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Darroudi S, Sharifan P, Sadeghzadeh P, Namjou N, Zamiri Bidary M, Zamani P, Esmaily H, Ferns GA, Moohebati M, Ghayour-Mobarhan M. Overweight and Obesity are Potential Risk Factors for Disrupted Nocturnal Sleep in Iranian Adults: A Cross-Sectional Study. Int J Public Health 2021; 66:633183. [PMID: 34744585 PMCID: PMC8565265 DOI: 10.3389/ijph.2021.633183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 09/13/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Obesity is a risk factor for several chronic conditions, including sleep disorders. We aimed to analyze the relationship between BMI, body fat percentage (FAT%), hip and waist circumference, and weight on the duration of nocturnal sleep. Methods: This study was part of the MASHAD cohort study. In all participants BMI and FAT% were measured. BMI was used to categorize individuals as obese, overweight, and normal subjects. FAT% was used to categorize individuals into tertile: tertile 1 (low) < 27.5, tertile 2 (medium) 27.5-41, and tertile 3 (high) > 41. The level of nightly sleep duration was categorized into three groups: <6, 6-8 (reference group), and >8 h. Results: There was a significant inverse association between body weight and duration of sleep (p < 0.05). Obese and overweight participants had 1.152 OR (CI:1.083-1.225) and 1.126 OR (CI:1.063-1.194) for a short duration of nocturnal sleep, respectively, relative to those with a normal BMI. Conclusion: BMI was an independent determinant of nocturnal sleep duration; obesity and overweight may have negative consequences on sleep duration. Weight control should be considered as a factor in adjusting sleep quality.
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Affiliation(s)
- Susan Darroudi
- Student Research Committee, International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Payam Sharifan
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Parastoo Sadeghzadeh
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Negin Namjou
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Zamiri Bidary
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Parvin Zamani
- Department of Medical Biotechnology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaily
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A. Ferns
- Brighton and Sussex Medical School, Division of Medical Education, Brighton, United Kingdom
| | - Mohsen Moohebati
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- Student Research Committee, International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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52
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Gu H, Kong W, Yin H, Zheng Y. Prevalence of sleep impairment in patients with tinnitus: a systematic review and single-arm meta-analysis. Eur Arch Otorhinolaryngol 2021; 279:2211-2221. [PMID: 34708282 DOI: 10.1007/s00405-021-07092-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 09/12/2021] [Indexed: 02/08/2023]
Abstract
PURPOSE This study aimed to comprehensively review the literature and synthesize relevant data to examine the pooled prevalence of poor sleep quality (sleep impairment) and assess overall sleep quality in patients with tinnitus. METHODS This meta-analysis systematically searched both English (PubMed, Embase, and Web of Science) and Chinese (Wanfang Data Chinese database, Veep Chinese Database, and Chinese National Knowledge Infrastructure) databases. Data extraction and quality assessment were independently performed by two authors. The pooled prevalence of sleep impairment and poor sleep quality was calculated via a random-effects model. Sub-group and sensitivity analyses were performed to explore the source of heterogeneity. RESULTS A total of seven studies were included with a total sample of 3041 tinnitus participants. The pooled prevalence of sleep impairment was 53.5% (95% confidence interval: 40.2-66.8%) and the I2 was 97.8% (Q = 7.90, p = 0.000). There were significant differences in the prevalence of poor sleep quality between males and females (39.1% vs. 44.6%, P = 0.034), between different PSQI cut-off values ≥ 7 and > 5 (53.1% vs. 53.8%, P = 0.000), and between sample sizes > 200 and ≤ 200 (54.0% vs. 52.7%, P = 0.000). In non-Asia area, the prevalence (56.6%, 95% CI: 42.6-70.5%) was lower than that in Asia areas (34.5%, 95% CI: 25.7-43.3%). CONCLUSION Sleep impairment is common among patients with tinnitus. Development of interventions for conditions associated with poor sleep quality should be recommended to offer a safe and efficacious solution for this population.
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Affiliation(s)
- Hailing Gu
- Department of Otolaryngology-Head and Neck Surgery, Hearing Center/Hearing and Speech Science Laboratory, West China Hospital of Sichuan University, 37 Guo Xue Lane, Chengdu, People's Republic of China
| | - Weili Kong
- Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Huilin Yin
- Department of Otolaryngology-Head and Neck Surgery, Hearing Center/Hearing and Speech Science Laboratory, West China Hospital of Sichuan University, 37 Guo Xue Lane, Chengdu, People's Republic of China
| | - Yun Zheng
- Department of Otolaryngology-Head and Neck Surgery, Hearing Center/Hearing and Speech Science Laboratory, West China Hospital of Sichuan University, 37 Guo Xue Lane, Chengdu, People's Republic of China.
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53
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Smith JL, Allen JW, Haack CI, Wehrmeyer KL, Alden KG, Lund MB, Mascaro JS. Impact of App-Delivered Mindfulness Meditation on Functional Connectivity, Mental Health, and Sleep Disturbances Among Physician Assistant Students: Randomized, Wait-list Controlled Pilot Study. JMIR Form Res 2021; 5:e24208. [PMID: 34665153 PMCID: PMC8564666 DOI: 10.2196/24208] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 04/23/2021] [Accepted: 07/23/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Health care provider and trainee burnout results in substantial national and institutional costs and profound social effects. Identifying effective solutions and interventions to cultivate resilience among health care trainees is critical. Although less is known about the mental health needs of physician assistants (PAs) or PA students, accumulating research indicates that they experience similarly alarming rates of burnout, depression, and emotional exhaustion. Mobile app-delivered mindfulness meditation may be an effective part of salubrious programming to bolster long-term resilience and health among PA students. OBJECTIVE This study aims to examine the impact of app-delivered mindfulness meditation on self-reported mental health symptoms among PA students. A secondary aim is to investigate changes in brain connectivity to identify neurobiological changes related to changes in mental health symptoms. METHODS We recruited PA students enrolled in their third semester of PA school and used a longitudinal, randomized, wait-list-controlled design. Participants randomized to the mindfulness group were provided 1-year subscriptions to the 10% Happier app, a consumer-based meditation app, and asked to practice every day for 8 weeks. Before randomization and again after completion of the 8-week program, all participants completed resting-state functional magnetic resonance imaging as well as self-report assessments of burnout, depression, anxiety, and sleep impairment. App use was acquired as a measure of mindfulness practice time. RESULTS PA students randomized to the mindfulness group reported improvements in sleep impairment compared with those randomized to the wait-list control group (ηp2=0.42; P=.01). Sleep impairment decreased significantly in the mindfulness group (19% reduction; P=.006) but not in the control group (1% reduction; P=.71). There were no other significant changes in mental health for those randomized to app-delivered mindfulness. Across all students, changes in sleep impairment were associated with increased resting-state functional connectivity between the medial prefrontal cortex (a component of the default mode network) and the superior temporal gyrus, as well as between areas important for working memory. Changes in connectivity predicted categorical conversion from impaired to nonimpaired sleep in the mindfulness group. CONCLUSIONS This pilot study is the first to examine app-based mindfulness for PA students' mental health and investigate the impact of mindfulness on PA students' brain function. These findings suggest that app-delivered mindfulness may be an effective tool to improve sleep dysfunction and that it may be an important part of the programming necessary to reduce the epidemic of suffering among health profession trainees.
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Affiliation(s)
- Jeremy L Smith
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, United States
| | - Jason W Allen
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, United States
- Department of Neurology, Emory University, Atlanta, GA, United States
| | - Carla I Haack
- Department of Surgery, Emory University, Atlanta, GA, United States
| | - Kathryn L Wehrmeyer
- Department of Family and Preventative Medicine, Emory University, Atlanta, GA, United States
| | - Kayley G Alden
- Department of Family and Preventative Medicine, Emory University, Atlanta, GA, United States
| | - Maha B Lund
- Physician Assistant Program, Department of Family and Preventative Medicine, Emory University, Atlanta, GA, United States
| | - Jennifer S Mascaro
- Department of Family and Preventative Medicine, Emory University, Atlanta, GA, United States
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Vieira FDST, Muraro AP, Rodrigues PRM, Sichieri R, Pereira RA, Ferreira MG. Lifestyle-related behaviors and depressive symptoms in college students. CAD SAUDE PUBLICA 2021; 37:e00202920. [PMID: 34644759 DOI: 10.1590/0102-311x00202920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 01/08/2021] [Indexed: 12/15/2022] Open
Abstract
This study sought to examine the association between lifestyle-related behaviors and depressive symptoms among college students. This cross-sectional study analyzed baseline data of a dynamic-cohort study from a public university in Central-Western Brazil, in all 21 undergraduate full-time courses. Students up to 25 years old who were enrolled for the first time in a university were included in the study, except pregnant and/or nursing women. All students who met the eligibility criteria were invited to participate in the study. From a total of 1,212 eligible students, 1,038 were included (85.6%). All participants answered a self-administered questionnaire on smoking, alcohol consumption, screen time, sleep duration, and meal patterns. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Multivariate Poisson regression models stratified by sex were used to estimate the associations. Depressive symptoms was observed in 31.6% (males 23.6%; females 39.9%; p-value chi-square test = 0.01) of the students. Smoking, drinking spirits, and having irregular meal habits were directly associated with depressive symptoms in both males and females. The co-occurrence of two risk behaviors (men: aPR = 2.23, 95%CI: 1.25; 3.99; women: aPR = 1.54, 95%CI: 1.03; 2.30) and three or more risk behaviors (men: aPR = 3.42, 95%CI: 1.90; 6.16; women: aPR = 2.09, 95%CI: 1.39; 3.15) increased the occurrence of depressive symptoms among the students. Lifestyle-related unhealthy behaviors were associated with an increased occurrence of depressive symptoms among college students. These findings suggest the need of interventions encouraging changes in lifestyle to promote mental health and to improve the quality of life in this group.
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Affiliation(s)
| | - Ana Paula Muraro
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| | | | - Rosely Sichieri
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Rosangela Alves Pereira
- Departamento de Nutrição Social e Aplicada, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
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Ng APP, Chin WY, Wan EYF, Chen J, Lau CS. Prevalence of depression and suicide ideation in Hong Kong doctors: a cross-sectional study. Sci Rep 2021; 11:19366. [PMID: 34588512 PMCID: PMC8481547 DOI: 10.1038/s41598-021-98668-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 09/14/2021] [Indexed: 11/18/2022] Open
Abstract
Depression amongst physicians can lead to poor individual and institutional outcomes. This study examined the prevalence and factors associated with depression and suicidal ideation amongst doctors in Hong Kong. Doctors who graduated from medical school at the University of Hong Kong between 1995 and 2014 were invited to participate in a survey measuring depressive symptoms, suicidal ideation and thoughts of self-harm, lifestyle behaviours, career satisfaction and socio-demographic characteristics. Data collection occurred between January and April 2016. The prevalence of screened-positive depression was 16.0% and 15.3% of respondents reported having suicidal ideation. Amongst those with positive depression screening scores, less than half reported having a diagnosed mood disorder. Sleeping fewer hours was associated with higher depression scores (P < 0.001) and an increased odds of meeting the cut-off for depression (P < 0.001). Factors associated with suicidal ideation included being unmarried (P = 0.012) and sleeping fewer hours (P = 0.022). Hong Kong doctors appear to have high rates of undiagnosed depression, and high levels of depressive symptoms and suicidal ideations. There is a need for greater awareness of the morbidity due to depression and to promote better mental health help-seeking among physicians. Barriers to mental health help-seeking need to be addressed and appropriate resources allocated to reduce suffering.
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Affiliation(s)
- Amy Pui Pui Ng
- Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, 1 Haiyuan 1st Rd, Futian District, Shenzhen, 518053, Guangdong Province, China.,Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 3/F., 161 Main Street, Ap Lei Chau Clinic, Ap Lei Chau, Hong Kong, Hong Kong SAR
| | - Weng Yee Chin
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 3/F., 161 Main Street, Ap Lei Chau Clinic, Ap Lei Chau, Hong Kong, Hong Kong SAR. .,Li Ka Shing Faculty of Medicine, Bau Institute of Medical and Health Sciences Education, The University of Hong Kong, 21 Sassoon Road, Pok Fu Lam, Hong Kong, Hong Kong SAR.
| | - Eric Yuk Fai Wan
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 3/F., 161 Main Street, Ap Lei Chau Clinic, Ap Lei Chau, Hong Kong, Hong Kong SAR.,Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, HKU, 2/F, Laboratory Block, 21 Sassoon Road, Pok Fu Lam, Hong Kong, Hong Kong SAR
| | - Julie Chen
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 3/F., 161 Main Street, Ap Lei Chau Clinic, Ap Lei Chau, Hong Kong, Hong Kong SAR.,Li Ka Shing Faculty of Medicine, Bau Institute of Medical and Health Sciences Education, The University of Hong Kong, 21 Sassoon Road, Pok Fu Lam, Hong Kong, Hong Kong SAR
| | - Chak Sing Lau
- Department of Medicine Hong Kong, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Room 405B, 4/F, Professorial Block, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong, Hong Kong SAR
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56
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Milasauskiene E, Burkauskas J, Podlipskyte A, Király O, Demetrovics Z, Ambrasas L, Steibliene V. Compulsive Internet Use Scale: Psychometric Properties and Associations With Sleeping Patterns, Mental Health, and Well-Being in Lithuanian Medical Students During the Coronavirus Disease 2019 Pandemic. Front Psychol 2021; 12:685137. [PMID: 34512443 PMCID: PMC8428172 DOI: 10.3389/fpsyg.2021.685137] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/26/2021] [Indexed: 12/24/2022] Open
Abstract
Background: The increase in problematic Internet use (PIU) among medical students and resident doctors during the coronavirus disease 2019 (COVID-19) pandemic may be leading to significant impairments in everyday functioning, including sleeping patterns, anxiety, depressive symptoms, and overall well-being. The Compulsive Internet Use Scale (CIUS) has been developed to assess the severity of PIU, however, it has not been elucidated whether this scale is also applicable to medical students and resident doctors. The first aim of this study was to explore the psychometric properties of the Lithuanian version of the CIUS. The second aim was to examine associations between subjectively reported mental health symptoms and PIU during the COVID-19 pandemic. Methods: A total of 524 medical students and resident doctors (78.60% women, mean age 24 [SD 3] years old) participated in an online survey between December 2020 and February 2021. Participants completed the CIUS, the Pittsburgh Sleep Quality Index (PSQI) questionnaire, the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder Assessment-7 (GAD-7), and the WHO-Five Well-Being Index questionnaire (WHO-5). Results: The confirmatory factor analysis (CFA) suggested brief versions (CIUS-5, CIUS-7, and CIUS-9) rather than the original (CIUS-14) version of the CIUS questionnaire as reliable and structurally stable instruments that can be used to measure compulsive Internet use severity in the sample of medical students and resident doctors. The most prevalent online behaviors were social media use (90.1%), online shopping (15.6%), and online gaming/gambling (11.3%). Students with higher CIUS scores reported significantly lower academic achievements during the 6 months (r = 0.12-0.13; p < 0.006), as well as more severe depressive and anxiety symptoms, worsened sleep quality, and lower sense of well-being (r = 0.21-0.41; p's < 0.001). Both, during workdays (d = 0.87) and weekend (d = 0.33), students spent more time online than resident doctors (p's < 0.001). Conclusion: The brief, 5-, 7-, and 9-item versions of the Lithuanian CIUS are reliable and valid self-report screening instruments for evaluating the severity of PIU symptoms among the medical student population. Symptoms of PIU during the COVID-19 period were associated with worsened self-reported mental health and everyday functioning.
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Affiliation(s)
- Egle Milasauskiene
- Clinic of Psychiatry, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Julius Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga, Lithuania
| | - Aurelija Podlipskyte
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga, Lithuania
| | - Orsolya Király
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
| | - Laurynas Ambrasas
- Clinic of Psychiatry, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vesta Steibliene
- Clinic of Psychiatry, Lithuanian University of Health Sciences, Kaunas, Lithuania.,Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga, Lithuania
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Zhang Z, Hu Y, Chen Y, Liao Z, Zheng Y, Ding L. Sleep disorders and related factors among frontline medical staff supporting Wuhan during the COVID-19 outbreak. Bull Menninger Clin 2021; 85:254-270. [PMID: 34468214 DOI: 10.1521/bumc_2012_85_01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Sleep problems among frontline medical staff during the COVID-19 epidemic require attention. A total of 249 frontline medical staff who were recruited to support Wuhan completed this cross-sectional study. A web-based questionnaire about insomnia, depression, anxiety, and fatigue was used to assess mental health status. The prevalence of sleep disorders among frontline medical staff was 50.6%. More time spent in Wuhan and a history of insomnia, depression, anxiety, and fatigue were associated with a higher risk of insomnia. People who stayed in Wuhan for a long time with a history of insomnia, depression, anxiety, and fatigue symptoms might be at high risk of insomnia.
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Affiliation(s)
- Zhenqing Zhang
- Xiamen Xianyue Hospital, Xiamen, Fujian, China.,Psychiatrist at the Obsessive and Compulsive Disorder Treatment Center
| | - Yanyu Hu
- Xiamen Xianyue Hospital, Xiamen, Fujian, China.,Psychiatrist at the Sleep Medicine Center
| | - Yingying Chen
- Xiamen Xianyue Hospital, Xiamen, Fujian, China.,Psychiatrists in the Department of Psychiatry
| | - Zhenhua Liao
- Xiamen Xianyue Hospital, Xiamen, Fujian, China.,Department of Science and Education
| | - Yixiong Zheng
- Xiamen Xianyue Hospital, Xiamen, Fujian, China.,Psychiatrists in the Department of Psychiatry
| | - Lijun Ding
- Xiamen Xianyue Hospital, Xiamen, Fujian, China.,Department of Science and Education
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58
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Low back pain and its correlations with poor sleep quality among health care providers. J Taibah Univ Med Sci 2021; 17:28-37. [PMID: 35140562 PMCID: PMC8801478 DOI: 10.1016/j.jtumed.2021.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/08/2021] [Accepted: 09/01/2021] [Indexed: 11/24/2022] Open
Abstract
Objective Methods Results Conclusion
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59
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Facebook addiction and depression: Loneliness as a moderator and poor sleep quality as a mediator. TELEMATICS AND INFORMATICS 2021. [DOI: 10.1016/j.tele.2021.101617] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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60
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Tuura RO, Volk C, Callaghan F, Jaramillo V, Huber R. Sleep-related and diurnal effects on brain diffusivity and cerebrospinal fluid flow. Neuroimage 2021; 241:118420. [PMID: 34302966 DOI: 10.1016/j.neuroimage.2021.118420] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/25/2021] [Accepted: 07/20/2021] [Indexed: 10/20/2022] Open
Abstract
The question of how waste products are cleared from the brain, and the role which sleep plays in this process, is critical for our understanding of a range of physical and mental illnesses. In rodents, both circadian and sleep-related processes appear to facilitate clearance of waste products. The purpose of this study was to investigate whether overnight changes in diffusivity, brain volumes, and cerebrospinal fluid flow measured with MRI are associated with sleep parameters from overnight high-density sleep EEG, and circadian markers. In healthy adults investigated with MRI before and after sleep EEG, we observed an increase in water diffusivity overnight, which was positively related to the proportion of total sleep time spent in rapid eye movement (REM) sleep, and negatively associated with the fraction of sleep time spent in non rapid eye movement (NREM) sleep. Diffusivity was also associated with the sleep midpoint, a circadian marker. CSF flow increased overnight; this increase was unrelated to sleep or diffusivity measures but was associated with circadian markers. These results provide evidence for both sleep related and diurnal effects on water compartmentalisation within the brain.
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Affiliation(s)
- Ruth O'Gorman Tuura
- Center for MR Research, University Children's Hospital, University of Zürich, Switzerland; Children's Research Center, University Children's Hospital, University of Zürich, Switzerland.
| | - Carina Volk
- Center for MR Research, University Children's Hospital, University of Zürich, Switzerland; Children's Research Center, University Children's Hospital, University of Zürich, Switzerland
| | - Fraser Callaghan
- Center for MR Research, University Children's Hospital, University of Zürich, Switzerland; Children's Research Center, University Children's Hospital, University of Zürich, Switzerland
| | - Valeria Jaramillo
- Children's Research Center, University Children's Hospital, University of Zürich, Switzerland; Child Development Center and Pediatric Sleep Center, University Children's Hospital, Zürich, Switzerland
| | - Reto Huber
- Children's Research Center, University Children's Hospital, University of Zürich, Switzerland; Child Development Center and Pediatric Sleep Center, University Children's Hospital, Zürich, Switzerland; Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
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61
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Atomoxetine and circadian gene expression in human dermal fibroblasts from study participants with a diagnosis of attention-deficit hyperactivity disorder. J Neural Transm (Vienna) 2021; 128:1121-1133. [PMID: 34273025 PMCID: PMC8295110 DOI: 10.1007/s00702-021-02373-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 06/27/2021] [Indexed: 11/23/2022]
Abstract
Atomoxetine (ATO) is a second line medication for attention-deficit hyperactivity disorder (ADHD). We proposed that part of the therapeutic profile of ATO may be through circadian rhythm modulation. Thus, the aim of this study was to investigate the circadian gene expression in primary human-derived dermal fibroblast cultures (HDF) after ATO exposure. We analyzed circadian preference, behavioral circadian and sleep parameters as well as the circadian gene expression in a cohort of healthy controls and participants with a diagnosis of ADHD. Circadian preference was evaluated with German Morningness-Eveningness-Questionnaire (D-MEQ) and rhythms of sleep/wake behavior were assessed via actigraphy. After ex vivo exposure to different ATO concentrations in HDF cultures, the rhythmicity of circadian gene expression was analyzed via qRT-PCR. No statistical significant effect of both groups (healthy controls, ADHD group) for mid-sleep on weekend days, mid-sleep on weekdays, social jetlag, sleep WASO and total number of wake bouts was observed. D-MEQ scores indicated that healthy controls had no evening preference, whereas subjects with ADHD displayed both definitive and moderate evening preferences. ATO induced the rhythmicity of Clock in the ADHD group. This effect, however, was not observed in HDF cultures of healthy controls. Bmal1 and Per2 expression showed a significant ZT × group interaction via mixed ANOVA. Strong positive correlations for chronotype and circadian genes were observed for Bmal1, Cry1 and Per3 among the study participants. Statistical significant different Clock, Bmal1 and Per3 expressions were observed in HDFs exposed to ATO collected from ADHD participants exhibiting neutral and moderate evening preference, as well as healthy participants with morning preferences. The results of the present study illustrate that ATO impacts on circadian function, particularly on Clock, Bmal1 and Per2 gene expression.
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Yu EYT, Yeung CHN, Wan EYF, Tang EHM, Wong CKH, Cheung BMY, Lam CLK. Association between health behaviours and cardiometabolic dysregulation: a population-based survey among healthy adults in Hong Kong. BMJ Open 2021; 11:e043503. [PMID: 34244247 PMCID: PMC8273464 DOI: 10.1136/bmjopen-2020-043503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 06/02/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To explore the association between cardiometabolic dysregulation, an integral component of allostatic load, and health risk behaviours (HRBs) of the Hong Kong healthy adult population. DESIGN Secondary analysis of cross-sectional anonymous data. SETTING Data on sociodemographics, self-reported health status, HRBs and biomarkers were extracted from the Hong Kong Population Health Survey 2014/2015. PARTICIPANTS One thousand five hundred and fifty-one participants aged 18-64 years without self-reported diagnoses of hypertension, diabetes mellitus, hyperlipidaemia, cardiovascular disease, cognitive impairment or cancer. PRIMARY OUTCOME MEASURES Cardiometabolic dysregulation index (CMDI), ranging from 0 to 6, was calculated by counting the number of biomarkers including systolic blood pressure, diastolic blood pressure, waist to hip ratio, glycated haemoglobin, total cholesterol to high-density lipoprotein cholesterol ratio, and triglycerides that were above the respective normal level suggested by international guidelines and literature. HRBs including smoking, dietary habits and sleeping hours were collected by self-report questionnaire. Alcohol consumption was assessed by the 10-item Alcohol Use Disorders Identification Test, while physical activity level was measured using the Global Physical Activity Questionnaire. A composite HRB score, ranging from 0 to 5, was calculated as the cumulative number of HRBs. The effect of HRB on CMDI was evaluated by negative binomial regression with adjustment for socioeconomic status, health awareness and comorbidities of the participants. RESULTS The mean CMDI of the studied population was 1.6; 29.5% had a CMDI of 0, whereas 1.5% had a CMDI of 6. Significant difference was observed in mean CMDI between gender and different age groups. Sleeping less than 6 hours (incidence rate ratio (IRR)=1.26, p<0.001), smoking (IRR=1.15, p=0.027), insufficient physical activity (IRR=1.12, p=0.007) and higher composite HRB score (IRR=1.12, 95% CI 1.06 to 1.18) were significantly associated with higher CMDI. CONCLUSION Smoking, physical inactivity and inadequate sleep-an essential yet often overlooked health behaviour-were associated with higher CMDI in the Hong Kong healthy adult population.
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Affiliation(s)
- Esther Yee Tak Yu
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
| | | | - Eric Yuk Fai Wan
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong
| | - Eric Ho Man Tang
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
| | - Carlos King Ho Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong
| | | | - Cindy Lo Kuen Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
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Lyu X, Li K, Liu Q, Wang X, Yang Z, Yang Y, Yang Q, Wang H, Yuan N, Ji C, Kong F, Li W, Yin M, Li Z, Zou S, Zhao X, Fang X, Zhang C, Du X. Sleep status of psychiatric nurses: A survey from China. Nurs Open 2021; 9:2720-2728. [PMID: 34198365 PMCID: PMC9584482 DOI: 10.1002/nop2.972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 04/26/2021] [Accepted: 06/02/2021] [Indexed: 12/02/2022] Open
Abstract
Aim Our study aimed to evaluate the sleep status of psychiatric nurses in Chinese population and analyse the influencing factors. Design Cross‐sectional, correlation design with logistic regression analysis. Methods We investigated 1,044 psychiatric nurses from seven psychiatric hospitals in China. Pittsburgh Sleep Quality Index and Maslach Burnout Inventory General Survey were used as main measures. Results The average Pittsburgh Sleep Quality Index score of 1,044 psychiatric nurses was 7.00 ± 3.59, and 38.63% of nurses had a total Pittsburgh Sleep Quality Index score >7. Our study found that middle‐night shift nurses had poor sleep quality and sleep disorders are positively correlated with emotional exhaustion and cynical disregard for job burnout. Middle‐night shift nurses showed 1.586 times more likely to suffer from sleep disorders than those non‐middle‐night shift. The higher the score of emotional exhaustion, the greater the risk of sleep disorders.
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Affiliation(s)
- Xiaoli Lyu
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Kan Li
- Jiangxi Mental Hospital, Nanchang, China
| | - Qin Liu
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xinda Wang
- TaiCang Third People's Hospital, Taicang, China
| | - Zhong Yang
- The Third People's Hospital of Changshu, Changshu, China
| | - Yang Yang
- Mental Hospital of Yunnan Province, Kunming, China
| | - Qun Yang
- Nanchong Psychosomatic Hospital, Nanchong, China
| | - Hao Wang
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Nian Yuan
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Caifang Ji
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Fanzhen Kong
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Weiqin Li
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Ming Yin
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Zhe Li
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Siyun Zou
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xueli Zhao
- Department of Emergency, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Xiaojia Fang
- Department of Emergency, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Caiyi Zhang
- Department of Emergency, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Xiangdong Du
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
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Devine JK, Schwartz LP, Hursh SR, Mosher E, Schumacher S, Boyle L, Davis JE, Smith M, Fitzgibbons S. Trends in Strategic Napping in Surgical Residents by Gender, Postgraduate Year, Work Schedule, and Clinical Rotation. JOURNAL OF SURGICAL EDUCATION 2021; 78:1256-1268. [PMID: 33229212 DOI: 10.1016/j.jsurg.2020.11.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/10/2020] [Accepted: 11/15/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To identify surgical resident and clinical rotation attributes which predict on-shift napping through objectively measured sleep patterns and work schedules over a 2-month period. DESIGN In a cross-sectional study, participants provided schedules, completed the Epworth Sleepiness Scale (ESS), and wore sleep-tracking devices (Zulu watch) continuously for 8 weeks. Multiple linear regression predicted percent days with on-shift napping from resident and rotation characteristics. SETTING Greater Washington, DC area hospitals. PARTICIPANTS Twenty-two (n = 22) surgical residents rotating in at least 1 of 5 different clinical rotation categories. RESULTS Residents slept 6 hours within a 24-hour period (370 ± 129 minutes) with normal sleep efficiency (sleep efficiency (SE): 87.13% ± 7.55%). Resident ESS scores indicated excessive daytime sleepiness (11.64 ± 4.03). Ninety-five percent (n = 21) of residents napped on-shift. Residents napped on-shift approximately 32% of their working days and were most likely to nap when working between 23:00 and 05:00 hours. Earlier shift start times predicted less on-shift napping (B = -0.08, SE = 0.04, β = -2.40, t = -2.09, p = 0.05) while working more night shifts (B = 1.55, SE = 0.44, β = 4.12, t = 3.52, p = 0.003) and shifts over 24 hours (B = 1.45, SE = 0.55, β = 1.96, t = 2.63, p = 0.01) predicted more frequent on-shift napping. CONCLUSIONS Residents are taking advantage of opportunities to nap on-shift. Working at night seems to drive on-shift napping. However, residents still exhibit insufficient sleep and daytime sleepiness which could reduce competency and represent a safety risk to themselves and/or patients. These findings will help inform intervention strategies which are tailored to surgical residents using a biomathematical model of fatigue.
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Affiliation(s)
| | | | - Steven R Hursh
- Institutes for Behavior Resources, Baltimore, Maryland; Johns Hopkins University School of Medicine, Baltmore Maryland
| | | | | | - Lisa Boyle
- Medstar Georgetown University Hospital, Washington, DC
| | - Jonathan E Davis
- Georgetown University School of Medicine, Washington, DC; MedStar Health Research Institute, Hyattsville, Maryland
| | - Mark Smith
- MedStar Institutes for Innovation, Washington, DC
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65
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Fang L, Hsiao LP, Fang SH, Chen BC. Workplace bullying, personality traits and health among hospital nurses: The mediating effect of social support. J Clin Nurs 2021; 30:3590-3600. [PMID: 34114285 DOI: 10.1111/jocn.15881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/30/2021] [Accepted: 05/07/2021] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES This study aimed to explore the status of nursing staff's workplace bullying, personality traits, social support and mental health, to find out the predictors of nursing staff's health, and to explore whether social support is a mediator to regulate the impact of workplace bullying on mental health. BACKGROUND Bullying could cause physical and psychological problems, and nursing workplace bullying causes not only health problems of nursing staff but also patient safety problems. "Workplace bullying" is a worthy topic to pay attention to. Only limited studies could be discovered about the mediating effects between workplace bullying and health. METHODS Cross-sectional and correlation designs were used. The STROBE was used as a checklist for this study. RESULTS The results showed that the frequency of poor sleep quality ≥3 days in recent 2 weeks (p < .001), external control personality traits (p = .016), workplace bullying (p < .001) and less social support (p = .001) were the main predictors of the health problems among nurses, and social support was the mediator between workplace bullying and health problems. CONCLUSION It is recommended that hospital managers should apply regular sleep-wake schedule by designing a biological clock-compliant shift in order to promote good sleep hygiene of the nurses. Providing educational programmes and building up policies to decrease workplace bullying and increase social supports are suggested. RELEVANCE TO CLINICAL PRACTICE Hospital managers should provide education and training related to the prevention of bullying and establish communication and consultation channels for the bullied. Nursing managers should also educate nurses to establish effective social networks with family, friends and colleagues to prevent health problems.
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Affiliation(s)
- Li Fang
- Department of Nursing, Fooyin University, Kaohsiung City, Taiwan, R.O.C
| | - Li-Ping Hsiao
- Department of Nursing, Pingtung Christian Hospital, Pingtung City, Taiwan, R.O.C
| | - Shu-Hui Fang
- Department of Foreign Languages, Fooyin University, Kaohsiung City, Taiwan, R.O.C
| | - Bao-Chen Chen
- Department of Nursing, Pingtung Christian Hospital, Pingtung City, Taiwan, R.O.C
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66
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Adler DA, Tseng VWS, Qi G, Scarpa J, Sen S, Choudhury T. Identifying Mobile Sensing Indicators of Stress-Resilience. PROCEEDINGS OF THE ACM ON INTERACTIVE, MOBILE, WEARABLE AND UBIQUITOUS TECHNOLOGIES 2021; 5. [PMID: 35445162 PMCID: PMC9017954 DOI: 10.1145/3463528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Resident physicians (residents) experiencing prolonged workplace stress are at risk of developing mental health symptoms. Creating novel, unobtrusive measures of resilience would provide an accessible approach to evaluate symptom susceptibility without the perceived stigma of formal mental health assessments. In this work, we created a system to find indicators of resilience using passive wearable sensors and smartphone-delivered ecological momentary assessment (EMA). This system identified indicators of resilience during a medical internship, the high stress first-year of a residency program. We then created density estimation approaches to predict these indicators before mental health changes occurred, and validated whether the predicted indicators were also associated with resilience. Our system identified resilience indicators associated with physical activity (step count), sleeping behavior, reduced heart rate, increased mood, and reduced mood variability. Density estimation models were able to replicate a subset of the associations between sleeping behavior, heart rate, and resilience. To the best of our knowledge, this work provides the first methodology to identify and predict indicators of resilience using passive sensing and EMA. Researchers studying resident mental health can apply this approach to design resilience-building interventions and prevent mental health symptom development.
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Affiliation(s)
| | | | - Gengmo Qi
- Computer Science, Cornell University
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67
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Lin H, Jin M, Liu Q, Du Y, Fu J, Sun C, Ma F, Li W, Liu H, Zhang X, Zhu Y, Chen Y, Sun Z, Wang G, Huang G, Yan J. Gender-specific prevalence and influencing factors of depression in elderly in rural China: A cross-sectional study. J Affect Disord 2021; 288:99-106. [PMID: 33848754 DOI: 10.1016/j.jad.2021.03.078] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/23/2021] [Accepted: 03/24/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND With an aging population, late-life depression has been a major health problem in rural China. This study aims to explore the gender-specific prevalence of geriatric depression in rural Tianjin, its influencing factors, and to provide a scientific basis for the prevention and intervention of depression in the elderly. METHODS A cross-sectional study of 4,933 elderly individuals in rural Tianjin was conducted using the cluster sampling method. The independent samples t-test and chi-squared test were used to assess differences in participants' characteristics by depressive symptoms, while multiple linear regressions and multiple logistic regressions were used to analyze the potential influencing factors of depression. RESULTS The prevalence of geriatric depression was found to be 12.2% in the study participants (9.5% in men and 14.5% in women). Gender, education, household income, employment, living alone, social activities, physical exercise and chronic diseases were associated with depression (P<0.05). In addition to the above factors, sleep duration was also related with scores on self-rating depression scale (P<0.05). LIMITATIONS The study used a cross-sectional approach, so causation cannot be concluded. CONCLUSIONS Late-life depression is a serious mental health issue in rural China, highlighting the importance of appropriate diagnosis and treatment as a priority to improve the quality of mental health.
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Affiliation(s)
- Hongyan Lin
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Mengdi Jin
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Qian Liu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Yue Du
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Department of Social Medicine and Health Administration, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Jingzhu Fu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Changqing Sun
- Neurosurgical Department of Baodi Clinical College of Tianjin Medical University, Tianjin, China
| | - Fei Ma
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wen Li
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Huan Liu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Xumei Zhang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Yun Zhu
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yongjie Chen
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Zhuoyu Sun
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Guangshun Wang
- Department of Tumour, Baodi Clinical College of Tianjin Medical University, Tianjin, China
| | - Guowei Huang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Jing Yan
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Department of Social Medicine and Health Administration, School of Public Health, Tianjin Medical University, Tianjin, China.
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68
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Zhao A, Ma B, Xu L, Yao M, Zhang Y, Xue B, Ren J, Chang D, Liu J. Jiedu Tongluo Granules Ameliorates Post-stroke Depression Rat Model via Regulating NMDAR/BDNF Signaling Pathway. Front Pharmacol 2021; 12:662003. [PMID: 34093193 PMCID: PMC8173625 DOI: 10.3389/fphar.2021.662003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 04/28/2021] [Indexed: 01/26/2023] Open
Abstract
Post-stroke depression (PSD) is one of the most common stroke complications, which seriously affects stroke’s therapeutic effect and brings great pain for patients. The pathological mechanism of PSD has not been revealed. Jiedu Tongluo granules (JDTLG) is an effective traditional Chinese medicine for PSD treatment which is widely used in clinical treatment. JDTLG has a significant therapeutic effect against PSD, but the mechanism is still unclear. The PSD rat model was established by carotid artery embolization combined with chronic sleep deprivation followed by treating with JDTLG. Neurobehavioral and neurofunctional experiments were engaged in studying the neural function of rats. Histomorphology, proteomics, and western blotting researches were performed to investigate the potential molecular mechanisms related to JDTLG therapy. Oral treatment of JDTLG could significantly improve the symptoms of neurological deficit and depression symptoms of PSD rats. Proteomic analysis identified several processes that may involve the regulation of JDTLG on the PSD animal model, including energy metabolism, nervous system, and N-methyl-D-aspartate receptor (NMDAR)/brain-derived neurotrophic factor (BDNF) signal pathway. Our results showed that JDTLG could reduce glutamate (Glu) level and increase gamma-aminobutyric acid (GABA) level via regulating the NMDAR/BDNF pathway, which may play a vital role in the occurrence and development of PSD.
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Affiliation(s)
- Aimei Zhao
- Beijing Key Laboratory of Pharmacology of Chinese Materia Region, Institute of Basic Medical Sciences, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Bo Ma
- Beijing Key Laboratory of Pharmacology of Chinese Materia Region, Institute of Basic Medical Sciences, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China.,State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li Xu
- Beijing Key Laboratory of Pharmacology of Chinese Materia Region, Institute of Basic Medical Sciences, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Mingjiang Yao
- Beijing Key Laboratory of Pharmacology of Chinese Materia Region, Institute of Basic Medical Sciences, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Yehao Zhang
- Beijing Key Laboratory of Pharmacology of Chinese Materia Region, Institute of Basic Medical Sciences, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Bingjie Xue
- Beijing Key Laboratory of Pharmacology of Chinese Materia Region, Institute of Basic Medical Sciences, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Junguo Ren
- Beijing Key Laboratory of Pharmacology of Chinese Materia Region, Institute of Basic Medical Sciences, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Dennis Chang
- NICM, Western Sydney University, Penrith, NSW, Australia
| | - Jianxun Liu
- Beijing Key Laboratory of Pharmacology of Chinese Materia Region, Institute of Basic Medical Sciences, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
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Zhang Z, Hu Y, Chen Y, Liao Z, Zheng Y, Ding L. Sleep disorders and related factors among frontline medical staff supporting Wuhan during the COVID-19 outbreak. Bull Menninger Clin 2021:1-17. [PMID: 33939498 DOI: 10.1521/bumc_2021_85_01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Sleep problems among frontline medical staff during the COVID-19 epidemic require attention. A total of 249 frontline medical staff who were recruited to support Wuhan completed this cross-sectional study. A web-based questionnaire about insomnia, depression, anxiety, and fatigue was used to assess mental health status. The prevalence of sleep disorders among frontline medical staff was 50.6%. More time spent in Wuhan and a history of insomnia, depression, anxiety, and fatigue were associated with a higher risk of insomnia. People who stayed in Wuhan for a long time with a history of insomnia, depression, anxiety, and fatigue symptoms might be at high risk of insomnia.
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Affiliation(s)
- Zhenqing Zhang
- Xiamen Xianyue Hospital, Xiamen, Fujian, China
- Psychiatrist at the Obsessive and Compulsive Disorder Treatment Center
| | - Yanyu Hu
- Xiamen Xianyue Hospital, Xiamen, Fujian, China
- Psychiatrist at the Sleep Medicine Center
| | - Yingying Chen
- Xiamen Xianyue Hospital, Xiamen, Fujian, China
- Psychiatrist at the Department of Psychiatry
| | - Zhenhua Liao
- Xiamen Xianyue Hospital, Xiamen, Fujian, China
- Department of Science and Education
| | - Yixiong Zheng
- Xiamen Xianyue Hospital, Xiamen, Fujian, China
- Psychiatrist at the Department of Psychiatry
| | - Lijun Ding
- Xiamen Xianyue Hospital, Xiamen, Fujian, China
- Department of Science and Education
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Kwok C. Depression, Stress, and Perceived Medical Errors in Singapore Psychiatry Residents. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2021; 45:169-173. [PMID: 33409942 DOI: 10.1007/s40596-020-01376-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 11/17/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Doctors in training, especially psychiatrists, are at high risk of depression and burnout, which have been linked to increased medical errors. This study looks at prevalence and risk factors of depression and perceived stress among psychiatry residents in Singapore. METHODS An anonymous online questionnaire was completed by 65.3% (47/72) of residents, which included the Patient Health Questionnaire-9 (PHQ-9), Perceived Stress Scale (PSS), and 2 burnout screening questions. They were asked if they were concerned about making a medical error. RESULTS Majority of residents (70.2%) slept 6-8 h/night, while 55.3% worked < 60 h/week. Based on PHQ-9 score ≥ 10, 38.3% had depression. Depression was associated with sleeping < 6 h/night (OR 13.62, 2.96-62.6; p = 0.0008) and working ≥ 60 h/week (OR 3.8, 1.096-13.18; p = 0.035). Six residents (12.8%) endorsed suicidal ideation. The mean score on the PSS scale was 23.89 ± 1.95. Higher PSS scores were associated with sleeping < 6 h/night (OR 4.92, 1.51-8.33; p = 0.007). One third of residents (34%) reported feeling burnt out fairly or very often. Residents who slept < 6 h/night were more likely to report feeling burnt out (OR 6.69, 1.69-26.45; p = 0.0068). PHQ scores correlated highly with PSS scores and burnout measures. Self-perceived medical errors were associated with depressive symptoms, suicidal thoughts, and < 6 h/night of sleep. CONCLUSIONS Less sleep and longer working hours were associated with higher risk of depression, suicidality, stress, and perceived medical errors in Singapore psychiatry residents. It is important to address depression and stress as it can affect physician well-being and patient care.
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Affiliation(s)
- Cecilia Kwok
- Singapore General Hospital, Singapore, Singapore.
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Mayama M, Sekine M, Onodera Y, Suemitsu T, Maeda Y, Nakano K, Sugita Y, Ogura J, Ohsuga T, Kodera C, Murakami T, Kido M, Suzuki Y, Shibata A, Nishijima K, Umazume T, Nakagawa S, Unno N, Komatsu H, Shozu M, Enomoto T, Watari H. Attitudes toward overtime work and self-training: A survey on obstetricians and gynecologists in Japan. J Obstet Gynaecol Res 2021; 47:1666-1674. [PMID: 33691346 DOI: 10.1111/jog.14735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 02/20/2021] [Indexed: 11/28/2022]
Abstract
AIM The Ministry of Health, Labour, and Welfare of Japan proposed a regulation of overtime work as a reform in work style. However, the regulation may deteriorate the quality of medical services due to the reduction in training time. Thus, the study aimed to reveal perceptions in terms of generation gaps in views on self-training and overtime work, among members of the Japan Society of Obstetrics and Gynecology (JSOG). METHODS A web-based, self-administered questionnaire survey was conducted among members of the JSOG. In total, 1256 respondents were included in the analysis. Data were collected on age, sex, experience as a medical doctor, location of workplace, work style, the type of main workplace, and number of full-time doctors in the main workplace. The study examined the attitudes of the respondents toward overtime work and self-training. The respondents were categorized based on experience as a medical doctor. RESULTS According to years of experience, 112 (8.9%), 226 (18.0%), 383 (30.5%), 535 (42.6%) doctors have been working for ≤5, 6-10, 11-19, and ≥ 20 years, respectively. Although 54.5% of doctors with ≤5 years of experience expected the regulation on working hours to improve the quality of medical services, those with ≥20 years of experience expressed potential deterioration. After adjusting for covariates, more years of experience were significantly related with the expectation of deterioration in the quality of medical services. CONCLUSIONS The study revealed a generation gap in the views about self-training and overtime work among obstetricians and gynecologists in Japan.
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Affiliation(s)
- Michinori Mayama
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Masayuki Sekine
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yohei Onodera
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan
| | - Tokumasa Suemitsu
- Department of Obstetrics and Gynecology, Kameda Medical Center, Kamogawa, Japan
| | - Yuto Maeda
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Kazutoshi Nakano
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Japan
| | - Yosuke Sugita
- Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan
| | - Jumpei Ogura
- Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takuma Ohsuga
- Department of Gynecology and Obstetrics, Kyoto University Hospital, Kyoto, Japan
| | - Chisato Kodera
- Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Takashi Murakami
- Department of Obstetrics and Gynecology, Shiga University of Medical Science, Otsu, Japan
| | - Michiko Kido
- Department of Obstetrics and Gynecology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Yukio Suzuki
- Department of Obstetrics and Gynecology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Ayako Shibata
- Department of Obstetrics and Gynecology, Yodogawa Christian Hospital, Osaka, Japan
| | - Koji Nishijima
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takeshi Umazume
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Satoshi Nakagawa
- Departments of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Nobuya Unno
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Hiroaki Komatsu
- Department of Obstetrics and Gynecology, Tottori University School of Medicine, Yonago, Japan
| | - Makio Shozu
- Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hidemichi Watari
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Wu Y, Jiang F, Wu S, Liu Y, Tang YL. Sleep duration and satisfaction among physicians in tertiary public hospitals in China: a large sample national survey. J Occup Med Toxicol 2021; 16:8. [PMID: 33663542 PMCID: PMC7934372 DOI: 10.1186/s12995-021-00298-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 02/25/2021] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES To investigate the sleep duration and level of satisfaction among physicians in tertiary public hospitals in China, and to explore associated factors. METHODS A national online cross-sectional survey was conducted. Totally 20,786 physicians from 136 hospitals participated in the survey. Data were collected using an online self-reported questionnaire. Descriptive and logistic regression statistics were performed using the STATA software. RESULTS The mean total sleep duration was 6.37 ± 0.87 h. Of all participants, 61.06% (n = 12,691) reported short sleep duration (less than 7 h per day). 46.97% (n = 9764) were not satisfied with their sleep. An older age and job-related factors (longer working hours per week, specialty including internal medicine, Ob/GYN and emergency medicine, working more night shifts, heavier workload, and working in East China) were significantly associated with reported short sleep duration. CONCLUSIONS The majority of physicians in Chinese public hospitals experienced insufficient sleep duration. Changes are required to improve the wellbeing of physicians and patient outcomes.
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Affiliation(s)
- Yinuo Wu
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Feng Jiang
- Institute of Health Yangtze River Delta, Shanghai Jiao Tong University, 1954 Huashan, Xuhui District, Shanghai, 200030 China
| | - Shichao Wu
- Peking University Shenzhen Hospital, Shenzhen, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, 5 Dongdan Santiao, Dongcheng District, Beijing, 100730 China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
- Atlanta VA Medical Center, Decatur, GA USA
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73
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Sleep-Wake Timings in Adolescence: Chronotype Development and Associations with Adjustment. J Youth Adolesc 2021; 50:628-640. [PMID: 33606125 DOI: 10.1007/s10964-021-01407-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 01/29/2021] [Indexed: 10/22/2022]
Abstract
Adolescent sleep research has focused heavily on duration and quality with less work examining chronotype, defined as individual differences in sleep-wake timings driven by the circadian rhythm. This study filled a gap in the literature by utilizing actigraphy-based sleep estimates in an accelerated longitudinal design in order to better understand the developmental trajectory and individual stability of chronotype during adolescence, as well as the associations between chronotype with risky behaviors, substance use, and depressive symptoms. A total of 329 adolescents (57% female; 21% Asian American, 31% European American, 41% Latino, 7% other ethnicity) provided actigraphy-based estimates of sleep and completed questionnaires at up to three time points, two years apart, beginning at 14-17 years of age. Multilevel modeling revealed a non-linear developmental trend in chronotype whereby eveningness increased from 14 to 19 years of age followed by a trend toward morningness. Individual differences in chronotype exhibited modest stability during adolescent development. Furthermore, greater evening chronotype was associated with more risky behaviors and substance use among males, and more substance use among older adolescents, whereas depressive symptoms were not associated with chronotype. The findings from this study may have practical implications for adolescent behavioral health interventions targeted at reducing risky behaviors and substance use among youth.
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74
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Day-to-day variability in sleep parameters and depression risk: a prospective cohort study of training physicians. NPJ Digit Med 2021; 4:28. [PMID: 33603132 PMCID: PMC7892862 DOI: 10.1038/s41746-021-00400-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 01/11/2021] [Indexed: 01/31/2023] Open
Abstract
While 24-h total sleep time (TST) is established as a critical driver of major depression, the relationships between sleep timing and regularity and mental health remain poorly characterized because most studies have relied on either self-report assessments or traditional objective sleep measurements restricted to cross-sectional time frames and small cohorts. To address this gap, we assessed sleep with a wearable device, daily mood with a smartphone application and depression through the 9-item Patient Health Questionnaire (PHQ-9) over the demanding first year of physician training (internship). In 2115 interns, reduced TST (b = -0.11, p < 0.001), later bedtime (b = 0.068, p = 0.015), along with increased variability in TST (b = 0.4, p = 0.0012) and in wake time (b = 0.081, p = 0.005) were associated with more depressive symptoms. Overall, the aggregated impact of sleep variability parameters and of mean sleep parameters on PHQ-9 were similar in magnitude (both r2 = 0.01). Within individuals, increased TST (b = 0.06, p < 0.001), later wake time (b = 0.09, p < 0.001), earlier bedtime (b = - 0.07, p < 0.001), as well as lower day-to-day shifts in TST (b = -0.011, p < 0.001) and in wake time (b = -0.004, p < 0.001) were associated with improved next-day mood. Variability in sleep parameters substantially impacted mood and depression, similar in magnitude to the mean levels of sleep parameters. Interventions that target sleep consistency, along with sleep duration, hold promise to improve mental health.
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75
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Lu L, Lok KI, Zhang Q, Zhang L, Xiang Y, Ungvari GS, Hall BJ, An FR, Xiang YT. Sleep disturbance and its association with quality of life among psychiatric nurses in China. PeerJ 2021; 9:e10659. [PMID: 33643702 PMCID: PMC7896499 DOI: 10.7717/peerj.10659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 12/07/2020] [Indexed: 12/23/2022] Open
Abstract
Background Sleep disturbance is associated with a number of negative adverse outcomes. This study examined the prevalence of sleep disturbance and its association with demographic and clinical characteristics and quality of life (QOL) in psychiatric nurses in China. Methods This is a multi-center, cross-sectional study involving 11 psychiatric hospitals in China. Three types of sleep disturbance (difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS) and early-morning awakening (EMA)) and QOL were measured by standardized questions or instruments. Results A total of 1,847 psychiatric nurses participated. The overall prevalence of at least one type of sleep disturbance was 71.5% (95% CI [69.3–73.5]); the prevalence of DIS, DMS and EMA was 58.5% (95% CI [56.2–60.8]), 53.7% (95% CI [51.4–56.0]) and 54.6% (95% CI [52.3–56.9]), respectively. Nurses with sleep disturbance had significantly lower QOL in physical (F(1, 1,846) = 219.12, P < 0.001), psychological (F(1, 1,846) = 72.18, P < 0.001), social (F(1, 1,846) = 37.57, P < 0.001) and environmental domains (F(1, 1,846) = 95.45, P < 0.001). Multivariable logistic regression analyses revealed that shift work (DIS, OR = 1.6, 95% CI [1.28–1.98]; DMS, OR = 1.2, 95% CI [1.001–1.54]; EMA, OR = 1.3, 95% CI [1.02–1.58]) and alcohol use (DIS, OR = 1.8, 95% CI [1.46–2.32]; DMS, OR = 1.8, 95% CI [1.43–2.23]; EMA, OR = 1.7, 95% CI [1.33–2.07]) were positively associated with sleep disturbance, while higher monthly income (DIS, OR = 0.5, 95% CI [0.38–0.75]; DMS, OR = 0.7, 95% CI [0.51–0.98]) was negatively associated with sleep disturbance. Conclusion Sleep disturbance was common among nurses in psychiatric hospitals in China, particularly those on shifts and having alcohol use. Health authorities should develop effective measures to reduce risk of sleep disturbance in this population.
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Affiliation(s)
- Li Lu
- Center for Cognition and Brain Sciences, University of Macau, Macau SAR, China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China.,Team IETO, Bordeaux Population Health Research Center, UMR U1219, INSERM, Université de Bordeaux, Bordeaux, France
| | - Ka-In Lok
- Kiang Wu Nursing College of Macau, Macau SAR, China
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Ling Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yifan Xiang
- Pui Ching Middle School Macau, Macao SAR, China
| | - Gabor S Ungvari
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, WA, Australia.,University of Notre Dame Australia, Fremantle, WA, Australia
| | - Brian J Hall
- Global and Community Mental Health Research Group, New York University (Shanghai), Shanghai, China
| | - Feng-Rong An
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yu-Tao Xiang
- Center for Cognition and Brain Sciences, University of Macau, Macau SAR, China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China
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76
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Alshabibi AS, Suleiman ME, Tapia KA, Heard R, Brennan PC. Impact of Hours Awake and Hours Slept at Night on Radiologists' Mammogram Interpretations. J Am Coll Radiol 2021; 18:730-738. [PMID: 33482116 DOI: 10.1016/j.jacr.2020.12.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/17/2020] [Accepted: 12/17/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To examine whether radiologists' mammogram reading performance varies according to how long they have been awake ("hours awake") and the number of hours they slept ("hours slept") the night before a reading session. METHODS Retrospective data were retrieved from the BreastScreen Reader Assessment Strategy database. Malignancy-enriched mammographic readings were performed by 133 radiologists. Information on their hours awake and hours slept was collected. Analysis of covariance was performed to determine whether these two variables influenced radiologists' sensitivity, specificity, lesion sensitivity, receiver operating characteristic (ROC) curve, and jackknife alternative free-response ROC. Radiologists were divided into a more experienced and a less experienced groups (based on reading ≥2,000 and <2,000 mammogram readings per year, respectively). RESULTS The hours awake significantly influenced less experienced radiologists' lesion sensitivity (F6,63 = 2.51; P = .03). Those awake for <2 hours had significantly lower lesion sensitivity than those awake for 8 to 10 hours (P = .01), and those awake for 4 to 6 hours had significantly lower lesion sensitivity than those awake for 8 to 10 hours (P = .002) and 10 to 12 hours (P = .02). The hours slept also influenced the ROC values of less experienced radiologists (F1,68 = 4.96; P = .02). Radiologists with up to 6 hours of sleep had a significantly lower value (0.72) than those who had slept more than 6 hours (0.77). No statistically significant findings were noted for more experienced radiologists. CONCLUSION Inexperienced radiologists' performance may be influenced by the hours awake and hours slept before reading sessions.
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Affiliation(s)
- Abdulaziz S Alshabibi
- Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Health Sciences, University of Sydney, Cumberland Campus, Lidcombe, Australia; Department of Radiology and Medical Imaging, College of Applied Medical Sciences of King Saud University, Riyadh, Saudi Arabia.
| | - Mo'ayyad E Suleiman
- Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Health Sciences, University of Sydney, Cumberland Campus, Lidcombe, Australia
| | - Kriscia A Tapia
- Australian Council on Healthcare Standards, Ultimo, Australia
| | - Robert Heard
- Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Health Sciences, University of Sydney, Cumberland Campus, Lidcombe, Australia
| | - Patrick C Brennan
- Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Health Sciences, University of Sydney, Cumberland Campus, Lidcombe, Australia
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77
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Myers B, Vidhatha R, Nicholas B, Stephanie C, Quinn T, Chang HW, Bhutani T, Liao W. Sleep and the gut microbiome in psoriasis: clinical implications for disease progression and the development of cardiometabolic comorbidities. JOURNAL OF PSORIASIS AND PSORIATIC ARTHRITIS 2021; 6:27-37. [PMID: 35784674 PMCID: PMC9249097 DOI: 10.1177/2475530320964781] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Background Sleep dysfunction and sleep disorders are important comorbidities of psoriasis. Not only do these sleep comorbidities contribute to reduced quality of life, but they may also lead to worsening psoriasis and increased susceptibility to cardiometabolic diseases. While psoriasis and sleep dysfunction are thought to be linked by itch, depression, and immune system dysregulation, the relationship between psoriasis and sleep dysfunction is not yet fully understood. Objective We sought to compare previous studies characterizing the gut microbiome in psoriasis and sleep dysfunction and examine the potential relevance of shared findings on cardiometabolic and overall health. Methods We performed literature searches of PubMed and Embase databases to find studies evaluating the gut microbiome in psoriasis, sleep dysfunction, and cardiometabolic diseases. Results Studies characterizing the gut microbiome in psoriasis and sleep dysfunction reveal shared findings, specifically an increased Firmicutes to Bacteroidetes ratio and reduced abundance of short chain fatty acid-producing bacteria. These dysbiotic features have also been shown to promote systemic inflammation and cardiometabolic disease. Conclusion In favoring an increased Firmicutes to Bacteroidetes ratio and reduced abundance of short chain fatty acid-producing bacteria, sleep dysfunction could be contributing to worsening psoriasis and cardiometabolic comorbidities through intestinal dysbiosis. Future studies are needed to determine whether gut- and sleep-targeting interventions could be therapeutic in psoriasis patients with poor sleep.
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Affiliation(s)
- Bridget Myers
- University of California, San Francisco, Department of Dermatology
| | - Reddy Vidhatha
- University of California, San Francisco, Department of Dermatology
| | | | - Chan Stephanie
- University of California, San Francisco, Department of Dermatology
| | - Thibodeaux Quinn
- University of California, San Francisco, Department of Dermatology
| | - Hsin-Wen Chang
- University of California, San Francisco, Department of Dermatology
| | - Tina Bhutani
- University of California, San Francisco, Department of Dermatology
| | - Wilson Liao
- University of California, San Francisco, Department of Dermatology
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78
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Saadeh H, Saadeh M, Almobaideen W, Al Refaei A, Shewaikani N, Al Fayez RQ, Khawaldah H, Abu-Shanab S, Al-Hussaini M. Effect of COVID-19 Quarantine on the Sleep Quality and the Depressive Symptom Levels of University Students in Jordan During the Spring of 2020. Front Psychiatry 2021; 12:605676. [PMID: 33664681 PMCID: PMC7920987 DOI: 10.3389/fpsyt.2021.605676] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 01/25/2021] [Indexed: 01/08/2023] Open
Abstract
Objectives: This study was designed to assess the effect of COVID-19 home quarantine and its lifestyle challenges on the sleep quality and mental health of a large sample of undergraduate University students in Jordan. It is the first study applied to the Jordanian population. The aim was to investigate how quarantine for several weeks changed the students' habits and affected their mental health. Methods: A cross-sectional study was conducted using a random representative sample of 6,157 undergraduate students (mean age 19.79 ± 1.67 years, males 28.7%) from the University of Jordan through voluntarily filling an online questionnaire. The Pittsburgh Sleep Quality Index (PSQI) and the Center for Epidemiologic Studies-Depression Scale (CES-D) were used to assess sleep quality and depressive symptoms, respectively. Results: The PSQI mean score for the study participants was 8.1 ± 3.6. The sleep quality of three-quarters of the participants was negatively affected by the extended quarantine. Nearly half of the participants reported poor sleep quality. The prevalence of poor sleep quality among participants was 76% (males: 71.5% and females: 77.8%). Similarly, the prevalence of the depressive symptoms was 71% (34% for moderate and 37% for high depressive symptoms), with females showing higher prevalence than males. The overall mean CES-D score for the group with low depressive symptoms is 9.3, for the moderate group is 19.8, while it is 34.3 for the high depressive symptoms group. More than half of the students (62.5%) reported that the quarantine had a negative effect on their mental health. Finally, females, smokers, and students with decreased income levels during the extended quarantine were the common exposures that are significantly associated with a higher risk of developing sleep disturbances and depressive symptoms. Conclusions: Mass and extended quarantine succeeded in controlling the spread of the COVID-19 virus; however, it comes with a high cost of potential psychological impacts. Most of the students reported that they suffer from sleeping disorders and had a degree of depressive symptoms. Officials should provide psychological support and clear guidance to help the general public to reduce these potential effects and overcome the quarantine period with minimum negative impacts.
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Affiliation(s)
- Heba Saadeh
- Computer Science Department, King Abdullah II School of Information Technology Faculty, The University of Jordan, Amman, Jordan
| | - Maha Saadeh
- Computer Engineering and Informatics, Middlesex University Dubai, Dubai, United Arab Emirates
| | - Wesam Almobaideen
- Computer Science Department, King Abdullah II School of Information Technology Faculty, The University of Jordan, Amman, Jordan.,Electrical Engineering and Computing Sciences, Rochester Institute of Technology, Dubai, United Arab Emirates
| | | | | | - Reem Qadan Al Fayez
- Computer Information System Department, King Abdullah II School of Information Technology Faculty, The University of Jordan, Amman, Jordan
| | - Hamzah Khawaldah
- Geography Department, School of Arts, The University of Jordan, Amman, Jordan
| | | | - Maysa Al-Hussaini
- Department of Pathology and Laboratory Medicine, King Hussein Cancer Center, Amman, Jordan.,Human Research Protection Program Office, King Hussein Cancer Center, Amman, Jordan
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79
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Reynolds AC, Ferguson SA, Appleton SL, Crowther ME, Melaku YA, Gill TK, Rajaratnam SMW, Adams RJ. Prevalence of Probable Shift Work Disorder in Non-Standard Work Schedules and Associations with Sleep, Health and Safety Outcomes: A Cross-Sectional Analysis. Nat Sci Sleep 2021; 13:683-693. [PMID: 34104021 PMCID: PMC8178694 DOI: 10.2147/nss.s301493] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/03/2021] [Indexed: 12/13/2022] Open
Abstract
PURPOSE We aimed to estimate the prevalence of probable shift work disorder (pSWD) in a representative sample of Australian workers and identify sleep, health and safety correlates. PATIENTS AND METHODS In 2019, data were collected from working respondents as part of a cross-sectional national sleep health survey conducted online (n=964 total; n=448 individuals on non-standard work schedules). We established the prevalence of pSWD according to International Classification of Sleep Disorders criteria (ICSD-R, ICSD-2 and ICSD-3). Poisson regression was used to determine crude and adjusted prevalence association (prevalence ratio, PR) of pSWD with sleep, health and safety outcomes. RESULTS Overall prevalence of pSWD in workers on non-standard work schedules was 10.5%, ranging from 9.6% in early morning workers to 12.7% in rotating shift workers. In adjusted models, workers who met the criteria for pSWD were 1.8 times more likely to report both depression/bipolar disorder, and anxiety/panic disorder, and 1.7 times more likely to report work errors due to a sleep problem. CONCLUSION The prevalence of pSWD in employees engaged in non-standard work schedules is influenced by selection of factors used to quantify pSWD, including sleep/wake patterns. Higher likelihoods of mental health problems and workplace errors in those with pSWD highlight the importance of intervention and management of this under-recognised sleep disorder.
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Affiliation(s)
- Amy C Reynolds
- Flinders Health and Medical Research Institute (Sleep Health)/Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia.,Appleton Institute, CQ University Australia, Wayville, SA, Australia
| | - Sally A Ferguson
- Appleton Institute, CQ University Australia, Wayville, SA, Australia
| | - Sarah L Appleton
- Flinders Health and Medical Research Institute (Sleep Health)/Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia
| | - Meagan E Crowther
- Appleton Institute, CQ University Australia, Wayville, SA, Australia
| | - Yohannes Adama Melaku
- Flinders Health and Medical Research Institute (Sleep Health)/Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia
| | - Tiffany K Gill
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Shantha M W Rajaratnam
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Robert J Adams
- Flinders Health and Medical Research Institute (Sleep Health)/Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia
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80
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Liu T, Qiu B, Zhang C, Deng M, Liang Z, Qi Y. Health-related quality of life in pilots of a Chinese commercial airline. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2020; 76:511-517. [PMID: 33355043 DOI: 10.1080/19338244.2020.1863765] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Health-related quality of life (HRQOL) is currently an important issue in the medical industry. However, data on HRQOL in commercial airline pilots are lacking. This study aimed to investigate HRQOL and its related factors in a sample of commercial pilots. A purposive sample of 373 participants was recruited from a Chinese Commercial Airline. The median (IQR) score for physical health, psychological health and social relationship were 64.3 (75-53.6), 62.5 (70.8-54.2) and 75 (75-58.3), respectively. The mean (SD) score for Environment was 62.2 (16). After controlling for demographics, the multiple linear regression analyses showed that physical activity, fruit intake and vegetable intake were positively correlated with HRQOL score (p < .05), while time-zone flights, smoking, alcohol drinking and being dyslipidemic showed a negative correlation with HRQOL score (p < .05). Healthcare providers should consider time-zone flights, behavioral factors and dyslipidemia when planning related health promotion and disease prevention programs for commercial pilots in the future.
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Affiliation(s)
- Tiebing Liu
- Civil Aviation Medicine Institute, Civil Aviation Medicine Center, Civil Aviation Administration of China (Civil Aviation General Hospital), Beijing, People's Republic of China
| | - Bing Qiu
- Civil Aviation Medicine Institute, Civil Aviation Medicine Center, Civil Aviation Administration of China (Civil Aviation General Hospital), Beijing, People's Republic of China
| | - Chuanyin Zhang
- Aviation Hygiene Management Division, China Southern Airlines Company Limited, Guangzhou, People's Republic of China
| | - Mingzhao Deng
- Aviation Hygiene Management Division, China Southern Airlines Company Limited, Guangzhou, People's Republic of China
| | - Zhaohui Liang
- Aviation Hygiene Management Division, China Southern Airlines Company Limited, Guangzhou, People's Republic of China
| | - Yanmin Qi
- Civil Aviation Medicine Institute, Civil Aviation Medicine Center, Civil Aviation Administration of China (Civil Aviation General Hospital), Beijing, People's Republic of China
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Fulfillment, burnout and resilience in emergency medicine-Correlations and effects on patient and provider outcomes. PLoS One 2020; 15:e0240934. [PMID: 33075090 PMCID: PMC7571699 DOI: 10.1371/journal.pone.0240934] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 10/06/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Healthcare provider wellness have been reported to correlate with patient care outcomes. It is not understood whether synergistic effects may exist between them. OBJECTIVE We aim to investigate three provider wellness markers and determine their associations with provider self-reported medical errors and intent-to-leave outcomes among Emergency Department (ED) providers. DESIGN This is a multi-center retrospective study. METHOD Three wellness domains include professional fulfillment (PF), burnout (BO), and personal resilience (PR). Two outcomes measured as provider self-reported medical errors and provider intent-to-leave. Correlations between wellness markers and outcomes were analyzed. When adjusted for other confounders (provider demographics, provider experience, and operational environment), a multivariate logistic regression analysis was performed to further determine the interactions among these three domains on provider wellness affecting patient and provider related outcomes. RESULTS Total 242 surveys were collected from providers at 16 different EDs. The median score of PF were 2.83 among physicians and 2.67 among APPs, BO were 1.00 (physicians) and 0.95 (APPs), and PR were 0.88 (physicians) and 0.81 (APPs). The median scores of self-reported medical errors were 1.50 (physicians) and 0.95 (APPs), and intent-to-leave were 1.00 (physicians and APPs). High correlations occurred among PF, BO, and PR. When analyzed together, high PF, low BO, and high PR functioned as a protective effect on provider intent-to-leave (adjusted odds ratios = 0.09, 95% CI 0.03-0.30). CONCLUSION High correlations occurred among three provider wellness markers with no significant difference between physicians and APPs. Providers with high PR, low BO, and high PR tended to be more stable in their jobs.
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82
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Larisch LM, Kallings LV, Hagströmer M, Desai M, von Rosen P, Blom V. Associations between 24 h Movement Behavior and Mental Health in Office Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176214. [PMID: 32867159 PMCID: PMC7503924 DOI: 10.3390/ijerph17176214] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/27/2020] [Accepted: 08/19/2020] [Indexed: 12/15/2022]
Abstract
The associations between 24 h movement behavior, i.e., the way people distribute their time in different movement-related behaviors, on mental health are not well understood. This study applied a compositional data analysis approach to explore cross-sectional associations between device-measured moderate to vigorous physical activity (MVPA), light intensity physical activity (LIPA), sedentary behavior (SED), self-reported time in bed and mental health outcomes, i.e., depression or anxiety symptoms, burnout, mental wellbeing and stress, in office workers. ActiGraph accelerometers were worn for 24 h for at least 4 days to assess MVPA, LIPA, and SED. Sleep diaries were used in addition to identify time in bed. Analytic sample sizes for the different outcomes ranged from N = 345-370 participants. In this population of office workers with high levels of MVPA, the entire movement behavior composition was not associated to any of the mental health outcomes, but MVPA relative to all other behaviors was positively associated with mental wellbeing. This confirms the importance of MVPA for health relative to other movement-related behaviors.
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Affiliation(s)
- Lisa-Marie Larisch
- Department for Physical Activity and Health, The Swedish School of Sport and Health Sciences, 114 33 Stockholm, Sweden; (L.V.K.); (V.B.)
- Correspondence: ; Tel.: +46-72-247-8050
| | - Lena V. Kallings
- Department for Physical Activity and Health, The Swedish School of Sport and Health Sciences, 114 33 Stockholm, Sweden; (L.V.K.); (V.B.)
- Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, 752 36 Uppsala, Sweden
| | - Maria Hagströmer
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, 141 83 Stockholm, Sweden; (M.H.); (P.v.R.)
- Academic Primary Health Care Centre, Region Stockholm, 113 65 Stockholm, Sweden
- Department of Health Promoting Science, Sophiahemmet University, 11486 Stockholm, Sweden
| | - Manisha Desai
- Quantitative Science Unit, Stanford University, Palo Alto, CA 94304, USA;
| | - Philip von Rosen
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, 141 83 Stockholm, Sweden; (M.H.); (P.v.R.)
| | - Victoria Blom
- Department for Physical Activity and Health, The Swedish School of Sport and Health Sciences, 114 33 Stockholm, Sweden; (L.V.K.); (V.B.)
- Department of Neuroscience, Karolinska Institutet, 171 65 Stockholm, Sweden
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Weiss C, Woods K, Filipowicz A, Ingram KK. Sleep Quality, Sleep Structure, and PER3 Genotype Mediate Chronotype Effects on Depressive Symptoms in Young Adults. Front Psychol 2020; 11:2028. [PMID: 32982844 PMCID: PMC7479229 DOI: 10.3389/fpsyg.2020.02028] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 07/21/2020] [Indexed: 11/13/2022] Open
Abstract
Depression and its related mood disorders are a major global health issue that disproportionately affects young adults. A number of factors that influence depressive symptoms are particularly relevant to the young adult developmental stage, including sleep loss, poor sleep quality, and the tendency toward eveningness in circadian preferences. However, relatively few studies have examined the relationship between sleep and circadian phenotypes, and their respective influences on mood, or considered potential molecular mechanisms driving these associations. Here, we use a multi-year, cross-sectional study of 806 primarily undergraduates to examine the relationships between sleep-wake chronotype, sleep disturbance, depression and genotypes associated with the PER3 variable number of tandom repeats (VNTR) polymorphism-circadian gene variants associated with both chronotype and sleep homeostatic drive. In addition, we use objective, Fitbit-generated sleep structure data on a subset of these participants (n = 67) to examine the relationships between chronotype, depression scores, actual measures of sleep duration, social jetlag, and the percent of deep and rapid eye movement (REM) sleep per night. In this population, chronotype is weakly associated with depressive symptoms and moderately correlated with self-reported sleep disturbance. Sleep disturbance is significantly associated with depression scores, but objective sleep parameters are not directly correlated with Beck Depression Inventory (BDI-II) scores, with the exceptions of a moderate correlation between social jetlag and depression scores in females and a marginal correlation between sleep duration and depression scores. Multiple regression and path analyses reveal that chronotype effects on depressive symptoms in this population are mediated largely by sleep disturbance. The PER3 VNTR genotype significantly predicts depressive symptoms in a model with objective sleep parameters, but it does not significantly predict depressive symptoms in a model with chronotype or subjective sleep disturbance. Interestingly, PER35,5 genotypes, in males only, are independently related to chronotype and depression scores. Our results support hypotheses linking subjective sleep quality and chronotype and provide a first step in understanding how objective sleep structure may be linked to chronotype and depressive symptoms. Our results also suggest that circadian gene variants may show sex-specific effects linking sleep duration and sleep structure to depression.
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Affiliation(s)
- Chloe Weiss
- Department of Biology, Colgate University, Hamilton, NY, United States
| | - Kerri Woods
- Department of Biology, Colgate University, Hamilton, NY, United States
| | - Allan Filipowicz
- Samuel Curtis Johnson Graduate School of Management, Cornell University, Ithaca, NY, United States
| | - Krista K. Ingram
- Department of Biology, Colgate University, Hamilton, NY, United States
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Costa C, Mondello S, Micali E, Indelicato G, Licciardello AA, Vitale E, Briguglio G, Teodoro M, Fenga C. Night shift work in resident physicians: does it affect mood states and cognitive levels? J Affect Disord 2020; 272:289-294. [PMID: 32553370 DOI: 10.1016/j.jad.2020.03.139] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 02/12/2020] [Accepted: 03/29/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND The effects of night shift work on health status have been widely studied. Night workers seem to smoke more, eat badly and show a low propensity to physical activity. Night work can be associated with an increase in cardiovascular and gastrointestinal disorders, alterations in immune response, diabetes, aging, hormonal imbalance, and premature death; alteration of circadian rhythm is also regarded as a risk factor for breast cancer and neuropsychiatric disorders. Moreover, several studies have highlighted the effects of sleep deprivation on clinical performance, quality of care and personal safety of healthcare personnel. No studies have investigated the effects of night work on Italian resident physicians and compared its effect across specialties. This study aims to assess the prevalence of sleep disorders, possible cognitive impairment and mood states, in relation to night shift work among resident physicians. METHODS 80 resident physicians, attending the postgraduate training into an Hospital located in the South of Italy, were divided into 4 areas (medical, surgical, services and anaesthesia). They were recruited from July 2017 to June 2018 and participated to a survey consisting of 4 questionnaires to investigate the presence of sleep deprivation and sleep quality (Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index), their cognitive status (Mini Mental State examination) and mood profiles (Profile of Mood States, POMS). Analysis of variance was used for comparison of questionnaires scores across specialties. RESULTS Authors reported no sleep deprivation, no sleep disorders and their outcomes, no changes in intellectual efficiency and no cognitive impairment in this population, neither in the areas performing night shifts nor in those involving only day shifts. Mood states measured by POMS showed a borderline level of Anger-Hostility (A) value among the residents of the medical area and services, and an increase slightly beyond the physiological levels of the T-score 50 of Fatigue-Inertia (F) always in the same groups. An increase in the Vigour-Activity (V) value beyond T-score 50 levels was also observed among residents of all the areas considered. CONCLUSIONS Emotional involvement could be attributed to the gap between high professional demand and lack of experience and knowledge among trainees. Tutors should help their students in order to identify earlier changes in the mood. Improvement in the organization of the trainee's activity could reduce the emotional overload.
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Affiliation(s)
- Chiara Costa
- Clinical and Experimental Medicine Department, University of Messina, Messina 98125, Italy
| | - Stefania Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, Messina 98125, Italy
| | | | - Giuliano Indelicato
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, Messina 98125, Italy
| | - Antonino Andrea Licciardello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, Messina 98125, Italy
| | - Ermanno Vitale
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, Messina 98125, Italy
| | - Giusi Briguglio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, Messina 98125, Italy
| | - Michele Teodoro
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, Messina 98125, Italy.
| | - Concettina Fenga
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, Messina 98125, Italy
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85
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Boland EM, Goldschmied JR, Wakschal E, Nusslock R, Gehrman PR. An Integrated Sleep and Reward Processing Model of Major Depressive Disorder. Behav Ther 2020; 51:572-587. [PMID: 32586431 PMCID: PMC7321921 DOI: 10.1016/j.beth.2019.12.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 11/07/2019] [Accepted: 12/11/2019] [Indexed: 12/17/2022]
Abstract
Major depressive disorder with comorbid sleep disturbance has been associated with negative outcomes, including lower rates of treatment response and a greater likelihood of depressive relapse compared to those without sleep disturbance. However, little, if any, research has been conducted to understand why such negative treatment outcomes occur when sleep disturbance is present. In this conceptual review, we argue that the relationship of sleep disturbance and negative treatment outcomes may be mediated by alterations in neural reward processing in individuals with blunted trait-level reward responsivity. We first briefly characterize sleep disturbance in depression, discuss the nature of reward processing impairments in depression, and summarize the sleep/reward relationship in healthy human subjects. We then introduce a novel Integrated Sleep and Reward model of the course and maintenance of major depressive disorder and present preliminary evidence of sleep and reward interaction in unipolar depression. Finally, we discuss limitations of the model and offer testable hypotheses and directions for future research.
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Affiliation(s)
- Elaine M Boland
- MIRECC, Cpl. Michael J. Crescenz VA Medical Center, Philadelphia; Perelman School of Medicine of the University of Pennsylvania.
| | | | - Emily Wakschal
- MIRECC, Cpl. Michael J. Crescenz VA Medical Center, Philadelphia
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86
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Boivin MJ, Fatehi F, Phillips-Chan AE, Richardson JR, Summers AN, Foley SA. Exploratory study of a screening measure for polycystic ovarian syndrome, quality of life assessment, and neuropsychological evaluation. BMC WOMENS HEALTH 2020; 20:132. [PMID: 32576264 PMCID: PMC7313190 DOI: 10.1186/s12905-020-00994-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 06/18/2020] [Indexed: 02/06/2023]
Abstract
Background The universally adopted 2018 PCOS medical diagnostic and treatment guidelines for Polycystic Ovarian Syndrome (PCOS) cites the need for a brief screening measure that can be easily administered in the clinical care setting. We evaluate a 12-item questionnaire emphasizing the medical symptoms of PCOS with a group of women with PCOS as well as comparison samples of college women not diagnosed with PCOS. Method Of 120 undergraduate psychology women 18 to 41 years of age, 86 screened negative on a 12-item PCOS symptoms inventory. They were compared to a group of PCOS patients diagnosed medically in a manner consistent with the Teede et al. (2018) evidence-based diagnostic guidelines. The screen-positive, screen-negative, and PCOS-confirmed groups were compared on the PCOS Quality-of-Life (QoL) questionnaire, Zung Self-Rating Depression Scale (ZDS), Spielberg State-Trait Anxiety Inventory (STAI), Fatigue Symptom Inventory (FSI), Spiritual well-being and Spiritual Beliefs Inventories, the computerized Automated Neuropsychological Assessment Metric (ANAM) battery, and an experimental tachistoscopic Bilateral Perceptual Asymmetries Letter and Dots Matching Bilateral Field Advantage (BFA) test (to evaluate the effects of early brain androgenization possible from PCOS). For each questionnaire and neuropsychological performance principal outcome, the Linear Mixed Effects (LME) model was employed to evaluate the predictive significance of demographic characteristics and group membership (confirmed cases, screen negative and screen positive cases) for these outcomes. Results The PCOS-confirmed women scored more poorly than the screen-negative (reference) and screen-positive groups on all the measures of physical, emotional, social, and spiritual well-being measures. On the ANAM neuropsychological battery, PCOS-confirmed women did more poorly on Sternberg Memory and Stimulus Response throughput measures. They also had slower correct response speed for both the unilateral and bilateral dot- and letter-matching tachistoscopic stimulus presentations. However, the bilateral field advantage throughput performance ratio did not differ among groups, which is a global measure of bilateral versus unilateral brain/behavior asymmetries. Conclusion PCOS screening can be a feasible and important part of women’s healthcare. PCOS-confirmed women should receive not only the medical standard of care from the 2018 guidelines, but also comprehensive psychosocial and neurocognitive support to enhance their quality of life.
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Affiliation(s)
- Michael J Boivin
- Department of Psychiatry and Neurology & Ophthalmology, Michigan State University, East Lansing, 909 Wilson Road, Rm 327, West Fee Road, East Lansing, MI, 48824, USA.
| | - Farnaz Fatehi
- Department of Psychiatry and Neurology & Ophthalmology, Michigan State University, East Lansing, 909 Wilson Road, Rm 327, West Fee Road, East Lansing, MI, 48824, USA
| | | | - Julia R Richardson
- Department of Psychology, Indiana Wesleyan University, Marion, Indiana, USA
| | - Amanda N Summers
- Department of Psychology, Indiana Wesleyan University, Marion, Indiana, USA
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87
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Arbour MW, Gordon IK, Saftner M, Tanner T. The experience of sleep deprivation for midwives practicing in the united states. Midwifery 2020; 89:102782. [PMID: 32554134 DOI: 10.1016/j.midw.2020.102782] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 05/27/2020] [Accepted: 06/08/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Midwives in the United States who work shifts longer than 12 h have higher rates of excessive daytime sleepiness than midwives who work shifts of 12 h or less. Increased levels of excessive daytime sleepiness can lead to negative life impacts and may increase the risk for accidents and professional burnout. OBJECTIVE To describe midwives' experiences related to sleep and sleep deprivation as a result of their work and call-shift schedules. METHODS A survey designed to explore the experience and impact of work on sleep and sleepiness among midwives in the United States was sent to members of the American College of Nurse-Midwives (N = 4358). The survey included an open-ended question about midwives' experiences related to sleep or sleep deprivation. This analysis of the qualitative data was conducted using qualitative description and qualitative content analysis by two of the authors. RESULTS There were a total of 753 midwife respondents (response rate = 17%); of those 268 responded to the qualitative question about sleep. Three main themes were identified: barriers and challenges contributing to sleep deprivation; negative consequences of sleep deprivation; and strategies that helped midwives cope with or reduce sleep deprivation. DISCUSSION Midwives reported suffering health and safety consequences as a result of insufficient sleep, including impacts to their personal health, clinical errors, and errors in driving after an extended period awake. Nurses, midwives, physicians, and administrators are encouraged to work together to develop strategies and policies to ameliorate the risks and impacts of sleep deprivation for all clinicians, including midwives.
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Affiliation(s)
- Megan W Arbour
- Frontier Nursing University, 195 School St, Hyden, KY 41749, United States.
| | - Ira Kantrowitz Gordon
- University of Washington School of Nursing, Box 357260, University of Washington, Seattle, WA 98195, United States.
| | - Melissa Saftner
- University of Minnesota, School of Nursing, 308 Harvard Street SE, Minneapolis, MN 55455, United States.
| | - Tanya Tanner
- Frontier Nursing University, 195 School St, Hyden, KY 41749, United States.
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Ballesio A, Lombardo C, Lucidi F, Violani C. Caring for the carers: Advice for dealing with sleep problems of hospital staff during the COVID-19 outbreak. J Sleep Res 2020; 30:e13096. [PMID: 32515084 PMCID: PMC7300547 DOI: 10.1111/jsr.13096] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/07/2020] [Accepted: 05/08/2020] [Indexed: 12/26/2022]
Abstract
Hospital staff are at the frontline in the COVID‐19 outbreak. The stressors they experience may induce sleep problems in a population already at risk. Sleep deprivation, long shifts and insomnia in hospital staff have been associated with individual, organizational and public health hazards. These include increased risk of mental and somatic disorders, altered immune responses, medical errors, misunderstandings, drowsy driving and burnout. In March 2020, the World Health Organization called for providing access to mental health and counselling for health professionals involved in the COVID‐19 outbreak. To answer this call, we propose practical advice for the management of sleep problems (sleep deprivation, insomnia and shift work) that can be included in supportive interventions. The advice is based on psychobiological principles of sleep regulation and on guidelines for the treatment of insomnia and was implemented within an initiative offering psychological support to the staff of three university hospitals in Rome.
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Affiliation(s)
- Andrea Ballesio
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.,Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Caterina Lombardo
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Fabio Lucidi
- Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Cristiano Violani
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
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Cao R, Gao T, Ren H, Hu Y, Qin Z, Liang L, Mei S. The relationship between bullying victimization and depression in adolescents: multiple mediating effects of internet addiction and sleep quality. PSYCHOL HEALTH MED 2020; 26:555-565. [PMID: 32479131 DOI: 10.1080/13548506.2020.1770814] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Various studies have found that bullying victimization is an important factor affecting depression. However, few studies have explored the underlying mechanism of this effect. The purpose of this study was to examine the effects of bullying victimization on depression, as well as the mediating roles of internet addiction and sleep quality. The participants were 2022 Chinese junior high school students who completed questionnaires regarding bullying victimization, internet addiction, sleep quality and depression. Correlation analysis indicated that bullying victimization, poor sleep quality, internet addiction, and depression have significant, positive correlations with each other. Hayes' PROCESS macro revealed that internet addiction and sleep quality played multiple mediation roles in the relationship between bullying victimization and depression. These results suggested that effective strategies focusing on improving problematic internet use along with sleep quality may contribute to reducing the negative effect of bullying victimization on depressive symptoms.
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Affiliation(s)
- Ruilin Cao
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Tingting Gao
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Hui Ren
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Yueyang Hu
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Zeying Qin
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Leilei Liang
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Songli Mei
- School of Public Health, Jilin University, Changchun, Jilin Province, China
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Poor Sleep Hygiene is Associated with Decreased Discrimination and Inattention on Continuous Performance Task in Doctor of Physical Therapy Students: A Cross-sectional Study. ACTA ACUST UNITED AC 2020; 34:160-165. [PMID: 34211256 DOI: 10.1097/jte.0000000000000135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Introduction Reduced sleep quality impairs learning, memory formation, attention, and executive function ability. Poor sleep quality or sleep hygiene has been shown to impair academic performance of undergraduate and medical students. The purpose of this study was to examine the association between sleep quality, sleep hygiene, and cognitive performance in Doctor of Physical Therapy (DPT) students. Methods Fifty DPT students at the University of Kansas Medical Center completed the Pittsburgh Sleep Quality Index (PSQI) and the Sleep Hygiene Index (SHI). Cognitive performance was assessed using the Continuous Performance Test (CPT) which is a test of sustained attention and the Trail-Making Task (TMT) to assess executive functioning. An actigraph was worn for one week to objectively characterize sleep outcomes. Spearman's correlations were performed to assess the association between self-report sleep quality, sleep hygiene, and outcomes on the cognitive tasks. Post-hoc Mann-Whitney and Kruskal-Wallis tests were conducted to examine group differences between sleep outcomes and cognitive performance for demographic variable categories. Results Twenty-three students (46%) reported poor sleep quality, and 27 participants (54%) had objectively-reported poor sleep quality. There was a significant positive correlation between SHI and Detectability (rs= 0.297, p= 0.036) and Omissions (rs=.343, p=0.015). There were group differences between sex and number of pets on the CPT outcomes, and there was a significant group difference between the number of drinks/week categories on the SHI. Discussion and Conclusions About half of the participants were identified as having poor sleep quality. Poorer sleep hygiene was associated with poorer discrimination and inattention, which could potentially impact the students' academic and clinical performance as well as their health and wellbeing. Also, certain demographic variables may modulate the results.
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Gupta G, Shellhaas RA. Losing Sleep: Considering Caregivers of Children with Rare Epilepsy Syndromes. THE JOURNAL OF PEDIATRICS: X 2020; 2:100022. [PMID: 37332627 PMCID: PMC10236555 DOI: 10.1016/j.ympdx.2020.100022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Gita Gupta
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
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Xu S, Ouyang X, Shi X, Li Y, Chen D, Lai Y, Fan F. Emotional exhaustion and sleep-related worry as serial mediators between sleep disturbance and depressive symptoms in student nurses: A longitudinal analysis. J Psychosom Res 2020; 129:109870. [PMID: 31862630 DOI: 10.1016/j.jpsychores.2019.109870] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 11/05/2019] [Accepted: 11/10/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The multi-wave longitudinal study was to explore the underlying mechanisms between sleep disturbance and depressive symptoms for up to 9.5 months among student nurses and to examine whether emotional exhaustion and sleep-related worry could be the mediators. METHODS 856 student nurses aged 15-24 years (mean age = 17.8 years; all female) were recruited from a nursing school. Participants reported demographic variables (age, sibling, location, health condition, family monthly income and parents' marital quality) at baseline (Time1), Body Mass Index, weekly exercise, sleep disturbance and depressive symptoms at 3-month into internship (Time2), emotional exhaustion and sleep-related worry at 6-month into internship (Time3), and depressive symptoms at 9.5-month follow-up (Time4). Mediation analyses with bootstrapping were conducted to investigate the mediating role of emotional exhaustion and sleep-related worry in the relationship between sleep disturbance and depressive symptoms. RESULTS Adjusted analyses suggested that the direct effect of sleep disturbance on depressive symptoms was not significant (β = 0.026, SE = 0.069, p = .71). Mediation analyses revealed two significant indirect effects between Time2 sleep disturbance and Time4 depressive symptoms with the mediating effect of emotional exhaustion (β = 0.019, SE = 0.009, BC95%CI [0.0036,0.0405]) and sleep-related worry (β = 0.016, SE = 0.008, BC95%CI [0.0026,0.0337]) respectively. When testing serial multiple mediation, the specific indirect effect of sleep disturbance on depressive symptoms through both emotional exhaustion and sleep-related worry was significant (β = 0.005, SE = 0.003, BC95%CI [0.0004,0.0123]). CONCLUSIONS Emotional exhaustion and sleep-related worry were positively associated with sleep disturbance and depressive symptoms.
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Affiliation(s)
- Shuling Xu
- School of Psychology, Center for Studies of Psychological Application, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou, China
| | - Xi Ouyang
- School of Psychology, Center for Studies of Psychological Application, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou, China
| | - Xuliang Shi
- School of Psychology, Center for Studies of Psychological Application, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou, China; College of Education, Hebei University, Hebei, China
| | - Yuanyuan Li
- School of Psychology, Center for Studies of Psychological Application, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou, China
| | - Dingxuan Chen
- School of Psychology, Center for Studies of Psychological Application, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou, China
| | - Yuan Lai
- School of Psychology, Center for Studies of Psychological Application, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou, China
| | - Fang Fan
- School of Psychology, Center for Studies of Psychological Application, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou, China.
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Liu RQ, Bloom MS, Wu QZ, He ZZ, Qian Z, Stamatakis KA, Liu E, Vaughn M, Lawrence WR, Yang M, Lu T, Hu QS, Dong GH. Association between depressive symptoms and poor sleep quality among Han and Manchu ethnicities in a large, rural, Chinese population. PLoS One 2019; 14:e0226562. [PMID: 31856188 PMCID: PMC6922383 DOI: 10.1371/journal.pone.0226562] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 11/28/2019] [Indexed: 02/07/2023] Open
Abstract
Objectives To estimate the relationship between sleep quality and depression, among Han and Manchu ethnicities, in a rural Chinese population. Methods A sample of 8,888 adults was selected using a multistage cluster and random sampling method. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Depressive symptoms were assessed via the Center for Epidemiological Survey, Depression Scale (CES-D). Logistic regression was conducted to assess associations between sleep quality and depression. Results The prevalence of poor sleep quality and depression in the Manchus (20.74% and 22.65%) was significantly lower than that in the Hans (29.57% and 26.25%), respectively. Depressive participants had higher odds ratios of global and all sub PSQI elements than non-depressive participants, both among the Hans and the Manchus. Additive interactions were identified between depressive symptoms and ethnicity with global and four sub-PSQI elements, including subjective sleep quality, sleep disturbance, use of sleep medication and daytime dysfunction. Conclusions The findings revealed that the prevalence of poor sleep quality and depression among the Hans was greater than among the Manchus. Depression was associated with higher odds of poor sleep quality.
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Affiliation(s)
- Ru-Qing Liu
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Michael S. Bloom
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, New York, United States of America
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, Rensselaer, New York, United States of America
| | - Qi-Zhen Wu
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhi-Zhou He
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhengmin Qian
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri, United States of America
| | - Katherine A. Stamatakis
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri, United States of America
| | - Echu Liu
- Department of Health Management & Policy, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri, United States of America
| | - Michael Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri, United States of America
| | - Wayne R. Lawrence
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, Rensselaer, New York, United States of America
| | - Mingan Yang
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, San Diego State University, San Diego, California, United States of America
| | - Tao Lu
- Department of Mathematics and Statistics, University of Nevada, Reno, Nevada, United States of America
| | - Qian-Sheng Hu
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
- * E-mail: (GD); (QH)
| | - Guang-Hui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
- * E-mail: (GD); (QH)
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Pereira-Lima K, Mata DA, Loureiro SR, Crippa JA, Bolsoni LM, Sen S. Association Between Physician Depressive Symptoms and Medical Errors: A Systematic Review and Meta-analysis. JAMA Netw Open 2019; 2:e1916097. [PMID: 31774520 PMCID: PMC6902829 DOI: 10.1001/jamanetworkopen.2019.16097] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
IMPORTANCE Depression is highly prevalent among physicians and has been associated with increased risk of medical errors. However, questions regarding the magnitude and temporal direction of these associations remain open in recent literature. OBJECTIVE To provide summary relative risk (RR) estimates for the associations between physician depressive symptoms and medical errors. DATA SOURCES A systematic search of Embase, ERIC, PubMed, PsycINFO, Scopus, and Web of Science was performed from database inception to December 31, 2018. STUDY SELECTION Peer-reviewed empirical studies that reported on a valid measure of physician depressive symptoms associated with perceived or observed medical errors were included. No language restrictions were applied. DATA EXTRACTION AND SYNTHESIS Study characteristics and RR estimates were extracted from each article. Estimates were pooled using random-effects meta-analysis. Differences by study-level characteristics were estimated using subgroup meta-analysis and metaregression. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was followed. MAIN OUTCOMES AND MEASURES Relative risk estimates for the associations between physician depressive symptoms and medical errors. RESULTS In total, 11 studies involving 21 517 physicians were included. Data were extracted from 7 longitudinal studies (64%; with 5595 individuals) and 4 cross-sectional studies (36%; with 15 922 individuals). The overall RR for medical errors among physicians with a positive screening for depression was 1.95 (95% CI, 1.63-2.33), with high heterogeneity across the studies (χ2 = 49.91; P < .001; I2 = 82%; τ2 = 0.06). Among the variables assessed, study design explained the most heterogeneity across studies, with lower RR estimates associated with medical errors in longitudinal studies (RR, 1.62; 95% CI, 1.43-1.84; χ2 = 5.77; P = .33; I2 = 13%; τ2 < 0.01) and higher RR estimates in cross-sectional studies (RR, 2.51; 95% CI, 2.20-2.83; χ2 = 5.44; P = .14; I2 = 45%; τ2 < 0.01). Similar to the results for the meta-analysis of physician depressive symptoms associated with subsequent medical errors, the meta-analysis of 4 longitudinal studies (involving 4462 individuals) found that medical errors associated with subsequent depressive symptoms had a pooled RR of 1.67 (95% CI, 1.48-1.87; χ2 = 1.85; P = .60; I2 = 0%; τ2 = 0), suggesting that the association between physician depressive symptoms and medical errors is bidirectional. CONCLUSIONS AND RELEVANCE Results of this study suggest that physicians with a positive screening for depressive symptoms are at higher risk for medical errors. Further research is needed to evaluate whether interventions to reduce physician depressive symptoms could play a role in mitigating medical errors and thus improving physician well-being and patient care.
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Affiliation(s)
- Karina Pereira-Lima
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Douglas A. Mata
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sonia R. Loureiro
- Department of Neuroscience and Behavior, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - José A. Crippa
- Department of Neuroscience and Behavior, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Lívia M. Bolsoni
- Department of Neuroscience and Behavior, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Srijan Sen
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor
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96
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Kalmbach DA, Cheng P, Ong JC, Ciesla JA, Kingsberg SA, Sangha R, Swanson LM, O'Brien LM, Roth T, Drake CL. Depression and suicidal ideation in pregnancy: exploring relationships with insomnia, short sleep, and nocturnal rumination. Sleep Med 2019; 65:62-73. [PMID: 31710876 DOI: 10.1016/j.sleep.2019.07.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/03/2019] [Accepted: 07/09/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Sleep problems and depression are highly prevalent in pregnancy. Nocturnal rumination has been linked to insomnia and depression in non-pregnant samples, but remains poorly characterized in pregnancy. This study explored relationships of depression and suicidal ideation with insomnia, short sleep, and nocturnal rumination in mid-to-late pregnancy. METHODS In this study, 267 pregnant women were recruited from obstetric clinics and completed online surveys on sleep, depression, and nocturnal rumination. RESULTS Over half (58.4%) of the sample reported clinical insomnia on the Insomnia Severity Index, 16.1% screened positive for major depression on the Edinburgh Postnatal Depression Scale (EPDS), and 10.1% endorsed suicidal ideation. Nocturnal rumination was more robustly associated with sleep onset difficulties than with sleep maintenance issues. Depressed women were at greater odds of sleep onset insomnia (OR = 2.80), sleep maintenance insomnia (OR = 6.50), high nocturnal rumination (OR = 6.50), and negative perinatal-focused rumination (OR = 2.70). Suicidal ideation was associated with depression (OR = 3.64) and negative perinatal-focused rumination (OR = 3.50). A four-group comparison based on insomnia status and high/low rumination revealed that pregnant women with insomnia and high rumination endorsed higher rates of depression (35.6%) and suicidal ideation (17.3%) than good-sleeping women with low rumination (1.2% depressed, 4.9% suicidal). Women with insomnia alone (depression: 3.9%, suicidal: 5.9%) or high rumination alone (depression: 10.7%, suicidal: 7.1%) did not differ from good-sleeping women with low rumination. CONCLUSIONS High rumination and insomnia are highly common in mid-to-late pregnancy and both are associated with depression and suicidal ideation. Depression and suicidal ideation are most prevalent in pregnant women with both insomnia and high rumination. CLINICALTRIALS. GOV IDENTIFIER NCT03596879.
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Affiliation(s)
- David A Kalmbach
- Thomas Roth Sleep Disorders & Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI, 48202, USA.
| | - Philip Cheng
- Thomas Roth Sleep Disorders & Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI, 48202, USA
| | - Jason C Ong
- Departments of Neurology and Psychiatry & Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
| | - Jeffrey A Ciesla
- Department of Psychological Sciences, Kent State University, Kent, OH, 44240, USA
| | - Sheryl A Kingsberg
- Departments of Reproductive Biology and Psychiatry, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Roopina Sangha
- Department of Obstetrics & Gynecology, Henry Ford Health System, Detroit, MI, 48202, USA
| | - Leslie M Swanson
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Louise M O'Brien
- Departments of Obstetrics & Gynecology and Neurology, Ann Arbor, MI, 48105, USA
| | - Thomas Roth
- Thomas Roth Sleep Disorders & Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI, 48202, USA
| | - Christopher L Drake
- Thomas Roth Sleep Disorders & Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI, 48202, USA
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97
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Kalmbach DA, Cheng P, Arnedt JT, Cuamatzi-Castelan A, Atkinson RL, Fellman-Couture C, Roehrs T, Drake CL. Improving Daytime Functioning, Work Performance, and Quality of Life in Postmenopausal Women With Insomnia: Comparing Cognitive Behavioral Therapy for Insomnia, Sleep Restriction Therapy, and Sleep Hygiene Education. J Clin Sleep Med 2019; 15:999-1010. [PMID: 31383238 PMCID: PMC6622507 DOI: 10.5664/jcsm.7882] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 02/26/2019] [Accepted: 03/11/2019] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Insomnia is a chief complaint among postmenopausal women, and insomnia impairs daytime functioning and reduces quality of life. Recent evidence supports the efficacy of cognitive behavioral therapy for insomnia (CBTI) for menopausal insomnia, but it remains unclear whether treating insomnia improves daytime function in this population. This study evaluated whether CBTI improves daytime fatigue, energy, self-reported sleepiness, work productivity, and quality of life in postmenopausal women with insomnia, and whether sleep restriction therapy (SRT)-a single component of CBTI-is equally efficacious. METHODS Single-site, randomized control trial. One hundred fifty postmenopausal women (56.44 ± 5.64 years) with perimenopausal or postmenopausal onset or exacerbation of chronic insomnia were randomized to 3 treatment conditions: sleep hygiene education control (SHE), SRT, and CBTI. Blinded assessments were performed at pretreatment, posttreatment, and 6-month follow-up. RESULTS CBTI and SRT produced moderate-to-large improvements in fatigue, energy, sleepiness, and work function at posttreatment and 6 months later. The CBTI group reported better quality of life as indicated by substantial improvements in emotional wellbeing and resiliency to physical and emotional problems, whereas the SRT and SHE groups only showed improvements in resiliency to physical problems. Pain complaints decreased as sleep improved but were not associated with specific treatment conditions. Similarly, insomnia remitters reported fewer daytime and nighttime hot flashes, although reductions were not associated with any specific treatment. CONCLUSIONS CBTI and SRT are efficacious options for postmenopausal women with chronic insomnia. Both interventions improve daytime function, quality of life, and work performance, although CBTI produces superior results including the added benefit of improved emotional health. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Title: Behavioral Treatment of Menopausal Insomnia; Sleep and Daytime Outcomes; Identifier: NCT01933295; URL: https://clinicaltrials.gov/ct2/show/record/NCT01933295.
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Affiliation(s)
- David A. Kalmbach
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, Michigan
| | - Philip Cheng
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, Michigan
| | - J. Todd Arnedt
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan
| | | | - Rachel L. Atkinson
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, Michigan
| | - Cynthia Fellman-Couture
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, Michigan
| | - Timothy Roehrs
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, Michigan
| | - Christopher L. Drake
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, Michigan
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98
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Medisauskaite A, Kamau C. Does occupational distress raise the risk of alcohol use, binge-eating, ill health and sleep problems among medical doctors? A UK cross-sectional study. BMJ Open 2019; 9:e027362. [PMID: 31092661 PMCID: PMC6530309 DOI: 10.1136/bmjopen-2018-027362] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES This study aims to assess the prevalence of health problems (eg, insomnia, binge-eating, substance use and ill health) among UK doctors and to investigate whether occupational distress increases the risk of health problems. DESIGN This study reports the analysis of data collected at the baseline stage of a randomised controlled trial (protocol #NCT02838290). SETTING Doctors were invited through medical Royal Colleges, the British Medical Association's research panel and a random selection of NHS trusts across various UK regions. PARTICIPANTS 417 UK doctors with an equivalent split of gender (48% males) and seniority (49% consultants). MAIN OUTCOMES AND MEASURES Outcomes were sleep problems (eg, insomnia), alcohol/drug use (eg, binge-drinking), ill health (eg, backache) and binge-eating (eg, uncontrollable eating). Predictor variables were occupational distress (psychiatric morbidity, burnout, job effort, work-life imbalance, coping with stress through self-blame or substances) and work factors (workplace and years practising medicine). RESULTS 44% of doctors binge-drank and 5% met the criteria for alcohol dependence; 24%-29% experienced negative emotions after overeating and 8% had a binge-eating disorder; 20%-61% had some type of sleep problem and 12% had severe/moderate insomnia; 69% had fatigue and 19%-29% experienced other types of ill health problems. The results show that occupational distress and job factors increase the odds of doctors using substances, having sleep problems, presenting with frequent symptoms of ill health and binge-eating. For example, burnout increased the risk of all types of sleep problems, eg, difficulty falling/staying asleep, insomnia (OR ≥1.344; p≤0.036). Even taking into consideration whether or not a doctor works in a hospital, the risk of health problems still rises when doctors have signs of occupational distress. CONCLUSION Early recognition of occupational distress can prevent health problems among UK doctors that can reduce the quality of patient care because of sickness-related absence.
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Affiliation(s)
| | - Caroline Kamau
- Department of Organizational Psychology, Birkbeck, University of London, London, UK
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99
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Jahrami H, Dewald-Kaufmann J, Faris MAI, AlAnsari AMS, Taha M, AlAnsari N. Prevalence of sleep problems among medical students: a systematic review and meta-analysis. J Public Health (Oxf) 2019. [DOI: 10.1007/s10389-019-01064-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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100
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Ma W, Song J, Wang H, Shi F, Zhou N, Jiang J, Xu Y, Zhang L, Yang L, Zhou M. Chronic paradoxical sleep deprivation-induced depression-like behavior, energy metabolism and microbial changes in rats. Life Sci 2019; 225:88-97. [PMID: 30953642 DOI: 10.1016/j.lfs.2019.04.006] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/28/2019] [Accepted: 04/02/2019] [Indexed: 12/14/2022]
Abstract
AIMS Given the lasting impact of chronic paradoxical sleep deprivation (PSD) on behavior and organism metabolic alternations, along with the role of the microbiome in neurobehavioral development and metabolism, we sought to examine the relationship between the microbiota and chronic PSD-induced behavioral and metabolic changes. MATERIALS AND METHODS Psychological status of 7-day PSD (7d-PSD) male rats was tested by behavioral method, serum inflammatory cytokines and hypothalamic-pituitary-adrenal (HPA) axis-related hormones. In addition, GC-MS based urine metabolomics and 16S rRNA gene sequencing approaches were applied to estimate the influences of chronic PSD on host metabolism and gut-microbiota. Furtherly, microbial functional prediction and Spearman's correlation analysis were implemented to manifest the relations between the differential urinary metabolites and gut microbiota. KEY FINDINGS 7d-PSD rats displayed depression-like behavior, metabolic and microbial changes. By integrating differential gut bacteria with indicators of depression and differential metabolites, we found that the alterations of Akkermansia, Oscillospira, Ruminococcus, Parabacteroides, Aggregatibacter and Phascolarctobacterium were closely related to abnormalities of depression symptoms and inflammatory cytokines. These bacteria also had close connections with host energy metabolism concerning arginine and proline metabolism, glycine, serine and threonine metabolism, and glyoxylate and dicarboxylate metabolism, pyruvate metabolism, which overlapped with the results of 16S rRNA gene function annotation. SIGNIFICANCE These data suggest that a specific situation of circadian disturbance, chronic PSD-induced alterations in gut microbiota and related host changes in metabolism may be the pathogenesis of depression.
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Affiliation(s)
- Weini Ma
- Center for Chinese Medicine Therapy and Systems Biology, Institute for Interdisciplinary Medicine Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Jing Song
- Center for Chinese Medicine Therapy and Systems Biology, Institute for Interdisciplinary Medicine Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Heran Wang
- School of Basic Medical Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Fangyu Shi
- School of Basic Medical Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Nian Zhou
- Center for Chinese Medicine Therapy and Systems Biology, Institute for Interdisciplinary Medicine Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Jiaye Jiang
- Experiment Center of Teaching & Learning, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Ying Xu
- Department of Physiology, School of Basic Medical Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Lei Zhang
- Shanghai Innovation Center of TCM Health Service, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Li Yang
- Center for Chinese Medicine Therapy and Systems Biology, Institute for Interdisciplinary Medicine Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; The Ministry of Education (MOE) Key Laboratory for Standardization of Chinese Medicines and the State Administration of Traditional Chinese Medicine (SATCM) Key Laboratory for New Resources and Quality Evaluation of Chinese Medicines, Institute of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Mingmei Zhou
- Center for Chinese Medicine Therapy and Systems Biology, Institute for Interdisciplinary Medicine Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
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