Sleep Medicine (A.P., R.B.P.), Hôpital du Sacré-Coeur de Montréal; and Department of Neurology and Neurosurgery (R.B.P.), McGill University, Montreal, Quebec, Canada
| | - Mariève Cyr
- From the Integrated Program in Neuroscience (S.Z.), McGill University; Research Institute of the McGill University Health Centre (S.Z., A.P., R.B.P.); Faculty of Medicine and Health Sciences (M.C.), McGill University; Centre for Advanced Research in Sleep Medicine (A.P., R.B.P.), Hôpital du Sacré-Coeur de Montréal; and Department of Neurology and Neurosurgery (R.B.P.), McGill University, Montreal, Quebec, Canada
| | - Amélie Pelletier
- From the Integrated Program in Neuroscience (S.Z.), McGill University; Research Institute of the McGill University Health Centre (S.Z., A.P., R.B.P.); Faculty of Medicine and Health Sciences (M.C.), McGill University; Centre for Advanced Research in Sleep Medicine (A.P., R.B.P.), Hôpital du Sacré-Coeur de Montréal; and Department of Neurology and Neurosurgery (R.B.P.), McGill University, Montreal, Quebec, Canada
| | - Ronald B Postuma
- From the Integrated Program in Neuroscience (S.Z.), McGill University; Research Institute of the McGill University Health Centre (S.Z., A.P., R.B.P.); Faculty of Medicine and Health Sciences (M.C.), McGill University; Centre for Advanced Research in Sleep Medicine (A.P., R.B.P.), Hôpital du Sacré-Coeur de Montréal; and Department of Neurology and Neurosurgery (R.B.P.), McGill University, Montreal, Quebec, Canada.
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92
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Najib J, Toderika Y, Dima L. Daridorexant, an Orexin Receptor Antagonist for the Management of Insomnia. Am J Ther 2023; 30:e360-e368. [PMID: 37449930 DOI: 10.1097/mjt.0000000000001647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
BACKGROUND Insomnia is a common sleep disorder that is diagnosed primarily by patients' subjective reported symptoms. Daridorexant is a new dual orexin receptor antagonist that was recently approved by Food and Drug Administration for insomnia characterized by difficulty falling asleep and/or maintaining sleep. MECHANISM OF ACTION, PHARMACODYNAMICS, AND PHARMACOKINETICS The orexin neuropeptide signaling system plays a role in wakefulness, and blocking the wake-promoting neuropeptides results in diminished wake signaling, thus exerting a sedative effect using an entirely different mechanism of action than the classical sleep promoting agents. The drug has quick onset of action, high volume of distribution, and high protein binding. Pharmacokinetics and pharmacodynamic parameters were similar in patients of different sex and age and were not significantly affected by race, body size, or mild-to-moderate kidney impairment. Dose limitation to 25 mg in moderate liver impairment and no use in severe liver impairment are recommended. The drug undergoes hepatic CYP3A4 metabolism; thus, caution with strong CYP3A4 inhibitors and inducers is warranted. CLINICAL TRIALS The drug was approved based on phase 3 trials involving study 1 and study 2. Study 1 noted daridorexant at doses of 25 and 50 mg demonstrated a statistically significant improvement in wake time after sleep onset, latency to persistent sleep, and self-reported total sleep time against placebo at months 1 and 3. Similarly in study 2, compared with placebo, the 25 mg dose demonstrated statistically significant improvement in wake time after sleep onset, latency to persistent sleep, and self-reported total sleep time at months 1 and 3. Treatment-emergent adverse events were similar for daridorexant and placebo, with nasopharyngitis and headache most frequently reported. THERAPEUTIC ADVANCE Daridorexant is a novel agent with demonstrated efficacy in sleep onset and maintenance and decrease in daytime sedation. Preliminary results from a 1-year extension study note similar incidences of mild-to-moderate side effects as noted in previous trials. Further studies are needed to establish its place in the pharmacological treatment of insomnia.
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Affiliation(s)
- Jadwiga Najib
- Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Long Island University, Brooklyn, NY; and
| | - Yuliana Toderika
- Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Long Island University, Brooklyn, NY; and
| | - Lorena Dima
- Department of Fundamental Disciplines and Clinical Prevention, Faculty of Medicine, Transilvania University of Brasov, Brasov, Romania
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93
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Ding X, Li Q, Tang YY. The thalamic clustering coefficient moderates the vigor-sleep quality relationship. Sleep Biol Rhythms 2023; 21:369-375. [PMID: 38476314 PMCID: PMC10899908 DOI: 10.1007/s41105-023-00456-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 03/06/2023] [Indexed: 03/28/2023]
Abstract
Sleep disorders affect more than one-quarter of the world's population, resulting in reduced daytime productivity, impaired immune function, and an increased risk of cardiovascular disease. It is important to identify the physiological and psychological factors related to sleep for the prevention and treatment of sleep disorders. In this study, we correlated measurements of emotional state, sleep quality, and some brain neural activity parameters to better understand the brain and psychological factors related to sleep. Resting-state functional magnetic resonance imaging (rs-fMRI) of 116 healthy undergraduates were analyzed using graph theory to assess regional topological characteristics. Among these, the left thalamic cluster coefficient proved to be the ablest to reflect the characteristics of the sleep neural graph index. The Profile of Mood States (POMS) was used to measure vigor, and the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. The results showed that the left thalamic clustering coefficient was negatively correlated with sleep quality and vigor. Further, the left thalamic clustering coefficient moderated the relationship between vigor and sleep quality. When the left thalamic clustering coefficient was very low, there was a significant positive correlation between vigor and sleep quality. However, when the left thalamic clustering coefficient was high, the correlation between vigor and sleep quality became insignificant. The relationship between vigor and sleep quality is heterogeneous. Analyzing the function of the left thalamic neural network could help understand the variation in the relationship between vigor and sleep quality in different populations. Such observations may help in the development of personalized interventions for sleep disorders.
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Affiliation(s)
- Xiaoqian Ding
- College of Psychology, Liaoning Normal University, Dalian, 116029 China
| | - Qingmin Li
- College of Psychology, Liaoning Normal University, Dalian, 116029 China
| | - Yi-Yuan Tang
- College of Health Solutions, Arizona State University, Tempe, AZ 85281 USA
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004 USA
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94
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Boiko A, Gaiduk M, Scherz WD, Gentili A, Conti M, Orcioni S, Martínez Madrid N, Seepold R. Monitoring of Cardiorespiratory Parameters during Sleep Using a Special Holder for the Accelerometer Sensor. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23115351. [PMID: 37300078 DOI: 10.3390/s23115351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 06/01/2023] [Accepted: 06/04/2023] [Indexed: 06/12/2023]
Abstract
Sleep is extremely important for physical and mental health. Although polysomnography is an established approach in sleep analysis, it is quite intrusive and expensive. Consequently, developing a non-invasive and non-intrusive home sleep monitoring system with minimal influence on patients, that can reliably and accurately measure cardiorespiratory parameters, is of great interest. The aim of this study is to validate a non-invasive and unobtrusive cardiorespiratory parameter monitoring system based on an accelerometer sensor. This system includes a special holder to install the system under the bed mattress. The additional aim is to determine the optimum relative system position (in relation to the subject) at which the most accurate and precise values of measured parameters could be achieved. The data were collected from 23 subjects (13 males and 10 females). The obtained ballistocardiogram signal was sequentially processed using a sixth-order Butterworth bandpass filter and a moving average filter. As a result, an average error (compared to reference values) of 2.24 beats per minute for heart rate and 1.52 breaths per minute for respiratory rate was achieved, regardless of the subject's sleep position. For males and females, the errors were 2.28 bpm and 2.19 bpm for heart rate and 1.41 rpm and 1.30 rpm for respiratory rate. We determined that placing the sensor and system at chest level is the preferred configuration for cardiorespiratory measurement. Further studies of the system's performance in larger groups of subjects are required, despite the promising results of the current tests in healthy subjects.
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Affiliation(s)
- Andrei Boiko
- Ubiquitous Computing Lab, Department of Computer Science, HTWG Konstanz-University of Applied Sciences, 78462 Konstanz, Germany
| | - Maksym Gaiduk
- Ubiquitous Computing Lab, Department of Computer Science, HTWG Konstanz-University of Applied Sciences, 78462 Konstanz, Germany
| | - Wilhelm Daniel Scherz
- Ubiquitous Computing Lab, Department of Computer Science, HTWG Konstanz-University of Applied Sciences, 78462 Konstanz, Germany
| | - Andrea Gentili
- Dipartimento di Ingegneria dell'Informazione, Università Politecnica delle Marche, 60131 Ancona, Italy
| | - Massimo Conti
- Dipartimento di Ingegneria dell'Informazione, Università Politecnica delle Marche, 60131 Ancona, Italy
| | - Simone Orcioni
- Dipartimento di Ingegneria dell'Informazione, Università Politecnica delle Marche, 60131 Ancona, Italy
| | | | - Ralf Seepold
- Ubiquitous Computing Lab, Department of Computer Science, HTWG Konstanz-University of Applied Sciences, 78462 Konstanz, Germany
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95
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Verma K, Singh D, Srivastava A. Comparative impact of yoga and ayurveda practice in insomnia: A randomized controlled trial. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:160. [PMID: 37404923 PMCID: PMC10317263 DOI: 10.4103/jehp.jehp_1489_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/24/2022] [Indexed: 07/06/2023]
Abstract
BACKGROUND Insomnia is connected with a lifted hazard for neurocognitive dysfunction and psychiatric disarranges. Clinical observations of psychosomatic patients indicate that their distorted somatopsychic functioning necessitates their practice of yoga-like therapy. Sleep and its modifications and management have also been explained well in ayurveda. This study aimed to compare the effectiveness of Yoga and Nasya Karma on the sleep quality, stress, cognitive function, and quality of life of people suffering from acute insomnia. MATERIAL AND METHODS It was an open-label, randomized controlled trial. A total of 120 participants were randomly (computer-generated randomization) equally allocated to three groups, yoga group (G-1), ayurveda group (G-2), and control group (G-3). All the groups were assessed on the first day before the start of the yoga regime and the 48th day. Participants in the study were included in the age group of 18 to 45 years, fulfilling DSM-V criteria for insomnia, physically fit for the yoga module, and Nasya procedure. Outcomes were measured by the Pittsburgh Sleep Quality Index (PSQI) questionnaire, Perceived Stress Scale (PSS), cognitive failure questionnaire, and WHO Quality of Life Scale-Brief (WHOQOL-Brief). Proportions and frequencies were described for categorical variables and compared using the Chi-square test. ANOVA (one-way) and post hoc analysis, Bonferroni test, were performed for multiple comparisons in groups at a significance level of P < 0.05 using SPSS (23 version). RESULTS A total of 112 participants were analyzed as per protocol analysis. All groups have observed significant mean differences for stress (<0.05) and sleep quality (<0.05). All five aspects of quality of life - general health (<0.05), physical health (<0.01), psychological health (<0.05), social health (<0.05), and environmental health (<0.05) - had a significant mean difference in all three groups. All three aspects of cognitive failure, forgetfulness (<0.05), distractibility (<0.05), and false triggers (<0.01) had a significant mean difference in scores for all three groups. CONCLUSION Yoga practice was effective, followed by ayurveda and the control group in reducing stress and improving sleep, cognitive function, and quality of life.
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Affiliation(s)
- Kanika Verma
- Department of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bengaluru, Karnataka, India
| | - Deepeshwar Singh
- Department of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bengaluru, Karnataka, India
| | - Alok Srivastava
- Department of Panchkarma, Uttarakhand Ayurved University, Dehradun, Uttarakhand, India
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96
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Wang L, Gui J, Ding R, Yang X, Yang J, Luo H, Huang D, Han Z, Jiang L. Dietary Intake of Flavonoids Associated with Sleep Problems: An Analysis of Data from the National Health and Nutrition Examination Survey, 2007-2010. Brain Sci 2023; 13:873. [PMID: 37371353 DOI: 10.3390/brainsci13060873] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/18/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023] Open
Abstract
Flavonoids possess the latent ability to protect against sleep disorders. We examined the correlation between daily flavonoid intake and sleep duration, and sleep disorders. We enrolled 8216 participants aged ≥ 20 from the National Health and Nutrition Examination Survey (NHANES, 2007-2010), carrying out a cross-sectional study. Flavonoid intake was collected by dietary intake interview recalls. Logistic regression was utilized to evaluate the association between flavonoid intake sleep duration, and sleep disorders. We used subgroup and interaction analysis to explore differences between subgroups. When adjusting covariates in model 2, anthocyanidins, flavan-3-ols, flavones, flavonols, and the sum of flavonoids were considerably related to insufficient sleep duration (odds ratio (OR) (95% confidence interval (CI)); 0.83 (0.72, 0.95); 0.91 (0.83, 0.98); 0.63 (0.41, 0.98); 0.78 (0.64, 0.94); 0.85 (0.76, 0.95), respectively); the converse association was observed between flavanones, and flavones and the risk of sleep disorders (OR (95% CI); 0.85 (0.77, 0.95); 0.61 (0.41, 0.90), respectively). In relation to insufficient sleep, there were statistically significant interactions between flavonoid consumption and race/ethnicity, and education level. In relation to insufficient sleep, there were statistically significant interactions between flavonoid consumption and working status. In this study, we found that certain flavonoids were linked to increased sleep duration and a lower risk of sleep problems. Our research indicated that flavonoids might be a preventive factor for sleep disorders.
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Affiliation(s)
- Lingman Wang
- Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Jianxiong Gui
- Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Ran Ding
- Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Xiaoyue Yang
- Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Jiaxin Yang
- Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Hanyu Luo
- Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Dishu Huang
- Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Ziyao Han
- Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Li Jiang
- Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
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97
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Bridges J, Shishavan HH, Salmon A, Metersky M, Kim I. Exploring the Potential of Pulse Transit Time as a Biomarker for Sleep Efficiency through a Comparison Analysis with Heart Rate and Heart Rate Variability. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23115112. [PMID: 37299839 DOI: 10.3390/s23115112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/17/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023]
Abstract
The relationship between sleep dynamics and blood pressure (BP) changes is well established. Moreover, sleep efficiency and wakefulness during sleep (WASO) events have a significant impact on BP dipping. Despite this knowledge, there is limited research on the measurement of sleep dynamics and continuous blood pressure (CBP). This study aims to explore the relationship between sleep efficiency and cardiovascular function indicators such as pulse transit time (PTT), as a biomarker of CBP, and heart rate variability (HRV), measured using wearable sensors. The results of the study conducted on 20 participants at the UConn Health Sleep Disorders Center suggest a strong linear relationship between sleep efficiency and changes in PTT (r2 = 0.8515) and HRV during sleep (r2 = 5886). The findings of this study contribute to our understanding of the relationship between sleep dynamics, CBP, and cardiovascular health.
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Affiliation(s)
- Jenna Bridges
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT 06030, USA
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - Hossein Hamidi Shishavan
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT 06030, USA
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - Adrian Salmon
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Connecticut Health, Farmington, CT 06030, USA
| | - Mark Metersky
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Connecticut Health, Farmington, CT 06030, USA
| | - Insoo Kim
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT 06030, USA
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
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98
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Kawasaki Y, Kitamura E, Kasai T. Impact of Body Composition on Sleep and Its Relationship with Sleep Disorders: Current Insights. Nat Sci Sleep 2023; 15:375-388. [PMID: 37220427 PMCID: PMC10200107 DOI: 10.2147/nss.s340946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 05/04/2023] [Indexed: 05/25/2023] Open
Abstract
Sleep is involved in many physiological processes and is essential for both physical and mental health. Obesity and sleep deprivation due to sleep disorders are major public health issues. Their incidence is increasing, and they have a wide range of adverse health-related consequences, including life-threatening cardiovascular disease. The impact of sleep on obesity and body composition is well-known, and many studies have shown an association between insufficient or excessive sleep duration and obesity, body fat percentage, and weight gain. However, there is growing evidence of the effects of body composition on sleep and sleep disorders (particularly sleep disordered breathing) through anatomical and physiological mechanisms (nocturnal fluid shift, core body temperature, or diet). Although some research has been conducted on the bidirectional effects of sleep-disordered breathing and body composition, the specific effects of obesity and body composition on sleep and the underlying mechanisms that explain these effects remain unclear. Therefore, this review summarizes the findings on the effects of body composition on sleep and draws conclusions and proposals for future research in this field.
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Affiliation(s)
- Yu Kawasaki
- Department of Obstetrics and Gynecology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Eri Kitamura
- Department of Obstetrics and Gynecology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takatoshi Kasai
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Sleep and Sleep-Disordered Breathing Center, Juntendo University Hospital, Tokyo, Japan
- Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Cardiovascular Management and Remote Monitoring, Juntendo University Graduate School of Medicine, Tokyo, Japan
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99
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Zhu Y, Li J, Kim J, Li S, Zhao Y, Bahari J, Eliahoo P, Li G, Kawakita S, Haghniaz R, Gao X, Falcone N, Ermis M, Kang H, Liu H, Kim H, Tabish T, Yu H, Li B, Akbari M, Emaminejad S, Khademhosseini A. Skin-interfaced electronics: A promising and intelligent paradigm for personalized healthcare. Biomaterials 2023; 296:122075. [PMID: 36931103 PMCID: PMC10085866 DOI: 10.1016/j.biomaterials.2023.122075] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 02/23/2023] [Accepted: 03/02/2023] [Indexed: 03/09/2023]
Abstract
Skin-interfaced electronics (skintronics) have received considerable attention due to their thinness, skin-like mechanical softness, excellent conformability, and multifunctional integration. Current advancements in skintronics have enabled health monitoring and digital medicine. Particularly, skintronics offer a personalized platform for early-stage disease diagnosis and treatment. In this comprehensive review, we discuss (1) the state-of-the-art skintronic devices, (2) material selections and platform considerations of future skintronics toward intelligent healthcare, (3) device fabrication and system integrations of skintronics, (4) an overview of the skintronic platform for personalized healthcare applications, including biosensing as well as wound healing, sleep monitoring, the assessment of SARS-CoV-2, and the augmented reality-/virtual reality-enhanced human-machine interfaces, and (5) current challenges and future opportunities of skintronics and their potentials in clinical translation and commercialization. The field of skintronics will not only minimize physical and physiological mismatches with the skin but also shift the paradigm in intelligent and personalized healthcare and offer unprecedented promise to revolutionize conventional medical practices.
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Affiliation(s)
- Yangzhi Zhu
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States.
| | - Jinghang Li
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States
| | - Jinjoo Kim
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States
| | - Shaopei Li
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States
| | - Yichao Zhao
- Interconnected and Integrated Bioelectronics Lab, Department of Electrical and Computer Engineering, and Materials Science and Engineering, University of California, Los Angeles, CA, 90095, United States
| | - Jamal Bahari
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States
| | - Payam Eliahoo
- Biomedical Engineering Department, University of Southern California, Los Angeles, CA, 90007, United States
| | - Guanghui Li
- The Centre of Nanoscale Science and Technology and Key Laboratory of Functional Polymer Materials, Institute of Polymer Chemistry, College of Chemistry, Nankai University, Tianjin, 300071, China; Renewable Energy Conversion and Storage Center (RECAST), Nankai University, Tianjin, 300071, China
| | - Satoru Kawakita
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States
| | - Reihaneh Haghniaz
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States
| | - Xiaoxiang Gao
- Department of Nanoengineering, University of California, San Diego, La Jolla, CA, 92093, United States
| | - Natashya Falcone
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States
| | - Menekse Ermis
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States
| | - Heemin Kang
- Department of Materials Science and Engineering, Korea University, Seoul, 02841, Republic of Korea
| | - Hao Liu
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, Xi'an, 710049, PR China
| | - HanJun Kim
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States; College of Pharmacy, Korea University, Sejong, 30019, Republic of Korea
| | - Tanveer Tabish
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 7BN, United Kingdom
| | - Haidong Yu
- Frontiers Science Center for Flexible Electronics, Xi'an Institute of Flexible Electronics (IFE) and Xi'an Institute of Biomedical Materials & Engineering, Northwestern Polytechnical University, Xi'an, 710072, PR China
| | - Bingbing Li
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States; Department of Manufacturing Systems Engineering and Management, California State University, Northridge, CA, 91330, United States
| | - Mohsen Akbari
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States; Laboratory for Innovation in Microengineering (LiME), Department of Mechanical Engineering, Center for Biomedical Research, University of Victoria, Victoria, BC V8P 2C5, Canada
| | - Sam Emaminejad
- Interconnected and Integrated Bioelectronics Lab, Department of Electrical and Computer Engineering, and Materials Science and Engineering, University of California, Los Angeles, CA, 90095, United States
| | - Ali Khademhosseini
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States.
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100
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Yoo L, Tsai CS, Heitkemper M, Kamp K. Systematic review: Individual-level factors and social determinants of health impacting sleep health in individuals with inflammatory bowel disease. J Adv Nurs 2023; 79:1650-1663. [PMID: 36756952 PMCID: PMC10182249 DOI: 10.1111/jan.15576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 12/13/2022] [Accepted: 01/20/2023] [Indexed: 02/10/2023]
Abstract
AIM To examine the individual-level factors and social determinants of health (SDOH) linked to sleep health among individuals with inflammatory bowel disease (IBD). DESIGN Systematic review without meta-analysis. DATA SOURCES Four databases (PubMed, Web of Science, CINAHL and PsycINFO) were searched in February 2022. REVIEW METHODS Databases were searched with keywords related to IBD and sleep. The review was conducted per the PRISMA protocol. The checklist for analytical cross-sectional studies published by the Joanna Briggs Institute was used for quality appraisal. Factors were organized by individual, social and societal levels according to the social-ecological model of sleep health. RESULTS In the review, 45 studies were identified and synthesized. All studies examined individual-level factors with sleep, with age being the most common factor studied. Only nine studies considered a social determinant of health which included marital status, number of children, education level, annual income, employment status, work tenure, type of employment, area of residence, minority status/ethnicity and COVID-19. However, the source of information for the social determinant of health was not clearly defined for more than half of these studies. CONCLUSION Although IBD sleep research has explored individual-level factors (i.e. age) that impact sleep health, there is a lack of information on the SDOH that can contribute to sleep health. IMPACT This review provides insight into the different factors that have been examined in IBD sleep research. By determining the SDOH that impact sleep, nursing research can inform sustainable and tailored interventions that focus on changing behaviour and improving sleep of individuals of varying backgrounds and life experiences. There is a continued need for nurses in practice and research to explore the SDOH that influence health outcomes and the daily lives of those with IBD.
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Affiliation(s)
- Linda Yoo
- University of Washington, Seattle, Washington, USA
| | | | | | - Kendra Kamp
- University of Washington, Seattle, Washington, USA
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