101
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Dönmezdil S, Araç S. Effect of shift work in intensive care on attention disorder in nurses. Int J Clin Pract 2021; 75:e13774. [PMID: 33078452 DOI: 10.1111/ijcp.13774] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 10/09/2020] [Indexed: 11/29/2022] Open
Abstract
AIM The purpose of this study was to determine the level of attention between shifts and to make recommendations about the regulation of shifts. METHODS The researchers applied the Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Pittsburgh Sleep Quality Index (PSQI) and Stroop color word interaction test (SCWI) in 72 intensive care workers working in different shifts. RESULT The study included a total of 72 participants, including 30 (43.3%) females and 42 (58.3%) males. There were statistically significant differences between the groups in the sub-items of the HAM-D and SCWI test (Table 3). There was a significant elongation in the night-shift employees at all times within the SCWI sub-items. A significant height in the number of errors and corrections in the cards applied in the continuation of the test was also determined in the night-shift group. CONCLUSION This study revealed a significant decrease in the level of attention in the night-shift compared with the day-shift. This increase in attention deficit may also be a preventable cause of increased mortality in the night-shift.
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Affiliation(s)
- Süleyman Dönmezdil
- Department of Psychiatry, University of Health Sciences, Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey
| | - Songül Araç
- Department of Emergency Medicine, University of Health Sciences, Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey
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102
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Astill Wright L, Roberts NP, Barawi K, Simon N, Zammit S, McElroy E, Bisson JI. Disturbed Sleep Connects Symptoms of Posttraumatic Stress Disorder and Somatization: A Network Analysis Approach. J Trauma Stress 2021; 34:375-383. [PMID: 33170989 PMCID: PMC9943267 DOI: 10.1002/jts.22619] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 10/04/2020] [Accepted: 10/10/2020] [Indexed: 12/13/2022]
Abstract
Posttraumatic stress disorder (PTSD) and physical health problems, particularly somatic symptom disorder, are highly comorbid. Studies have only examined this co-occurrence at the disorder level rather than assessing the associations between specific symptoms. Using network analysis to identify symptoms that act as bridges between these disorders may allow for the development of interventions to specifically target this comorbidity. We examined the association between somatization and PTSD symptoms via network analysis. This included 349 trauma-exposed individuals recruited through the National Centre for Mental Health PTSD cohort who completed the Clinician-Administered PTSD Scale for DSM-5 and the Patient Health Questionnaire-15. A total of 215 (61.6%) individuals met the DSM-5 diagnostic criteria for PTSD. An exploratory graph analysis identified four clusters of densely connected symptoms within the overall network: PTSD, chronic pain, gastrointestinal issues, and more general somatic complaints. Sleep difficulties played a key role in bridging PTSD and somatic symptoms. Our network analysis demonstrates the distinct nature of PTSD and somatization symptoms, with this association connected by disturbed sleep.
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Affiliation(s)
- Laurence Astill Wright
- Division of Psychological Medicine and Clinical NeurosciencesCardiff University School of MedicineCardiffUnited Kingdom
| | - Neil P. Roberts
- Division of Psychological Medicine and Clinical NeurosciencesCardiff University School of MedicineCardiffUnited Kingdom,Directorate of Psychology and Psychological TherapiesCardiff & Vale University Health BoardCardiffUnited Kingdom
| | - Kali Barawi
- Division of Psychological Medicine and Clinical NeurosciencesCardiff University School of MedicineCardiffUnited Kingdom
| | - Natalie Simon
- Division of Psychological Medicine and Clinical NeurosciencesCardiff University School of MedicineCardiffUnited Kingdom
| | - Stanley Zammit
- Division of Psychological Medicine and Clinical NeurosciencesCardiff University School of MedicineCardiffUnited Kingdom,Centre for Academic Mental HealthPopulation Health SciencesUniversity of BristolBristolUnited Kingdom
| | - Eoin McElroy
- Department of NeurosciencePsychology and BehaviourUniversity of LeicesterLeicesterUnited Kingdom
| | - Jonathan I. Bisson
- Division of Psychological Medicine and Clinical NeurosciencesCardiff University School of MedicineCardiffUnited Kingdom
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Di Vico IA, Cirillo G, Tessitore A, Siciliano M, Venturelli M, Falup-Pecurariu C, Tedeschi G, Morgante F, Tinazzi M. Fatigue in hypokinetic, hyperkinetic, and functional movement disorders. Parkinsonism Relat Disord 2021; 86:114-123. [PMID: 33839028 DOI: 10.1016/j.parkreldis.2021.03.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 02/25/2021] [Accepted: 03/19/2021] [Indexed: 12/20/2022]
Abstract
The emerging science of fatigue has soundly endorsed the need for its unified definition, shared terminology and increased recognition in neurological illnesses. Nevertheless, the real impact of fatigue remains under-recognized. Fatigue describes a sense of tiredness, lack of energy or need for increased effort often perceived as overwhelming, pervasive, and disabling. It is a common feature of chronic medical conditions and neurological diseases, including Parkinson's disease (PD) and other hypokinetic, hyperkinetic, and functional movement disorders (FMD). While there is solid evidence for the burden of fatigue in PD, knowledge of fatigue in other movement disorders (MDS) is still limited. Lack of consensus definition, rigorous measures and the high prevalence of potential confounders such as apathy, depression and sleepiness are the main obstacles in studying fatigue in MDS. This review of the prevalence, impact, and clinical correlates of fatigue in common MDS summarizes current hypotheses for the pathophysiological mechanisms underlying fatigue and gives a brief overview of treatment options. Fatigue is a prevalent, disabling, primary non-motor symptom (NMS) in MDS, including atypical and secondary parkinsonisms, dystonia, essential tremor (ET) and a hallmark feature of FMD. We report the hypothesis that fatigue is a perceptual disorder of the sensorimotor system. Given the relevance of this burdensome symptom, fatigue deserves greater clinical and research attention to better understand its manifestation and pathophysiology and to improve diagnosis and treatment.
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Affiliation(s)
- Ilaria Antonella Di Vico
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
| | - Giovanni Cirillo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy; Division of Human Anatomy - Neuronal Networks Morphology Lab, University of Campania "Luigi Vanvitelli", Naples, Italy; I Division of Neurology and Neurophysiopathology, Department of Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessandro Tessitore
- I Division of Neurology and Neurophysiopathology, Department of Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Mattia Siciliano
- I Division of Neurology and Neurophysiopathology, Department of Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy; Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Massimo Venturelli
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Gioacchino Tedeschi
- I Division of Neurology and Neurophysiopathology, Department of Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesca Morgante
- Institute of Molecular and Clinical Sciences, St George's University of London, London, UK; Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Michele Tinazzi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
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Prescribing Pattern of Hypnotic Medications in Patients Initiating Treatment at Japanese Hospitals: A Nationwide, Retrospective, Longitudinal, Observational Study Using a Claims Database. Drugs Real World Outcomes 2021; 8:277-288. [PMID: 33713330 PMCID: PMC8324698 DOI: 10.1007/s40801-021-00244-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2021] [Indexed: 12/01/2022] Open
Abstract
Background Prolonged treatment of insomnia using benzodiazepine (BZD) receptor agonists, including BZD and non-BZD hypnotic drugs, can cause drug dependence, tolerance, abuse and other adverse events. These side effects are more common and/or severe in older adults taking different hypnotic drugs concomitantly. Therefore, a single prescription is limited to 30 daily doses for most BZD receptor agonists and restrictions apply to the prescription of more than three types of hypnotic drugs in Japan. Little is known, however, about the real-world prescribing pattern of hypnotic drugs in Japan. Objective We analysed prescribing patterns for hypnotic drugs in Japan to evaluate whether real-world use differs from guideline recommendations. Methods In this nationwide, retrospective, longitudinal, observational study, we analysed the types of hypnotic drugs prescribed, duration of medication and treatment setting in a subset of hospitals in Japan using a hospital-based administrative claims database (Medical Data Vision). Patients initiating treatment with hypnotic drugs between January 2012 and December 2016 were included in the analyses to assess the duration of medication and occurrence of co-prescription of a second and third hypnotic drug, within a year from prescription of the first hypnotic drugs. Results In 261,167 patients analysed, the first hypnotic drugs prescribed were BZDs (59.7%), non-BZDs (36.8%), a melatonin receptor agonist [MRA] (3.1%) and an orexin receptor antagonist [ORA] (0.4%). Benzodiazepine and non-BZD hypnotic drugs were mostly prescribed in inpatient settings (57.7% and 63.0%, respectively) and the MRA and ORA mostly in outpatient settings (62.6% and 65.4%, respectively). The departments that prescribed the most patients their first hypnotic drugs were internal medicine (23.6%), general surgery (11.8%), orthopaedic surgery (11.4%) and urology (5.3%). Of the total prescriptions of MRA and ORA as the first hypnotic drugs, 22.0% and 31.8% were in internal medicine, 4.4% each in general surgery, 6.0% and 4.5% in orthopaedic surgery, 9.7% and 4.4% in neurology, and 10.1% and 12.2% in psychiatry departments, respectively. Mean duration of medication was 1.13 months for non-BZDs, 1.15 months for BZDs, 1.29 months for the ORA and 1.83 months for the MRA. Overall, 5.3% (95% confidence interval 5.2–5.4) of patients were prescribed a second hypnotic drug; of these, 8.4% (95% confidence interval 8.0–8.9) were prescribed at least three hypnotic drugs within a year. Patients who were prescribed three or more hypnotic drugs received higher doses of the first drug than patients who received fewer hypnotic drugs. Conclusions Benzodiazepine receptor agonists were the most common hypnotic drugs prescribed as the first drug to patients in Japan. Further education and awareness may be needed on the risk of complications and adverse events associated with these therapies. The duration of BZD receptor agonist use was shorter than for the MRA and ORA, in accordance with prescribing guidelines. Long-term use and co-prescribing of hypnotic drugs were also uncommon.
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105
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Terán-Pérez G, Portillo-Vásquez A, Arana-Lechuga Y, Sánchez-Escandón O, Mercadillo-Caballero R, González-Robles RO, Velázquez-Moctezuma J. Sleep and Mental Health Disturbances Due to Social Isolation during the COVID-19 Pandemic in Mexico. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062804. [PMID: 33801928 PMCID: PMC8002080 DOI: 10.3390/ijerph18062804] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 02/14/2021] [Accepted: 03/02/2021] [Indexed: 02/06/2023]
Abstract
The coronavirus disease (COVID-19) that broke out in China in December 2019 rapidly became a worldwide pandemic. In Mexico, the conditions requiring the declaration of a sanitary emergency were reached by the last week of March 2020, and health authorities' limited mobility and imposed social isolation were the main strategies to keep the virus from spreading. Thus, daily living conditions changed drastically in a few days, generating a stressful situation characterized by an almost complete lack of mobility, social isolation, and forced full-time interactions with family members. Soon, complaints of sleep disturbances, anxiety, and symptoms of depression were reported. The present study reports the results of an online survey performed during the first two months of isolation. Questionnaires exploring sleep disturbances, anxiety, and depression were sent to people who responded to an open invitation. A total of 1230 participants filled out the sleep questionnaire, 812 responded to the anxiety questionnaire, and 814 responded to the depression questionnaire. Both men and women reported poor sleep quality, but women showed a higher proportion (79%) than men (60%); young women were more likely to be affected by social isolation. Concerning anxiety and depression, both sexes reported high similar symptoms. These data suggest that stressful conditions related to social isolation and the economic uncertainty caused by the pandemic may induce mental health disturbances, which may become worse with sleep restriction.
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Affiliation(s)
- Guadalupe Terán-Pérez
- Centro de Sueño y Neurociencias, Benito Juárez, 06700 Mexico City, Mexico; (G.T.-P.); (A.P.-V.); (Y.A.-L.)
| | - Angelica Portillo-Vásquez
- Centro de Sueño y Neurociencias, Benito Juárez, 06700 Mexico City, Mexico; (G.T.-P.); (A.P.-V.); (Y.A.-L.)
| | - Yoaly Arana-Lechuga
- Centro de Sueño y Neurociencias, Benito Juárez, 06700 Mexico City, Mexico; (G.T.-P.); (A.P.-V.); (Y.A.-L.)
- Sleep Disorders Clinic, Universidad Autonoma Metropolitana, Iztapalapa, 09340 Mexico City, Mexico;
| | | | - Roberto Mercadillo-Caballero
- Consejo Nacional de Ciencia y Tecnologia, Universidad Autonoma Metropolitana-Iztapalapa, 09340 Mexico City, Mexico;
| | | | - Javier Velázquez-Moctezuma
- Centro de Sueño y Neurociencias, Benito Juárez, 06700 Mexico City, Mexico; (G.T.-P.); (A.P.-V.); (Y.A.-L.)
- Sleep Disorders Clinic, Universidad Autonoma Metropolitana, Iztapalapa, 09340 Mexico City, Mexico;
- Correspondence:
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106
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Lopez-Quintero C, Warren T, Falise A, Sharma V, Bares C, Oshri A. Prevalence and drug use correlates of extra-medical use of prescription medications for sleep among adults in the United States: Results of the 2015-2018 National Survey on Drug Use and Health. Pharmacol Biochem Behav 2021; 204:173169. [PMID: 33684453 DOI: 10.1016/j.pbb.2021.173169] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND This paper examines the epidemiology of extra-medical use of prescription medications for sleep among a nationally representative sample of U.S. adults. METHODS We analyzed data from the 2015-2018 National Surveys on Drug Use and Health. The sample includes 3410 U.S. adults who reported extra-medical use of prescription medications for sleep. Multinomial logistic regression models identified correlates of type of drug used [i.e., sedatives and/or tranquilizers-only (ST-only), prescription pain relievers-only (PPR-only), or sedatives, tranquilizers, and prescription pain relievers (ST + PPR)], and logistic regression models identified correlates of reasons for extra-medical use (i.e., sleep-only vs. sleep and recreational). RESULTS About 60% (95%CI = 58.9, 63.5) of the sample reported extra-medical use of ST-only, followed by PPR-only (29.9%, 95%CI = 27.5, 32.5), and ST + PPR (8.9%, 95%CI = 7.7, 10.4). Recreational use was reported by 28.4% (95% CI = 26.5, 30.4) of the sample. The odds of extra-medical use of PPR-only (aRRR = 3.1, 95%CI = 2.1, 4.5) and ST + PPR (aRRR = 1.9, 95%CI = 1.2, 3.1) as opposed to ST-only, were greater among Non-Hispanic Blacks than Non-Hispanic Whites. Compared to non-alcohol users, those with a past-12 months diagnosis of alcohol use disorder were more likely to use ST + PPR rather than ST-only (aIRR = 2.0, 95%CI = 1.1, 3.7). Non-Hispanic Blacks (aOR = 0.6, 95%CI = 0.4, 08) and individuals living in rural areas (aOR = 0.5, 95%CI = 0.3, 09) were less likely to report extra-medical use of prescription medications for recreational reasons than Non-Hispanic Whites and those residing in large metropolitan areas, respectively. CONCLUSIONS Extra-medical use of PPR-only and ST + PPR as an aid to sleep, is prevalent among Non-Hispanic Blacks, young adults, and those residing in rural areas. Most individuals reported that extra-medical use of prescription medications was primarily motivated by sleep reasons, rather than by sleep and recreational reasons. Potential interventions include access to sleep treatments, education on the effectiveness and risk associated with extra-medical use and co-use of prescription medications for sleep, and research on sleep-related disparities.
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Affiliation(s)
| | - Trey Warren
- Department of Epidemiology, University of Florida, Gainesville, FL 32611, USA.
| | - Alyssa Falise
- Department of Epidemiology, University of Florida, Gainesville, FL 32611, USA.
| | - Vinita Sharma
- Department of Epidemiology, University of Florida, Gainesville, FL 32611, USA.
| | - Cristina Bares
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Assaf Oshri
- Department of Human Development and Family Science, College of Family and Consumer Sciences, University of Georgia, Athens, GA, 30602, USA.
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107
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Chronic sleep fragmentation enhances habenula cholinergic neural activity. Mol Psychiatry 2021; 26:941-954. [PMID: 30980042 PMCID: PMC6790161 DOI: 10.1038/s41380-019-0419-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 02/21/2019] [Accepted: 03/26/2019] [Indexed: 01/25/2023]
Abstract
Sleep is essential to emotional health. Sleep disturbance, particularly REM sleep disturbance, profoundly impacts emotion regulation, but the underlying neural mechanisms remain elusive. Here we show that chronic REM sleep disturbance, achieved in mice by chronic sleep fragmentation (SF), enhanced neural activity in the medial habenula (mHb), a brain region increasingly implicated in negative affect. Specifically, after a 5-day SF procedure that selectively fragmented REM sleep, cholinergic output neurons (ChNs) in the mHb exhibited increased spontaneous firing rate and enhanced firing regularity in brain slices. The SF-induced firing changes remained intact upon inhibition of glutamate, GABA, acetylcholine, and histamine receptors, suggesting cell-autonomous mechanisms independent of synaptic transmissions. Moreover, the SF-induced hyperactivity was not because of enhanced intrinsic membrane excitability, but was accompanied by depolarized resting membrane potential in mHb ChNs. Furthermore, inhibition of TASK-3 (KCNK9) channels, a subtype of two-pore domain K+ channels, mimicked the SF effects by increasing the firing rate and regularity, as well as depolarizing the resting membrane potential in mHb ChNs in control-sleep mice. These effects of TASK-3 inhibition were absent in SF mice, suggesting reduced TASK-3 activity following SF. By contrast, inhibition of small-conductance Ca2+-activated K+ (SK) channels did not produce similar effects. Thus, SF compromised TASK-3 function in mHb ChNs, which likely led to depolarized resting membrane potential and increased spontaneous firing. These results not only demonstrate that selective REM sleep disturbance leads to hyperactivity of mHb ChNs, but also identify a key molecular substrate through which REM sleep disturbance may alter affect regulation.
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108
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McNett S, Lind MJ, Brown RC, Hawn S, Berenz EC, Brown E, McDonald SD, Pickett T, Danielson CK, Thomas S, Amstadter AB. Sleep Quality Moderates the Relationship between Anxiety Sensitivity and PTSD Symptoms in Combat-exposed Veterans. Behav Sleep Med 2021; 19:208-220. [PMID: 32063030 DOI: 10.1080/15402002.2020.1726749] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective/Background: Posttraumatic stress disorder (PTSD) and related conditions (e.g., depression) are common in Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn (OEF/OIF/OND) veterans. High anxiety sensitivity (AS), defined as fear of anxiety and anxiety-related consequences, is related to greater PTSD and depressive symptoms; however, few studies have identified possible modifiers of these associations. The current study examined the moderating role of sleep quality in the associations between AS and PTSD and depressive symptoms. Participants: Participants were 155 OEF/OIF/OND community veterans ages 21-40 (12.3% women). Methods: Participants completed a semi-structured clinical interview for DSM-IV PTSD symptoms (Clinician Administered PTSD Scale; CAPS) and self-report measures of anxiety sensitivity (Anxiety Sensitivity Index), sleep quality (Pittsburgh Sleep Quality Index global score; PSQI), and depressive symptoms (Beck Depression Inventory-II; BDI-II). Results: Results of hierarchical linear regression models indicated that the main effects of AS and global PSQI score were significantly associated with greater PTSD and depressive symptoms (both with sleep items removed), above and beyond the covariates of trauma load and military rank. Sleep quality moderated the relationship between AS and PTSD symptoms (but not depressive symptoms), such that greater AS was associated with greater PTSD symptoms for individuals with good sleep quality, but not poor sleep quality. Conclusions: Sleep quality and AS account for unique variance in PTSD and depressive symptoms in combat-exposed veterans. AS may be less relevant to understanding risk for PTSD among combat-exposed veterans experiencing poor sleep quality.
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Affiliation(s)
- Sage McNett
- Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University , Richmond, Virginia
| | - Mackenzie J Lind
- Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University , Richmond, Virginia
| | - Ruth C Brown
- Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University , Richmond, Virginia
| | - Sage Hawn
- Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University , Richmond, Virginia.,Department of Psychology, Virginia Commonwealth University , Richmond, Virginia
| | - Erin C Berenz
- Department of Psychology, University of Illinois at Chicago , Illinois
| | - Emily Brown
- Dornsife School of Public Health, Drexel University , Philadelphia, Pennsylvania
| | - Scott D McDonald
- Department of Psychology, Virginia Commonwealth University , Richmond, Virginia.,Hunter Holmes McGuire VA Medical Center , Richmond, Virginia.,Department of Physical Medicine & Rehabilitation, Virginia Commonwealth University , Richmond, Virginia
| | - Treven Pickett
- Department of Psychology, Virginia Commonwealth University , Richmond, Virginia.,Hunter Holmes McGuire VA Medical Center , Richmond, Virginia.,Department of Physical Medicine & Rehabilitation, Virginia Commonwealth University , Richmond, Virginia
| | - Carla Kmett Danielson
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina , Charleston, South Carolina
| | - Suzanne Thomas
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina , Charleston, South Carolina
| | - Ananda B Amstadter
- Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University , Richmond, Virginia.,Department of Psychology, Virginia Commonwealth University , Richmond, Virginia
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109
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Investigating the effect of a nap following experimental trauma on analogue PTSD symptoms. Sci Rep 2021; 11:4710. [PMID: 33633161 PMCID: PMC7907077 DOI: 10.1038/s41598-021-83838-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 01/25/2021] [Indexed: 01/27/2023] Open
Abstract
Cognitive models assume that the incomplete integration of a traumatic experience into the autobiographical memory results in typical symptoms associated with post-traumatic stress disorder (PTSD) such as intrusive re-experiencing. Sleep supports the integration of new experiences into existing memory networks through memory consolidation. In fifty-six females, we investigated whether a 90-min daytime nap (n = 33) compared to a wake period (n = 23) after being exposed to an experimental trauma (i.e. a trauma film) prevents PTSD analogue symptoms. Intrusive memories were recorded for seven days using a diary, overall PTSD symptoms were assessed using the Impact of Event Scale (IES-R) and affective response to trauma cues were measured one week after experimental trauma. The two groups did not differ in any of the analogue PTSD symptoms. However, participants obtaining rapid eye movement (REM) sleep in the nap experienced less distressing intrusive memories. Moreover, the duration of REM sleep and slow wave activity was negatively correlated with analogue PTSD symptoms. Our findings suggest that even a short sleep period after experimental trauma can play a protective role in trauma memory formation but only if the nap contains REM sleep. Our data provide additional evidence for a critical role of REM sleep in PTSD development.
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110
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Qazi T, Smith A, Alexander M, Hammer D, Wu T, Auerbach S, Noronha A, Wasan S, Jones E, Weinberg J, Farraye FA. Disparities in Objective Sleep Quality as Assessed Through Wrist Actigraphy in Minority Patients With Inflammatory Bowel Disease. Inflamm Bowel Dis 2021; 27:371-378. [PMID: 32448906 DOI: 10.1093/ibd/izaa106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Indexed: 12/09/2022]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is associated with a reduced quality of life. Minority patients with IBD specifically report more impairing symptoms compared with nonminority patients. Sleep quality, a key component of quality of life, is significantly compromised in minority patients compared with nonminority patients. Nevertheless, subjective and objective sleep assessments in minority patients with IBD have not explicitly been assessed. The purpose of this prospective cohort study is to assess and compare objective sleep parameters utilizing wrist actigraphy between minority and nonminority IBD patients. METHODS In this institutional review board approved study, 74 patients with IBD were recruited and stratified into 2 cohorts by self-identification: white nonminority patients and minority patients. Patients in the minority cohort included black and Hispanic individuals (black and nonblack). Exclusion criteria included significant comorbidity, a history of an underlying sleep disorder, or patients who did not self-identify into categorized cohorts. Sleep was measured not only through wrist-based actigraphy but also with sleep surveys. Sleep parameters were compared between minority and nonminority cohorts. Regression analyses were performed to assess for factors independently associated with parameters of poor sleep quality. RESULTS Sixty-four patients (86.4%) were included in the final analysis. Thirty-one individuals (48.4%) were categorized into the nonminority cohort, and 33 (51.6%) patients were in the minority cohort. A significantly higher number of minority patients had poorer sleep efficiency and fragmented sleep compared with nonminority patients (90.9% vs 67.7%; P = 0.03 and 87.8% vs 61.3%; P = 0.02). In the adjusted analysis, minority status was independently associated with poor sleep efficiency (odds ratio = 6.41; 95% confidence interval, 1.48-28.17; P = 0.0139) and fragmented sleep (odds ratio = 4.98; 95% confidence interval, 1.09-22.89; P = 0.0389). CONCLUSIONS Minority patients with IBD were shown to have poorer objective measures of sleep as assessed through wrist actigraphy compared to nonminority patients. Cultural competency in the care of minority patients with IBD, specifically focusing on the management of psychosocial issues, is needed to address these disparities in sleep. The inclusion of minority patients with IBD in studies investigating sleep and other psychosocial issues are warranted not only to assess potential disparities in disease course but also to determine the etiologies of poor sleep in minority patients with IBD.
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Affiliation(s)
- Taha Qazi
- Cleveland Clinic, Digestive Disease and Surgery Institute, Cleveland, Ohio, USA
| | - Alexander Smith
- Boston University School of Medicine, Boston, Massachusetts, USA
| | - Megan Alexander
- Boston University School of Medicine, Boston, Massachusetts, USA
| | - David Hammer
- Department of Neurology, Boston University School of Medicine and Sleep Disorders Center, Boston Medical Center, Boston, Massachusetts, USA
| | - Ting Wu
- Department of Neurology, Boston University School of Medicine and Sleep Disorders Center, Boston Medical Center, Boston, Massachusetts, USA
| | - Sanford Auerbach
- Department of Neurology, Boston University School of Medicine and Sleep Disorders Center, Boston Medical Center, Boston, Massachusetts, USA
| | - Ansu Noronha
- Section of Gastroenterology, Boston Medical Center, Boston, Massachusetts, USA
| | - Sharmeel Wasan
- Section of Gastroenterology, Boston Medical Center, Boston, Massachusetts, USA
| | - Eric Jones
- Boston University School of Public Health, Department of Biostatistics, Boston, Massachusetts, USA
| | - Janice Weinberg
- Boston University School of Public Health, Department of Biostatistics, Boston, Massachusetts, USA
| | - Francis A Farraye
- Section of Gastroenterology, Boston Medical Center, Boston, Massachusetts, USA.,Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA
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Semsarian CR, Woodforde A, Cheung JMY, Rigney G, Blunden S, Cistulli PA, Bin YS. The need for sleep and circadian education in Australian high schools: incidental results from a survey of university students. Health Promot J Austr 2021; 33:170-175. [PMID: 33544942 DOI: 10.1002/hpja.462] [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: 09/18/2020] [Revised: 01/25/2021] [Accepted: 01/31/2021] [Indexed: 11/06/2022] Open
Abstract
ISSUE ADDRESSED To describe the need for high school sleep education from the perspective of undergraduate university students. METHODS Undergraduate students who completed an online course on sleep and circadian health were surveyed 6 months after course completion. Students were asked whether a similar course would have benefited them as high school students, and about the need for sleep education in high schools. Thematic analysis of this qualitative data was carried out. RESULTS Eighty-nine students who had attended 71 unique high schools provided responses. Eight-one per cent thought they would have benefitted from a similar course during high school and identified domains of sleep knowledge particularly relevant to high school students. They cited environmental barriers to healthy sleep present during high school and believed that sleep education could improve students' lifestyle, sleep and performance. Nineteen per cent of students said they would not have benefited, because they perceived sleeping patterns during high school to be nonmodifiable or believed that previous sleep education was sufficient. Of the respondents who did not think students would benefit, 53% would still tell their high school principal that there was a need for sleep education. CONCLUSIONS The findings support the need for engaging sleep education for high school students. Future studies should examine the perspectives of students in high school directly, rather than undergraduate students who have already shown an interest in sleep health. SO WHAT?: Sleep health is missing from the Australian school curriculum. Online courses may be an engaging method of promoting sleep and circadian health to high school students.
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Affiliation(s)
| | - Alisha Woodforde
- Sleep Research Group, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Janet M Y Cheung
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Gabrielle Rigney
- Appleton Institute of Behavioural Science, Central Queensland University, Wayville, Australia
| | - Sarah Blunden
- Appleton Institute of Behavioural Science, Central Queensland University, Wayville, Australia
| | - Peter A Cistulli
- Sleep Research Group, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Yu Sun Bin
- Sleep Research Group, Charles Perkins Centre, University of Sydney, Sydney, Australia
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112
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Sleep Quality, Mental and Physical Health: A Differential Relationship. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020460. [PMID: 33435528 PMCID: PMC7826982 DOI: 10.3390/ijerph18020460] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 01/04/2021] [Accepted: 01/06/2021] [Indexed: 11/22/2022]
Abstract
This study aimed to explore the association between sleep quality and its components and both dimensions of health-related quality of life (HRQoL) in a sample of young adults. The sample comprised 337 participants with a mean age of 19.6 y (SD = 2.22). Sleep quality and HRQoL were measured through the Pittsburgh Sleep Quality Index and the SF-12, respectively. Regression analyses were used to investigate the association between sleep quality and HRQoL. Our results confirm the significant association between sleep quality and both physical (p = 0.015; β = −0.138; R2 = 0.07) and mental (p < 0.001; β = −0.348; R2 = 0.22) HRQoL in the adjusted models. However, our results also highlight the differential association between sleep quality and mental and physical HRQoL. Whereas all the sleep quality components (except sleep latency; p = 0.349) were significantly associated with mental HRQoL (p < 0.05), just two subscales (subjective sleep quality; p = 0.021; β = −0.143 and sleep disturbances p = 0.002; β = −0.165) showed a significant association. This study showed that there is a stronger association between sleep quality and mental health than sleep quality and physical health in young adults.
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113
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Radhakrishnan A, Govindaraj R, Sasidharan A, Ravindra PN, Yadav R, Kutty BM. People with dyssomnia showed increased vulnerability to CoVID-19 pandemic: a questionnaire-based study exploring the patterns and predictors of sleep quality using the latent class analysis technique in Indian population. Sleep Med 2021; 79:29-39. [PMID: 33485259 PMCID: PMC7834060 DOI: 10.1016/j.sleep.2020.12.041] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 12/20/2020] [Accepted: 12/30/2020] [Indexed: 01/07/2023]
Abstract
INTRODUCTION CoVID-19 pandemic and the subsequent lockdown have impacted the sleep quality and the overall wellbeing of mankind. The present epidemiological study measured various aspects of sleep disturbance such as sleep quality, daytime impairments, negative emotionality, sleep hygiene, and well-being associated with CoVID-19 pandemic among the Indian population. METHODS This cross-sectional voluntary online survey (using Google form) was communicated across the country from 4th June to 3rd July 2020 through mail and social media applications. The responses received (N = 450) were categorized and validated using the latent class analysis and logistic regression tests respectively, and the classes and subclasses derived were profiled. These techniques are used for the first time in a CoVID-19 sleep study. RESULTS Out of the three classes derived from the LCA, people with severe dyssomnia belonging to class 1 (33.3%) showed high daytime impairments, negative emotionality and high vulnerability towards CoVID-19 pandemic measures. In addition, the two subclasses derived from the severe dyssomnia group; one with negative emotionality predominance and the other with excessive daytime sleepiness, were similarly affected by CoVID-19 measures. People with moderate dyssomnia (class 2, 28.5%) showed frequent arousals with daytime impairments and the majority (38.2%) which fell in to class 3, the 'no dyssomnia' category, were not impacted by CoVID-19 pandemic. CONCLUSION People with existing sleep problems or those who were vulnerable to the same were the ones affected by CoVID-19 pandemic. Those with inadequate emotional coping styles have showed heightened vulnerability. Proper medical and cognitive interventions are highly recommended for this population. No or moderate dyssomnia categories (class 3 and 2 respectively) were less impacted by CoVID-19.
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Affiliation(s)
- Arathi Radhakrishnan
- Centre for Consciousness Studies, Department of Neurophysiology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Ramajayam Govindaraj
- Centre for Consciousness Studies, Department of Neurophysiology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Arun Sasidharan
- Centre for Consciousness Studies, Department of Neurophysiology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - P N Ravindra
- Centre for Consciousness Studies, Department of Neurophysiology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Ravi Yadav
- Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Bindu M Kutty
- Centre for Consciousness Studies, Department of Neurophysiology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India.
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114
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Laaboub N, Gholam M, Sibailly G, Sjaarda J, Delacrétaz A, Dubath C, Grosu C, Piras M, Ansermot N, Crettol S, Vandenberghe F, Grandjean C, Gamma F, Bochud M, von Gunten A, Plessen KJ, Conus P, Eap CB. Associations Between High Plasma Methylxanthine Levels, Sleep Disorders and Polygenic Risk Scores of Caffeine Consumption or Sleep Duration in a Swiss Psychiatric Cohort. Front Psychiatry 2021; 12:756403. [PMID: 34987426 PMCID: PMC8721597 DOI: 10.3389/fpsyt.2021.756403] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 11/12/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: We first sought to examine the relationship between plasma levels of methylxanthines (caffeine and its metabolites) and sleep disorders, and secondarily between polygenic risk scores (PRS) of caffeine consumption or sleep duration with methylxanthine plasma levels and/or sleep disorders in a psychiatric cohort. Methods: Plasma levels of methylxanthines were quantified by ultra-high performance liquid chromatography/tandem mass spectrometry. In inpatients, sleep disorder diagnosis was defined using ICD-10 "F51.0," sedative drug intake before bedtime, or hospital discharge letters, while a subgroup of sedative drugs was used for outpatients. The PRS of coffee consumption and sleep duration were constructed using publicly available GWAS results from the UKBiobank. Results: 1,747 observations (1,060 patients) were included (50.3% of observations with sleep disorders). Multivariate analyses adjusted for age, sex, body mass index, setting of care and psychiatric diagnoses showed that patients in the highest decile of plasma levels of methylxanthines had more than double the risk for sleep disorders compared to the lowest decile (OR = 2.13, p = 0.004). PRS of caffeine consumption was associated with plasma levels of caffeine, paraxanthine, theophylline and with their sum (β = 0.1; 0.11; 0.09; and 0.1, pcorrected = 0.01; 0.02; 0.02; and 0.01, respectively) but not with sleep disorders. A trend was found between the PRS of sleep duration and paraxanthine levels (β = 0.13, pcorrected = 0.09). Discussion: Very high caffeine consumption is associated with sleep disorders in psychiatric in- and outpatients. Future prospective studies should aim to determine the benefit of reducing caffeine consumption in high caffeine-consuming patients suffering from sleep disorders.
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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, Prilly, Switzerland
| | - Mehdi Gholam
- Center of 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, Prilly, Switzerland
| | - Jennifer Sjaarda
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Aurélie Delacrétaz
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland.,Les Toises Psychiatry and Psychotherapy Center, Lausanne, Switzerland
| | - Céline Dubath
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Claire Grosu
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Marianna Piras
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Nicolas Ansermot
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Severine Crettol
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Frederik Vandenberghe
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Carole Grandjean
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Franziska Gamma
- Les Toises Psychiatry and Psychotherapy Center, Lausanne, Switzerland
| | - Murielle Bochud
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Armin von Gunten
- Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Kerstin Jessica Plessen
- Service of Child and Adolescent 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, 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, Geneva, Switzerland
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115
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Melhuish Beaupre LM, Tiwari AK, Gonçalves VF, Zai CC, Marshe VS, Lewis CM, Martin NG, McIntosh AM, Adams MJ, Baune BT, Levinson DF, Boomsma DI, Penninx BWJH, Breen G, Hamilton S, Awasthi S, Ripke S, Jones L, Jones I, Byrne EM, Hickie IB, Potash JP, Shi J, Weissman MM, Milaneschi Y, Shyn SI, de Geus EJC, Willemsen G, Brown GM, Kennedy JL. Potential Genetic Overlap Between Insomnia and Sleep Symptoms in Major Depressive Disorder: A Polygenic Risk Score Analysis. Front Psychiatry 2021; 12:734077. [PMID: 34925085 PMCID: PMC8678563 DOI: 10.3389/fpsyt.2021.734077] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 11/01/2021] [Indexed: 11/14/2022] Open
Abstract
Background: The prevalence of insomnia and hypersomnia in depressed individuals is substantially higher than that found in the general population. Unfortunately, these concurrent sleep problems can have profound effects on the disease course. Although the full biology of sleep remains to be elucidated, a recent genome-wide association (GWAS) of insomnia, and other sleep traits in over 1 million individuals was recently published and provides many promising hits for genetics of insomnia in a population-based sample. Methods: Using data from the largest available GWAS of insomnia and other sleep traits, we sought to test if sleep variable PRS scores derived from population-based studies predicted sleep variables in samples of depressed cases [Psychiatric Genomics Consortium - Major Depressive Disorder subjects (PGC MDD)]. A leave-one-out analysis was performed to determine the effects that each individual study had on our results. Results: The only significant finding was for insomnia, where p-value threshold, p = 0.05 was associated with insomnia in our PGC MDD sample (R 2 = 1.75-3, p = 0.006). Conclusion: Our results reveal that <1% of variance is explained by the variants that cover the two significant p-value thresholds, which is in line with the fact that depression and insomnia are both polygenic disorders. To the best of our knowledge, this is the first study to investigate genetic overlap between the general population and a depression sample for insomnia, which has important treatment implications, such as leading to novel drug targets in future research efforts.
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Affiliation(s)
- Lindsay M Melhuish Beaupre
- Molecular Brain Science Research Department, Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - Arun K Tiwari
- Molecular Brain Science Research Department, Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Vanessa F Gonçalves
- Molecular Brain Science Research Department, Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Clement C Zai
- Molecular Brain Science Research Department, Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Victoria S Marshe
- Molecular Brain Science Research Department, Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - Cathryn M Lewis
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, United Kingdom.,Department of Medical and Molecular Genetics, King's College London, London, United Kingdom
| | - Nicholas G Martin
- Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Andrew M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Mark J Adams
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany.,Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia.,Melbourne Medical School, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Doug F Levinson
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Dorret I Boomsma
- Department of Biological Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam UMC/Vrije Universiteit, Amsterdam, Netherlands
| | - Gerome Breen
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, United Kingdom.,National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, King's College London, London, United Kingdom
| | - Steve Hamilton
- The Permanente Medical Group, San Francisco, CA, United States
| | - Swapnil Awasthi
- Department of Psychiatry and Psychotherapy, Universitäts Medizin Berlin Campus Charité Mitte, Berlin, Germany
| | - Stephan Ripke
- Department of Psychiatry and Psychotherapy, Universitäts Medizin Berlin Campus Charité Mitte, Berlin, Germany.,Analytic and Translational Genetic Unit, Massachusetts General Hospital, Boston, MA, United States.,Medical and Population Genetics, Broad Institute, Cambridge, MA, United States.,Department of Psychiatry, Charité, Berlin, Germany
| | - Lisa Jones
- Psychological Medicine, University of Worcester, Worcester, United Kingdom
| | - Ian Jones
- Medical Research Council (MRC) Centre for Neuropsychiatric Genetics and Genomics, Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, United Kingdom
| | - Enda M Byrne
- Institute for Molecular Bioscience, University of Queensland, Brisbane, QLD, Australia
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - James P Potash
- Psychiatry Department, University of Iowa, Iowa City, IA, United States
| | - Jianxin Shi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - Myrna M Weissman
- Psychiatry Department, Columbia University College of Physicians and Surgeons, New York, NY, United States.,Division of Epidemiology, New York State Psychiatric Institute, New York, NY, United States
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam UMC/Vrije Universiteit, Amsterdam, Netherlands
| | - Stanley I Shyn
- Washington Permanente Medical Group, Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Eco J C de Geus
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam UMC/Vrije Universiteit, Amsterdam, Netherlands
| | - Gonneke Willemsen
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam UMC/Vrije Universiteit, Amsterdam, Netherlands
| | - Gregory M Brown
- Molecular Brain Science Research Department, Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - James L Kennedy
- Molecular Brain Science Research Department, Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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116
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Kaczkurkin AN, Tyler J, Turk-Karan E, Belli G, Asnaani A. The Association between Insomnia and Anxiety Symptoms in a Naturalistic Anxiety Treatment Setting. Behav Sleep Med 2021; 19:110-125. [PMID: 31955594 PMCID: PMC7369215 DOI: 10.1080/15402002.2020.1714624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective/Background: Few studies have examined the relationship between insomnia and anxiety treatment outcomes in naturalistic settings. Furthermore, prior studies typically examine insomnia within a single anxiety diagnosis without accounting for the high overlap between disorders. Here we investigate the association between insomnia and multiple anxiety disorders over a course of cognitive behavioral treatment (CBT) in a naturalistic treatment setting. Participants: Insomnia was assessed in 326 patients seeking treatment at a clinic specializing in CBT for anxiety. Methods: Multilevel modeling was used to investigate whether insomnia moderated reductions in anxiety symptoms. A cross-lagged analysis tested for bidirectional effects between insomnia and anxiety. Multiple regression was used to investigate the relationship between insomnia and anxiety while controlling for the other anxiety disorders and depression. Results: While there was a significant reduction in insomnia during treatment in all anxiety disorders, the majority of the most severe patients remained in the clinical range at post-treatment. Baseline insomnia did not significantly moderate anxiety outcomes, suggesting that patients with high or low levels of insomnia will do equally well in CBT for anxiety. The bidirectional effect between insomnia and anxiety did not reach significance. Additionally, posttraumatic stress disorder, generalized anxiety disorder, and panic disorder were associated with the greatest endorsement of insomnia, after controlling for the overlap between disorders. Conclusions: Sleep problems may persist after anxiety treatment, suggesting that CBT for insomnia may be warranted during or after a course of CBT for anxiety. Importantly, baseline insomnia does not impede anxiety reduction during CBT.
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Affiliation(s)
| | - Jeremy Tyler
- University of Pennsylvania, Department of Psychiatry, Center for the Treatment and Study of Anxiety, Philadelphia, PA, USA 19104
| | - Elizabeth Turk-Karan
- University of Pennsylvania, Department of Psychiatry, Center for the Treatment and Study of Anxiety, Philadelphia, PA, USA 19104
| | - Gina Belli
- University of Pennsylvania, Department of Psychiatry, Center for the Treatment and Study of Anxiety, Philadelphia, PA, USA 19104
| | - Anu Asnaani
- University of Utah, Department of Psychology, Salt Lake City, UT 84112
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117
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Alfini AJ, Won J, Weiss LR, Nyhuis CC, Shackman AJ, Spira AP, Smith JC. Impact of exercise on older adults' mood is moderated by sleep and mediated by altered brain connectivity. Soc Cogn Affect Neurosci 2020; 15:1238-1251. [PMID: 33201227 PMCID: PMC7745152 DOI: 10.1093/scan/nsaa149] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/25/2020] [Accepted: 10/27/2020] [Indexed: 01/01/2023] Open
Abstract
Older adults comprise the fastest growing global demographic and are at increased risk of poor mental health outcomes. Although aerobic exercise and sleep are critical to the preservation of emotional well-being, few studies have examined their combined mood-enhancing effects, or the potential neural mechanisms underlying these effects. Here, we used a randomized crossover design to test the impact of acute exercise on mood and the intrinsic functional connectivity (iFC) of the cingulo-opercular network in physically healthy older adults. Wrist actigraphy provided objective indices of sleep. Results revealed that 30 min of moderate-intensity aerobic exercise acutely enhanced positive affect (PA) and reduced iFC between the cingulo-opercular network and the hippocampus. Both effects were magnified among older adults with greater sleep disturbance. Exercise-induced changes in hippocampal iFC mediated relations between sleep disturbance and exercise-induced increases in PA. These findings provide evidence that aerobic exercise enhances mood, that it does so by altering connectivity between the anterior insula-a key hub in the cingulo-opercular network-and the hippocampus and that lower sleep quality is a stronger predictor of these effects among older adults. These observations underscore the benefits of moderate-intensity exercise-a safe and scalable behavioral intervention-and provide new clues about the neural circuitry underlying the interactive effects of sleep and exercise on mood.
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Affiliation(s)
- Alfonso J Alfini
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Junyeon Won
- Department of Kinesiology, University of Maryland School of Public Health, College Park, MD 20742, USA
| | - Lauren R Weiss
- Department of Kinesiology, University of Maryland School of Public Health, College Park, MD 20742, USA
- Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD 20742, USA
| | - Casandra C Nyhuis
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Alexander J Shackman
- Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD 20742, USA
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
- Center on Aging and Health, Johns Hopkins School of Medicine and Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - J Carson Smith
- Department of Kinesiology, University of Maryland School of Public Health, College Park, MD 20742, USA
- Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD 20742, USA
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118
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Psychological correlates of poor sleep quality among U.S. young adults during the COVID-19 pandemic. Sleep Med 2020; 78:51-56. [PMID: 33385779 DOI: 10.1016/j.sleep.2020.12.009] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/09/2020] [Accepted: 12/09/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Uncertainty due to the COVID-19 pandemic may result in problematic sleep that can lead to negative effects on overall health. This unprecedented and stressful time can be even more detrimental for young adults with pre-existing mental health conditions. The purpose of this study is to investigate potential risk factors (i.e., current mental health symptoms, and COVID-19-related grief and worry) on sleep quality of U.S. young adults during the initial months of the global pandemic. METHOD This cross-sectional study examined 908 young adults in the weeks following the declaration of the coronavirus pandemic as a national emergency by the United States. A series of hierarchical multiple regression analyses examined depression, anxiety, and PTSD, as well as COVID-19-related grief and worry as predictors of young adults' sleep quality. RESULTS Young adults experienced high rates of sleep problems during the first two months (April to May 2020) of the pandemic. Depressive and anxiety symptoms appear to be predictors of sleep quality regardless of any pre-existing diagnosis. Furthermore, high levels of PTSD symptoms and COVID-19-related worry were associated with young adults' poor sleep. CONCLUSIONS Our findings point to possible psychological factors that uniquely explain young adults' poor sleep quality during the COVID-19 pandemic in the U.S. This study shed new light on how the COVID-19 pandemic might affect the sleep behaviors of young adults without a pre-existing mental health diagnosis. Implications for supporting young adults sleep and well-being during the pandemic are addressed.
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119
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Bajaj S, Blair KS, Schwartz A, Dobbertin M, Blair RJR. Worry and insomnia as risk factors for depression during initial stages of COVID-19 pandemic in India. PLoS One 2020; 15:e0243527. [PMID: 33301508 PMCID: PMC7728274 DOI: 10.1371/journal.pone.0243527] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/23/2020] [Indexed: 12/21/2022] Open
Abstract
The biggest nationwide COVID-19 pandemic lockdown worldwide was enforced in India for an initial period of 21-days. Emerging evidence suggests that pandemic situations and associated lockdowns have an adverse impact on sleep and mental health. However, prediction of sleep health from sociodemographic characteristics and the public’s worry during the initial stages of the COVID-19 pandemic has not been extensively explored so far. It’s also unclear whether sleep outcomes mediate the association between worry and mental health during pandemic situations. A web-survey (N = 391) on sociodemographic characteristics, COVID-19 related worry, sleep health (insomnia and daytime sleepiness), and depression was conducted during the initial 21-days of the COVID-19 stringent lockdown in India. Multiple regression analyses showed that variables, including sex, age, income level, and worry score, contributed to the significant regression equation for insomnia but not for daytime sleepiness. Specifically, the female, younger, lower income, and highly worried populations contributed significantly more than the male, elderly, higher income, and less worried populations, respectively, to the prediction of insomnia. Mediation analyses showed that insomnia, but not daytime sleepiness, fully mediated the relationship between worry score and severity of depressive symptoms. We provide evidence that the female, younger, lower income, and worried populations may be at higher risk for insomnia during pandemic situations. Current evidence gives hope that improving sleep may reduce depressive symptoms during a pandemic situation. This underscores the importance of the implementation of effective public health policies in conjunction with strategical responses to the COVID-19 pandemic.
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Affiliation(s)
- Sahil Bajaj
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States of America
- Program for Trauma and Anxiety (PTAC), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States of America
- * E-mail:
| | - Karina S. Blair
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States of America
- Program for Trauma and Anxiety (PTAC), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States of America
| | - Amanda Schwartz
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States of America
- Program for Trauma and Anxiety (PTAC), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States of America
| | - Matthew Dobbertin
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States of America
- Program for Trauma and Anxiety (PTAC), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States of America
| | - R. James R. Blair
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States of America
- Program for Trauma and Anxiety (PTAC), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States of America
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Saah FI, Amu H. Sleep quality and its predictors among waiters in upscale restaurants: A descriptive study in the Accra Metropolis. PLoS One 2020; 15:e0240599. [PMID: 33049002 PMCID: PMC7553280 DOI: 10.1371/journal.pone.0240599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 09/29/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Poor mental and sleep health negatively affects work performance, turnover intention, and information retention. We examined the impact of waiting job in upscale restaurants on the sleep health of waiters. MATERIALS AND METHODS This was a descriptive study which collected cross-sectional data from waiters of upscale restaurants, using PSQI and DASS-21 questionnaires. Descriptive and inferential statistics comprising mean, frequency, percentage, chi-square, and logistic regression were adopted in presenting the results. RESULTS Sleep quality was poor among 74% of the waiters. The predictors of sleep quality were sex (p = 0.002), role at restaurant (p = 0.004), non-prescription drug use (p<0.001), depression (p<0.001), anxiety (p<0.001), and stress (p<0.001). The prevalence of anxiety, depression, and stress among the waiters was 52.3%, 38.3%, and 34.4% respectively. Stationed (AOR = 4.72, 95%CI = 1.7-812.53, p = 0.002) and supervising (AOR = 3.08, 95%CI = 1.25-7.57, p = 0.014) waiters were more likely to have good sleep quality than headwaiters. Waiters who had depression, anxiety, and stress were, however, 8% (AOR = 0.92, 95%CI = 0.46-1.85, p = 0.819), 28% (AOR = 0.72, 95%CI = 0.38-1.36, p = 0.315), and 49% (AOR = 0.51, 95%CI = 0.24-1.07, p = 0.073) less likely to have a good sleep quality than those who respectively did not have depression, anxiety, and stress. CONCLUSIONS Sleep quality was poor among most of the waiters. If this persists, Ghana may not be able to meet the Sustainable Development Goal 3.4 target of promoting mental health and wellbeing. To improve sleep quality and accelerate progress towards achievement of the SDG target, there should be increased collaboration among stakeholders in the health and hospitality industries to develop innovative interventions to reduce poor sleep quality among workers.
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Affiliation(s)
- Farrukh Ishaque Saah
- Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
- * E-mail:
| | - Hubert Amu
- Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
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Tymofiyeva O, Yuan JP, Kidambi R, Huang CY, Henje E, Rubinstein ML, Jariwala N, Max JE, Yang TT, Xu D. Neural Correlates of Smartphone Dependence in Adolescents. Front Hum Neurosci 2020; 14:564629. [PMID: 33132878 PMCID: PMC7577047 DOI: 10.3389/fnhum.2020.564629] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 09/15/2020] [Indexed: 11/13/2022] Open
Abstract
Increases in depressive and suicide-related symptoms among United States adolescents have been recently linked to increased use of smartphones. Understanding of the brain mechanisms that underlie the potential smartphone dependence may help develop interventions to address this important problem. In this exploratory study, we investigated the neural mechanisms underlying potential smartphone dependence in a sample of 19 adolescent volunteers who completed self-assessments of their smartphone dependence, depressive symptoms, and sleep problems. All 19 adolescents underwent diffusion MRI that allowed for assessment of white matter structural connectivity within the framework of connectomics. Based on previous literature on the neurobiology of addiction, we hypothesized a disruption of network centrality of three nodes in the mesolimbic network: Nucleus Accumbens, anterior cingulate cortex, and amygdala. Our results showed positive correlations between the node centrality of the right amygdala and self-reported smartphone dependence, between smartphone dependence and sleep problems, and between sleep problems and depressive symptoms. A higher phone dependence was observed in females compared to males. Supported by these results, we propose a model of how smartphone dependence can be linked to aberrations in brain networks, sex, sleep disturbances, and depression in adolescents.
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Affiliation(s)
- Olga Tymofiyeva
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Justin P Yuan
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States.,Department of Psychology, Stanford University, Stanford, CA, United States
| | - Roma Kidambi
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Chiung-Yu Huang
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Eva Henje
- Department of Psychiatry and Behavioral Sciences, The Langley Porter Psychiatric Institute, Division of Child and Adolescent Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States.,Department of Clinical Science, Child and Adolescent Psychiatry, Umeå University, Umeå, Sweden
| | - Mark L Rubinstein
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, United States
| | - Namasvi Jariwala
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Jeffrey E Max
- Department of Psychiatry, University of California, San Diego, Rady Children's Hospital-San Diego, San Diego, CA, United States
| | - Tony T Yang
- Department of Psychiatry and Behavioral Sciences, The Langley Porter Psychiatric Institute, Division of Child and Adolescent Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Duan Xu
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
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Thota D. Evaluating the Relationship Between Fitbit Sleep Data and Self-Reported Mood, Sleep, and Environmental Contextual Factors in Healthy Adults: Pilot Observational Cohort Study. JMIR Form Res 2020; 4:e18086. [PMID: 32990631 PMCID: PMC7556371 DOI: 10.2196/18086] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/05/2020] [Accepted: 08/21/2020] [Indexed: 12/18/2022] Open
Abstract
Background Mental health disorders can disrupt a person’s sleep, resulting in lower quality of life. Early identification and referral to mental health services are critical for active duty service members returning from forward-deployed missions. Although technologies like wearable computing devices have the potential to help address this problem, research on the role of technologies like Fitbit in mental health services is in its infancy. Objective If Fitbit proves to be an appropriate clinical tool in a military setting, it could provide potential cost savings, improve clinician access to patient data, and create real-time treatment options for the greater active duty service member population. The purpose of this study was to determine if the Fitbit device can be used to identify indicators of mental health disorders by measuring the relationship between Fitbit sleep data, self-reported mood, and environmental contextual factors that may disrupt sleep. Methods This observational cohort study was conducted at the Madigan Army Medical Center. The study included 17 healthy adults who wore a Fitbit Flex for 2 weeks and completed a daily self-reported mood and sleep log. Daily Fitbit data were obtained for each participant. Contextual factors were collected with interim and postintervention surveys. This study had 3 specific aims: (1) Determine the correlation between daily Fitbit sleep data and daily self-reported sleep, (2) Determine the correlation between number of waking events and self-reported mood, and (3) Explore the qualitative relationships between Fitbit waking events and self-reported contextual factors for sleep. Results There was no significant difference in the scores for the pre-intevention Pittsburg Sleep Quality Index (PSQI; mean 5.88 points, SD 3.71 points) and postintervention PSQI (mean 5.33 points, SD 2.83 points). The Wilcoxon signed-ranks test showed that the difference between the pre-intervention PSQI and postintervention PSQI survey data was not statistically significant (Z=0.751, P=.05). The Spearman correlation between Fitbit sleep time and self-reported sleep time was moderate (r=0.643, P=.005). The Spearman correlation between number of waking events and self-reported mood was weak (r=0.354, P=.163). Top contextual factors disrupting sleep were “pain,” “noises,” and “worries.” A subanalysis of participants reporting “worries” found evidence of potential stress resilience and outliers in waking events. Conclusions Findings contribute valuable evidence on the strength of the Fitbit Flex device as a proxy that is consistent with self-reported sleep data. Mood data alone do not predict number of waking events. Mood and Fitbit data combined with further screening tools may be able to identify markers of underlying mental health disease.
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Affiliation(s)
- Darshan Thota
- Madigan Army Medical Center, Joint Base Lewis-McChord, WA, United States
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123
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Sanz-Milone V, Narciso FV, da Silva A, Misuta M, de Mello MT, Esteves AM. Sleep of Wheelchair Rugby Athletes: Training, Rest and
Competition. Int J Sports Med 2020; 42:169-174. [DOI: 10.1055/a-1192-5845] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
AbstractThe aim of this study was to evaluate the sleep-wake cycle of wheelchair rugby
athletes during the pre-season compared to in-season. Wheelchair Rugby athletes
wore an actigraph monitor during two respective 10-day periods: 1) pre-season
and 2) in-season, each of which comprised three training days, three rest days,
and four competition days, respectively. In addition, the players completed
questionnaires regarding sleepiness, subjective quality of sleep, and
chronotype, as well as the use of the sleep diary along with the actigraph
measurements (20 days). The wheelchair rugby athletes had poor subjective sleep
quality in both stages observed by sleep efficiency below 85% (ES 0.31)
and high score in the Pittsburgh questionnaire (effect size-ES 0.55), the
actigraphy results presented an increase of sleep latency (ES 0.47), and wake
after sleep onset (ES 0.42). When comparing the athlete’s routine, the
competition days, demonstrated a reduction in the total time of sleep and the
sleep efficiency, in addition to an increase in wakefulness after sleep onset
when compared with the training and rest periods. As a result, the wheelchair
rugby players did not describe a pattern of sleep-wake cycle during different
training phases, as well as poor sleep quality.
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Affiliation(s)
- Victor Sanz-Milone
- Faculdade de Educação Física, Universidade
Estadual de Campinas, Campinas, Brazil
| | - Fernanda V. Narciso
- Escola de Educação Física, Fisioterapia e
Terapia Ocupacional, Universidade Federal de Minas Gerais, Belo Horizonte,
Brazil
| | - Andressa da Silva
- Escola de Educação Física, Fisioterapia e
Terapia Ocupacional, Universidade Federal de Minas Gerais, Belo Horizonte,
Brazil
| | - Milton Misuta
- Faculdade de Ciências Aplicadas, Universidade Estadual de
Campinas, Limeira, Brazil
| | - Marco Túlio de Mello
- Escola de Educação Física, Fisioterapia e
Terapia Ocupacional, Universidade Federal de Minas Gerais, Belo Horizonte,
Brazil
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124
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Cabrera Y, Holloway J, Poe GR. Sleep Changes Across the Female Hormonal Cycle Affecting Memory: Implications for Resilient Adaptation to Traumatic Experiences. J Womens Health (Larchmt) 2020; 29:446-451. [PMID: 32186966 DOI: 10.1089/jwh.2020.8332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
We review findings and propose a model explaining why women's adaptation to traumatic stress might be different than men's, including the role of cycling hormones and sleep differences in the development of post-traumatic stress and other stress-related disorders. Women are diagnosed with stress-related mental health disorders at a higher frequency than men. Most mental health disorders involve sleep disturbances, which may contribute to these disorders. The mechanisms by which sleep contributes to the development of mental health disorders in women have not been addressed in basic research. Sleep features such as spindle density and rapid eye movement (REM) sleep theta power are important for the role of sleep in emotion and cognition. The effect of hormonal cycles on these and other critical sleep features is only beginning to be understood. We explore what sleep factors could confer resilience to mental health disorders and how they might be altered by hormonal cycles in women. We target a specific system at the nexus of arousal control, stress response, and memory consolidation processes that has not been explored at all in women or across the hormonal cycle in animal studies: the locus coeruleus noradrenergic (LC-NE) system.
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Affiliation(s)
- Yesenia Cabrera
- Department of Integrative Biology and Physiology, University of California Los Angeles, Los Angeles, California
| | - Jasmine Holloway
- Department of Integrative Biology and Physiology, University of California Los Angeles, Los Angeles, California
| | - Gina R Poe
- Department of Integrative Biology and Physiology, University of California Los Angeles, Los Angeles, California.,Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
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Olashore AA, Akanni OO, Ayilara OO. Psychological Distress, Drug Use, and Internet Use: The Association with Poor Sleep Quality in a Sample of Secondary School Students. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2020; 14:1178221820957306. [PMID: 32963471 PMCID: PMC7488876 DOI: 10.1177/1178221820957306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/11/2020] [Indexed: 12/03/2022]
Abstract
Sleep problems are common among children and adolescents. Sleep quality plays a significant role in their mental health. We aimed to determine the prevalence of poor sleep quality (PSQ) among secondary school students, identify sociodemographic factors associated with PSQ in this group, and examine the independent associations of psychological distress, stimulant use, and internet use with PSQ. Data were collected from 420 secondary school students from four different schools who were selected using a mixture of convenience and random sampling. A set of questionnaires was administered to collect data, and it consisted of 5 sections measuring: the sociodemographic, drug use, psychological distress, internet use, and sleep quality. A total of 378 questionnaires were analyzed. The participants comprised 174 (46.2%) males and 203 (53.8%) females who were between 10 and 21 years. The mean age was 14.78 years. The prevalence of those who had PSQ was 12.2%. A logistic regression model showed that anxiety (AOR = 1.20, 95% CI: 1.10-1.32), depression (AOR = 1.12, 95% CI: 1.00-1.25), and internet use (AOR = 1.02, 95% CI: 1.00-1.03) were significantly associated with PSQ. PSQ commonly exists among students and has a relationship with their psychological state and potentially addictive behavior, such as internet use. We prescribed the optimal treatment of psychological disorders and addictive behavior, of which sleep problems are a typical fallout.
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Affiliation(s)
- Anthony A Olashore
- Department of Psychiatry, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Oluyemi O Akanni
- Clinical Services, Federal Neuropsychiatric Hospital, Benin City, Edo State, Nigeria
| | - Olaniyi O Ayilara
- Clinical Services, Federal Neuropsychiatric Hospital, Benin City, Edo State, Nigeria
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126
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Veale D, Ali S, Papageorgiou A, Gournay K. The psychiatric ward environment and nursing observations at night: A qualitative study. J Psychiatr Ment Health Nurs 2020; 27:342-351. [PMID: 31823429 DOI: 10.1111/jpm.12583] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 12/03/2019] [Accepted: 12/06/2019] [Indexed: 01/23/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Nursing observations at night are conducted on psychiatric wards to ensure the safety and well-being of patients as well as to reduce the risk of suicide or severe harm. To our knowledge, no studies have examined the lived experience of the psychiatric ward environment and of nursing observations at night. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: The main complaint from patients was the constant interruption of their sleep, as most of the patients in this study were observed 2-4 times an hour. Their sleep was interrupted by (a) the light from torches shone into their faces by staff checking on their safety, (b) the noises produced by the opening and closing of bedroom/ward doors, and/or (c) staff talking to each other during the observation. Patients also reported that they found having somebody enter the room in the middle of the night intimidating and unsettling. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Poor sleep has been associated with an increase in suicide risk and mental health problems. Identifying practices that promote sleep hygiene is vital. The study could be used to develop a Quality Improvement Project to improve patients' sleep and perhaps reduce duration of stay. ABSTRACT: Introduction A fundamental component of nursing care is observations at night to ensure the well-being of patients. However, there is no literature on the lived experience by inpatients of such observations or of the general environment of a psychiatric ward at night. Aim/Question This study aims (a) to understand the lived experience of being an inpatient on a psychiatric ward at night with a focus on intermittent observations and (b) contribute to developing a tool to monitor the psychiatric ward environment for use in quality improvement projects. Method Semi-structured interviews were conducted with twelve inpatients from five psychiatric wards who had experienced intermittent observations at night. These interviews were subsequently transcribed and analysed using content analysis. Results Environmental disturbances including light and noise, invasion of privacy and safety considerations on the ward all contributed to sleep disturbance. The unintended consequences of disturbances caused by intermittent night observations, and by staff in general and other patients formed the core of the inpatients' experience. We developed a clinical tool that could be used to identify the factors that are relevant on an individual ward. Discussion Participants interviewed unanimously agreed that poor sleep quality had a significant negative impact on their psychological and social well-being. These were discussed in relation to the environment and the experience of observations at night. Implications for nursing practice Deprivation of inpatients' sleep is currently under-reported, and the usefulness of intermittent observations at night in psychiatric wards is questioned. Much could be done to adjust the environment at night to support quality sleep and improve psychiatric symptoms. This paper aims to highlight the lived experience of patients to help bring improvements.
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Affiliation(s)
- David Veale
- The Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Sabriha Ali
- The Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - Andriani Papageorgiou
- The Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - Kevin Gournay
- The Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
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127
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OSAS assessment with entropy analysis of high resolution snoring audio signals. Biomed Signal Process Control 2020. [DOI: 10.1016/j.bspc.2020.101965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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128
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Segarra M, Aburto MR, Hefendehl J, Acker-Palmer A. Neurovascular Interactions in the Nervous System. Annu Rev Cell Dev Biol 2020; 35:615-635. [PMID: 31590587 DOI: 10.1146/annurev-cellbio-100818-125142] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Molecular cross talk between the nervous and vascular systems is necessary to maintain the correct coupling of organ structure and function. Molecular pathways shared by both systems are emerging as major players in the communication of the neuronal compartment with the endothelium. Here we review different aspects of this cross talk and how vessels influence the development and homeostasis of the nervous system. Beyond the classical role of the vasculature as a conduit to deliver oxygen and metabolites needed for the energy-demanding neuronal compartment, vessels emerge as powerful signaling systems that control and instruct a variety of cellular processes during the development of neurons and glia, such as migration, differentiation, and structural connectivity. Moreover, a broad spectrum of mild to severe vascular dysfunctions occur in various pathologies of the nervous system, suggesting that mild structural and functional changes at the neurovascular interface may underlie cognitive decline in many of these pathological conditions.
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Affiliation(s)
- Marta Segarra
- Neuro and Vascular Guidance, Buchmann Institute for Molecular Life Sciences, University of Frankfurt, D-60438 Frankfurt am Main, Germany; , .,Institute of Cell Biology and Neuroscience, University of Frankfurt, D-60438 Frankfurt am Main, Germany
| | - Maria R Aburto
- Neuro and Vascular Guidance, Buchmann Institute for Molecular Life Sciences, University of Frankfurt, D-60438 Frankfurt am Main, Germany; , .,Institute of Cell Biology and Neuroscience, University of Frankfurt, D-60438 Frankfurt am Main, Germany
| | - Jasmin Hefendehl
- Neurovascular Disorders, Buchmann Institute for Molecular Life Sciences, University of Frankfurt, D-60438 Frankfurt am Main, Germany.,Institute of Cell Biology and Neuroscience, University of Frankfurt, D-60438 Frankfurt am Main, Germany
| | - Amparo Acker-Palmer
- Neuro and Vascular Guidance, Buchmann Institute for Molecular Life Sciences, University of Frankfurt, D-60438 Frankfurt am Main, Germany; , .,Institute of Cell Biology and Neuroscience, University of Frankfurt, D-60438 Frankfurt am Main, Germany.,Max Planck Institute for Brain Research, D-60438 Frankfurt am Main, Germany
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Prakash J, Chatterjee K, Srivastava K, Chauhan VS, Chail A. Role of various lifestyle and behavioral strategies in positive mental health across a preventive to therapeutic continuum. Ind Psychiatry J 2020; 29:185-190. [PMID: 34158700 PMCID: PMC8188916 DOI: 10.4103/ipj.ipj_126_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/03/2020] [Accepted: 09/23/2020] [Indexed: 11/04/2022] Open
Abstract
There is growing interest in lifestyle and behavioral strategies not only in prevention but also in the management of psychiatric morbidity. Available literature in this direction was accessed, and the role of various lifestyle and behavioral factors was explored. There is strong evidence of the role of good sleep, nutritious diet, exercise, social connectedness, enhanced self-esteem, sense of purpose in life, resilience, mindfulness, and environmental mastery in the promotion of mental well-being and prevention and management of psychiatric disorders. There is a significant scope of lifestyle and behavioral intervention in ensuring positive mental health spanning from preventive to therapeutic dimension.
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Affiliation(s)
- Jyoti Prakash
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - K Chatterjee
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - K Srivastava
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - V S Chauhan
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - A Chail
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
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130
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Haines-Delmont A, Chahal G, Bruen AJ, Wall A, Khan CT, Sadashiv R, Fearnley D. Testing Suicide Risk Prediction Algorithms Using Phone Measurements With Patients in Acute Mental Health Settings: Feasibility Study. JMIR Mhealth Uhealth 2020; 8:e15901. [PMID: 32442152 PMCID: PMC7380988 DOI: 10.2196/15901] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 02/21/2020] [Accepted: 02/29/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Digital phenotyping and machine learning are currently being used to augment or even replace traditional analytic procedures in many domains, including health care. Given the heavy reliance on smartphones and mobile devices around the world, this readily available source of data is an important and highly underutilized source that has the potential to improve mental health risk prediction and prevention and advance mental health globally. OBJECTIVE This study aimed to apply machine learning in an acute mental health setting for suicide risk prediction. This study uses a nascent approach, adding to existing knowledge by using data collected through a smartphone in place of clinical data, which have typically been collected from health care records. METHODS We created a smartphone app called Strength Within Me, which was linked to Fitbit, Apple Health kit, and Facebook, to collect salient clinical information such as sleep behavior and mood, step frequency and count, and engagement patterns with the phone from a cohort of inpatients with acute mental health (n=66). In addition, clinical research interviews were used to assess mood, sleep, and suicide risk. Multiple machine learning algorithms were tested to determine the best fit. RESULTS K-nearest neighbors (KNN; k=2) with uniform weighting and the Euclidean distance metric emerged as the most promising algorithm, with 68% mean accuracy (averaged over 10,000 simulations of splitting the training and testing data via 10-fold cross-validation) and an average area under the curve of 0.65. We applied a combined 5×2 F test to test the model performance of KNN against the baseline classifier that guesses training majority, random forest, support vector machine and logistic regression, and achieved F statistics of 10.7 (P=.009) and 17.6 (P=.003) for training majority and random forest, respectively, rejecting the null of performance being the same. Therefore, we have taken the first steps in prototyping a system that could continuously and accurately assess the risk of suicide via mobile devices. CONCLUSIONS Predicting for suicidality is an underaddressed area of research to which this paper makes a useful contribution. This is part of the first generation of studies to suggest that it is feasible to utilize smartphone-generated user input and passive sensor data to generate a risk algorithm among inpatients at suicide risk. The model reveals fair concordance between phone-derived and research-generated clinical data, and with iterative development, it has the potential for accurate discriminant risk prediction. However, although full automation and independence of clinical judgment or input would be a worthy development for those individuals who are less likely to access specialist mental health services, and for providing a timely response in a crisis situation, the ethical and legal implications of such advances in the field of psychiatry need to be acknowledged.
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Affiliation(s)
- Alina Haines-Delmont
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom
| | - Gurdit Chahal
- CLARA Labs, CLARA Analytics, Santa Clara, CA, United States
| | - Ashley Jane Bruen
- University of Liverpool, Health Services Research, Liverpool, United Kingdom
| | - Abbie Wall
- University of Liverpool, Health Services Research, Liverpool, United Kingdom
| | | | | | - David Fearnley
- Mersey Care NHS Foundation Trust, Prescot, United Kingdom
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131
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Dai YX, Tai YH, Chen CC, Chang YT, Chen TJ, Chen MH. Bidirectional association between alopecia areata and sleep disorders: a population-based cohort study in Taiwan. Sleep Med 2020; 75:112-116. [PMID: 32858349 DOI: 10.1016/j.sleep.2020.06.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/22/2020] [Accepted: 06/09/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND The relationship between alopecia areata (AA) and sleep disorders remains uncertain. This study aims to investigate the bidirectional association between AA and sleep disorders. METHODS To assess the risk of developing sleep disorders, we recruited 5648 patients with AA and 22,592 matched controls from the National Health Insurance Research Database (NHIRD) in Taiwan. Similarly, risk of developing AA was assessed in 93,130 patients with sleep disorders (including 7310 patients with obstructive sleep apnea [OSA] and 85,820 patients with non-apnea insomnia) and 372,520 matched controls. Cox regression model was used for the analysis. RESULTS AA patients had a significantly increased risk of developing OSA (adjusted hazard ratio [aHR] 3.80; 95% confidence interval [CI] 2.53-5.71) and non-apnea insomnia (aHR 4.20; 95% CI 3.68-4.79). Conversely, presence of sleep disorders significantly increased the risk of AA development (aHR 4.70; 95% CI 3.99-5.54). Both OSA (aHR 3.89; 95% CI 2.46-6.16) and nonapnea insomnia (aHR 4.77; 95% CI 4.03-5.64) were associated an increased risk of developing AA. CONCLUSIONS Patients with AA have a higher risk of developing sleep disorders compared to controls, and vice versa. Further studies are needed to investigate the shared pathogenic mechanism underlying these two conditions.
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Affiliation(s)
- Ying-Xiu Dai
- Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ying-Hsuan Tai
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chih-Chiang Chen
- Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yun-Ting Chang
- Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Mu-Hong Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
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132
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Effects of Aerobic Dance Training on Psychological Well-Being and Immune Function of Women Living With HIV. J Assoc Nurses AIDS Care 2020; 30:238-244. [PMID: 30822296 DOI: 10.1097/jnc.0000000000000020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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133
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Wang Y, Liu Z, Cai L, Guo R, Dong Y, Huang YH. A Critical Role of Basolateral Amygdala-to-Nucleus Accumbens Projection in Sleep Regulation of Reward Seeking. Biol Psychiatry 2020; 87:954-966. [PMID: 31924324 PMCID: PMC7210061 DOI: 10.1016/j.biopsych.2019.10.027] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 10/09/2019] [Accepted: 10/27/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Sleep impacts reward-motivated behaviors partly by retuning the brain reward circuits. The nucleus accumbens (NAc) is a reward processing hub sensitive to acute sleep deprivation. Glutamatergic transmission carrying reward-associated signals converges in the NAc and regulates various aspects of reward-motivated behaviors. The basolateral amygdala projection (BLAp) innervates broad regions of the NAc and critically regulates reward seeking. METHODS Using slice electrophysiology, we measured how acute sleep deprivation alters transmission at BLAp-NAc synapses in male C57BL/6 mice. Moreover, using SSFO (stabilized step function opsin) and DREADDs (designer receptors exclusively activated by designer drugs) (Gi) to amplify and reduce transmission, respectively, we tested behavioral consequences following bidirectional manipulations of BLAp-NAc transmission. RESULTS Acute sleep deprivation increased sucrose self-administration in mice and altered the BLAp-NAc transmission in a topographically specific manner. It selectively reduced glutamate release at the rostral BLAp (rBLAp) onto ventral and lateral NAc (vlNAc) synapses, but spared caudal BLAp onto medial NAc synapses. Furthermore, experimentally facilitating glutamate release at rBLAp-vlNAc synapses suppressed sucrose reward seeking. Conversely, mimicking sleep deprivation-induced reduction of rBLAp-vlNAc transmission increased sucrose reward seeking. Finally, facilitating rBLAp-vlNAc transmission per se did not promote either approach motivation or aversion. CONCLUSIONS Sleep acts on rBLAp-vINAc transmission gain control to regulate established reward seeking but does not convey approach motivation or aversion on its own.
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Affiliation(s)
- Yao Wang
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA,Department of Neuroscience, University of Pittsburgh, Pittsburgh, PA,These authors contributed equally to this work
| | - Zheng Liu
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA,These authors contributed equally to this work
| | - Li Cai
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Rong Guo
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Yan Dong
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA,Department of Neuroscience, University of Pittsburgh, Pittsburgh, PA
| | - Yanhua H. Huang
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
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134
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Consistency index of daily activity pattern and its correlations with subjective ratings of QOL. Sleep Biol Rhythms 2020. [DOI: 10.1007/s41105-020-00271-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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135
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Ong WJ, Tan XW, Shahwan S, Satghare P, Cetty L, Ng BT, Tang C, Verma S, Chong SA, Subramaniam M. Association between sleep quality and domains of quality of life amongst patients with first episode psychosis. Health Qual Life Outcomes 2020; 18:114. [PMID: 32349756 PMCID: PMC7189457 DOI: 10.1186/s12955-020-01367-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 04/16/2020] [Indexed: 01/04/2023] Open
Abstract
Background There is a lack of studies exploring associations between sleep and quality of life (QOL) among patients with schizophrenia who have limited exposure to antipsychotics and are in the early stage of their illness. Our study investigates the association of poor sleep quality and its components with domains of QOL amongst patients with first episode psychosis (FEP). Methods Data was utilized from a longitudinal study that examined sleep, smoking and alcohol use amongst patients with FEP who were enrolled in the Early Psychosis Intervention Programme (EPIP). The data were collected during the patients’ baseline visit; i.e., within 3 months of admission into the EPIP. The Pittsburgh Sleep Quality Index (PSQI) was employed to examine sleep quality and its 7 components over the last month. The WHO quality of life-BREF was used to examine QOL and its 4 domains: physical health, psychological, social relationship, and environment. Clinical data such as Positive and Negative Syndrome Scale (PANSS) and Global Assessment of Functioning (GAF) scores were obtained from a clinical data base. Linear regression analyses were conducted to investigate the association between poor sleep quality and the domains of QOL. Results Amongst the 280 recruited patients, 62.9% suffered from poor sleep quality. Poor sleep quality was associated with significantly lower scores in all domains of QOL, despite controlling for socio-demographics and clinical variables. Respondents with higher scores in subjective sleep quality and daytime dysfunction were associated with lower scores in the physical health and social relationship domain. Furthermore, respondents with higher scores in subjective sleep quality, sleep latency and daytime dysfunction were associated with lower scores in the psychological domain of QOL. Finally, respondents with higher scores in subjective sleep quality were associated with lower scores in the environment domain of QOL. Conclusions Our findings highlight the importance of monitoring sleep quality amongst patients with FEP to improve their QOL. Clinical programmes should also pay more attention to sleep components in order to maintain satisfactory QOL amongst patients with FEP. Future interventions should focus on improving the relevant sleep components to ensure better treatment outcomes.
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Affiliation(s)
- Wei Jie Ong
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Xiao Wei Tan
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Shazana Shahwan
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Pratika Satghare
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Laxman Cetty
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Boon Tat Ng
- Pharmancy Department, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Charmaine Tang
- Department of Early Psychosis Intervention, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Swapna Verma
- Department of Early Psychosis Intervention, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
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Cao B, Chen Y, McIntyre RS. Comprehensive review of the current literature on impact of ambient air pollution and sleep quality. Sleep Med 2020; 79:211-219. [PMID: 32912798 DOI: 10.1016/j.sleep.2020.04.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 02/08/2023]
Abstract
Air pollution is associated with increasing morbidity, mortality and decreasing health and life span. Accumulating epidemiological and experimental evidence has shown that exposure to ambient air pollutants such as particulate matters (PM) and gaseous components [eg, nitrogen dioxide (NO2), ozone (O3)] has detrimental effects on sleep quality. We conducted this comprehensive review to explore the association between ambient air pollution and sleep quality. A systematic search was conducted with the databases of PubMed and Web of Science from inception to November 2019. Overall, 15 studies with 133,695 subjects that evaluated the association between ambient air pollution and sleep quality were conducted in 10 different countries (ie, USA, Brazil, Canada, Chile, China, Egypt, Germany, Iran, Mexico, and Turkey). Most included studies in the current review have shown that one or more air pollutants have negative influences on sleep quality. Air pollutants might be one of the triggers for poor sleep quality via disparate mechanisms including but not limited to the central ventilator control centers, central nervous system, allergic and non-allergic mechanisms. The possible association between air pollution and select chronic diseases (eg, mental illnesses, cardiovascular diseases) and behaviors (eg, impulsivity) may also play important roles in explaining the association between ambient air pollution and sleep quality. The associations and underlying mechanisms between ambient air pollutants and sleep quality need to be clarified with long-term, multi-centered cohort studies.
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Affiliation(s)
- Bing Cao
- Key Laboratory of Cognition and Personality (SWU), Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, 400715, PR China.
| | - Yan Chen
- Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Department of Pharmacology, University of Toronto, Toronto, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada
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137
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Khalifa MKA, Salem HA, Shawky SM, Eassa HA, Elaidy AM. Enhancement of zaleplon oral bioavailability using optimized self-nano emulsifying drug delivery systems and its effect on sleep quality among a sample of psychiatric patients. Drug Deliv 2020; 26:1243-1253. [PMID: 31752566 PMCID: PMC6882476 DOI: 10.1080/10717544.2019.1687613] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The aim of this work is to develop self-nano emulsifying drug delivery system (SNEDDS) to enhance the oral bioavailability of zaleplon (Zal) as a poorly water-soluble drug. Moreover, the bioavailability and the effect on the quality of sleep among a sample of psychiatric patients is to be assessed. D-optimal mixture design was used for optimization. Optimized SNEDDS formulation was evaluated for droplet size, transmission electron microscope (TEM) and in-vitro dissolution test. Zal bioavailability was evaluated by determining its serum concentration and pharmacokinetic parameters in 8 patients after oral administration. Effect on sleep quality was assessed among 40 psychiatric patients. Patients’ sleep quality was assessed in 40 psychiatric patients before and after medication using the Arabic version of the Pittsburgh Sleep Quality Index (PSQI). Zal- SNEDDS appeared as nano-sized spherical vesicles. Moreover, Zal was completely dissolved from optimized formulation after 45 min indicating improved dissolution rate. Zal-SNEDDS showed significantly higher Cmax, Tmax and AUC0→∞ compared to commercial product after oral administration. Zal-SNEDDS significantly improved the total score of PSQIs (p < .001) with higher subjective sleep quality, reduced sleep latency, improved day time function and sleep disturbance (p < .001). Using sleep medication was reduced significantly (p = .027). However, it did not modify sleep duration or sleep efficiency. SNEDDS have improved Zal solubility and enhanced its bioavailability. Furthermore, Zal-SNEDDS have improved the total score of PSQIs and may be considered a good choice to enhance the quality of sleep among psychiatric patients.
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Affiliation(s)
- Maha K A Khalifa
- Department of Pharmaceutics and industrial Pharmacy, Faculty of Pharmacy, Al-Azhar University, Nasr City, Egypt
| | - Hoda A Salem
- Department of Clinical Pharmacy, Faculty of Pharmacy, Al-Azhar University, Nasr City, Egypt
| | - Seham M Shawky
- Department of Pharmaceutics and industrial Pharmacy, Faculty of Pharmacy, Al-Azhar University, Nasr City, Egypt
| | - Heba A Eassa
- Department of Pharmaceutics and industrial Pharmacy, Faculty of Pharmacy, Al-Azhar University, Nasr City, Egypt
| | - Asmaa M Elaidy
- Department of Psychiatry, Faculty of Medicine for girls, Al-Azhar University, Nasr City, Egypt
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138
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Abstract
The concept of sleep health provides a positive holistic framing of multiple sleep characteristics, including sleep duration, continuity, timing, alertness, and satisfaction. Sleep health promotion is an underrecognized public health opportunity with implications for a wide range of critical health outcomes, including cardiovascular disease, obesity, mental health, and neurodegenerative disease. Using a socioecological framework, we describe interacting domains of individual, social, and contextual influences on sleep health. To the extent that these determinants of sleep health are modifiable, sleep and public health researchers may benefit from taking a multilevel approach for addressing disparities in sleep health. For example, in addition to providing individual-level sleep behavioral recommendations, health promotion interventions need to occur at multiple contextual levels (e.g., family, schools, workplaces, media, and policy). Because sleep health, a key indicator of overall health, is unevenly distributed across the population, we consider improving sleep health a necessary step toward achieving health equity.
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Affiliation(s)
- Lauren Hale
- Program in Public Health; and Department of Family, Population, and Preventive Medicine; Renaissance School of Medicine, Stony Brook University, Stony Brook, New York 11794-8338, USA;
| | - Wendy Troxel
- Division of Behavior and Policy Sciences, RAND Corporation, Pittsburgh, Pennsylvania 15213, USA;
| | - Daniel J Buysse
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA;
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139
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Montagni I, Qchiqach S, Pereira E, Tully PJ, Tzourio C. Sex-specific associations between sleep and mental health in university students: a large cross-sectional study. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:278-285. [PMID: 30615574 DOI: 10.1080/07448481.2018.1546183] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 10/11/2018] [Accepted: 11/03/2018] [Indexed: 06/09/2023]
Abstract
Objective: To examine the associations between sleep problems and mental health dimensions in university students, and the effect of sex on these associations. Participants: Self-reported survey data from 3,483 students aged 18-30 years was drawn from a larger web-based study (i-Share) conducted in France in the years 2013-2017. Methods: We performed logistic regression analyses stratified by sex using insufficient sleep duration, poor sleep quality, difficulty initiating sleep and excessive daytime sleepiness, in relation with stress, self-esteem, depression and anxiety. Results: All sleep problems were strongly associated with all mental health dimensions, particularly anxiety, in female students. Sleep and mental health problems were also associated in male students, with the exception of low self-esteem, but odds ratios were lower than for female students. Conclusions: Present findings warrant attention to propose early interventions targeting sleep and mental health in the university setting taking sex into account.
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Affiliation(s)
- Ilaria Montagni
- Bordeaux Population Health Research Center, Team HEALTHY, UMR 1219, Univ. Bordeaux, Inserm, Bordeaux, France
| | - Sarah Qchiqach
- Bordeaux Population Health Research Center, Team HEALTHY, UMR 1219, Univ. Bordeaux, Inserm, Bordeaux, France
| | - Edwige Pereira
- Bordeaux Population Health Research Center, Team HEALTHY, UMR 1219, Univ. Bordeaux, Inserm, Bordeaux, France
| | - Phillip J Tully
- Centre for Men's Health, University of Adelaide, Adelaide, Australia
| | - Christophe Tzourio
- Bordeaux Population Health Research Center, Team HEALTHY, UMR 1219, Univ. Bordeaux, Inserm, Bordeaux, France
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Khan WAA, Conduit R, Kennedy GA, Jackson ML. The relationship between shift-work, sleep, and mental health among paramedics in Australia. Sleep Health 2020; 6:330-337. [PMID: 32223969 DOI: 10.1016/j.sleh.2019.12.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/13/2019] [Accepted: 12/01/2019] [Indexed: 10/24/2022]
Abstract
OBJECTIVES This study aimed to investigate the prevalence of sleep and mental health issues, the role of chronotype, and the relationship between these variables in Australian paramedics. DESIGN A cross-sectional study. SETTINGS Cross-sectional survey. MEASUREMENTS Paramedics were invited to complete an online survey to assess stress, posttraumatic stress disorder (PTSD), depression, anxiety, daytime sleepiness, insomnia, sleep quality, shift-work disorder, bruxism, obstructive sleep apnea, narcolepsy, chronotype, fatigue, and well-being. PARTICIPANTS A total of 136 paramedics responded to the survey (age, 39.1 ± 12.1 years; 45.8% men and 54.2% women; 85.4% rotating shift-workers, 7% rural shift-workers, and 7.6% fixed rosters). RESULTS Paramedics reported significantly higher levels of depression symptoms, anxiety symptoms, fatigue, PTSD symptoms, insomnia symptoms, narcolepsy, and significantly poorer sleep quality and general well-being than norms from the general population of Australia and Western countries (all p < .05). From regression analyses, insomnia explained the greatest amount of variance in depression and anxiety scores, followed by fatigue and PTSD (adjusted R-squared for depression and anxiety models = .58 and = .44, respectively, p < .001). The majority of participants were intermediate chronotype (57%), followed by morning (32%) and evening type (11%). Evening chronotypes showed significantly higher depression scores (p < .001), anxiety (p < .05), PTSD symptoms (p < .05), poorer sleep quality (p < .05), and general well-being (p < .001) compared with morning types. CONCLUSION Addressing sleep issues and matching chronotype to shift preference in paramedics may help to reduce depression, anxiety, and improve well-being.
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Affiliation(s)
- Wahaj Anwar A Khan
- Psychology Discipline, School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia; Occupational Health Department, Faculty of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Russell Conduit
- Psychology Discipline, School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia.
| | - Gerard A Kennedy
- Psychology Discipline, School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia
| | - Melinda L Jackson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia; Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
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Šmotek M, Fárková E, Manková D, Kopřivová J. Evening and night exposure to screens of media devices and its association with subjectively perceived sleep: Should "light hygiene" be given more attention? Sleep Health 2020; 6:498-505. [PMID: 32197951 DOI: 10.1016/j.sleh.2019.11.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 11/18/2019] [Accepted: 11/22/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The aim of the study was to examine subjective sleep quality in a population of healthy volunteers and its association with evening and night light exposure to screens of media devices. METHODS A total of 693 participants (mean age 31.2±11.4 years, 159 men, and 538 women) completed an online questionnaire battery consisting of several sleep-related questionnaires: PSQI, FSS, MCTQ, MEQ, and added questions assessing the timing and character the evening and night exposure to electronical devices (TV, PC, tablets, and phones), and the use of various filters blocking short-wavelength light. RESULTS Statistical analyses show that longer cumulative exposure to screen light in the evening was associated with greater sleep inertia in the morning (P = .019, η2=0.141) and longer sleep latency on workdays P = .038, η2=0.135). Furthermore, exposure to screen light 1.5 h before sleep or during night awakenings was also associated with a decreased chance to wake up before alarm clock (P = .003, d=0.30), larger social jet lag (P < .001, d=0.15), more daytime dysfunction (P < .001, d=0.40), decreased subjective sleep quality (P = .024, d=0.16), and more fatigue (P < .001, d=0.52). A statistical trend for an increase in duration of sleep on weekdays (P = .058, d=0.23) was also found in participants using blue-light filters in the evening hours. DISCUSSION Our results are in line with other studies that converge to show the negative association of evening and night exposure to short-wavelength light on subjective and objective sleep parameters. Results suggest that light hygiene in general population should be given more attention not only in the context of clinical sleep medicine but also in the realm of public health.
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Affiliation(s)
- Michal Šmotek
- National Institute of Mental Health, Klecany, Czech Republic; Third Faculty of Medicine, Charles University, Prague, Czech Republic.
| | - Eva Fárková
- National Institute of Mental Health, Klecany, Czech Republic; Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Denisa Manková
- National Institute of Mental Health, Klecany, Czech Republic
| | - Jana Kopřivová
- National Institute of Mental Health, Klecany, Czech Republic; Third Faculty of Medicine, Charles University, Prague, Czech Republic
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Ogeil RP, Witt K, Scott D, Smith K, Lubman DI. Self-reported sleep disturbance in ambulance attendances for suicidal ideation and attempted suicide between 2012 and 2017. J Affect Disord 2020; 265:364-371. [PMID: 32090761 DOI: 10.1016/j.jad.2019.11.158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 10/28/2019] [Accepted: 11/30/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND Sleep disturbances are among the top-ten warning signs for suicide, however there has been limited investigation of the relationship between these variables in acute presentations, particularly community settings. We examined ambulance attendances for suicide ideation and attempt to explore the role of sleep and co-morbid factors (mental health symptoms, attendance time, and alcohol and benzodiazepine use). METHODS Coded clinical records from Ambulance Victoria for the period 1 January 2012 to 30 June 2017 were analysed. RESULTS Paramedics attended 97,198 cases of suicidal ideation or suicide attempt during the study period. Just over half (56.4%) of these were for suicidal ideation, and 43.6% were for attempted suicide. Depression symptomology-related attendances were more common than those for anxiety and despite a lower proportion of both sleep and current anxiety-related symptoms, benzodiazepine use was significantly more common in attendances for suicide attempts (25.9%) than for ideation (2.2%). Co-morbid benzodiazepine use was associated with attempted suicide (OR: 10.37 (10.04-10.72), in a hierarchical regression model. LIMITATIONS Data represent self-report/paramedic observation only, and do include validated measures of sleep or drug use. Sleep disturbance is likely under recorded in ambulance attendances given the primary role of paramedics is to stabilise patients, and minimise risk of harm during transport. CONCLUSION This study reports internationally unique data, and provides the first examination of ambulance coded clinical records for suicide ideation and attempt. Sleep disturbances had a unique role in these attendances, over and above common co-occurring factors including drug use and mental health diagnoses.
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Affiliation(s)
- Rowan P Ogeil
- Eastern Health Clinical School, Monash University, Box Hill, VIC 3128, Australia; Turning Point, Eastern Health, 110 Church St., Richmond, VIC 3121, Australia; Monash Addiction Research Centre, Frankston, VIC 3199, Australia.
| | - Katrina Witt
- Eastern Health Clinical School, Monash University, Box Hill, VIC 3128, Australia; Turning Point, Eastern Health, 110 Church St., Richmond, VIC 3121, Australia; Monash Addiction Research Centre, Frankston, VIC 3199, Australia
| | - Deborah Scott
- Eastern Health Clinical School, Monash University, Box Hill, VIC 3128, Australia; Turning Point, Eastern Health, 110 Church St., Richmond, VIC 3121, Australia; Monash Addiction Research Centre, Frankston, VIC 3199, Australia
| | - Karen Smith
- Ambulance Victoria, Doncaster, VIC 3108, Australia; Department of Community Emergency Health and Paramedic Practice, Monash University, Frankston, VIC 3199, Australia; Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Dan I Lubman
- Eastern Health Clinical School, Monash University, Box Hill, VIC 3128, Australia; Turning Point, Eastern Health, 110 Church St., Richmond, VIC 3121, Australia; Monash Addiction Research Centre, Frankston, VIC 3199, Australia
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143
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Rao WW, Li W, Qi H, Hong L, Chen C, Li CY, Ng CH, Ungvari GS, Xiang YT. Sleep quality in medical students: a comprehensive meta-analysis of observational studies. Sleep Breath 2020; 24:1151-1165. [PMID: 32072469 DOI: 10.1007/s11325-020-02020-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/07/2020] [Accepted: 01/20/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Poor sleep quality is common in medical students and is associated with a number of negative health outcomes. However, the prevalence estimates of poor sleep quality in medical students vary widely across studies. We thus conducted a meta-analysis of the prevalence of poor sleep quality and its mediating factors in medical students. METHODS A systematic literature search of PubMed, EMBASE, Web of Science, PsycINFO, and Medline Complete was performed. The random-effects model was used to analyze the pooled prevalence of poor sleep quality and its 95% confidence intervals (CIs). RESULTS A total of 57 studies with 25,735 medical students were included. The pooled prevalence of poor sleep quality was 52.7% (95% CI: 45.3% to 60.1%) using the Pittsburgh Sleep Quality Index (PSQI). The pooled mean total PSQI score across 41 studies with available data was 6.1 (95% CI: 5.6 to 6.5). Subgroup analyses found that PSQI cutoff value and study region were associated with the prevalence of poor sleep quality (P = 0.0003 VS. P = 0.005). Across the continents, poor sleep quality was most common in Europe, followed by the Americas, Africa, Asia, and Oceania. Meta-regression analyses found that smaller sample size (slope = - 0.0001, P = 0.009) was significantly associated with higher prevalence of poor sleep quality. CONCLUSIONS Poor sleep quality is common among medical students, especially in Europe and the Americas continets. Due to the negative health outcomes, regular screening of poor sleep quality and effective interventions are needed for medical students.
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Affiliation(s)
- Wen-Wang Rao
- Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China
| | - Wen Li
- Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China
| | - Han Qi
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Liu Hong
- Department of Psychiatry, WuZhongpei Memorial Hospital, Shunde District of Foshan City, 528300, Guangdong, China.,Postgraduate Academy of Guangdong Medical University, Zhanjiang, 524000, China
| | - Chao Chen
- Department of Psychiatry, WuZhongpei Memorial Hospital, Shunde District of Foshan City, 528300, Guangdong, China
| | - Chun-Yang Li
- Department of Psychiatry, WuZhongpei Memorial Hospital, Shunde District of Foshan City, 528300, Guangdong, China
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Victoria, Australia
| | - Gabor S Ungvari
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia.,University of Notre Dame Australia, Fremantle, Australia
| | - Yu-Tao Xiang
- Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China.
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144
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Gonzalez A, Tyminski Q. Sleep deprivation in an American homeless population. Sleep Health 2020; 6:489-494. [PMID: 32061552 DOI: 10.1016/j.sleh.2020.01.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/26/2019] [Accepted: 01/02/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND The Centers for Disease Control and Prevention recently labeled sleep deprivation an epidemic in America with 35% of Americans reporting less than the recommended 7-9 hours of sleep each night. A recent study in France found that people experiencing homelessness sleep less and experience increased daytime fatigue as compared with the general population. Sleep intervention and research are rarely the focus for this population resulting in insufficient literature and knowledge to date on sleep health in people experiencing homelessness. OBJECTIVES The objective of this study was to determine quality, quantity, supports, and barriers to sleep within a homeless population. DESIGN A mixed-methods survey was conducted to obtain data on sleep in the homeless population. PARTICIPANTS 32 English-speaking adults experiencing homelessness were recruited from a local homeless organization. MEASURES A web-based survey and two self-report standardized assessments were administered. Standardized assessments included Patient-Reported Outcomes Measurement Information System (PROMIS) Short Form v1.0-Fatigue 13a and the PROMIS Short Form v1.0-Sleep Disturbance 8b. RESULTS Seventy-five percent of participants report getting less than the 7-9 recommended hours of sleep per night. Participants scored almost one standard deviation above the mean on both PROMIS measures demonstrating greater fatigue and sleep disturbance as compared with the general population. Four themes were identified via qualitative analysis: lack of environmental control, emotion and thought, substance use as a sleep aid, and sleep is important for health and daily function. CONCLUSIONS Results indicate a need for sleep hygiene intervention within the homeless population. Sleep deprivation is a barrier to the population's ability to obtaining housing.
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Affiliation(s)
- Ariana Gonzalez
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO.
| | - Quinn Tyminski
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO
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145
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Sleep symptoms and long-term outcome in adolescents with major depressive disorder: a naturalistic follow-up study. Eur Child Adolesc Psychiatry 2020; 29:595-603. [PMID: 31696307 PMCID: PMC7250797 DOI: 10.1007/s00787-019-01436-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 10/31/2019] [Indexed: 12/22/2022]
Abstract
Sleep abnormalities in major depressive disorder (MDD) have been suggested to represent a vulnerability trait, which might predispose the individual to long-term psychiatric morbidity. In this study, we sought to assess whether the presence of sleep symptoms among adolescents with MDD is associated with poorer long-term outcome in young adulthood during naturalistic follow-up. Adolescent outpatients diagnosed with MDD (n = 166; age 13-19 years, 17.5% boys) were followed up during 8 years in naturalistic settings. N = 112 adolescents (16.1% boys) completed the 8-year assessment. Sleep symptoms and psychosocial functioning were assessed with structured clinical interviews, and depressive and anxiety symptoms with questionnaires. The severity of sleep symptoms at baseline was not associated with worse outcome at 8 years in terms of any of the outcome measures tested. In particular, the presence of a disturbed sleep-wake rhythm at baseline was associated with a more favourable outcome at 8 years: less depression and anxiety symptoms and higher level of psychosocial functioning. The presence of sleep symptoms in young adulthood was associated with the presence of current depression and anxiety symptoms and poorer psychosocial functioning. The presence of sleep symptoms at follow-up seems to be state-dependent: they are observed in conjunction with other psychiatric symptoms. Contrary to our hypothesis, our results suggest that sleep complaints among adolescents with MDD do not lead to poorer long-term clinical outcome in young adulthood. The link between sleep-wake rhythm disturbance and better long-term outcome needs to be confirmed and examined in detail in further studies, but here we speculate about possible explanations.
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146
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Yirmiya ET, Mekori-Domachevsky E, Weinberger R, Taler M, Carmel M, Gothelf D. Exploring the potential association among sleep disturbances, cognitive impairments, and immune activation in 22q11.2 deletion syndrome. Am J Med Genet A 2019; 182:461-468. [PMID: 31837200 DOI: 10.1002/ajmg.a.61424] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 09/29/2019] [Accepted: 11/07/2019] [Indexed: 11/11/2022]
Abstract
22q11.2 deletion syndrome (22q11.DS) is a neurogenetic disorder caused by a microdeletion in chromosome 22. Its phenotype includes high rates of psychiatric disorders, immune system abnormalities, and cognitive impairments. We assessed the quality of sleep in 22q11.2DS and its potential link to inflammatory markers and cognitive deficits. Thirty-three 22q11.2DS individuals and 24 healthy controls were studied. Sleep parameters were assessed by the Pittsburgh sleep quality index (PSQI) questionnaire and correlated with serum cytokine levels and cognitive functioning, measured using the Penn computerized neurocognitive battery (CNB). The 22q11.2DS individuals had significantly worse sleep quality scores than the controls, unrelated to the psychiatric or physical comorbidities common to 22q11.2DS. Interleukin 6 levels were correlated with the overall score of the PSQI questionnaire for nonpsychotic 22q11.2DS participants only. Several domains of the CNB were associated with poorer sleep quality, suggesting that cognitive impairments in 22q11.2DS may be at least partially explained by poor sleep quality. Our findings confirm sleep impairments in individuals with 22q11.2DS, which might negatively affect their cognitive functioning, and corroborate a potential role of immunological pathways in the 22q11.2DS neuro-phenotype.
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Affiliation(s)
- Erez T Yirmiya
- George S. Wise Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel.,The Behavioral Neurogenetics Center, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel
| | - Ehud Mekori-Domachevsky
- The Behavioral Neurogenetics Center, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronnie Weinberger
- The Behavioral Neurogenetics Center, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Taler
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.,Biological Psychiatry Laboratory, Felsenstein Medical Research Center, Petah Tikva, Israel
| | - Miri Carmel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Biological Psychiatry Laboratory, Felsenstein Medical Research Center, Petah Tikva, Israel
| | - Doron Gothelf
- The Behavioral Neurogenetics Center, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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147
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Jawinski P, Kirsten H, Sander C, Spada J, Ulke C, Huang J, Burkhardt R, Scholz M, Hensch T, Hegerl U. Human brain arousal in the resting state: a genome-wide association study. Mol Psychiatry 2019; 24:1599-1609. [PMID: 29703947 DOI: 10.1038/s41380-018-0052-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 01/22/2018] [Accepted: 02/19/2018] [Indexed: 12/20/2022]
Abstract
Arousal affects cognition, emotion, and behavior and has been implicated in the etiology of psychiatric disorders. Although environmental conditions substantially contribute to the level of arousal, stable interindividual characteristics are well-established and a genetic basis has been suggested. Here we investigated the molecular genetics of brain arousal in the resting state by conducting a genome-wide association study (GWAS). We selected N = 1877 participants from the population-based LIFE-Adult cohort. Participants underwent a 20-min eyes-closed resting state EEG, which was analyzed using the computerized VIGALL 2.1 (Vigilance Algorithm Leipzig). At the SNP-level, GWAS analyses revealed no genome-wide significant locus (p < 5E-8), although seven loci were suggestive (p < 1E-6). The strongest hit was an expression quantitative trait locus (eQTL) of TMEM159 (lead-SNP: rs79472635, p = 5.49E-8). Importantly, at the gene-level, GWAS analyses revealed significant evidence for TMEM159 (p = 0.013, Bonferroni-corrected). By mapping our SNPs to the GWAS results from the Psychiatric Genomics Consortium, we found that all corresponding markers of TMEM159 showed nominally significant associations with Major Depressive Disorder (MDD; 0.006 ≤ p ≤ 0.011). More specifically, variants associated with high arousal levels have previously been linked to an increased risk for MDD. In line with this, the MetaXcan database suggests increased expression levels of TMEM159 in MDD, as well as Autism Spectrum Disorder, and Alzheimer's Disease. Furthermore, our pathway analyses provided evidence for a role of sodium/calcium exchangers in resting state arousal. In conclusion, the present GWAS identifies TMEM159 as a novel candidate gene which may modulate the risk for psychiatric disorders through arousal mechanisms. Our results also encourage the elaboration of the previously reported interrelations between ion-channel modulators, sleep-wake behavior, and psychiatric disorders.
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Affiliation(s)
- Philippe Jawinski
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany. .,Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany. .,Depression Research Centre, German Depression Foundation, Leipzig, Germany.
| | - Holger Kirsten
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany.,Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany
| | - Christian Sander
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany.,Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Janek Spada
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Christine Ulke
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Jue Huang
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany
| | - Ralph Burkhardt
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany
| | - Markus Scholz
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Tilman Hensch
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany
| | - Ulrich Hegerl
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany.,Depression Research Centre, German Depression Foundation, Leipzig, Germany
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148
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Cao B, Park C, Rosenblat JD, Chen Y, Iacobucci M, Subramaniapillai M, Mansur RB, Zuckerman H, Lee Y, McIntyre RS. Changes in sleep predict changes in depressive symptoms in depressed subjects receiving vortioxetine: An open-label clinical trial. J Psychopharmacol 2019; 33:1388-1394. [PMID: 31530216 DOI: 10.1177/0269881119874485] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Sleep disturbances are frequently reported in patients with major depressive disorder. We aimed to investigate the effects of vortioxetine on sleep quality and association between changes in sleep and treatment response. METHODS This study is a post-hoc analysis of a clinical trial that sought to evaluate the sensitivity to cognitive change of THINC-integrated tool in patients with major depressive disorder. In total, 92 patients (aged 18 to 65) meeting Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria for moderate or severe major depressive disorder and 54 healthy controls were included. All patients received open-label vortioxetine (10-20 mg/day, flexibly dosed) for 8 weeks. Herein, the primary outcomes of interest were changes in sleep, as measured by the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Insomnia Severity Index, between weeks 0, 2, and 8. The association between changes in sleep and depressive symptom severity was secondarily assessed. RESULTS We observed that sleep, as indicated by scores of Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Insomnia Severity Index, was significantly poorer in patients with major depressive disorder compared to healthy controls at weeks 0, 2, and 8 (p < 0.05). Among patients with major depressive disorder, we observed significant improvements on the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Insomnia Severity Index between weeks 0 and 8 (p < 0.05). We observed a significant association between improvements on the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Insomnia Severity Index and improvement of depressive symptoms. CONCLUSION Improvement of depressive symptoms in major depressive disorder patients treated with vortioxetine was associated with significant improvements in sleep. Furthermore, improvements in sleep were predictive of antidepressant response and were linearly correlated with improvement in overall depressive symptom severity.
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Affiliation(s)
- Bing Cao
- School of Psychology and Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China.,Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Caroline Park
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Joshua D Rosenblat
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Yan Chen
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Michelle Iacobucci
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Mehala Subramaniapillai
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Hannah Zuckerman
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.,Brain and Cognition Discovery Foundation, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Pharmacology, University of Toronto, Toronto, ON, Canada
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149
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Lauriola M, Carleton RN, Tempesta D, Calanna P, Socci V, Mosca O, Salfi F, De Gennaro L, Ferrara M. A Correlational Analysis of the Relationships among Intolerance of Uncertainty, Anxiety Sensitivity, Subjective Sleep Quality, and Insomnia Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3253. [PMID: 31491841 PMCID: PMC6765836 DOI: 10.3390/ijerph16183253] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 08/29/2019] [Accepted: 08/31/2019] [Indexed: 02/05/2023]
Abstract
In this study, we used structural equation modeling to investigate the interplay among Intolerance of Uncertainty (IU), Anxiety Sensitivity (AS), and sleep problems. Three hundred undergraduate students completed the Intolerance of Uncertainty Scale, the Intolerance of Uncertainty Inventory, the Anxiety Sensitivity Index, the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Pittsburgh Sleep Quality Index and the Insomnia Severity Index. 68% and 40% of the students reported poor sleep quality or sub-threshold insomnia problems, respectively. Depression and anxiety levels were above the cut-off for about one-fourth of the participants. Structural equation modeling revealed that IU was strongly associated with AS, in turn influencing both insomnia severity and sleep quality via depression and anxiety. Significant indirect effects revealed that an anxious pathway was more strongly associated with insomnia severity, while a depression pathway was more relevant for worsening the quality of sleep. We discussed the results in the frameworks of cognitive models of insomnia. Viewing AS and IU as antecedents of sleep problems and assigning to AS a pivotal role, our study suggested indications for clinical interventions on a population at risk for sleep disorders.
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Affiliation(s)
- Marco Lauriola
- Department of Social and Developmental Psychology, Sapienza, University of Rome, 00185 Rome, Italy.
| | | | - Daniela Tempesta
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
| | - Pierpaolo Calanna
- Department of Dynamic and Clinical Psychology, Sapienza, University of Rome, 00185 Rome, Italy.
| | - Valentina Socci
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
| | - Oriana Mosca
- Department of Social and Developmental Psychology, Sapienza, University of Rome, 00185 Rome, Italy.
| | - Federico Salfi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
| | - Luigi De Gennaro
- Department of Psychology, Sapienza, University of Rome, 00185 Rome, Italy.
| | - Michele Ferrara
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
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150
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Goldstein TR, Franzen PL. Sleep difficulties and suicidality in youth: current research and future directions. Curr Opin Psychol 2019; 34:27-31. [PMID: 31539832 DOI: 10.1016/j.copsyc.2019.08.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 08/12/2019] [Accepted: 08/16/2019] [Indexed: 01/05/2023]
Abstract
Studies have established a clear relationship between subjective sleep problems and the continuum of suicidality in adolescents. These studies are primarily cross-sectional in nature and conducted with epidemiological and depressed clinical samples. More recent studies focus on prospective data. Herein, we provide an update on current studies on the sleep-suicide association among youth. To further the critical mission of youth suicide prevention, future directions include more nuanced study of sleep employing a sleep health framework, longitudinal studies employing both objective and subjective sleep measures, fine-grained temporal associations between these constructs and their fluctuations over time, as well as enhanced understanding of the mechanisms underlying these associations.
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Affiliation(s)
- Tina R Goldstein
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, United States.
| | - Peter L Franzen
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, United States.
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