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Burgess HJ, Rizvydeen M, Fogg LF, Keshavarzian A. A single dose of alcohol does not meaningfully alter circadian phase advances and phase delays to light in humans. Am J Physiol Regul Integr Comp Physiol 2016; 310:R759-65. [PMID: 26936778 PMCID: PMC4867406 DOI: 10.1152/ajpregu.00001.2016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 02/29/2016] [Indexed: 01/13/2023]
Abstract
Central circadian timing influences mental and physical health. Research in nocturnal rodents has demonstrated that when alcohol is consumed, it reaches the central hypothalamic circadian pacemaker (suprachiasmatic nuclei) and can directly alter circadian phase shifts to light. In two separate studies, we examined, for the first time, the effects of a single dose of alcohol on circadian phase advances and phase delays to light in humans. Two 23-day within-subjects placebo-controlled counterbalanced design studies were conducted. Both studies consisted of 6 days of fixed baseline sleep to stabilize circadian timing, a 2-day laboratory session, a 6-day break, and a repeat of 6 days of fixed sleep and a 2-day laboratory session. In the phase advance study (n= 10 light drinkers, 24-45 yr), the laboratory sessions consisted of a baseline dim light phase assessment, sleep episode, alcohol (0.6 g/kg) or placebo, 2-h morning bright light pulse, and final phase assessment. In the phase-delay study (n= 14 light drinkers, 22-44 yr), the laboratory sessions consisted of a baseline phase assessment, alcohol (0.8 g/kg) or placebo, 2-h late night bright light pulse, sleep episode, and final phase assessment. In both studies, alcohol either increased or decreased the observed phase shifts to light (interaction P≥ 0.46), but the effect of alcohol vs. placebo on phase shifts to light was always on average smaller than 30 min. Thus, no meaningful effects of a single dose of alcohol vs. placebo on circadian phase shifts to light in humans were observed.
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Affiliation(s)
- Helen J Burgess
- Biological Rhythms Research Laboratory, Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois;
| | - Muneer Rizvydeen
- Biological Rhythms Research Laboratory, Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Louis F Fogg
- College of Nursing, Rush University Medical Center, Chicago, Illinois; and
| | - Ali Keshavarzian
- Department of Digestive Diseases, Rush University Medical Center, Chicago, Illinois
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Fatseas M, Kervran C, Auriacombe M. [Sleep disorders and addictions: Impact on quality of life and relapse vulnerability]. Presse Med 2016; 45:1164-1169. [PMID: 26970937 DOI: 10.1016/j.lpm.2016.01.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 01/13/2016] [Accepted: 01/20/2016] [Indexed: 11/15/2022] Open
Abstract
There is a bidirectional association between sleep disorders and addiction. Sleep problems negatively impact the quality of life of subjects with addictions (psychological state, pain perception, drug use). Sleep disorders are associated with a higher risk of relapse among sujects with addiction. The association between sleep disorders and relapse may be related to poor quality of life or to a higher level of craving. Maintaining abstinence and reducing craving episodes among subjects with addiction is the first-line treatment to reduce sleep disorders. Specific interventions focused on sleep disorders are needed when sleep disorders persist during abstinence and may improve global addiction outcome.
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Affiliation(s)
- Mélina Fatseas
- Université de Bordeaux, 33076 Bordeaux cedex, France; SANPsy CNRS USR 3413, Addiction psychiatry Team, 33076 Bordeaux, France; Pôle d'Addictologie, CH Ch. Perrens, CHU de Bordeaux, 33076 Bordeaux, France.
| | - Charlotte Kervran
- Université de Bordeaux, 33076 Bordeaux cedex, France; SANPsy CNRS USR 3413, Addiction psychiatry Team, 33076 Bordeaux, France; Pôle d'Addictologie, CH Ch. Perrens, CHU de Bordeaux, 33076 Bordeaux, France
| | - Marc Auriacombe
- Université de Bordeaux, 33076 Bordeaux cedex, France; SANPsy CNRS USR 3413, Addiction psychiatry Team, 33076 Bordeaux, France; Pôle d'Addictologie, CH Ch. Perrens, CHU de Bordeaux, 33076 Bordeaux, France.
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Steinan MK, Morken G, Lagerberg TV, Melle I, Andreassen OA, Vaaler AE, Scott J. Delayed sleep phase: An important circadian subtype of sleep disturbance in bipolar disorders. J Affect Disord 2016; 191:156-63. [PMID: 26655861 DOI: 10.1016/j.jad.2015.11.025] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 11/13/2015] [Accepted: 11/15/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND Theoretical models of Bipolar Disorder (BD) highlight that sleep disturbances may be a marker of underlying circadian dysregulation. However, few studies of sleep in BD have reported on the most prevalent circadian sleep abnormality, namely Delayed Sleep Phase (DSP). METHODS A cross-sectional study of 404 adults with BD who met published clinical criteria for insomnia, hypersomnia or DSP, and who had previously participated in a study of sleep in BD using a comprehensive structured interview assessment. RESULTS About 10% of BD cases with a sleep problem met criteria for a DSP profile. The DSP group was younger and had a higher mean Body Mass Index (BMI) than the other groups. Also, DSP cases were significantly more likely to be prescribed mood stabilizers and antidepressant than insomnia cases. An exploratory analysis of selected symptom item ratings indicated that DSP was significantly more likely to be associated with impaired energy and activity levels. LIMITATIONS The cross-sectional design precludes examination of longitudinal changes. DSP is identified by sleep profile, not by diagnostic criteria or objective sleep records such as actigraphy. The study uses data from a previous study to identify and examine the DSP group. CONCLUSIONS The DSP group identified in this study can be differentiated from hypersomnia and insomnia groups on the basis of clinical and demographic features. The association of DSP with younger age, higher BMI and impaired energy and activity also suggest that this clinical profile may be a good proxy for underlying circadian dysregulation.
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Affiliation(s)
- Mette Kvisten Steinan
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology & Department of Psychiatry, St. Olavs University Hospital, Trondheim, Norway
| | - Gunnar Morken
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology & Department of Psychiatry, St. Olavs University Hospital, Trondheim, Norway
| | - Trine V Lagerberg
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, Oslo, Norway
| | - Ingrid Melle
- NORMENT, Institute of Clinical Medicine, University of Oslo, & NORMENT Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Norway
| | - Arne E Vaaler
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology & Department of Psychiatry, St. Olavs University Hospital, Trondheim, Norway
| | - Jan Scott
- Academic Psychiatry, Institute of Neuroscience, Newcastle University, Centre for Affective Disorders, Institute of Psychiatry, London, United Kingdom.
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Abstract
The circadian system regulates the timing and expression of nearly all biological processes, most notably, the sleep-wake cycle, and disruption of this system can result in adverse effects on both physical and mental health. The circadian rhythm sleep-wake disorders (CRSWDs) consist of 5 disorders that are due primarily to pathology of the circadian clock or to a misalignment of the timing of the endogenous circadian rhythm with the environment. This article outlines the nature of these disorders, the association of many of these disorders with psychiatric illness, and available treatment options.
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Affiliation(s)
- Sabra M Abbott
- Department of Neurology, Northwestern University Feinberg School of Medicine, 710 North Lake Shore Drive, Suite 500, Chicago, IL 60611, USA
| | - Kathryn J Reid
- Department of Neurology, Northwestern University Feinberg School of Medicine, 710 North Lake Shore Drive, Suite 500, Chicago, IL 60611, USA
| | - Phyllis C Zee
- Department of Neurology, Northwestern University Feinberg School of Medicine, 710 North Lake Shore Drive, Suite 500, Chicago, IL 60611, USA.
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Kervran C, Fatséas M, Serre F, Taillard J, Beltran V, Leboucher J, Debrabant R, Alexandre JM, Daulouède JP, Philip P, Auriacombe M. Association between morningness/eveningness, addiction severity and psychiatric disorders among individuals with addictions. Psychiatry Res 2015; 229:1024-30. [PMID: 26250146 DOI: 10.1016/j.psychres.2015.05.026] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 05/18/2015] [Accepted: 05/20/2015] [Indexed: 11/26/2022]
Abstract
Studies have shown that Evening-Type (ET) subjects used more stimulating and sedative substances, and presented more psychiatric disorders than Morning-Type (MT) subject. However, there is a lack of data on the chronotype of patients with addiction. The aim of our study was to describe chronotype and associated factors in a sample of outpatients beginning treatment for addiction. Subjects were assessed with the Morningness-Eveningness questionnaire of Hörne & Ostberg, the Addiction Severity Index and the Mini International Neuropsychiatric Interview. In the 333 subjects with an addiction, 20% were MT and 32% were ET. When comparing ET to MT, multivariate analysis showed that ET was significantly associated with poly-problematic addiction, non-substance addictions, cannabis addiction, and mood disorders, but not with severity of addiction. MT was associated with antisocial personality disorder. Results suggested that chronotype was associated with specific addiction pattern and psychiatric disorders.
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Affiliation(s)
- Charlotte Kervran
- Université de Bordeaux, Bordeaux, France; Addiction Psychiatry Team, SANPsy CNRS USR 3413, Bordeaux, France; Pôle Addictologie, CH Ch. Perrens et CHU de Bordeaux, Bordeaux, France
| | - Mélina Fatséas
- Université de Bordeaux, Bordeaux, France; Addiction Psychiatry Team, SANPsy CNRS USR 3413, Bordeaux, France; Pôle Addictologie, CH Ch. Perrens et CHU de Bordeaux, Bordeaux, France
| | - Fuschia Serre
- Université de Bordeaux, Bordeaux, France; Addiction Psychiatry Team, SANPsy CNRS USR 3413, Bordeaux, France; Pôle Addictologie, CH Ch. Perrens et CHU de Bordeaux, Bordeaux, France
| | - Jacques Taillard
- Université de Bordeaux, Bordeaux, France; Sleep and Attention Team, SANPsy CNRS USR 3413, Bordeaux, France
| | - Virginie Beltran
- Université de Bordeaux, Bordeaux, France; Addiction Psychiatry Team, SANPsy CNRS USR 3413, Bordeaux, France; Centre d׳Addictologie, BIZIA et CH de Bayonne, Bayonne, France
| | - Juliette Leboucher
- Université de Bordeaux, Bordeaux, France; Addiction Psychiatry Team, SANPsy CNRS USR 3413, Bordeaux, France; Pôle Addictologie, CH Ch. Perrens et CHU de Bordeaux, Bordeaux, France
| | - Romain Debrabant
- Université de Bordeaux, Bordeaux, France; Addiction Psychiatry Team, SANPsy CNRS USR 3413, Bordeaux, France; Pôle Addictologie, CH Ch. Perrens et CHU de Bordeaux, Bordeaux, France
| | - Jean-Marc Alexandre
- Université de Bordeaux, Bordeaux, France; Addiction Psychiatry Team, SANPsy CNRS USR 3413, Bordeaux, France; Pôle Addictologie, CH Ch. Perrens et CHU de Bordeaux, Bordeaux, France
| | - Jean-Pierre Daulouède
- Université de Bordeaux, Bordeaux, France; Addiction Psychiatry Team, SANPsy CNRS USR 3413, Bordeaux, France; Centre d׳Addictologie, BIZIA et CH de Bayonne, Bayonne, France
| | - Pierre Philip
- Université de Bordeaux, Bordeaux, France; Sleep and Attention Team, SANPsy CNRS USR 3413, Bordeaux, France
| | - Marc Auriacombe
- Université de Bordeaux, Bordeaux, France; Addiction Psychiatry Team, SANPsy CNRS USR 3413, Bordeaux, France; Pôle Addictologie, CH Ch. Perrens et CHU de Bordeaux, Bordeaux, France.
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Fares S, Hermens DF, Naismith SL, White D, Hickie IB, Robillard R. Clinical correlates of chronotypes in young persons with mental disorders. Chronobiol Int 2015; 32:1183-91. [DOI: 10.3109/07420528.2015.1078346] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Rajaratnam SM, Licamele L, Birznieks G. Delayed sleep phase disorder risk is associated with absenteeism and impaired functioning. Sleep Health 2015; 1:121-127. [DOI: 10.1016/j.sleh.2015.03.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 03/05/2015] [Accepted: 03/06/2015] [Indexed: 12/12/2022]
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Bedont JL, Blackshaw S. Constructing the suprachiasmatic nucleus: a watchmaker's perspective on the central clockworks. Front Syst Neurosci 2015; 9:74. [PMID: 26005407 PMCID: PMC4424844 DOI: 10.3389/fnsys.2015.00074] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 04/23/2015] [Indexed: 11/13/2022] Open
Abstract
The circadian system constrains an organism's palette of behaviors to portions of the solar day appropriate to its ecological niche. The central light-entrained clock in the suprachiasmatic nucleus (SCN) of the mammalian circadian system has evolved a complex network of interdependent signaling mechanisms linking multiple distinct oscillators to serve this crucial function. However, studies of the mechanisms controlling SCN development have greatly lagged behind our understanding of its physiological functions. We review advances in the understanding of adult SCN function, what has been described about SCN development to date, and the potential of both current and future studies of SCN development to yield important insights into master clock function, dysfunction, and evolution.
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Affiliation(s)
- Joseph L Bedont
- Department of Neuroscience, Johns Hopkins University School of Medicine Baltimore, MD, USA
| | - Seth Blackshaw
- Department of Neuroscience, Johns Hopkins University School of Medicine Baltimore, MD, USA ; Department of Ophthalmology, Johns Hopkins University School of Medicine Baltimore, MD, USA ; Department of Physiology, Johns Hopkins University School of Medicine Baltimore, MD, USA ; Department of Neurology, Johns Hopkins University School of Medicine Baltimore, MD, USA ; Center for High-Throughput Biology, Johns Hopkins University School of Medicine Baltimore, MD, USA
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Zhang L, Evans DS, Raheja UK, Stephens SH, Stiller JW, Reeves G, Johnson M, Ryan KA, Weizel N, Vaswani D, McLain H, Shuldiner AR, Mitchell BD, Hsueh WC, Snitker S, Postolache TT. Chronotype and seasonality: morningness is associated with lower seasonal mood and behavior changes in the Old Order Amish. J Affect Disord 2015; 174:209-14. [PMID: 25527990 PMCID: PMC4356625 DOI: 10.1016/j.jad.2014.11.039] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 11/20/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND Several studies documented that lower scores on the Morningness-Eveningness Questionnaire (MEQ) are associated with a higher global seasonality of mood (GSS). As for the Modern Man artificial lighting predominantly extends evening activity and exposure to light, and as evening bright light phase is known to delay circadian rhythms, this chronic exposure could potentially lead to both lower Morningness as well as higher GSS. The aim of the study was to investigate if the MEQ-GSS relationship holds in the Old Order Amish of Lancaster County, PA, a population that does not use network electrical light. METHODS 489 Old Order Amish adults (47.6% women), with average (SD) age of 49.7 (14.2) years, completed both the Seasonal Pattern Assessment Questionnaire (SPAQ) for the assessment of GSS, and MEQ. Associations between GSS scores and MEQ scores were analyzed using linear models, accounting for age, gender and relatedness by including the relationship matrix in the model as a random effect. RESULTS GSS was inversely associated with MEQ scores (p=0.006, adjusted). LIMITATIONS include a potential recall bias associated with self-report questionnaires and no actual light exposure measurements. CONCLUSION We confirmed the previously reported inverse association between MEQ scores and lower seasonality of mood, for the first time in a population that does not use home network electrical lighting. This result suggests that the association is not a byproduct of exposure to network electric light, and calls for additional research to investigate mechanisms by which Morningness is negatively associated with seasonality.
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Affiliation(s)
- Layan Zhang
- Mood and Anxiety Program, University of Maryland School of Medicine,
Baltimore, MD, USA,Saint Elizabeths Hospital, Psychiatry Residency Training Program,
Washington, DC, USA
| | - Daniel S. Evans
- California Pacific Medical Center Research Institute, San Francisco,
CA, USA
| | - Uttam K. Raheja
- Mood and Anxiety Program, University of Maryland School of Medicine,
Baltimore, MD, USA,Saint Elizabeths Hospital, Psychiatry Residency Training Program,
Washington, DC, USA
| | - Sarah H. Stephens
- Division of Endocrinology, Diabetes and Nutrition, Department of
Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - John W. Stiller
- Mood and Anxiety Program, University of Maryland School of Medicine,
Baltimore, MD, USA,Saint Elizabeths Hospital, Psychiatry Residency Training Program,
Washington, DC, USA
| | - Gloria Reeves
- Division of Child and Adolescent Psychiatry & University of
Maryland Child and Adolescent Mental Health Innovations Center, University of
Maryland School of Medicine, Baltimore, MD, USA
| | - Mary Johnson
- Department of Ophthalmology & Visual Sciences, University of
Maryland School of Medicine, Baltimore, MD
| | - Kathleen A Ryan
- Division of Endocrinology, Diabetes and Nutrition, Department of
Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Nancy Weizel
- Division of Child and Adolescent Psychiatry & University of
Maryland Child and Adolescent Mental Health Innovations Center, University of
Maryland School of Medicine, Baltimore, MD, USA
| | - Dipika Vaswani
- Mood and Anxiety Program, University of Maryland School of Medicine,
Baltimore, MD, USA
| | - Hassan McLain
- Mood and Anxiety Program, University of Maryland School of Medicine,
Baltimore, MD, USA
| | - Alan R. Shuldiner
- Division of Endocrinology, Diabetes and Nutrition, Department of
Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Braxton D. Mitchell
- Division of Endocrinology, Diabetes and Nutrition, Department of
Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Wen-Chi Hsueh
- Phoenix Epidemiology and Clinical Research Branch, NIDDK, National
Institutes of Health, Phoenix, AZ
| | - Soren Snitker
- Division of Endocrinology, Diabetes and Nutrition, Department of
Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Teodor T. Postolache
- Mood and Anxiety Program, University of Maryland School of Medicine,
Baltimore, MD, USA,VISN 5 Capitol Health Care Network Mental Illness Research Education
and Clinical Center (MIRECC), Baltimore, MD, USA and VISN 19 MIRECC, Denver,
Colorado, USA,Corresponding author at: University of Maryland School
of Medicine, Mood and Anxiety Program, Department of Psychiatry, 685 West
Baltimore Street, MSTF Building Room 930, Baltimore, MD 21201, USA., Tel.:
+1 4107062323; fax: +1 4107060751.,
(T.T. Postolache)
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Nota JA, Coles ME. Duration and Timing of Sleep are Associated with Repetitive Negative Thinking. COGNITIVE THERAPY AND RESEARCH 2014. [DOI: 10.1007/s10608-014-9651-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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de Souza CM, Hidalgo MPL. The midpoint of sleep on working days: a measure for chronodisruption and its association to individuals' well-being. Chronobiol Int 2014; 32:341-8. [PMID: 25392279 DOI: 10.3109/07420528.2014.979941] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
There is consistent evidence suggesting a relationship between individuals' sleep-wake rhythms and well-being. The indiscriminate demands from daily working routines, which do not respect this individual physiological rhythm, might be mediating this phenomenon. The aim of the present study was to evaluate the relationship between the characteristics of sleep routines during working days and psychological well-being. This was a cross-sectional study on 825 individuals from rural communities from southern Brazil. The study protocol included a questionnaire on demographic characteristics, working routines, health complaints, and habits; the Munich Chronotype Questionnaire for sleep-wake rhythm and; the WHO-Five well-being index. Since sex has been shown to affect sleep circadian rhythm and well-being, analysis was performed on men and women separately. In the proposed hierarchical regression models, different factors contributed to well-being according to sex. Among men, sleep-wake and work-related variables did not predict well-being scores. Among women, later midpoints of sleep on working days (B = -1.243, SE B = 0.315, β = -0.220), working more days per week (B = -1.507, SE B = 0.494, β = 0.150), having longer working journeys (B = -0.293, SE B = 0.105, β = -0.166), earlier working journey midpoints (B = 0.465, SE B = 0.222, β = 0.115), and being exposed to less sunlight (B = 0.140, SE B = 0.064, β = 0.103) predicted worse well-being. For the subgroup of women with days free from work, we have found a correlation between later midpoints of sleep during the week with worse well-being (Pearson's r = -0.159, p = 0.045) while the same relationship was not significantly observed with the midpoint of sleep on non-working days (Pearson's r = -0.153, p = 0.054). Considering WHO-Five as categorical, based on proposed clinical cut-offs, among women working 7-d/week, those with worst well-being (WHO-Five < 13) had the latest midpoint of sleep (F = 4.514, p = 0.012). Thus, the midpoint of sleep on working days represents the interaction between individuals' sleep-wake behavior and working routines. It plays an important role as a stress factor and may be a useful alternative variable related to chronodisruption.
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Kripke DF, Klimecki WT, Nievergelt CM, Rex KM, Murray SS, Shekhtman T, Tranah GJ, Loving RT, Lee HJ, Rhee MK, Shadan FF, Poceta JS, Jamil SM, Kline LE, Kelsoe JR. Circadian polymorphisms in night owls, in bipolars, and in non-24-hour sleep cycles. Psychiatry Investig 2014; 11:345-62. [PMID: 25395965 PMCID: PMC4225198 DOI: 10.4306/pi.2014.11.4.345] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 04/18/2014] [Accepted: 04/18/2014] [Indexed: 12/13/2022] Open
Abstract
People called night owls habitually have late bedtimes and late times of arising, sometimes suffering a heritable circadian disturbance called delayed sleep phase syndrome (DSPS). Those with DSPS, those with more severe progressively-late non-24-hour sleep-wake cycles, and those with bipolar disorder may share genetic tendencies for slowed or delayed circadian cycles. We searched for polymorphisms associated with DSPS in a case-control study of DSPS research participants and a separate study of Sleep Center patients undergoing polysomnography. In 45 participants, we resequenced portions of 15 circadian genes to identify unknown polymorphisms that might be associated with DSPS, non-24-hour rhythms, or bipolar comorbidities. We then genotyped single nucleotide polymorphisms (SNPs) in both larger samples, using Illumina Golden Gate assays. Associations of SNPs with the DSPS phenotype and with the morningness-eveningness parametric phenotype were computed for both samples, then combined for meta-analyses. Delayed sleep and "eveningness" were inversely associated with loci in circadian genes NFIL3 (rs2482705) and RORC (rs3828057). A group of haplotypes overlapping BHLHE40 was associated with non-24-hour sleep-wake cycles, and less robustly, with delayed sleep and bipolar disorder (e.g., rs34883305, rs34870629, rs74439275, and rs3750275 were associated with n=37, p=4.58E-09, Bonferroni p=2.95E-06). Bright light and melatonin can palliate circadian disorders, and genetics may clarify the underlying circadian photoperiodic mechanisms. After further replication and identification of the causal polymorphisms, these findings may point to future treatments for DSPS, non-24-hour rhythms, and possibly bipolar disorder or depression.
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Affiliation(s)
- Daniel F. Kripke
- Department of Psychiatry, University of California, San Diego, CA, USA
- Viterbi Family Sleep Center, Scripps Clinic, La Jolla, CA, USA
| | - Walter T. Klimecki
- Department of Pharmacology and Toxicology, University of Arizona, Tucson, AZ, USA
| | | | - Katharine M. Rex
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Sarah S. Murray
- Department of Pathology, Center for Advanced Laboratory Medicine, University of California, San Diego, CA, USA
| | - Tatyana Shekhtman
- Department of Psychiatry, University of California, San Diego, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
| | - Gregory J. Tranah
- California Pacific Medical Center Research Institute, San Francisco, CA, USA
| | | | - Heon-Jeong Lee
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Min Kyu Rhee
- Department of Psychology, Gyeongsang National University, Jinju, Republic of Korea
| | | | | | - Shazia M. Jamil
- Viterbi Family Sleep Center, Scripps Clinic, La Jolla, CA, USA
| | | | - John R. Kelsoe
- Department of Psychiatry, University of California, San Diego, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
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Landtblom AM, Engström M. The sleepy teenager - diagnostic challenges. Front Neurol 2014; 5:140. [PMID: 25136329 PMCID: PMC4120676 DOI: 10.3389/fneur.2014.00140] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Accepted: 07/14/2014] [Indexed: 02/04/2023] Open
Abstract
The sleepy teenager puts the doctor in a, often tricky, situation where it must be decided if we deal with normal physiology or if we should suspect pathological conditions. What medical investigations are proper to consider? What differential diagnoses should be considered in the first place? And what tools do we actually have? The symptoms and problems that usually are presented at the clinical visit can be both of medical and psychosocial character – and actually they are often a mixture of both. Subsequently, the challenge to investigate the sleepy teenager often includes the examination of a complex behavioral pattern. It is important to train and develop diagnostic skills and to realize that the physiological or pathological conditions that can cause the symptoms may have different explanations. Research in sleep disorders has shown different pathological mechanisms congruent with the variations in the clinical picture. There are probably also different patterns of involved neuronal circuits although common pathways may exist. The whole picture remains to be drawn in this interesting and challenging area.
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Affiliation(s)
- Anne-Marie Landtblom
- Department of Clinical and Experimental Medicine, Division of Neurology, IKE, County Council, Linköping University , Linköping , Sweden ; Neurology Unit, Department of Medical Specialist, IMM, County Council, Linköping University , Motala , Sweden ; Department of Neuroscience, Uppsala University , Uppsala , Sweden ; Division of Radiological Sciences, Department of Medical and Health Sciences, Linköping University , Linköping , Sweden
| | - Maria Engström
- Division of Radiological Sciences, Department of Medical and Health Sciences, Linköping University , Linköping , Sweden
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Alvaro PK, Roberts RM, Harris JK. The independent relationships between insomnia, depression, subtypes of anxiety, and chronotype during adolescence. Sleep Med 2014; 15:934-41. [PMID: 24958244 DOI: 10.1016/j.sleep.2014.03.019] [Citation(s) in RCA: 113] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 03/02/2014] [Accepted: 03/21/2014] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To investigate the independent effects of depression and subtypes of anxiety on insomnia, and vice versa, and the independent effect of chronotype on insomnia, depression, and subtypes of anxiety. METHODS In all, 318 South Australian high school students from grades 7-11 (age range, 12-18years; mean, 14.97±1.34) participated in this cross-sectional study. Validated self-report questionnaires were used to assess insomnia, depression, subtypes of anxiety, and chronotype. RESULTS After confounder variables were controlled, insomnia predicted depression and panic disorder (PD), whereas insomnia was predicted by depression and generalized anxiety disorder (GAD). Obsessive-compulsive disorder (OCD), separation anxiety (SAD), and social phobia (SP) were not significantly related to insomnia. Eveningness predicted the models in which depression and PD predicted insomnia and vice versa. Eveningness also predicted the models in which insomnia was predicted by OCD, SAD, and SP. CONCLUSIONS Insomnia independently predicts depression and is predicted by depression and GAD, but not by other forms of anxiety. The independent prediction of insomnia on PD is unlikely to be clinically significant. Chronotype independently predicts and hence is a risk factor for insomnia and depression, but not subtypes of anxiety. Theoretical and clinical implications are discussed.
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Affiliation(s)
- Pasquale K Alvaro
- School of Psychology, University of Adelaide, South Australia, Australia.
| | - Rachel M Roberts
- School of Psychology, University of Adelaide, South Australia, Australia
| | - Jodie K Harris
- Flinders University of South Australia, Centre for Treatment of Anxiety and Depression, SA Health, University of Adelaide, South Australia, Australia
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Abstract
Circadian rhythms are near 24-h patterns of physiology and behaviour that are present independent of external cues including hormones, body temperature, mood, and sleep propensity. The term 'circadian misalignment' describes a variety of circumstances, such as inappropriately timed sleep and wake, misalignment of sleep/wake with feeding rhythms, or misaligned central and peripheral rhythms. The predominance of early research focused on misalignment of sleep to the biological night. However, discovery of clock genes and the presence of peripheral circadian oscillators have expanded the definitions of misalignment. Experimental studies conducted in animal models and humans have provided evidence of potential mechanisms that link misalignment to negative outcomes. These include dysregulation of feeding behaviours, changes in appetite stimulating hormones, glucose metabolism and mood. This review has two foci: (1) to describe how circadian misalignment has been defined and evaluated in laboratory and field experiments, and (2) to describe evidence linking different types of circadian misalignment to increased risk for physical (cardiovascular disease, diabetes, obesity, cancer) and psychiatric (depression, bipolar, schizophrenia, attention deficit) disorders. This review will describe the role of circadian misalignment as a risk factor for disease in the general population and in clinical populations, including circadian rhythm sleep disorders and psychiatric disorders.
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Affiliation(s)
- Kelly Glazer Baron
- Feinberg School of Medicine, Northwestern University , Chicago, Illinois USA
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68
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Abstract
Despite its pervasiveness in primary care, deficient sleep often is underappreciated as a cue to other health risks. Accordingly, this review discusses contemporary evidence-based perspectives on impaired sleep and its associations with other lifestyle medicine concerns, including obesity, cardiovascular conditions, psychological problems, and health-compromising habits. The potential clinical benefits of promoting sleep health also will be considered.
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Affiliation(s)
- Lisa Terre
- Department of Psychology, University of Missouri-Kansas City, Kansas City, Missouri
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69
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Wilhelmsen-Langeland A, Saxvig IW, Pallesen S, Nordhus IH, Vedaa Ø, Lundervold AJ, Bjorvatn B. A randomized controlled trial with bright light and melatonin for the treatment of delayed sleep phase disorder: effects on subjective and objective sleepiness and cognitive function. J Biol Rhythms 2013; 28:306-21. [PMID: 24132057 DOI: 10.1177/0748730413500126] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Delayed sleep phase disorder (DSPD) is a circadian rhythm sleep disorder. Patients with DSPD have problems initiating sleep if they go to bed at a conventional time, and they often have problems waking at desired times. If they rise early in the morning, they usually experience severe sleepiness during morning hours. In the present study, we investigated the short- and long-term effects on measures of subjective and objective sleepiness and cognitive function of bright light and melatonin treatment alongside gradually advanced rise times in adolescents and young adults. Four treatment conditions were used in the short-term intervention (2 weeks): dim light (placebo) + placebo capsule, bright light + placebo capsule, dim light (placebo) + melatonin capsule, and bright light + melatonin capsule. This was followed by a long-term intervention (3 months) including 2 conditions: no treatment and combined bright light + melatonin treatment. Effects of treatment on sleepiness and fatigue were the primary outcome measures, and effects on cognitive function were secondary outcome measures. On a gradual advancement of the rise time schedule, all treatment conditions (bright light, melatonin, combination, and placebo) were almost equally effective in improving subjective daytime sleepiness, fatigue, and cognitive function in the 2-week study. The 2-week intervention showed no effect on objective sleepiness. Long-term treatment increased some of the positive effects seen after 2 weeks. The combined bright light and melatonin treatment improved subjective daytime sleepiness, fatigue, and cognitive function in the 3-month study. The no-treatment group returned to baseline values on most variables. In conclusion, a gradual advancement of rise times seems to produce positive effects on subjective sleepiness, fatigue, and cognitive performance during short-term treatment of patients with DSPD. However, the benefits from gradually advanced rise times seem to wear off, suggesting that the continuation of bright light and melatonin treatment is beneficial to maintain positive effects over time.
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Bonmati-Carrion MA, Middleton B, Revell V, Skene DJ, Rol MA, Madrid JA. Circadian phase assessment by ambulatory monitoring in humans: correlation with dim light melatonin onset. Chronobiol Int 2013; 31:37-51. [PMID: 24164100 DOI: 10.3109/07420528.2013.820740] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The increased prevalence of circadian disruptions due to abnormal coupling between internal and external time makes the detection of circadian phase in humans by ambulatory recordings a compelling need. Here, we propose an accurate practical procedure to estimate circadian phase with the least possible burden for the subject, that is, without the restraints of a constant routine protocol or laboratory techniques such as melatonin quantification, both of which are standard procedures. In this validation study, subjects (N = 13) wore ambulatory monitoring devices, kept daily sleep diaries and went about their daily routine for 10 days. The devices measured skin temperature at wrist level (WT), motor activity and body position on the arm, and light exposure by means of a sensor placed on the chest. Dim light melatonin onset (DLMO) was used to compare and evaluate the accuracy of the ambulatory variables in assessing circadian phase. An evening increase in WT: WTOnset (WTOn) and "WT increase onset" (WTiO) was found to anticipate the evening increase in melatonin, while decreases in motor activity (Activity Offset or AcOff), body position (Position Offset (POff)), integrative TAP (a combination of WT, activity and body position) (TAPOffset or TAPOff) and an increase in declared sleep propensity were phase delayed with respect to DLMO. The phase markers obtained from subjective sleep (R = 0.811), WT (R = 0.756) and the composite variable TAP (R = 0.720) were highly and significantly correlated with DLMO. The findings strongly support a new method to calculate circadian phase based on WT (WTiO) that accurately predicts and shows a temporal association with DLMO. WTiO is especially recommended due to its simplicity and applicability to clinical use under conditions where knowing endogenous circadian phase is important, such as in cancer chronotherapy and light therapy.
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Affiliation(s)
- M A Bonmati-Carrion
- Chronobiology Laboratory, Department of Physiology, University of Murcia , 30100 Espinardo, Murcia , Spain and
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Broms U, Pitkäniemi J, Bäckmand H, Heikkilä K, Koskenvuo M, Peltonen M, Sarna S, Vartiainen E, Kaprio J, Partonen T. Long-term consistency of diurnal-type preferences among men. Chronobiol Int 2013; 31:182-8. [DOI: 10.3109/07420528.2013.836534] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Antúnez JM, Navarro JF, Adan A. Circadian Typology and Emotional Intelligence in Healthy Adults. Chronobiol Int 2013; 30:981-7. [DOI: 10.3109/07420528.2013.790397] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Partonen T. Hypothesis: Cryptochromes and Brown Fat are Essential for Adaptation and Affect Mood and Mood-Related Behaviors. Front Neurol 2012; 3:157. [PMID: 23133436 PMCID: PMC3488760 DOI: 10.3389/fneur.2012.00157] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Accepted: 10/16/2012] [Indexed: 01/04/2023] Open
Abstract
Solar radiation and ambient temperature have acted as selective physical forces among populations and thereby guided species distributions in the globe. Circadian clocks are universal and evolve when subjected to selection, and their properties contribute to variations in fitness within specific environments. Concerning humans, as compared to the remaining, the "evening owls" have a greater deviation from the 24 h cycle, are under a greater pressure to circadian desynchrony and more prone to a cluster of health hazards with the increased mortality. Because of their position in the hierarchy and repressive actions, cryptochromes are the key components of the feedback loops on which circadian clocks are built. Based on the evidence a new hypothesis is formulated in which brown adipocytes with their cryptochromes are responsive to a broad range of physical stimuli from the habitat and through their activity ensure adaptation of the individual. The over-activated brown adipose tissue with deficient cryptochromes might induce disrupted thermoregulation and circadian desynchrony, and thereby contribute to lowered mood and pronounced depressive behaviors.
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Affiliation(s)
- Timo Partonen
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare Helsinki, Finland ; Department of Psychiatry, University of Helsinki Helsinki, Finland
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