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Salwen-Deremer JK, Smith MT, Haskell HG, Schreyer C, Siegel CA. Poor Sleep in Inflammatory Bowel Disease Is Reflective of Distinct Sleep Disorders. Dig Dis Sci 2022; 67:3096-3107. [PMID: 34331174 DOI: 10.1007/s10620-021-07176-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/12/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Poor sleep is common in inflammatory bowel disease (IBD), predicting increased risk of flares, surgery, and/or hospitalization and reducing quality of life. AIMS To profile specific sleep disorder symptoms in IBD, informing intervention efforts. METHODS 312 adults with Crohn's disease or ulcerative colitis were recruited from an academic medical center in New Hampshire, USA. Participants completed online surveys about sleep including well-validated measures of sleep quality, insomnia, restless leg syndrome, sleep apnea, and circadian rhythms. Participants also answered questions about IBD-related problems that could interfere with sleep. RESULTS 69.4% of participants reported experiencing poor sleep and 50% reported clinically significant insomnia. Participants with active IBD symptoms were more likely to have poor sleep and insomnia. Of those with poor sleep, 67.8% met the clinical threshold for insomnia disorder and 31.3% met criteria for two or more sleep disorders. IBD-related sleep disruptions (e.g., nighttime awakenings due to bowel movements) were not significantly related to poor sleep quality, but significantly related to insomnia severity for participants with active Crohn's disease. CONCLUSIONS While poor sleep in IBD is reflective of a number of different sleep problems, it is most frequently related to insomnia. IBD symptom severity contributes to insomnia, but insomnia is also distinct from IBD-related sleep disruptions. Future research on the treatment of insomnia disorder in particular in individuals with IBD is warranted.
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Affiliation(s)
- Jessica K Salwen-Deremer
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, 03784, USA. .,Department of Medicine, Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
| | - Michael T Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Hannah G Haskell
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, 03784, USA
| | - Colleen Schreyer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Corey A Siegel
- Department of Medicine, Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
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García-Serrano C, Pujol Salud J, Aran-Solé L, Sol J, Ortiz-Congost S, Artigues-Barberà E, Ortega-Bravo M. Enhancing Night and Day Circadian Contrast through Sleep Education in Prediabetes and Type 2 Diabetes Mellitus: A Randomized Controlled Trial. BIOLOGY 2022; 11:biology11060893. [PMID: 35741413 PMCID: PMC9219735 DOI: 10.3390/biology11060893] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/31/2022] [Accepted: 06/08/2022] [Indexed: 05/01/2023]
Abstract
BACKGROUND Evidence supports a causal relationship between circadian disturbance and impaired glucose homeostasis. METHODS To determine the effect of an educational intervention delivered by primary care nurses to improve sleep hygiene, a parallel, open-label clinical trial in subjects aged 18 and older with impaired fasting glucose (IFG) or type 2 diabetes mellitus (T2DM) was performed. Study variables were sex, age, fasting glucose, glycated haemoglobin A1c (HbA1c), Pittsburgh Sleep Quality Index (PSQI), sleep duration and efficiency, body mass index, antidiabetic treatment, diet and physical exercise. An individual informative educational intervention was carried out following a bidirectional feedback method. The intervention aimed to develop skills to improve sleep through nine simple tips. An analysis of covariance was performed on all the mean centred outcome variables controlling for the respective baseline scores. RESULTS In the intervention group, PSQI dropped, the duration and quality of sleep increased, and a decrease in fasting glucose and in HbA1c levels was observed. CONCLUSION The proposed intervention is effective for improving sleep quality, length and efficiency, and for decreasing fasting glucose and HbA1c levels in only 3 months. These findings support the importance of sleep and circadian rhythm education focused on improving IFG and T2DM.
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Affiliation(s)
- Cristina García-Serrano
- Balaguer Primary Care Centre, Institut Català de la Salut (ICS), 25600 Lleida, Spain; (J.P.S.); (L.A.-S.); (S.O.-C.)
- Research Group in Therapies in Primary Care (GRETAPS), Fundació Institut Universitari per a la Recerca en Atenció Primària de Salut Jordi Gol i Gurina (IDIAP JGol), 25007 Lleida, Spain; (E.A.-B.); (M.O.-B.)
- Correspondence:
| | - Jesús Pujol Salud
- Balaguer Primary Care Centre, Institut Català de la Salut (ICS), 25600 Lleida, Spain; (J.P.S.); (L.A.-S.); (S.O.-C.)
- Biomedical Research Institute (IRB Lleida), University of Lleida (UdL), 25198 Lleida, Spain
| | - Lidia Aran-Solé
- Balaguer Primary Care Centre, Institut Català de la Salut (ICS), 25600 Lleida, Spain; (J.P.S.); (L.A.-S.); (S.O.-C.)
| | - Joaquim Sol
- Catalan Health Institute (ICS), Primary Care Lleida, Rambla Ferran, 44, 25007 Lleida, Spain;
- Research Support Unit (USR), Fundació Institut Universitari per a la Recerca en Atenció Primària de Salut Jordi Gol i Gurina (IDIAP JGol), 25007 Lleida, Spain
- Metabolic Phisiopathology Group, Department of Experimental Medicine, Biomedical Research Institute (IRB Lleida), University of Lleida (UdL), 25198 Lleida, Spain
| | - Sònia Ortiz-Congost
- Balaguer Primary Care Centre, Institut Català de la Salut (ICS), 25600 Lleida, Spain; (J.P.S.); (L.A.-S.); (S.O.-C.)
| | - Eva Artigues-Barberà
- Research Group in Therapies in Primary Care (GRETAPS), Fundació Institut Universitari per a la Recerca en Atenció Primària de Salut Jordi Gol i Gurina (IDIAP JGol), 25007 Lleida, Spain; (E.A.-B.); (M.O.-B.)
- Catalan Health Institute (ICS), Primary Care Lleida, Rambla Ferran, 44, 25007 Lleida, Spain;
- Research Support Unit (USR), Fundació Institut Universitari per a la Recerca en Atenció Primària de Salut Jordi Gol i Gurina (IDIAP JGol), 25007 Lleida, Spain
| | - Marta Ortega-Bravo
- Research Group in Therapies in Primary Care (GRETAPS), Fundació Institut Universitari per a la Recerca en Atenció Primària de Salut Jordi Gol i Gurina (IDIAP JGol), 25007 Lleida, Spain; (E.A.-B.); (M.O.-B.)
- Catalan Health Institute (ICS), Primary Care Lleida, Rambla Ferran, 44, 25007 Lleida, Spain;
- Research Support Unit (USR), Fundació Institut Universitari per a la Recerca en Atenció Primària de Salut Jordi Gol i Gurina (IDIAP JGol), 25007 Lleida, Spain
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Laaboub N, Dubath C, Ranjbar S, Sibailly G, Grosu C, Piras M, Délessert D, Richard-Lepouriel H, Ansermot N, Crettol S, Vandenberghe F, Grandjean C, Delacrétaz A, Gamma F, Plessen KJ, von Gunten A, Conus P, Eap CB. Insomnia disorders are associated with increased cardiometabolic disturbances and death risks from cardiovascular diseases in psychiatric patients treated with weight-gain-inducing psychotropic drugs: results from a Swiss cohort. BMC Psychiatry 2022; 22:342. [PMID: 35581641 PMCID: PMC9116036 DOI: 10.1186/s12888-022-03983-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 05/04/2022] [Indexed: 11/16/2022] Open
Abstract
STUDY OBJECTIVES Insomnia disorders as well as cardiometabolic disorders are highly prevalent in the psychiatric population compared to the general population. We aimed to investigate their association and evolution over time in a Swiss psychiatric cohort. METHODS Data for 2861 patients (8954 observations) were obtained from two prospective cohorts (PsyMetab and PsyClin) with metabolic parameters monitored routinely during psychotropic treatment. Insomnia disorders were based on the presence of ICD-10 "F51.0" diagnosis (non-organic insomnia), the prescription of sedatives before bedtime or the discharge letter. Metabolic syndrome was defined using the International Diabetes Federation definition, while the 10-year risk of cardiovascular event or death was assessed using the Framingham Risk Score and the Systematic Coronary Risk Estimation, respectively. RESULTS Insomnia disorders were observed in 30% of the cohort, who were older, predominantly female, used more psychotropic drugs carrying risk of high weight gain (olanzapine, clozapine, valproate) and were more prone to suffer from schizoaffective or bipolar disorders. Multivariate analyses showed that patients with high body mass index (OR = 2.02, 95%CI [1.51-2.72] for each ten-kg/m2 increase), central obesity (OR = 2.20, [1.63-2.96]), hypertension (OR = 1.86, [1.23-2.81]), hyperglycemia (OR = 3.70, [2.16-6.33]), high density lipoprotein hypocholesterolemia in women (OR = 1.51, [1.17-1.95]), metabolic syndrome (OR = 1.84, [1.16-2.92]) and higher 10-year risk of death from cardiovascular diseases (OR = 1.34, [1.17-1.53]) were more likely to have insomnia disorders. Time and insomnia disorders were associated with a deterioration of cardiometabolic parameters. CONCLUSIONS Insomnia disorders are significantly associated with metabolic worsening and risk of death from cardiovascular diseases in psychiatric patients.
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Affiliation(s)
- Nermine Laaboub
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Céline Dubath
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Setareh Ranjbar
- Center for Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Guibet Sibailly
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Claire Grosu
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Marianna Piras
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Didier Délessert
- Prison Medicine and Psychiatry Service, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Hélène Richard-Lepouriel
- Unit of Mood Disorders, Department of Psychiatry, Geneva University Hospital, Geneva, Switzerland
| | - Nicolas Ansermot
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Severine Crettol
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Frederik Vandenberghe
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Carole Grandjean
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Aurélie Delacrétaz
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
- Les Toises Psychiatry and Psychotherapy Center, Lausanne, Switzerland
| | - Franziska Gamma
- Les Toises Psychiatry and Psychotherapy Center, Lausanne, Switzerland
| | - Kerstin Jessica Plessen
- Service of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Armin von Gunten
- Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Philippe Conus
- Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Chin B Eap
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland.
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland.
- Center for Research and Innovation in Clinical Pharmaceutical Sciences, University of Lausanne, Lausanne, Switzerland.
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Lausanne, Switzerland.
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Association bBetween sSleep dDisorder and aAtrial fFibrillation: A nNationwide pPopulation-based cCohort sStudy. Sleep Med 2022; 96:50-56. [DOI: 10.1016/j.sleep.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 04/18/2022] [Accepted: 05/04/2022] [Indexed: 11/18/2022]
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Doycheva I, Ehrmann DA. Nonalcoholic fatty liver disease and obstructive sleep apnea in women with polycystic ovary syndrome. Fertil Steril 2022; 117:897-911. [PMID: 35512974 DOI: 10.1016/j.fertnstert.2022.03.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/24/2022] [Accepted: 03/29/2022] [Indexed: 12/12/2022]
Abstract
Nonalcoholic fatty liver disease (NAFLD) and obstructive sleep apnea are frequently associated with polycystic ovary syndrome (PCOS) but remain underrecognized. Women with PCOS have a 2-4 times higher risk of NAFLD independent of body mass index than healthy weight-matched controls. Insulin resistance and hyperandrogenemia together play a central role in the pathogenesis of NAFLD. Timely diagnosis of NAFLD is important because its progression can lead to nonalcoholic steatohepatitis and/or advanced liver fibrosis that can eventually result in liver-related mortality. The presence of NAFLD has also been associated with increased risks of type 2 diabetes, cardiovascular events, overall mortality, and extrahepatic cancers. The treatment of NAFLD in PCOS should include lifestyle interventions. Glucagon-like peptide 1 receptor agonists have shown promising results in patients with PCOS and NAFLD, but future randomized trails are needed to confirm this benefit. Likewise, the use of combined oral estrogen-progestin contraceptives may provide a benefit by decreasing hyperandrogenemia. Sleep disordered breathing is common among women with PCOS and is responsible for a number of cardiometabolic derangements. Obstructive sleep apnea is most often found in overweight and obese women with PCOS, but as is the case with NAFLD, its prevalence exceeds that of women who are of similar weight without PCOS. Left untreated, obstructive sleep apnea can precipitate or exacerbate insulin resistance, glucose intolerance, and hypertension.
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Affiliation(s)
- Iliana Doycheva
- Section of Endocrinology, Diabetes, and Metabolism, University of Chicago, Chicago, Illinois
| | - David A Ehrmann
- Section of Endocrinology, Diabetes, and Metabolism, University of Chicago, Chicago, Illinois.
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56
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Valenzuela PL, Santos-Lozano A, Torres-Barrán A, Morales JS, Castillo-García A, Ruilope LM, Ríos-Insua D, Ordovás JM, Lucia A. Poor self-reported sleep is associated with risk factors for cardiovascular disease: A cross-sectional analysis in half a million adults. Eur J Clin Invest 2022; 52:e13738. [PMID: 34958676 DOI: 10.1111/eci.13738] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/23/2021] [Accepted: 12/25/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sleep is known to affect cardiovascular health, but some controversy exists on the independent association between different sleep characteristics (duration, restfulness, difficulties falling asleep) and specific risk factors for cardiovascular disease (CVD). We aimed to assess the association between self-reported sleep characteristics and the likelihood of major CVD risk factors. METHODS Totally, 521,364 Spanish workers (32% female, 44 ± 9 years [18-64]) insured by an occupational risk prevention company participated in this nationwide cross-sectional study. Participants' sleep was considered 'poor' if they reported having ≥1 of the following conditions: excessively short (<6 h/d) or long (>9 h/d) sleep, unrestful sleep, or difficulties to fall asleep. We assessed the independent association between aforementioned sleep characteristics and the prevalence of hypertension, diabetes, hypercholesterolaemia, obesity and physical inactivity. RESULTS Poor sleep (reported by 33% of participants) was associated with a higher likelihood of presenting all CVD risk factors individually, particularly physical inactivity (which prevalence was ~3-fold higher in the poor sleep group compared with participants reporting no sleep abnormality). In separate analyses, all the different sleep characteristics were associated with the likelihood of ≥2 CVD risk factors. Participants with optimal sleep, normal sleep duration, no difficulties falling sleep and restful sleep showed a lower total CVD risk score than their peers with poor sleep, short sleep duration, difficulties falling sleep and unrestful sleep, respectively (all p < .001). CONCLUSIONS Poor sleep was associated with a higher likelihood of presenting major CVD risk factors. These findings might support the importance of monitoring and improving sleep patterns for primary CVD prevention.
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Affiliation(s)
- Pedro L Valenzuela
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain.,Physical Activity and Health Research Group ('PaHerg'), Research Institute of the Hospital, 12 de Octubre ('imas12'), Madrid, Spain
| | - Alejandro Santos-Lozano
- Physical Activity and Health Research Group ('PaHerg'), Research Institute of the Hospital, 12 de Octubre ('imas12'), Madrid, Spain.,i+HeALTH, European University Miguel de Cervantes, Valladolid, Spain
| | - Alberto Torres-Barrán
- Institute of Mathematical Sciences (ICMAT-CSIC), Madrid, Spain.,Komorebi AI Technologies, Madrid, Spain
| | - Javier S Morales
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Cadiz, Spain
| | | | - Luis M Ruilope
- Hypertension Unit and Cardiorenal Translational Laboratory, Research Institute of the Hospital, 12 de Octubre (imas12), Madrid, Spain
| | | | - José M Ordovás
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts, USA
| | - Alejandro Lucia
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain.,Physical Activity and Health Research Group ('PaHerg'), Research Institute of the Hospital, 12 de Octubre ('imas12'), Madrid, Spain
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Wang RS, Huang SH, Sun CA, Lin IL, Wang BL, Huang YC, Chien WC. Atrial Fibrillation's Influence on Short Sleep Duration Increases the Risk of Fatness in Management Executives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5438. [PMID: 35564833 PMCID: PMC9103176 DOI: 10.3390/ijerph19095438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/27/2022] [Accepted: 04/27/2022] [Indexed: 12/03/2022]
Abstract
This study explored whether atrial fibrillation (AF)’s influence on short sleep duration (SD) increases the subsequent risk of fatness in management executives. This study included 25,953 healthy individuals working as management executives with ages ranging from 35 to 65 years (19,100 men and 6853 women) who participated in a qualifying physical filter program from 2006 to 2017 in Taiwan. Men and women who slept < 4 h had a 4.35-fold and 5.26-fold higher risk of developing AF than those who slept 7−8 h normally. Men and women who slept < 4 h had a 6.44-fold and 9.62-fold higher risk of fatness than those who slept 7−8 h. Men and women with AF had a 4.52-fold and 6.25-fold higher risk of fatness than those without AF. It showed that AF induced by short SD increases the risk of fatness. A short SD can predict an increased risk of fatness among management executives in Taiwan.
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Affiliation(s)
- Richard S. Wang
- Program of Data Analytics and Business Computing, Stern School of Business, New York University, New York, NY 10003, USA;
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
| | - Shi-Hao Huang
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), Taipei 10608, Taiwan;
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Chien-An Sun
- Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City 242062, Taiwan;
- Big Data Center, College of Medicine, Fu-Jen Catholic University, New Taipei City 242062, Taiwan
| | - I-Long Lin
- Department of Computer Science and Engineering, Tatung University, Taipei 104327, Taiwan;
| | - Bing-Long Wang
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Yao-Ching Huang
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Wu-Chien Chien
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei 11490, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 11490, Taiwan
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Grandner MA. Sleep, Health, and Society. Sleep Med Clin 2022; 17:117-139. [DOI: 10.1016/j.jsmc.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Xu L, Zimmermann M, Forkey H, Griffin J, Wilds C, Morgan WS, Byatt N, McNeal CJ. How to Mitigate Risk of Premature Cardiovascular Disease Among Children and Adolescents with Mental Health Conditions. Curr Atheroscler Rep 2022; 24:253-264. [PMID: 35320835 PMCID: PMC8940585 DOI: 10.1007/s11883-022-00998-9] [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] [Subscribe] [Scholar Register] [Accepted: 12/09/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The goal of this article is to characterize the myriad of ways that children with mental health conditions can be at risk for premature cardiovascular disease (CVD) and various modalities to ameliorate this risk in childhood in order to improve the life course of these children. REVIEW FINDINGS Child and adolescent mental health conditions are a common yet underrecognized risk factor for premature CVD. The American Heart Association has recently included psychiatric conditions as a CVD risk factor (CVDRF) and the evidence linking childhood adversity to cardiometabolic disease. There are bidirectional and additive effects from the intrinsic emotional dysregulation and inflammatory changes from the mental health condition, the associations with risky health behaviors, and in some cases, metabolic side effects from pharmacotherapy. These pathways can be potentiated by toxic stress, a physiologic response to stressors from childhood adversity. Toxic stress is also associated with development of mental health conditions with epigenetic effects that can result in transgenerational inheritance of cardiometabolic risk. Exposure to toxic stress and mental health conditions in isolation sometimes compounded by pharmacotherapies used in treatment increase the risk of cardiometabolic diseases in childhood. The multiple pathways, which adversely influence cardiometabolic outcomes, encourage clinicians to consider strategies to mitigate these factors and justify the importance of early screening and treatment for CVDRFs. Mental health, health behaviors, and environmental factors co-occur and intersect in complex pathways that can increase CVD risk over the lifespan. Early detection and response can mitigate the risks associated with premature development of CVD.
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Affiliation(s)
- Lulu Xu
- Department of Psychiatry, UMass Chan Medical School, Worcester, MA, 01655, USA
| | - Martha Zimmermann
- Department of Psychiatry, UMass Chan Medical School, Worcester, MA, 01655, USA
| | - Heather Forkey
- Department of Pediatrics, UMass Chan Medical School, Worcester, MA, 01655, USA
| | - Jessica Griffin
- Department of Psychiatry, UMass Chan Medical School, Worcester, MA, 01655, USA
- Department of Pediatrics, UMass Chan Medical School, Worcester, MA, 01655, USA
| | - Caitlin Wilds
- Department of Psychiatry, UMass Chan Medical School, Worcester, MA, 01655, USA
- Boston Child Study Center, Boston, MA, 02116, USA
| | - Wynne S Morgan
- Department of Psychiatry, UMass Chan Medical School, Worcester, MA, 01655, USA
| | - Nancy Byatt
- Department of Psychiatry, UMass Chan Medical School, Worcester, MA, 01655, USA
| | - Catherine J McNeal
- Division of Cardiology, Department of Internal Medicine, Baylor Scott & White Health, Temple, TX, 76508, USA.
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Singh T, Ahmed TH, Mohamed N, Elhaj MS, Mohammed Z, Paulsingh CN, Mohamed MB, Khan S. Does Insufficient Sleep Increase the Risk of Developing Insulin Resistance: A Systematic Review. Cureus 2022; 14:e23501. [PMID: 35494895 PMCID: PMC9036496 DOI: 10.7759/cureus.23501] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 03/26/2022] [Indexed: 11/09/2022] Open
Abstract
It has been recommended that adults sleep a minimum of seven hours of sleep every night to maintain holistic health and well-being. A considerable fraction of the adult population suffers from sleep deprivation and related disorders. The stress of modern-day living may be the cause of this curtailment of sleep duration. The primary purpose of this study was to investigate the effects of reduced sleep on the development of insulin resistance and explore the possible mechanisms linking the two. We utilized databases like such as PubMed, PubMed Central (PMC), and Medical Literature Analysis and Retrieval System Online (MEDLINE) to systematically screen papers using keywords and Medical Subject Heading (MeSH) terms. A few articles were also retrieved from Cochrane Library. We applied inclusion/exclusion criteria after screening papers via title and abstracts. A quality appraisal check was doneperformed, and ten 10 related studies were strictly reviewed. Short sleep duration was significantly associated with insulin resistance. Inflammatory markers such as C-reactive protein (CRP) and serum amyloid A (SAA), biomarkers such as glucagon-like peptide-1 (GLP-1), and circadian misalignment may play a significant role in the pathogenesis of this association. To prevent metabolic complications such as type- 2 diabetes, adequate sleep (more than seven hours per night) is required in the adult population. The causal relationship between sleep deprivation and insulin resistance is multifactorial, and further studies are warranted to understand these mechanisms better.
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Park JS, Kim YJ, Heo W, Kim S. The Study of Variation of Metabolites by Sleep Deficiency, and Intervention Possibility of Aerobic Exercise. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052774. [PMID: 35270465 PMCID: PMC8910362 DOI: 10.3390/ijerph19052774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 11/19/2022]
Abstract
The purpose of this study is to determine the difference in sleep-related factors and metabolites between normal sleep (NS) and sleep deficiency (SD) and to analyze the variations in metabolites according to the intensity of aerobic exercise under SD conditions. This study was conducted on 32 healthy male university students. Participants experienced both NS (8 h of sleep per night for 3 consecutive days) and SD (4 h of sleep per night for 3 consecutive days). After the SD period, the participants underwent treatment for 30 min by the assigned group [sleep supplement after SD (SSD), low-intensity aerobic exercise after SD (LES), moderate-intensity aerobic exercise after SD (MES), high-intensity aerobic exercise after SD (HES)]. For analysis, sleep-related factors were measured, and metabolites were analyzed by untargeted metabolite analysis using gas chromatography-time-of-flight mass spectrometry. As a result, SD showed that total sleep time (TST), duration of rapid eye movement (REM), duration of light sleep, and duration of deep sleep were significantly decreased compared to NS, whereas the Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), and visual analogue scale (VAS) were significantly increased compared to NS. The difference in metabolites between NS and SD showed that there were significant changes in the seven metabolites. There were 18 metabolites that changed according to the treatment groups in SD conditions. In summary, SD can exacerbate sleep quality, induce daytime sleepiness, increase fatigue, and increase metabolites that cause insulin resistance. Aerobic exercise under SD conditions can reduce metabolites that induce insulin resistance and increase the metabolites that help relieve depression caused by SD. However, HES has a negative effect, which increases fatigue, whereas LES has no negative effect. Thus, this study suggests that LES is the most appropriate exercise method under SD conditions.
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Affiliation(s)
- Jong-Suk Park
- School of Global Sport Studies, Korea University, Sejong-si 30019, Korea;
| | - Young-Jun Kim
- Department of Food and Biotechnology, Korea University, Sejong-si 30019, Korea;
| | - Wan Heo
- Department of Food Science and Engineering, Seowon University, Cheongju-si 28674, Korea;
| | - Sangho Kim
- School of Global Sport Studies, Korea University, Sejong-si 30019, Korea;
- Correspondence: ; Tel.: +82-44-860-1371
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Fernández-Ballesteros R, Valeriano-Lorenzo E, Sánchez-Izquierdo M, Botella J. Behavioral Lifestyles and Survival: A Meta-Analysis. Front Psychol 2022; 12:786491. [PMID: 35185686 PMCID: PMC8854179 DOI: 10.3389/fpsyg.2021.786491] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/28/2021] [Indexed: 11/13/2022] Open
Abstract
The aim of the study is to determine the association between Behavioral Lifestyles (regular physical activity, healthy diet, sleeping, and weight control) and longevity in the elderly. A search strategy was conducted in the PsycInfo, Medline, PubMed, Web of Science (WoS), and Scopus databases. The primary outcome was mortality/survival. Four variables (mean of participant's age at the baseline of the study, follow-up years of the study, gender, and year of publication) were analyzed to evaluate the role of potential moderators. Ninety-three articles, totaling more than 2,800,000 people, were included in the meta-analysis. We found that the lifestyles analyzed predict greater survival. Specifically, doing regular physical activity, engaging in leisure activities, sleeping 7-8 h a day, and staying outside the BMI ranges considered as underweight or obesity are habits that each separately has a greater probability associated with survival after a period of several years.
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Affiliation(s)
| | | | | | - Juan Botella
- Department of Social Psychology and Methodology, Autonomous University of Madrid, Madrid, Spain
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Wang W, Wang X, Liu L, Liu Z, Han T, Sun C, Yang X. Dietary tryptophan and the risk of obesity and type 2 diabetes: Total effect and mediation effect of sleep duration. Obesity (Silver Spring) 2022; 30:515-523. [PMID: 35088560 DOI: 10.1002/oby.23343] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/29/2021] [Accepted: 11/02/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The aims of this study were to examine the effects of tryptophan consumption on obesity and type 2 diabetes (T2D) risk and whether sleep duration mediates these effects. METHODS Overall, data of 7,908 participants were obtained from the China Health and Nutrition Survey (1997-2011). A total of 6,373 and 4,398 participants who reported sleep duration and had blood samples, respectively, were incorporated into subgroup analyses. Multivariate Cox regression models were used to assess the associations between tertiles of tryptophan intake with obesity and T2D. General linear regression models were used to evaluate the effect of tryptophan on sleep time and plasma biomarkers. RESULTS Dietary tryptophan was significantly associated with decreased risk of obesity and T2D risk (hazard ratio tertile 3 to tertile 1 : 0.602 [95% CI: 0.500-0.724]; 0.693 [95% CI: 0.565-0.850]). Sleep duration was significantly higher, and hemoglobin A1c, total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B-100 (APO-B) were lower in the high tertile of tryptophan compared with the low tertile (p < 0.05). In addition, mediation effects on the associations of tryptophan intake with obesity and T2D risk were observed for sleep duration (estimated mediation percentage: 31.902% and 37.391%). CONCLUSIONS Dietary tryptophan showed advantageous effects on obesity and T2D risk. Furthermore, sleep duration potentially mediated for these effects.
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Affiliation(s)
- Weiqi Wang
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, People's Republic of China
| | - Xinyue Wang
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, People's Republic of China
| | - Lin Liu
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, People's Republic of China
| | - Zengjiao Liu
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, People's Republic of China
| | - Tianshu Han
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, People's Republic of China
| | - Changhao Sun
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, People's Republic of China
| | - Xue Yang
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, People's Republic of China
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Infant sleep and negative reactivity: The role of maternal adversity and perinatal sleep. Infant Behav Dev 2022; 66:101664. [PMID: 34958975 PMCID: PMC9162035 DOI: 10.1016/j.infbeh.2021.101664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 10/02/2021] [Accepted: 11/07/2021] [Indexed: 02/03/2023]
Abstract
Sleep during infancy contributes to the development and maintenance of infant regulatory functioning and may be an early risk marker for more difficult temperamental traits like negative reactivity. Further, maternal adverse childhood experiences (ACEs) may predispose individuals to greater sleep disturbances in adulthood and have been linked with sleep disturbances in both mothers and infants. Thus, examining maternal history of ACEs and maternal sleep difficulties during pregnancy and postpartum may provide insight into underlying risk factors affecting infant sleep difficulties and early temperament development. Fifty-nine mothers from a diverse, community sample (44% white) completed questionnaires on ACEs, maternal sleep, infant sleep, and infant temperament at 30-weeks gestation, 6-weeks postpartum, and 16-weeks postpartum. Results indicated that maternal ACES and sleep problems during pregnancy have long term implications for infant negative reactivity at 16-weeks, with significant indirect effects through maternal and infant sleep problems at 6-weeks. Addressing psychosocial functioning and prenatal sleep during pregnancy, particularly among women with high ACEs, may be a target of intervention to improve maternal and infant sleep health during the postpartum, and reduce the risk for difficult infant temperament.
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Weiss JT, Donlea JM. Roles for Sleep in Neural and Behavioral Plasticity: Reviewing Variation in the Consequences of Sleep Loss. Front Behav Neurosci 2022; 15:777799. [PMID: 35126067 PMCID: PMC8810646 DOI: 10.3389/fnbeh.2021.777799] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/16/2021] [Indexed: 12/13/2022] Open
Abstract
Sleep is a vital physiological state that has been broadly conserved across the evolution of animal species. While the precise functions of sleep remain poorly understood, a large body of research has examined the negative consequences of sleep loss on neural and behavioral plasticity. While sleep disruption generally results in degraded neural plasticity and cognitive function, the impact of sleep loss can vary widely with age, between individuals, and across physiological contexts. Additionally, several recent studies indicate that sleep loss differentially impacts distinct neuronal populations within memory-encoding circuitry. These findings indicate that the negative consequences of sleep loss are not universally shared, and that identifying conditions that influence the resilience of an organism (or neuron type) to sleep loss might open future opportunities to examine sleep's core functions in the brain. Here, we discuss the functional roles for sleep in adaptive plasticity and review factors that can contribute to individual variations in sleep behavior and responses to sleep loss.
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Affiliation(s)
- Jacqueline T. Weiss
- Department of Neurobiology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, United States
- Neuroscience Interdepartmental Program, University of California, Los Angeles, Los Angeles, CA, United States
| | - Jeffrey M. Donlea
- Department of Neurobiology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, United States
- *Correspondence: Jeffrey M. Donlea
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Catalan Serra P, Soler X. Obstructive Sleep apnea and cardiovascular events in Elderly Patients. Expert Rev Respir Med 2022; 16:197-210. [PMID: 35041560 DOI: 10.1080/17476348.2022.2030225] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION In recent decades, life expectancy has increased considerably. The cardiovascular effects of Obstructive Sleep Apnea (OSA) in the elderly lead to patient disability and high resource consumption. Intermittent nocturnal hypoxia leads to hemodynamic stress and adrenergic activation, which promotes cardiovascular disease. However, chronic intermittent hypoxia may protect elderly patients from cardiovascular events (CVE) due to biological adaptation. AREAS COVERED OSA patients are at increased risk of cardiovascular events. The severity of OSA increases cardiovascular risk, and this association also exists in the elderly. This article reviews the association between OSA, CPAP treatment, and CVE, particularly stroke and coronary heart disease (CHD), in the elderly. MEDLINE and the Cochrane Collaboration databases were searched from inception to July 2021. EXPERT COMMENTARY Although a positive association between OSA and the incidence of cardiovascular disease in the elderly has been established, the role of sleep apnea in certain cardiovascular events remains controversial. Most authors agree that untreated OSA is a risk factor for stroke or worse stroke prognosis. However, the association between OSA and CHD is usually less pronounced than between OSA and stroke, especially in the elderly.
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Affiliation(s)
| | - Xavier Soler
- Department of Pulmonary, Critical Care, and Sleep Medicine. University of California, San Diego, California
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67
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He J, Li X, Yu M. The correlation of serum/plasma IGF-1 concentrations with obstructive sleep apnea hypopnea syndrome: A meta-analysis and meta-regression. Front Endocrinol (Lausanne) 2022; 13:922229. [PMID: 36120463 PMCID: PMC9471370 DOI: 10.3389/fendo.2022.922229] [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: 04/17/2022] [Accepted: 08/11/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Obstructive sleep apnea hypopnea syndrome (OSAHS) is a common disease that has serious cardiovascular and metabolic effects. Insulin-like growth factor 1 (IGF-1) levels are reportedly reduced in patients with OSAHS; however, this is still a matter of debate. Therefore, we investigated the association between serum/plasma IGF-1 levels and OSAHS in this meta-analysis. METHODS Wan Fang, Excerpta Medica dataBASE, Web of Science, China National Knowledge Infrastructure, VIP, PubMed, and other databases were searched for materials published in any language before April 2, 2022. Two researchers analyzed the studies for quality according to the Newcastle-Ottawa Scale. The acquired data were analyzed using Stata 11.0 and R 3.6.1 software. The effect size was estimated and calculated using standard mean differences and correlation coefficients. Moreover, a combined analysis was conducted using either a random- or fixed-effects model. RESULTS Ultimately, 34 studies met our inclusion criteria. Our findings revealed that the plasma/serum IGF-1 concentrations in patients with OSAHS was significantly reduced compared with those in healthy subjects. Subgroup analyses were performed according to OSAHS severity, ethnicity, age, body mass index, specimen testing method, and study design. The outcomes suggested that nearly all subgroups of patients with OSAHS had reduced serum IGF-1 levels. Disease severity and differences in ethnicity were identified as possible influencing factors of serum IGF-1 levels in patients with OSAHS in the meta-regression analysis, and no other factors were found to alter plasma/serum IGF-1 concentrations. Moreover, plasma/serum IGF-1 concentrations were negatively correlated with apnea-hypopnea index and oxygen desaturation index scores and positively associated with minimum oxygen saturation. CONCLUSION Serum/plasma IGF-1 concentrations in patients with OSAHS were greatly reduced compared with those of patients in the control group, and were negatively correlated with apnea-hypopnea index and oxygen desaturation index scores and positively correlated with minimum oxygen saturation. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022322738.
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Affiliation(s)
- Jie He
- Clinical Medical College of Chengdu Medical College, Chengdu, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- *Correspondence: Jie He,
| | - Xiaoyan Li
- Clinical Medical College of Chengdu Medical College, Chengdu, China
- Department of Endocrinology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Mi Yu
- Clinical Medical College of Chengdu Medical College, Chengdu, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
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Li A, Zhang X, Guo Y, Wang J, Hao Y, Gu Y, Jie Y. The Association Between Dry Eye and Sleep Disorders: The Evidence and Possible Mechanisms. Nat Sci Sleep 2022; 14:2203-2212. [PMID: 36545475 PMCID: PMC9762265 DOI: 10.2147/nss.s378751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 11/01/2022] [Indexed: 12/16/2022] Open
Abstract
Dry eye is a disease that severely affects patients' quality of life, increasing the global burden on public health and finance. There is growing evidence that a poor lifestyle is a significant risk factor for dry eye. Along with the development of society, sleep, as a way of life, is also constantly changing. The main manifestations of sleep disorders are reduced sleep time, circadian rhythm disturbances, and sleep breathing disturbances. Sleep disorders and their secondary systemic diseases have attracted wide attention in recent years. This review mainly explored the correlation between sleep disorders and dry eye, and found that sleep-related problems and other factors potentially leading from sleep disorders could be critical factors for dry eye. These results suggest that ophthalmologists should pay attention to the sleep health problems in patients with dry eye, and we hope that this paper can provide help for future research in this field.
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Affiliation(s)
- Ao Li
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Xiaozhao Zhang
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yihan Guo
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Jingyi Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yiran Hao
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yixuan Gu
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Ying Jie
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
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Mehrdad M, Azarian M, Sharafkhaneh A, Alavi A, Zare R, Hassanzadeh Rad A, Dalili S. Association Between Poor Sleep Quality and Glycemic Control in Adult Patients with Diabetes Referred to Endocrinology Clinic of Guilan: A Cross-sectional Study. Int J Endocrinol Metab 2022; 20:e118077. [PMID: 35432555 PMCID: PMC8994826 DOI: 10.5812/ijem.118077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/28/2021] [Accepted: 10/25/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Diabetes is a prevalent chronic medical comorbid condition worldwide. Diabetes mellitus is associated with various sleep disorders. OBJECTIVES We aimed to determine the prevalence of poor sleep and the main factors of sleep interruptions in patients with diabetes mellitus. We further evaluated the association of sleep interruptions with glycemic control in this cohort. METHODS We conducted a cross-sectional study on 266 patients with type 1 and type 2 diabetes recruited from a university outpatient endocrinology clinic. Patients completed a checklist including demographic and disease-related characteristics in addition to the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality. Using the PSQI cutoff score of 5, we created two subgroups of good sleepers (GS) and poor sleepers (PS). RESULTS Our results showed that good sleeper and poor sleeper patients with diabetes were significantly different regarding sex, employment status, BMI, presence of diabetes-related complications, HbA1c, and 2-hour postprandial blood sugar (2HPPBS) (all significant at P < 0.05). The most prevalent factors of sleep interruptions were "waking up to use a bathroom", "feeling hot", "pain", "having coughs or snores", and "bad dreams". Among the subjective factors of sleep interruption, problems with sleep initiation, maintenance, or early morning awakenings in addition to having pain or respiratory problems such as coughing or snoring had the most significant associations with HbA1c. CONCLUSIONS Our study showed significant subjective sleep disturbances (both quality and quantity) in patients with diabetes mellitus (both type I and II) and its association with diabetes control. We further identified the main factors that led to sleep interruptions in this cohort.
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Affiliation(s)
- Mojtaba Mehrdad
- Department of Endocrinology, Guilan University of Medical Sciences, Rasht, Iran
| | - Mehrnaz Azarian
- Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran
| | - Amir Sharafkhaneh
- Telehealth Cardio-Pulmonary Rehabilitation Program, Medical Care Line, Michael E. DeBakey VA Medical Center, Houston, Texas, USA
| | - Ali Alavi
- Department of Internal Medicine, Inflammatory Lung Diseases Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Roghayeh Zare
- Neuroscience Research Center, Guilan University of Medical Sciences, Guilan, Iran
| | - Afagh Hassanzadeh Rad
- Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Setila Dalili
- Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Corresponding Author: Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
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70
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Chellappa SL, Qian J, Vujovic N, Morris CJ, Nedeltcheva A, Nguyen H, Rahman N, Heng SW, Kelly L, Kerlin-Monteiro K, Srivastav S, Wang W, Aeschbach D, Czeisler CA, Shea SA, Adler GK, Garaulet M, Scheer FAJL. Daytime eating prevents internal circadian misalignment and glucose intolerance in night work. SCIENCE ADVANCES 2021; 7:eabg9910. [PMID: 34860550 PMCID: PMC8641939 DOI: 10.1126/sciadv.abg9910] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 10/14/2021] [Indexed: 06/01/2023]
Abstract
Night work increases diabetes risk. Misalignment between the central circadian “clock” and daily behaviors, typical in night workers, impairs glucose tolerance, likely due to internal misalignment between central and peripheral circadian rhythms. Whether appropriate circadian alignment of eating can prevent internal circadian misalignment and glucose intolerance is unknown. In a 14-day circadian paradigm, we assessed glycemic control during simulated night work with either nighttime or daytime eating. Assessment of central (body temperature) and peripheral (glucose and insulin) endogenous circadian rhythms happened during constant routine protocols before and after simulated night work. Nighttime eating led to misalignment between central and peripheral (glucose) endogenous circadian rhythms and impaired glucose tolerance, whereas restricting meals to daytime prevented it. These findings offer a behavioral approach to preventing glucose intolerance in shift workers.
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Affiliation(s)
- Sarah L. Chellappa
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Jingyi Qian
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Nina Vujovic
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Christopher J. Morris
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Arlet Nedeltcheva
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Hoa Nguyen
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Nishath Rahman
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Su Wei Heng
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Lauren Kelly
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Kayla Kerlin-Monteiro
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Suhina Srivastav
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Wei Wang
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Daniel Aeschbach
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Department of Sleep and Human Factors Research, Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
- Institute of Experimental Epileptology and Cognition Research, Faculty of Medicine, University of Bonn, Bonn, Germany
| | - Charles A. Czeisler
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Steven A. Shea
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Gail K. Adler
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Marta Garaulet
- Department of Physiology, Regional Campus of International Excellence, University of Murcia, Murcia, Spain
- Biomedical Research Institute of Murcia, IMIB-Arrixaca-UMU, University Clinical Hospital, Murcia, Spain
| | - Frank A. J. L. Scheer
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
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Cable J, Schernhammer E, Hanlon EC, Vetter C, Cedernaes J, Makarem N, Dashti HS, Shechter A, Depner C, Ingiosi A, Blume C, Tan X, Gottlieb E, Benedict C, Van Cauter E, St-Onge MP. Sleep and circadian rhythms: pillars of health-a Keystone Symposia report. Ann N Y Acad Sci 2021; 1506:18-34. [PMID: 34341993 PMCID: PMC8688158 DOI: 10.1111/nyas.14661] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 06/21/2021] [Indexed: 12/24/2022]
Abstract
The human circadian system consists of the master clock in the suprachiasmatic nuclei of the hypothalamus as well as in peripheral molecular clocks located in organs throughout the body. This system plays a major role in the temporal organization of biological and physiological processes, such as body temperature, blood pressure, hormone secretion, gene expression, and immune functions, which all manifest consistent diurnal patterns. Many facets of modern life, such as work schedules, travel, and social activities, can lead to sleep/wake and eating schedules that are misaligned relative to the biological clock. This misalignment can disrupt and impair physiological and psychological parameters that may ultimately put people at higher risk for chronic diseases like cancer, cardiovascular disease, and other metabolic disorders. Understanding the mechanisms that regulate sleep circadian rhythms may ultimately lead to insights on behavioral interventions that can lower the risk of these diseases. On February 25, 2021, experts in sleep, circadian rhythms, and chronobiology met virtually for the Keystone eSymposium "Sleep & Circadian Rhythms: Pillars of Health" to discuss the latest research for understanding the bidirectional relationships between sleep, circadian rhythms, and health and disease.
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Affiliation(s)
| | - Eva Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Erin C Hanlon
- Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University of Chicago, Chicago, Illinois
| | - Céline Vetter
- Department of Integrative Physiology, University of Colorado at Boulder, Boulder, Colorado
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Jonathan Cedernaes
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Nour Makarem
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York
| | - Hassan S Dashti
- Department of Integrative Physiology, University of Colorado at Boulder, Boulder, Colorado
- Center for Genomic Medicine, Massachusetts General Hospital, and Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Ari Shechter
- Department of Medicine and Sleep Center of Excellence, Columbia University Irving Medical Center, New York, New York
| | - Christopher Depner
- Department of Health and Kinesiology, University of Utah, Salt Lake City, Utah
| | - Ashley Ingiosi
- Department of Biomedical Sciences, Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington
| | - Christine Blume
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, and Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
| | - Xiao Tan
- Department of Neuroscience (Sleep Science, BMC), Uppsala University, Uppsala, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
| | - Elie Gottlieb
- The Florey Institute of Neuroscience and Mental Health, and University of Melbourne, Melbourne, Victoria, Australia
| | - Christian Benedict
- Department of Neuroscience (Sleep Science, BMC), Uppsala University, Uppsala, Sweden
| | - Eve Van Cauter
- Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University of Chicago, Chicago, Illinois
| | - Marie-Pierre St-Onge
- Sleep Center of Excellence, Columbia University Irving Medical Center, New York, New York
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Martins-Oliveira M, Tavares I, Goadsby PJ. Was it something I ate? Understanding the bidirectional interaction of migraine and appetite neural circuits. Brain Res 2021; 1770:147629. [PMID: 34428465 DOI: 10.1016/j.brainres.2021.147629] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 12/18/2022]
Abstract
Migraine attacks can involve changes of appetite: while fasting or skipping meals are often reported triggers in susceptible individuals, hunger or food craving are reported in the premonitory phase. Over the last decade, there has been a growing interest and recognition of the importance of studying these overlapping fields of neuroscience, which has led to novel findings. The data suggest additional studies are needed to unravel key neurobiological mechanisms underlying the bidirectional interaction between migraine and appetite. Herein, we review information about the metabolic migraine phenotype and explore migraine therapeutic targets that have a strong input on appetite neuronal circuits, including the calcitonin gene-related peptide (CGRP), the pituitary adenylate cyclase-activating polypeptide (PACAP) and the orexins. Furthermore, we focus on potential therapeutic peptide targets that are involved in regulation of feeding and play a role in migraine pathophysiology, such as neuropeptide Y, insulin, glucagon and leptin. We then examine the orexigenic - anorexigenic circuit feedback loop and explore glucose metabolism disturbances. Additionally, it is proposed a different perspective on the most reported feeding-related trigger - skipping meals - as well as a link between contrasting feeding behaviors (skipping meals vs food craving). Our review aims to increase awareness of migraine through the lens of appetite neurobiology in order to improve our understanding of the earlier phase of migraine, encourage better studies and cross-disciplinary collaborations, and provide novel migraine-specific therapeutic opportunities.
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Affiliation(s)
- Margarida Martins-Oliveira
- Headache Group, Wolfson Centre for Age-Related Disease, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Nutrition and Metabolism Department, NOVA Medical School, Faculdade de Ciências Médicas de Lisboa, Universidade Nova de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisbon, Portugal.
| | - Isaura Tavares
- Department of Biomedicine, Unit of Experimental Biology, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal; Institute of Investigation and Innovation in Health (i3S), University of Porto, Portugal.
| | - Peter J Goadsby
- Headache Group, Wolfson Centre for Age-Related Disease, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA.
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Lian X, Gu J, Wang S, Yan J, Chen X, Wang M, Zhang Y, Wang L. Effects of sleep habits on acute myocardial infarction risk and severity of coronary artery disease in Chinese population. BMC Cardiovasc Disord 2021; 21:481. [PMID: 34620076 PMCID: PMC8499531 DOI: 10.1186/s12872-021-02251-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 09/08/2021] [Indexed: 01/10/2023] Open
Abstract
Background Growing evidence indicates that poor sleep harms health. Early to bed and early to rise is considered as a healthy lifestyle in Chinese population. The current study aimed to examine the effects of sleep habits on acute myocardial infarction (AMI) risk and severity of coronary artery disease (CAD) in Chinese population from two centers. Methods A total of 873 patients including 314 AMI cases and 559 controls were recruited from the inpatient cardiology department of the Affiliated Jiangning Hospital and the First Affiliated Hospital of Nanjing Medical University. 559 controls included 395 CAD cases and 164 non-CAD cases. We used a 17-item sleep factors questionnaire (SFQ) to evaluate sleep habits comprehensively by face-to-face interview. The severity of CAD was assessed by Gensini score in AMI and CAD groups. The effects of sleep factors on AMI risk and Gensini score were examined by unconditional logistic regression. Results After mutually adjustment for other sleep factors and demographic characteristics, the timing of sleep (24:00 and after) and morning waking (after 7:00) and sleep duration (< 6 h) were associated with increased risk of AMI (OR = 4.005, P < 0.001, OR = 2.544, P = 0.011 and OR = 2.968, P < 0.001, respectively). Lower level of light exposure at night was correlated with reduced risk of AMI (OR = 0.243, P = 0.009). In subgroup analysis by age, both late sleep timing and short sleep duration were associated with increased risk of AMI regardless of age. In subjects with age ≤ 65 years, daytime napping was related to reduced risk of AMI (OR = 0.645, P = 0.046). In subjects with age > 65 years, the frequency of night-time waking (3 times) was associated with increased risk of AMI (OR = 3.467, P = 0.035). Short sleep duration was correlated with increased risk of high Gensini score (OR = 2.374, P < 0.001). Conclusion Sleep insufficiency is an important risk factor both for AMI risk and CAD severity. Late sleeping is also associated with increased risk of AMI. In young and middle-aged people, regular naps may have a protective effect. Graphic abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s12872-021-02251-8.
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Affiliation(s)
- Xiaoqing Lian
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China.,Department of Cardiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, 211100, China
| | - Jie Gu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China
| | - Sibo Wang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China
| | - Jianjun Yan
- Department of Cardiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, 211100, China
| | - Xiaowen Chen
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China
| | - Mingwei Wang
- Department of Cardiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, 310015, China
| | - Yuqing Zhang
- Department of Cardiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, 211100, China
| | - Liansheng Wang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China.
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O'Hearn LA. The therapeutic properties of ketogenic diets, slow-wave sleep, and circadian synchrony. Curr Opin Endocrinol Diabetes Obes 2021; 28:503-508. [PMID: 34269711 DOI: 10.1097/med.0000000000000660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW To summarize emerging connections between sleep, ketogenic diets, and health. RECENT FINDINGS Mechanisms involved in the therapeutic benefits of ketogenic diets continue to be elucidated. Concurrently, the importance of sleep quality and circadian rhythms in their effects on metabolic and cognitive health is increasingly appreciated. Advances in the understanding of the actions of adenosine, nicotinamide adenine dinucleotide, and slow-wave sleep underscore connections between these areas of research. SUMMARY Many molecular pathways activated during ketogenic diets are known to modulate sleep-wake cycles, circadian rhythms, and sleep stages. Ketogenic diets often have beneficial effects on sleep at the same time as having beneficial effects on particular medical conditions. Enhancement of slow-wave sleep and rejuvenation of circadian programming may be synergistic with or causally involved in the benefits of ketogenic diets.
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75
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Insomnia symptoms are associated with an increased risk of type 2 diabetes mellitus among adults aged 50 and older. Sleep Breath 2021; 26:1409-1416. [PMID: 34564818 DOI: 10.1007/s11325-021-02497-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 09/09/2021] [Accepted: 09/21/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To evaluate the association of the different degrees of insomnia symptoms with subsequent incidence of type 2 diabetes mellitus (T2DM). METHODS The data were extracted from Health and Retirement Study 2006-2014 waves. The association of insomnia symptoms with T2DM incidence was evaluated by the competing risk model with cumulative incidence function (death was considered a competing event) and Cox proportional hazard model with the Kaplan-Meier method. Population attributable fraction (PAF) was calculated. All analyses related to our study were conducted between November 2020 and January 2021. RESULTS A total of 14,112 patients were included in this study, with an average follow-up of 6.4 years, and the incidence density was 17.9 per 1000 person-years. Insomnia symptoms were positively associated with T2DM incidence compared with those with no insomnia symptoms, regardless of competing risk model (≥ 1 symptoms: sub-distribution hazard ratio (SHR) 1.13; 95% confidence interval (CI) 1.02-1.26; P-trend = 0.012) and Cox proportional hazard model (≥ 1 symptoms: hazard ratio (HR) 1.13; 95% CI 1.02-1.26; P-trend = 0.013). The cumulative incidence function (Gray's test, p < 0.001) and Kaplan-Meier estimate (log-rank test, p < 0.001) also presented this positive relationship. This positive association was more apparent in women and participants with ages from 50 to 65 years. The PAF was 4.1% with 95% CI (0.7-7.9%). CONCLUSIONS Insomnia symptoms may be an important risk factor for the development of T2DM, which is unbiased by the death competing risk. These findings suggest that management of sleep problems may be an important part of strategies to prevent T2DM.
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76
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García-Aviles JE, Méndez-Hernández R, Guzmán-Ruiz MA, Cruz M, Guerrero-Vargas NN, Velázquez-Moctezuma J, Hurtado-Alvarado G. Metabolic Disturbances Induced by Sleep Restriction as Potential Triggers for Alzheimer's Disease. Front Integr Neurosci 2021; 15:722523. [PMID: 34539357 PMCID: PMC8447653 DOI: 10.3389/fnint.2021.722523] [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: 06/08/2021] [Accepted: 07/26/2021] [Indexed: 01/15/2023] Open
Abstract
Sleep has a major role in learning, memory consolidation, and metabolic function. Although it is known that sleep restriction increases the accumulation of amyloid β peptide (Aβ) and the risk to develop Alzheimer's disease (AD), the mechanism behind these effects remains unknown. In this review, we discuss how chronic sleep restriction induces metabolic and cognitive impairments that could result in the development of AD in late life. Here, we integrate evidence regarding mechanisms whereby metabolic signaling becomes disturbed after short or chronic sleep restriction in the context of cognitive impairment, particularly in the accumulation of Aβ in the brain. We also discuss the role of the blood-brain barrier in sleep restriction with an emphasis on the transport of metabolic signals into the brain and Aβ clearance. This review presents the unexplored possibility that the alteration of peripheral metabolic signals induced by sleep restriction, especially insulin resistance, is responsible for cognitive deficit and, subsequently, implicated in AD development.
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Affiliation(s)
- Jesús Enrique García-Aviles
- Area of Neurosciences, Biology of Reproduction Department, Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Unidad Iztapalapa, Mexico City, Mexico.,Posgrado en Biología Experimental, Universidad Autónoma Metropolitana, Unidad Iztapalapa, Mexico City, Mexico
| | - Rebeca Méndez-Hernández
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City, Mexico
| | - Mara A Guzmán-Ruiz
- Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Miguel Cruz
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades, Unidad de Investigación Médica en Bioquímica, Mexico City, Mexico
| | - Natalí N Guerrero-Vargas
- Departamento de Anatomía, Facultad de Medicina, Universidad Nacional Autónoma de México, México City, Mexico
| | - Javier Velázquez-Moctezuma
- Area of Neurosciences, Biology of Reproduction Department, Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Unidad Iztapalapa, Mexico City, Mexico
| | - Gabriela Hurtado-Alvarado
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City, Mexico
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Sakamoto R, Kazawa K, Jahan Y, Takeyama N, Moriyama M. Can a sleep disorder intervention-embedded self-management programme contribute to improve management of diabetes? A pilot single-arm pretest and post-test study. BMJ Open 2021; 11:e045783. [PMID: 34548342 PMCID: PMC8458311 DOI: 10.1136/bmjopen-2020-045783] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To investigate the efficacy and feasibility of a self-management programme incorporating a sleep intervention for improving diabetes outcomes. DESIGN A single-arm pre-test and post-test study was conducted within a community setting in Hiroshima, Japan. PARTICIPANTS Participants were aged 52-74 years and diagnosed with type 2 diabetic nephropathy stages 1-3. INTERVENTIONS Participants received self-management education from nurses for 6 months. First, the nurses assessed their sleep conditions using insomnia scales and a sleep metre. Then, the participants learnt self-management to increase their physical activity and improve their sleep condition. They also implemented diet therapy and medication adherence. OUTCOME MEASURES Physiological indicators, subjective and objective indicators of sleep quality, self-management indicators, quality of life (QOL) and feasibility were evaluated. To confirm the efficacy of intervention, Freidman tests, analysis of variance, Wilcoxon signed-rank test and t-test were performed. Pearson's correlations were analysed between activities and sleep condition. RESULTS Of the 26 enrolled participants, 24 completed the programme and were analysed. Among them, 15 participants (62.5%) had sleep disorders caused by multiple factors, such as an inappropriate lifestyle and physical factors that interfere with good sleep. Although insomnia scales did not change for the sleep disorders, their subjective health status improved. Regarding indicators related to diabetes management, lifestyles improved significantly. Haemoglobin A1c, body mass index, systolic blood pressure, non-high-density lipoprotein-cholesterol and QOL also improved. All participants except one were satisfied with the programme. However, use of the sleep metre and nurses' consultation about sleep disturbance were not well evaluated. CONCLUSIONS This programme was effective in improving diabetes status, lifestyle and behaviour changes. However, its effect on sleep condition was limited because of its complexity. A simple and novel approach is needed to strengthen the motivation for sleep behaviour change and to increase programme efficacy and feasibility. TRIAL REGISTRATION NUMBER UMIN000025906.
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Affiliation(s)
- Ritsuko Sakamoto
- Chronic Care and Family Nursing, Division of Nursing Science, Graduate School of Biomedical and Health Sciences, Hiroshima University Graduate School, Hiroshima, Japan
| | - Kana Kazawa
- Department of Medicine for Integrated Approach to Social Inclusion, Graduate School of Biomedical and Health Sciences, Hiroshima University Graduate School, Hiroshima, Japan
| | - Yasmin Jahan
- Chronic Care and Family Nursing, Division of Nursing Science, Graduate School of Biomedical and Health Sciences, Hiroshima University Graduate School, Hiroshima, Japan
| | - Naoko Takeyama
- Chronic Care and Family Nursing, Division of Nursing Science, Graduate School of Biomedical and Health Sciences, Hiroshima University Graduate School, Hiroshima, Japan
| | - Michiko Moriyama
- Chronic Care and Family Nursing, Division of Nursing Science, Graduate School of Biomedical and Health Sciences, Hiroshima University Graduate School, Hiroshima, Japan
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Guimarães KC, Silva CM, Latorraca CDOC, Oliveira RDÁ, Crispim CA. Is self-reported short sleep duration associated with obesity? A systematic review and meta-analysis of cohort studies. Nutr Rev 2021; 80:983-1000. [PMID: 34508648 DOI: 10.1093/nutrit/nuab064] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
CONTEXT A possible association between self-reported short sleep duration and risk of obesity has been studied. OBJECTIVE To analyze the association between sleep duration and obesity. METHODS The LILACS, Medline, Central, Embase, and OpenGrey databases were searched from inception until July 2020. Two authors screened the studies independently according to the PECO strategy, as follows: participants: > 18 years old; exposure: short sleep duration; control: regular sleep; outcome: obesity). Only cohort studies were included. A total of 3286 studies were retrieved with the search strategy, but only 36 were included. Disagreements were resolved by a third author. The quality of studies was assessed with Newcastle-Ottawa Quality Assessment Form for Cohort Studies. The certainty of the evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation. RESULTS Thirty-six studies were included, and 22 contributed quantitative data. Most of the studies (n = 27) assessed sleep by self-report. The meta-analysis showed a significant association between self-reported short sleep and development of obesity, and the chances of developing obesity increased when self-reported sleep duration decreased. CONCLUSIONS Self-reported short sleep was significantly associated with a higher incidence of obesity, with moderate quality of evidence. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42019130143.
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Affiliation(s)
- Kisian Costa Guimarães
- Graduate Program of Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Minas Gerais, Brazil
| | - Catarina Mendes Silva
- Graduate Program of Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Minas Gerais, Brazil
| | | | | | - Cibele Aparecida Crispim
- Graduate Program of Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Minas Gerais, Brazil
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Fei N, Choo-Kang C, Reutrakul S, Crowley SJ, Rae D, Bedu-Addo K, Plange-Rhule J, Forrester TE, Lambert EV, Bovet P, Riesen W, Korte W, Luke A, Layden BT, Gilbert JA, Dugas LR. Gut microbiota alterations in response to sleep length among African-origin adults. PLoS One 2021; 16:e0255323. [PMID: 34495955 PMCID: PMC8425534 DOI: 10.1371/journal.pone.0255323] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/14/2021] [Indexed: 12/15/2022] Open
Abstract
Sleep disorders are increasingly being characterized in modern society as contributing to a host of serious medical problems, including obesity and metabolic syndrome. Changes to the microbial community in the human gut have been reportedly associated with many of these cardiometabolic outcomes. In this study, we investigated the impact of sleep length on the gut microbiota in a large cohort of 655 participants of African descent, aged 25-45, from Ghana, South Africa (SA), Jamaica, and the United States (US). The sleep duration was self-reported via a questionnaire. Participants were classified into 3 sleep groups: short (<7hrs), normal (7-<9hrs), and long (≥9hrs). Forty-seven percent of US participants were classified as short sleepers and 88% of SA participants as long sleepers. Gut microbial composition analysis (16S rRNA gene sequencing) revealed that bacterial alpha diversity negatively correlated with sleep length (p<0.05). Furthermore, sleep length significantly contributed to the inter-individual beta diversity dissimilarity in gut microbial composition (p<0.01). Participants with both short and long-sleep durations exhibited significantly higher abundances of several taxonomic features, compared to normal sleep duration participants. The predicted relative proportion of two genes involved in the butyrate synthesis via lysine pathway were enriched in short sleep duration participants. Finally, co-occurrence relationships revealed by network analysis showed unique interactions among the short, normal and long duration sleepers. These results suggest that sleep length in humans may alter gut microbiota by driving population shifts of the whole microbiota and also specific changes in Exact Sequence Variants abundance, which may have implications for chronic inflammation associated diseases. The current findings suggest a possible relationship between disrupted sleep patterns and the composition of the gut microbiota. Prospective investigations in larger and more prolonged sleep researches and causally experimental studies are needed to confirm these findings, investigate the underlying mechanism and determine whether improving microbial homeostasis may buffer against sleep-related health decline in humans.
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Affiliation(s)
- Na Fei
- Microbiome Center, Department of Surgery, University of Chicago, Chicago, IL, United States of America
| | - Candice Choo-Kang
- Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL, United States of America
| | - Sirimon Reutrakul
- Department of Psychiatry & Behavioral Sciences, Biological Rhythms Research Laboratory, Rush University Medical Center, Chicago, IL, United States of America
| | - Stephanie J. Crowley
- Department of Psychiatry & Behavioral Sciences, Biological Rhythms Research Laboratory, Rush University Medical Center, Chicago, IL, United States of America
| | - Dale Rae
- Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
| | - Kweku Bedu-Addo
- Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
| | - Jacob Plange-Rhule
- Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
| | - Terrence E. Forrester
- Solutions for Developing Countries, University of the West Indies, Mona, Kingston, Jamaica
| | - Estelle V. Lambert
- Department of Physiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Pascal Bovet
- University Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
- Ministry of Health, Victoria, Republic of Seychelles
| | - Walter Riesen
- University Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
- Ministry of Health, Victoria, Republic of Seychelles
| | - Wolfgang Korte
- Center for Laboratory Medicine, Canton Hospital, St. Gallen, Switzerland
| | - Amy Luke
- Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL, United States of America
| | - Brian T. Layden
- Department of Psychiatry & Behavioral Sciences, Biological Rhythms Research Laboratory, Rush University Medical Center, Chicago, IL, United States of America
- Jesse Brown Veterans Affairs Medical Center, Chicago, Illinois, United States of America
| | - Jack A. Gilbert
- University of California San Diego, San Diego, California, United States of America
| | - Lara R. Dugas
- Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL, United States of America
- Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
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80
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Alshehri MM, Alenazi AM, Alothman SA, Rucker JL, Phadnis MA, Miles JM, Siengsukon CF, Kluding PM. Using Cognitive Behavioral Therapy for Insomnia in People with Type 2 Diabetes, Pilot RCT Part I: Sleep and Concomitant Symptom. Behav Sleep Med 2021; 19:652-671. [PMID: 33108932 DOI: 10.1080/15402002.2020.1831501] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE/BACKGROUND The primary aim of this study was to examine the effect of Cognitive Behavioral Therapy for Insomnia (CBT-I) on the severity of insomnia in people with Type 2 diabetes (T2D) compared to a health education (HE) control group. The secondary aim was to explore the effect of CBT-I on other sleep outcomes and concomitant symptoms. PARTICIPANTS Twenty-eight participants with T2D were randomly assigned to CBT-I (n = 14) or HE (n = 14). METHODS Validated assessments were used at baseline and post intervention to assess sleep outcomes and concomitant symptoms. In addition, actigraph and sleep diaries were used to measure sleep parameters. Independent sample t tests and Mann-Whitney U tests were utilized to measure between-group differences in the mean change scores. RESULTS Participants in the CBT-I group showed higher improvements in the following mean change scores compared to the HE group: insomnia symptoms (d = 1.78; p < .001), sleep quality (d = 1.53; p =.001), sleep self-efficacy (d = 1.67; p < .001). Both actigraph and sleep diary showed improvements in sleep latency and sleep efficiency in the CBT-I group as compared to the HE group. In addition, participants in the CBT-I group showed greater improvement in the mean change scores of depression symptoms (d = 1.49; p = .002) and anxiety symptoms (d = 0.88; p = .04) compared to the HE group. CONCLUSION This study identified a clinically meaningful effect of CBT-I on sleep outcomes and concomitant symptoms in people with T2D and insomnia symptoms. Further work is needed to investigate the long-term effects of CBT-I in people with T2D and insomnia symptoms.
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Affiliation(s)
- Mohammed M Alshehri
- Physical Therapy and Rehabilitation Science Department, University of Kansas Medical Center, Kansas City, Kansas.,Physical Therapy Department, Jazan University, Jazan, Saudi Arabia
| | - Aqeel M Alenazi
- Physical Therapy Department, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Shaima A Alothman
- Lifestyle and Health Research Center, Princess Nora Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Jason L Rucker
- Physical Therapy and Rehabilitation Science Department, University of Kansas Medical Center, Kansas City, Kansas
| | - Milind A Phadnis
- Department of Biostatistics, University of Kansas Medical Center, Kansas City, Kansas
| | - John M Miles
- Endocrinology Department, University of Kansas Medical Center, Kansas City, Kansas
| | - Catherine F Siengsukon
- Physical Therapy and Rehabilitation Science Department, University of Kansas Medical Center, Kansas City, Kansas
| | - Patricia M Kluding
- Physical Therapy and Rehabilitation Science Department, University of Kansas Medical Center, Kansas City, Kansas
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81
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Li J, Cao D, Huang Y, Chen Z, Wang R, Dong Q, Wei Q, Liu L. Sleep duration and health outcomes: an umbrella review. Sleep Breath 2021; 26:1479-1501. [PMID: 34435311 DOI: 10.1007/s11325-021-02458-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/18/2021] [Accepted: 07/28/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE To collect existing evidence on the relationship between sleep duration and health outcomes. METHODS A thorough search was conducted in PubMed, Web of Science, Embase, and the Cochrane Database of Systematic Reviews from inception to January, 2021. Meta-analyses of observational and interventional studies were eligible if they examined the associations between sleep duration and human health. RESULTS In total, this umbrella review identified 69 meta-analyses with 11 outcomes for cancers and 30 outcomes for non-cancer conditions. Inappropriate sleep durations may significantly elevate the risk for cardiovascular disease (CVD), cognitive decline, coronary heart disease (CHD), depression, falls, frailty, lung cancer, metabolic syndrome (MS), and stroke. Dose-response analysis revealed that a 1-h reduction per 24 hours is associated with an increased risk by 3-11% of all-cause mortality, CHD, osteoporosis, stroke, and T2DM among short sleepers. Conversely, a 1-h increment in long sleepers is associated with a 7-17% higher risk of stroke mortality, CHD, stroke, and T2DM in adults. CONCLUSION Inappropriate sleep duration is a risk factor for developing non-cancer conditions. Decreasing and increasing sleep hours towards extreme sleep durations are associated with poor health outcomes.
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Affiliation(s)
- Jin Li
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Dehong Cao
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Yin Huang
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Zeyu Chen
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Ruyi Wang
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Qiang Dong
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Qiang Wei
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China.
| | - Liangren Liu
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China.
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A Blanket Accommodative Sleep Posture Classification System Using an Infrared Depth Camera: A Deep Learning Approach with Synthetic Augmentation of Blanket Conditions. SENSORS 2021; 21:s21165553. [PMID: 34450994 PMCID: PMC8402261 DOI: 10.3390/s21165553] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 08/14/2021] [Accepted: 08/17/2021] [Indexed: 02/06/2023]
Abstract
Surveillance of sleeping posture is essential for bed-ridden patients or individuals at-risk of falling out of bed. Existing sleep posture monitoring and classification systems may not be able to accommodate the covering of a blanket, which represents a barrier to conducting pragmatic studies. The objective of this study was to develop an unobtrusive sleep posture classification that could accommodate the use of a blanket. The system uses an infrared depth camera for data acquisition and a convolutional neural network to classify sleeping postures. We recruited 66 participants (40 men and 26 women) to perform seven major sleeping postures (supine, prone (head left and right), log (left and right) and fetal (left and right)) under four blanket conditions (thick, medium, thin, and no blanket). Data augmentation was conducted by affine transformation and data fusion, generating additional blanket conditions with the original dataset. Coarse-grained (four-posture) and fine-grained (seven-posture) classifiers were trained using two fully connected network layers. For the coarse classification, the log and fetal postures were merged into a side-lying class and the prone class (head left and right) was pooled. The results show a drop of overall F1-score by 8.2% when switching to the fine-grained classifier. In addition, compared to no blanket, a thick blanket reduced the overall F1-scores by 3.5% and 8.9% for the coarse- and fine-grained classifiers, respectively; meanwhile, the lowest performance was seen in classifying the log (right) posture under a thick blanket, with an F1-score of 72.0%. In conclusion, we developed a system that can classify seven types of common sleeping postures under blankets and achieved an F1-score of 88.9%.
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83
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Tiwari R, Tam DNH, Shah J, Moriyama M, Varney J, Huy NT. Effects of sleep intervention on glucose control: A narrative review of clinical evidence. Prim Care Diabetes 2021; 15:635-641. [PMID: 33849816 DOI: 10.1016/j.pcd.2021.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 03/21/2021] [Accepted: 04/05/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Optimizing sleep has been recently gained exposure as a promising lifestyle consideration to aid in the control of diabetes. The evidence to support the impact of sleep quantity and quality on blood glucose control is largely acknowledged. This study aimed to review all published randomized controlled trials (RCTs) investigating the relationship between sleep and glucose control to synthesize an accurate overview. METHOD Literature from PubMed and Google Scholar was searched using the listed search terms to obtain RCTs on the role of sleep in glucose homeostasis. Seven RCTs were eligible and included in our review. References in these RCTs were screened for the presentation of the pathophysiology of metabolic disturbances relating to the sleep duration, and the relevant factors affecting blood glucose concentration. RESULTS Sleep deprivation and poor sleep quality are connected with blood glucose disturbance and reduction of insulin sensitivity. This leaves diabetic patients at an increased risk of glucose level fluctuations. However, the function of β-cells was likely to be conserved after 14-days of sleep deprivation. Sleep extension from 7 to 14 days improved blood glucose control and insulin sensitivity in both healthy and diabetes participants. Diabetes sleep education and personalized interventions that reduced stress and improved sleep quality contributed to glucose homeostasis in diabetic patients. Overall improving one's sleep hygiene was found to improve glucose control in diabetic patients. CONCLUSION Longer or short-term sleep deprivation may negatively affect glucose homeostasis, although the body temporarily compensates for the impaired function of β-cells when reduced sleep lasted up to 14 days. Thus, we recommend optimum sleep duration and optimistic sleep duration and sleep quality for decreasing risk and progression of diabetes.
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Affiliation(s)
- Ranjit Tiwari
- Faculty of Medicine, Institute of Medicine, Tribhuvan University, Kathmandu, 44600, Nepal; Online Research Club (http://onlineresearchclub.org), Nagasaki, 852-8523, Japan.
| | - Dao Ngoc Hien Tam
- Online Research Club (http://onlineresearchclub.org), Nagasaki, 852-8523, Japan; Asia Shine Trading & Service CO., LTD, Ho Chi Minh City, Viet Nam.
| | - Jaffer Shah
- Drexel University College of Medicine, Philadelphia, PA, USA.
| | - Michiko Moriyama
- Division of Nursing Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3 Minami-ku, Hiroshima 734-8553, Japan.
| | - Joseph Varney
- American University of the Caribbean, School of Medicine, St Maarten, SXM.
| | - Nguyen Tien Huy
- Institute of Research and Development, Duy Tan University, Da Nang 550000, Viet Nam; School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan.
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84
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Possible Preventative/Rehabilitative Role of Gliflozins in OSA and T2DM. A Systematic Literature Review-Based Hypothesis. Adv Ther 2021; 38:4195-4214. [PMID: 34273093 PMCID: PMC8342338 DOI: 10.1007/s12325-021-01791-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 05/13/2021] [Indexed: 02/07/2023]
Abstract
Obstructive sleep apnoea (OSA) is characterized by frequent apnoea episodes during sleep due to upper airway obstruction. The present review summarizes current knowledge on inter-relationships between OSA and type 2 diabetes mellitus (T2DM) and suggests the former as a possible target for sodium-glucose co-transporter-2 inhibitors (SGLT-2i). Based on pathophysiological mechanisms underlying OSA onset and renal SGLT-2 effects, we suggest that SGLT-2i indications might expand beyond current ones, including glucose, lipids, uric acid, blood pressure, and body weight control as well as chronic heart failure and kidney disease prevention.
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85
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Societal Changes Due to “COVID-19”. An Analysis of the Tourism Sector of Galicia, Spain. SUSTAINABILITY 2021. [DOI: 10.3390/su13158449] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
With the outbreak of the COVID-19 pandemic, an unprecedented global health and economic crisis started. This situation has had a devastating effect on all economic and social sectors, provoking either a decrease or cessation of business or profound changes in life habits. One of the most affected industries has been tourism, due to the resulting travel restrictions and a sharp drop in demand among travellers as well as temporary hotel and restaurant closures. Thus, the primary purpose of this study is to analyse the changes during the pandemic in individual consumers’ behaviour patterns in the tourism sector. Predictive market research techniques through quantitative analysis were carried out via surveys (n = 712). One of the more significant findings to emerge from this study is that recollection of these times will be in people’s minds for a long time after the pandemic. Notably, tourists will reward safety over leisure and will continue to undertake independent tours with their own vehicles. Findings also proved—and for the tourism sector this is good news—that travellers’ trust will be rebuilt, and tourists will be travelling again.
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86
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Vaseghi S, Arjmandi-Rad S, Nasehi M, Zarrindast MR. Cannabinoids and sleep-wake cycle: The potential role of serotonin. Behav Brain Res 2021; 412:113440. [PMID: 34216647 DOI: 10.1016/j.bbr.2021.113440] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 05/28/2021] [Accepted: 06/25/2021] [Indexed: 02/06/2023]
Abstract
Cannabis sativa (Marijuana) has a long history as a medicinal plant and Δ9-tetrahydrocannabinol (Δ9-THC) is the most active component in this plant. Cannabinoids are interesting compounds with various modulatory effects on physiological processes and cognitive functions. The use of cannabinoids is a double-edged sword, because they induce both adverse and therapeutic properties. One of the most important roles of cannabinoids is modulating sleep-wake cycle. Sleep, its cycle, and its mechanism are highly unknown. Also, the effects of cannabinoids on sleep-wake cycle are so inconsistent. Thus, understanding the role of cannabinoids in modulating sleep-wake cycle is a critical scientific goal. Cannabinoids interact with many neurotransmitter systems. In this review article, we chose serotonin due to its important role in regulating sleep-wake cycle. We found that the interaction between cannabinoids and serotonergic signaling especially in the dorsal raphe is extensive, unknown, and controversial.
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Affiliation(s)
- Salar Vaseghi
- Cognitive and Neuroscience Research Center (CNRC), Amir-Almomenin Hospital, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran; Department of Cognitive Neuroscience, Institute for Cognitive Science Studies (ICSS), Tehran, Iran.
| | - Shirin Arjmandi-Rad
- Institute for Cognitive & Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Mohammad Nasehi
- Cognitive and Neuroscience Research Center (CNRC), Amir-Almomenin Hospital, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Mohammad-Reza Zarrindast
- Department of Cognitive Neuroscience, Institute for Cognitive Science Studies (ICSS), Tehran, Iran; Department of Pharmacology School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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87
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Kishore K, Cusimano MD. The Fundamental Need for Sleep in Neurocritical Care Units: Time for a Paradigm Shift. Front Neurol 2021; 12:637250. [PMID: 34220667 PMCID: PMC8248989 DOI: 10.3389/fneur.2021.637250] [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: 12/03/2020] [Accepted: 04/27/2021] [Indexed: 11/30/2022] Open
Abstract
Intensive neurological assessments in neurocritical care settings for unduly prolonged period result in profound sleep deprivation in those patients that confounds the true neurological status of these patients, and the mounting apprehension in providers can beget a vicious cycle of even more intensive neurological assessments resulting in further sleep deprivation from being constantly woken up to be “assessed.” This iatrogenic state drives these patients into deep sleep stages that impact spontaneous breathing trials, weaken immunity, and lead to unwarranted investigations and interventions. There is dwindling value of prolonged frequent neurochecks beyond the initial 24–48 h of an intracranial event. We insist that sleep must be considered on at least an equal par to other functions that are routinely assessed. We reason that therapeutic sleep must be allowed to these patients in suitable amounts especially beyond the first 36–48 h to achieve ideal and swift recovery. This merits a paradigm shift.
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Affiliation(s)
- Kislay Kishore
- Division of Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Michael D Cusimano
- Division of Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
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88
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Alves SS, Silva-Junior RMPD, Servilha-Menezes G, Homolak J, Šalković-Petrišić M, Garcia-Cairasco N. Insulin Resistance as a Common Link Between Current Alzheimer's Disease Hypotheses. J Alzheimers Dis 2021; 82:71-105. [PMID: 34024838 DOI: 10.3233/jad-210234] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Almost 115 years ago, Alois Alzheimer described Alzheimer's disease (AD) for the first time. Since then, many hypotheses have been proposed. However, AD remains a severe health public problem. The current medical approaches for AD are limited to symptomatic interventions and the complexity of this disease has led to a failure rate of approximately 99.6%in AD clinical trials. In fact, no new drug has been approved for AD treatment since 2003. These failures indicate that we are failing in mimicking this disease in experimental models. Although most studies have focused on the amyloid cascade hypothesis of AD, the literature has made clear that AD is rather a multifactorial disorder. Therefore, the persistence in a single theory has resulted in lost opportunities. In this review, we aim to present the striking points of the long scientific path followed since the description of the first AD case and the main AD hypotheses discussed over the last decades. We also propose insulin resistance as a common link between many other hypotheses.
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Affiliation(s)
- Suélen Santos Alves
- Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School - University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil
| | - Rui Milton Patrício da Silva-Junior
- Department of Internal Medicine, Ribeirão Preto Medical School -University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil.,Department of Physiology, Ribeirão Preto Medical School - University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil
| | - Gabriel Servilha-Menezes
- Department of Physiology, Ribeirão Preto Medical School - University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil
| | - Jan Homolak
- Department of Pharmacology, University of Zagreb School of Medicine, Zagreb, Croatia.,Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Melita Šalković-Petrišić
- Department of Pharmacology, University of Zagreb School of Medicine, Zagreb, Croatia.,Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Norberto Garcia-Cairasco
- Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School - University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil.,Department of Physiology, Ribeirão Preto Medical School - University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil
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89
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Arslan NG, Pancar GS. Nailfold capillaroscopic changes of sleep apnea patients. Microvasc Res 2021; 137:104177. [PMID: 33984340 DOI: 10.1016/j.mvr.2021.104177] [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] [Received: 04/05/2021] [Revised: 05/01/2021] [Accepted: 05/06/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Obstructive Sleep Apnea Syndrome (OSAS) have frequent association with comorbidities and this makes it an independent risk factor for cardiovascular disease. Not only endothelial dysfunction, but also arterial stiffening, increased inflammatory mediators, oxidative stress after hypoxemia that develops due to OSAS, cause vascular pathologies in all diameters of vessels. Nail bed capillaroscopy is a simple, noninvasive, useful method to examine microcirculation and evaluate nail bed capillary abnormalities in diseases that cause vascular damage. The aim of this study is to examine microvascular changes in the nail bed of OSAS patients by capillaroscopy. METHODS 59 OSAS patients and 60 healthy cases (totally 119) were included. One single attended polysomnography was applied with Embla N7000 series (RemLogic Eastmed, Natus); and apnea-hypopnea index (AHI), oxygen de-saturation index >4% (ODI4%), minimum oxygen saturation (SaO2 Min.), total duration of oxygen desaturation, comorbidities, body mass index (BMI), smoking habit, sleep questionnaire applications were analyzed. Nailfold capillaroscopy was performed using a digital dermoscope (Molemax II, X30) and all images were evaluated for capillary density, capillary loop enlargement, capillary tortuosity, branching vessels, micro hemorrhages, avascular areas and splinter hemorrhages. RESULTS The prevalence rates of all capillaroscopy findings were significantly higher in the patient group (p < 0.05). There was an inverse and moderate relationship between AHI and mean saturation (p < 0.05). A statistically significant correlation was detected between the presence of hypertension (HT) and the severity of capillary tortuosity (CT) (p = 0.002), avascular area (AA) (p = 0.004), and periungual cyanosis (PUC) (p = 0.042); also between smoking habit and intensity of capillary dilatation, enlargement dilatation-enlarged giant capillaries (CELON) (p = 0.004), CT (p = 0.018) findings. Capillary distribution (CD), CELON, CT and AA findings were significantly higher in the group with low mean saturation (p < 0.05). DM was found to be significantly higher in individuals with high Epworth Sleep Scale (ESS) (p = 0.035). CONCLUSION In this study; 1) the nail bed capillaroscopy was used to examine vascular damage in OSAS, and 2) irregularities detected in the distal nail bed specific to a disease have been mentioned for the first time. It has been shown that endothelial damage is particularly related to the severity of hypoxia. HT and smoking history causes endothelial damage independent of the severity of the disease and hypoxia. Also, ESS may be more determinant in the screening of sleep disorders in diabetic patients.
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Affiliation(s)
- Nevra Gullu Arslan
- Samsun Educational and Research Hospital, Department of Pulmonology, TR-55000 Samsun, Turkey.
| | - Gunseli Sefika Pancar
- Samsun Education and Research Hospital, Department of Dermatology, TR-55000 İlkadim, Samsun, Turkey
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90
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Ordway MR, Condon EM, Ibrahim BB, Abel EA, Funaro MC, Batten J, Sadler LS, Redeker NS. A systematic review of the association between sleep health and stress biomarkers in children. Sleep Med Rev 2021; 59:101494. [PMID: 34098244 DOI: 10.1016/j.smrv.2021.101494] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 03/18/2021] [Accepted: 04/12/2021] [Indexed: 01/01/2023]
Abstract
Sleep is intimately linked with the stress response system. While the evidence for this connection has been systematically reviewed in the adult literature, to our knowledge no studies have examined this relationship in young children. Recent scientific interest in understanding the effects of adverse environments in early childhood, including an emphasis on understanding the role of sleep, highlights the importance of synthesizing the current evidence on the relationship between sleep and the stress response system in early childhood. The aim of this systematic review is to examine the relationship between sleep health and biomarkers of physiologic stress (neuroendocrine, immune, metabolic, cardiovascular) in healthy children ages 0-12 y. Following PRISMA guidelines, we identified 68 empirical articles and critically reviewed and synthesized the results across studies. The majority of studies included school-age children and reported sleep dimensions of duration or efficiency. Overall, evidence of associations between sleep health and stress biomarkers was strongest for neuroendocrine variables, and limited or inconsistent for studies of immune, cardiovascular, and metabolic outcomes. Gaps in the literature include prospective, longitudinal studies, inclusion of children under the age of 5 y, and studies using objective measures of sleep.
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Affiliation(s)
- Monica R Ordway
- Yale University School of Nursing, PO Box 27399, West Haven, CT, 06516-7300, USA; Yale School of Medicine, Department of Pediatrics, New Haven, CT, USA.
| | - Eileen M Condon
- Yale University School of Nursing, PO Box 27399, West Haven, CT, 06516-7300, USA
| | - Bridget B Ibrahim
- Yale University School of Nursing, PO Box 27399, West Haven, CT, 06516-7300, USA
| | - Emily A Abel
- Department of Human Development and Family Studies, Purdue University, 1202 West State Street, West Lafayette, IN, 47907-2055, USA
| | - Melissa C Funaro
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, 333 Cedar St., New Haven, CT, 06520-8014, USA
| | - Janene Batten
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, 333 Cedar St., New Haven, CT, 06520-8014, USA
| | - Lois S Sadler
- Yale University School of Nursing, PO Box 27399, West Haven, CT, 06516-7300, USA; Yale Child Study Center, 230 South Frontage Rd., New Haven, CT, 06520, USA
| | - Nancy S Redeker
- Yale University School of Nursing, PO Box 27399, West Haven, CT, 06516-7300, USA
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91
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Bawadi H, Al Sada A, Al Mansoori N, Al Mannai S, Hamdan A, Shi Z, Kerkadi A. Sleeping Duration, Napping and Snoring in Association with Diabetes Control among Patients with Diabetes in Qatar. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4017. [PMID: 33921201 PMCID: PMC8069870 DOI: 10.3390/ijerph18084017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/22/2021] [Accepted: 03/30/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Poor glycemic control is associated with chronic life-threatening complications. Several studies have revealed that sleep status is associated with glycemic control. AIM to examine the association between sleep duration, quality and glycemic control among adults with diabetes. METHODS Data on 2500 participants aged 18-60 years were collected from the Qatar Biobank (QBB). Sleep duration and quality were assessed by a self-completed health and lifestyle questionnaire, and glycemic control was assessed using HbA1c. Logistic regression was used to assess the association between sleep duration, napping, snoring and poor glycemic control. RESULTS After adjusting for age and gender, sleep duration was not associated with poor glycemic control. Lack of association persisted after controlling for smoking, physical activity, education, BMI, fruit and vegetable intake, insulin and medication use. However, sleeping for long hours at night (≥8 h) had a trend in increasing the risk of poor glycemic control (OR = 1.28; 95% CI: 0.94-1.74). Napping was positively associated with poor glycemic control. After adjusting for age and gender, patients who reported "sometimes, frequently, or always" napping had more than 30% increased risk of poor control as compared to patients who reported "never/rarely" napping. Snoring was not associated with poor glycemic control among the study sample when adjusted for age and gender (p = 0.61). Other factors were found to be associated with a better glycemic control such as female, high educational and high physical activity level. CONCLUSIONS our results suggest that napping may be an independent risk factor for a poor glycemic control in diabetes; further investigations are required.
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Affiliation(s)
- Hiba Bawadi
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha 2713, Qatar; (A.A.S.); (N.A.M.); (S.A.M.); (A.H.); (Z.S.); (A.K.)
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92
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Grabia M, Puścion-Jakubik A, Markiewicz-Żukowska R, Bielecka J, Mielech A, Nowakowski P, Socha K. Adherence to Mediterranean Diet and Selected Lifestyle Elements among Young Women with Type 1 Diabetes Mellitus from Northeast Poland: A Case-Control COVID-19 Survey. Nutrients 2021; 13:1173. [PMID: 33918177 PMCID: PMC8066783 DOI: 10.3390/nu13041173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 03/29/2021] [Accepted: 03/31/2021] [Indexed: 12/23/2022] Open
Abstract
An appropriate balanced diet and dietary patterns are important at every stage of life, but in the case of young patients with type 1 diabetes mellitus (T1DM), it is especially crucial during the COVID-19 pandemic. The aim of the study was to assess health and nutritional behaviors, mainly adherence to the Mediterranean diet (MD), during the second wave of the COVID-19 pandemic in Poland among women with T1DM, and to compare them with a healthy population. This survey (based on a questionnaire) was conducted in December 2020 and included 219 young women, healthy (n = 106) and with T1DM (n = 113), from northeast Poland. Over 30% of the study group admitted that they did not engage in any physical activity. A large proportion declared that their screen time was 5-7 h a day (48% in control and 40% in T1DM group). High intakes of sweet-beverages, sweets and red meat, but also low intakes of olive oil, fish and nuts were observed. The vast majority of participants (60% vs. 71%) were moderately adherent to the Mediterranean Diet Adherence Screener (MEDAS). The study demonstrated that despite the similarity between the behaviors of healthy people and those with T1DM, negative health and nutritional practices, such as low physical activity, long screen time, medium and high levels of stress and inappropriate eating habits were observed.
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Affiliation(s)
| | | | - Renata Markiewicz-Żukowska
- Department of Bromatology, Faculty of Pharmacy with the Division of Laboratory Medicine, Medical University of Białystok, Mickiewicza 2D Street, 15-222 Białystok, Poland; (M.G.); (A.P.-J.); (J.B.); (A.M.); (P.N.); (K.S.)
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93
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Salzano G, Maglitto F, Bisogno A, Vaira LA, De Riu G, Cavaliere M, di Stadio A, Mesolella M, Motta G, Ionna F, Califano L, Salzano FA. Obstructive sleep apnoea/hypopnoea syndrome: relationship with obesity and management in obese patients. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2021; 41:120-130. [PMID: 34028456 PMCID: PMC8142730 DOI: 10.14639/0392-100x-n1100] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/28/2020] [Indexed: 02/07/2023]
Abstract
Obstructive sleep apnoea/hypopnoea syndrome (OSAHS) is a disease characterised by upper airway obstruction during sleep, quite frequent in the general population, even if underestimated. Snoring, sleep apnoea and diurnal hypersomnia are common in these patients. Central obesity plays a key role: it reduces the size and changes the conformation of the upper airways, besides preventing lung expansion, with consequent reduction of lung volumes. Furthermore, obese people are also resistant to leptin, which physiologically stimulates ventilation; as a result, this causes scarce awakening during apnoea. OSAHS diagnosis is based on the combination of clinical parameters, such as apnoea/hypopnoea index (AHI), medical history, physical examination and Mallampati score. The first objective reference method to identify OSAHS is polysomnography followed by sleep endoscopy. Therapy provides in the first instance reduction of body weight, followed by continuous positive airway pressure (CPAP), which still remains the treatment of choice in most patients, mandibular advancement devices (MAD) and finally otolaryngology or maxillofacial surgery. Among surgical techniques, central is barbed reposition pharyngoplasty (BRP), used in the field of multilevel surgery.
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Affiliation(s)
- Giovanni Salzano
- Maxillo-Facial and ENT Surgery Unit, INT- IRCCS “Fondazione G. Pascale”, Naples, Italy
| | - Fabio Maglitto
- Maxillo-Facial and ENT Surgery Unit, INT- IRCCS “Fondazione G. Pascale”, Naples, Italy
| | - Antonella Bisogno
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, University of Salerno, Baronissi (Salerno), Italy
| | - Luigi Angelo Vaira
- Maxillofacial Surgery Unit, University Hospital of Sassari, Sassari, Italy
| | - Giacomo De Riu
- Maxillofacial Surgery Unit, University Hospital of Sassari, Sassari, Italy
| | - Matteo Cavaliere
- Department of Otolarhinolaryngology, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, Fisciano, Salerno, Italy
| | | | - Massimo Mesolella
- Department of Neuroscience, Reproductive and Odontostomatological Science, Ear Nose and Throat Unit, University of Naples “Federico II”, Naples, Italy
| | - Gaetano Motta
- Clinic of Otorhinolaryngology, Head and Neck Surgery Unit, Department of Anesthesiology, Surgical and Emergency Science, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Franco Ionna
- Maxillo-Facial and ENT Surgery Unit, INT- IRCCS “Fondazione G. Pascale”, Naples, Italy
| | - Luigi Califano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy
| | - Francesco Antonio Salzano
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, University of Salerno, Baronissi (Salerno), Italy
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Al-Yousif N, Rawal S, Jurczak M, Mahmud H, Shah FA. Endogenous Glucose Production in Critical Illness. Nutr Clin Pract 2021; 36:344-359. [PMID: 33682953 DOI: 10.1002/ncp.10646] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Regulation of endogenous glucose production (EGP) by hormonal, neuronal, and metabolic signaling pathways contributes to the maintenance of euglycemia under normal physiologic conditions. EGP is defined by the generation of glucose from substrates through glycogenolysis and gluconeogenesis, usually in fasted states, for local and systemic use. Abnormal increases in EGP are noted in patients with diabetes mellitus type 2, and elevated EGP may also impact the pathogenesis of nonalcoholic fatty liver disease and congestive heart failure. In this narrative review, we performed a literature search in PubMed to identify recently published English language articles characterizing EGP in critical illness. Evidence from preclinical and clinical studies demonstrates that critical illness can disrupt EGP through multiple mechanisms including increased systemic inflammation, counterregulatory hormone and catecholamine release, alterations in the hypothalamic-pituitary axis, insulin resistance, lactic acidosis, and iatrogenic insults such as vasopressors and glucocorticoids administered as part of clinical care. EGP contributes to hyperglycemia in critical illness when abnormally elevated and to hypoglycemia when abnormally depressed, each of which has been independently associated with increased mortality. Increased EGP may also promote protein catabolism that could worsen critical illness myopathy and impede recovery. Better understanding of the mechanisms and factors contributing to dysregulated EGP in critical illness may help in the development of therapeutic strategies that promote euglycemia, reduce intensive care unit-associated catabolism, and improve patient outcomes.
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Affiliation(s)
- Nameer Al-Yousif
- Department of Internal Medicine, UPMC Mercy Hospital, Pittsburgh, Pennsylvania, USA
| | - Sagar Rawal
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Michael Jurczak
- Division of Endocrinology and Metabolism, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Hussain Mahmud
- Division of Endocrinology and Metabolism, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Faraaz Ali Shah
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
- Acute Lung Injury Center of Excellence, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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95
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Montaruli A, Castelli L, Mulè A, Scurati R, Esposito F, Galasso L, Roveda E. Biological Rhythm and Chronotype: New Perspectives in Health. Biomolecules 2021; 11:biom11040487. [PMID: 33804974 PMCID: PMC8063933 DOI: 10.3390/biom11040487] [Citation(s) in RCA: 106] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/03/2021] [Accepted: 03/16/2021] [Indexed: 12/11/2022] Open
Abstract
The circadian rhythm plays a fundamental role in regulating biological functions, including sleep–wake preference, body temperature, hormonal secretion, food intake, and cognitive and physical performance. Alterations in circadian rhythm can lead to chronic disease and impaired sleep. The circadian rhythmicity in human beings is represented by a complex phenotype. Indeed, over a 24-h period, a person’s preferred time to be more active or to sleep can be expressed in the concept of morningness–eveningness. Three chronotypes are distinguished: Morning, Neither, and Evening-types. Interindividual differences in chronotypes need to be considered to reduce the negative effects of circadian disruptions on health. In the present review, we examine the bi-directional influences of the rest–activity circadian rhythm and sleep–wake cycle in chronic pathologies and disorders. We analyze the concept and the main characteristics of the three chronotypes.
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Affiliation(s)
- Angela Montaruli
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
- IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20161 Milan, Italy
| | - Lucia Castelli
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
| | - Antonino Mulè
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
| | - Raffaele Scurati
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
| | - Fabio Esposito
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
- IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20161 Milan, Italy
| | - Letizia Galasso
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
- Correspondence: ; Tel.: +2-5031-4656
| | - Eliana Roveda
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
- IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20161 Milan, Italy
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96
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Huang WC, Lin CY, Togo F, Lai TF, Liao Y, Park JH, Hsueh MC, Park H. Association between objectively measured sleep duration and physical function in community-dwelling older adults. J Clin Sleep Med 2021; 17:515-520. [PMID: 33135630 PMCID: PMC7927321 DOI: 10.5664/jcsm.8964] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 10/22/2020] [Accepted: 10/22/2020] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The aim of this research was to investigate the relationships between objectively measured sleep duration and physical function in older adults. METHODS We recruited community-dwelling older adults aged ≥ 60 years old in Taipei City, Taiwan. Sleep duration was measured with accelerometers and recorded as the total hours of sleep per night for each participant. The following physical functions were assessed: 1) grip strength (measured by handgrip dynamometer), 2) balance (1-leg standing test), 3) lower body strength (5-timed chair stand), 4) basic mobility (timed up and go test), 5) gait speed (5-m walk test). The relationships between sleep duration and physical function outcomes were analyzed using generalized additive models, controlling for objectively measured sedentary behavior and moderate-to-vigorous physical activity, and other sociodemographic variables. RESULTS A total of 121 older adults (men = 28.9%; mean age = 70.0 ± 5.0 years) was included in this study. A positive association of sleep duration with grip strength was found after adjusting for covariates (P = .005). No significant associations were observed between sleep duration and the other physical function outcomes. CONCLUSIONS For older adults, lengthening their sleep duration may be helpful to enhance the grip strength. This result has implications for improving their health by targeting better performance in specific physical functions. Further studies of sleep duration and physical function among older adults should investigate the underlying mechanisms.
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Affiliation(s)
- Wan-Chi Huang
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Chien-Yu Lin
- Graduate School of Sport Sciences, Waseda University, Tokorozawa City, Japan
| | - Fumiharu Togo
- Educational Physiology Laboratory, Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Ting-Fu Lai
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Yung Liao
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Jong-Hwan Park
- Health Convergence Medicine Laboratory, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Ming-Chun Hsueh
- Graduate Institute of Sport Pedagogy, University of Taipei, Taipei, Taiwan
| | - Hyuntae Park
- Department of Health Sciences, Graduate School of Dong-A University, Busan, Korea
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97
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Dose-Response Relationship between Night Work and the Prevalence of Impaired Fasting Glucose: The Korean Worker's Special Health Examination for Night Workers Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041854. [PMID: 33672896 PMCID: PMC7918366 DOI: 10.3390/ijerph18041854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/10/2021] [Accepted: 02/10/2021] [Indexed: 12/16/2022]
Abstract
Many studies have been conducted regarding the association between night work and diabetes, but the association between impaired fasting glucose (IFG) and night work is still unclear. The aim of this study was to evaluate this association using the Special Health Examination (SHEW) for Korean night workers. Laboratory, questionnaire, and physical examination data were collected for 80,077 manual workers between 2014 and 2016 from Korea Medical Institute, and associations of the data with IFG were evaluated using a multivariate logistic regression model. The odds ratios for IFG among those who worked night shifts for 2~5 years, 5~12 years, and 12 years or over (ref: <2 years) after adjusting for abdominal obesity were 1.14 (0.90–1.45), 1.41 (1.10–1.81), and 1.75 (1.41–2.19), respectively. A dose–response relationship was identified between the duration of night work and the prevalence of IFG (p for trend <0.05). A dose relationship remained significant when a subgroup of non-obese participants was analyzed. We identified an association and a dose–response relationship between the number of years of night work and IFG. To prevent the development of diabetes in night workers, we suggest that they should be pre-emptively screened and treated from the stage of IFG.
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98
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Wu IH, Heredia N, Dong Q, McNeill LH, Balachandran DD, Lu Q, Chang S. Sleep duration and type 2 diabetes risk: A prospective study in a population-based Mexican American cohort. Sleep Health 2021; 7:168-176. [PMID: 33582048 DOI: 10.1016/j.sleh.2020.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 12/03/2020] [Accepted: 12/09/2020] [Indexed: 12/20/2022]
Abstract
STUDY OBJECTIVES The primary aim of the study was to estimate the effect of sleep duration on prospective type 2 diabetes (T2D) risk across demographic characteristics and follow-up periods, and test body mass index (BMI) as a mediator and moderator. METHODS Data included adults (Mage = 39.0 ± 12.7 years) born in the United States or Mexico recruited from 2001 to 2012 in a Mexican American cohort study conducted in Houston, TX (n = 15,779). Participants completed self-reported questionnaires at baseline related to health, health behaviors (sleep duration, physical activity, smoking, drinking), and sociocultural factors and were followed up annually. RESULTS Cox proportional hazard models estimated hazard ratios (HR) for the effect of sleep duration on T2D diagnosis at follow-up. Of the participants, 10.3% were diagnosed with T2D. Self-reported ≤5 hours of sleep, compared to 7-8 hours, at baseline predicted greater risk for T2D (HR = 1.32, P = .001), yet was no longer significant after adjusting for sociodemographic characteristics and BMI. Notably, those with BMI <25 kg/m2 reporting ≤5 hours of sleep were at significant risk for T2D at 3 (HR = 4.13, P = .024) and 5-year follow-up (HR = 3.73, P = .008) compared to 7-8 hours. Obesity status accounted for 31.6% and 27.3% of the variance in the association between ≤5 and 6 hours of sleep and increased T2D risk, respectively. CONCLUSIONS Results highlighted the mediating and moderating role of BMI, and its effect on T2D risk at earlier follow-up among those without obesity. T2D prevention and control for Mexican American adults should consider the role of chronic sleep loss.
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Affiliation(s)
- Ivan Hc Wu
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
| | - Natalia Heredia
- Department of Health Promotion & Behavioral Sciences, The University of Texas Health Science Center at Houston, School of Public Health, Houston, Texas, USA
| | - Qiong Dong
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Lorna H McNeill
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Diwakar D Balachandran
- Department of Pulmonary Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Qian Lu
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Shine Chang
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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99
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Crowther ME, Ferguson SA, Vincent GE, Reynolds AC. Non-Pharmacological Interventions to Improve Chronic Disease Risk Factors and Sleep in Shift Workers: A Systematic Review and Meta-Analysis. Clocks Sleep 2021; 3:132-178. [PMID: 33525534 PMCID: PMC7930959 DOI: 10.3390/clockssleep3010009] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/21/2021] [Accepted: 01/25/2021] [Indexed: 12/12/2022] Open
Abstract
Shift work is associated with adverse chronic health outcomes. Addressing chronic disease risk factors including biomedical risk factors, behavioural risk factors, as well as sleep and perceived health status, affords an opportunity to improve health outcomes in shift workers. The present study aimed to conduct a systematic review, qualitative synthesis, and meta-analysis of non-pharmacological interventions targeting chronic disease risk factors, including sleep, in shift workers. A total of 8465 records were retrieved; 65 publications were eligible for inclusion in qualitative analysis. Random-effects meta-analysis were conducted for eight eligible health outcomes, including a total of thirty-nine studies. Interventions resulted in increased objective sleep duration (Hedges' g = 0.73; CI: 0.36, 1.10, k = 16), improved objective sleep efficiency (Hedges' g = 0.48; CI: 0.20, 0.76, k = 10) and a small increase in both subjective sleep duration (Hedges' g = 0.11; CI: -0.04, 0.27, k = 19) and sleep quality (Hedges' g = 0.11; CI: -0.11, 0.33, k = 21). Interventions also improved perceived health status (Hedges' g = 0.20; CI: -0.05, 0.46, k = 8), decreased systolic (Hedges' g = 0.26; CI: -0.54, 0.02, k = 7) and diastolic (Hedges' g = 0.06; CI: -0.23, 0.36, k = 7) blood pressure, and reduced body mass index (Hedges' g = -0.04; CI: -0.37, 0.29, k = 9). The current study suggests interventions may improve chronic disease risk factors and sleep in shift workers; however, this could only be objectively assessed for a limited number of risk factor endpoints. Future interventions could explore the impact of non-pharmacological interventions on a broader range of chronic disease risk factors to better characterise targets for improved health outcomes in shift workers.
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Affiliation(s)
- Meagan E Crowther
- The Appleton Institute, CQUniversity, 44 Greenhill Road, Wayville, SA 5034, Australia; (S.AF.); (G.EV.)
- School of Health, Medical and Applied Sciences, CQUniversity Australia, Adelaide Campus, Wayville, SA 5034, Australia
| | - Sally A Ferguson
- The Appleton Institute, CQUniversity, 44 Greenhill Road, Wayville, SA 5034, Australia; (S.AF.); (G.EV.)
- School of Health, Medical and Applied Sciences, CQUniversity Australia, Adelaide Campus, Wayville, SA 5034, Australia
| | - Grace E Vincent
- The Appleton Institute, CQUniversity, 44 Greenhill Road, Wayville, SA 5034, Australia; (S.AF.); (G.EV.)
- School of Health, Medical and Applied Sciences, CQUniversity Australia, Adelaide Campus, Wayville, SA 5034, Australia
| | - Amy C Reynolds
- Flinders Health and Medical Research Institute (Sleep Health)/Adelaide Institute for Sleep Health (AISH): A Flinders Centre of Research Excellence, College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia;
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100
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Davis SM, Mekany M, Kim JJ, Han JJ. Patient Sleep Quality in Acute Inpatient Rehabilitation. PM R 2021; 13:1385-1391. [PMID: 33432699 DOI: 10.1002/pmrj.12550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/23/2020] [Accepted: 01/05/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Sleep is an important component of neurorehabilitation. This study evaluates sleep quality in the acute inpatient rehabilitation setting and is the first to compare sleep quality in acute rehabilitation versus the acute care hospital and home settings. OBJECTIVE To assess patient sleep quality in the acute inpatient rehabilitation setting. DESIGN Cross-sectional survey study. SETTING Acute inpatient rehabilitation unit. PATIENTS Seventy-three patients admitted to the acute rehabilitation unit participated in the study. INTERVENTIONS A validated sleep questionnaire was provided on admission regarding sleep at home and in the acute care hospital. The questionnaire was repeated on discharge from the acute rehabilitation unit regarding sleep during their rehabilitation admission. MAIN OUTCOME MEASURES Visual analog scale of sleep depth, falling asleep, number of awakenings, percentage of time awake, and quality of sleep were obtained through use of the Richards-Campbell Sleep Questionnaire. These values were averaged to obtain "overall sleep perception." An additional question on environmental noise was added. Scores ranged from 0 for "worst sleep possible" to 100 for "best sleep possible." RESULTS Patients reported significantly better sleep in all domains and overall in the acute rehabilitation unit compared to the acute care hospital, with the exception of percentage of time awake. Patients also reported significantly better sleep depth but worse noise in the acute rehabilitation unit when compared to home. Similarly, patients reported significantly better sleep in all domains and overall at home in comparison to the acute care hospital with the exception of percentage of time awake. CONCLUSIONS Patient in the acute rehabilitation unit experience sleep quality that matches their experience at home and exceeds that in the hospital.
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Affiliation(s)
- Shane M Davis
- University of California Irvine Medical Center, Orange, CA
| | - Majid Mekany
- University of California Irvine Medical Center, Orange, CA
| | - Jeff J Kim
- University of California Irvine Medical Center, Orange, CA
| | - Jay J Han
- University of California Irvine Medical Center, Orange, CA
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