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Effect of chronic non-communicable diseases (CNCDs) on the sleep of Brazilians during the COVID-19 pandemic. Sleep Med 2021; 91:205-210. [PMID: 33736945 PMCID: PMC9017860 DOI: 10.1016/j.sleep.2021.02.052] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/18/2021] [Accepted: 02/22/2021] [Indexed: 11/23/2022]
Abstract
This study aimed to investigate the effect of Chronic Noncommunicable Diseases (CNCDs) on the onset or increase in sleep problems during the COVID-19 pandemic period. The role of the report of sadness or nervousness during the pandemic was also evaluated as a mediator of this association. Data from a behavior survey during COVID-19, conducted in Brazil with 45,161 people (18 years old or older), from April 24 to May 24, 2020, were used. The outcome variable was the onset or increase in sleep problems, and the exposure variable was the presence of CNCDs. The adjusted Odds Ratio of the association between CNCDs and sleep was estimated, and a mediation analysis was performed to test the effect of the report of sadness or nervousness on this association, using the Karlson Holm Breen method. The increase in sleep problems was reported by 44.9% of the population, and 33.9% reported at least one CNCD. The chance of sleep problems was higher among people with diabetes (1.34; 1.05–1.71), hypertension (1.26; 1.06–1.50), and with coronary heart diseases (1.36; 1.13–1.65) or respiratory diseases (1.42; 1.04–1.93). Compared to people without CNCDs, individuals with at least one CNCD had a 36% greater chance of impaired sleep (1.36; 1.19–1.55). The report of sadness or nervousness explained 45.1% of the association between CNCD and sleep. Our findings alert us to care for the emotional state and sleep of chronic patients during the waves of the COVID-19 pandemic, and indicate the need for sleep monitoring in this population.
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Huang WC, Lin CY, Togo F, Lai TF, Liao Y, Park JH, Hsueh MC, Park H. Association between objectively measured sleep duration and physical function in community-dwelling older adults. J Clin Sleep Med 2021; 17:515-520. [PMID: 33135630 PMCID: PMC7927321 DOI: 10.5664/jcsm.8964] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 10/22/2020] [Accepted: 10/22/2020] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The aim of this research was to investigate the relationships between objectively measured sleep duration and physical function in older adults. METHODS We recruited community-dwelling older adults aged ≥ 60 years old in Taipei City, Taiwan. Sleep duration was measured with accelerometers and recorded as the total hours of sleep per night for each participant. The following physical functions were assessed: 1) grip strength (measured by handgrip dynamometer), 2) balance (1-leg standing test), 3) lower body strength (5-timed chair stand), 4) basic mobility (timed up and go test), 5) gait speed (5-m walk test). The relationships between sleep duration and physical function outcomes were analyzed using generalized additive models, controlling for objectively measured sedentary behavior and moderate-to-vigorous physical activity, and other sociodemographic variables. RESULTS A total of 121 older adults (men = 28.9%; mean age = 70.0 ± 5.0 years) was included in this study. A positive association of sleep duration with grip strength was found after adjusting for covariates (P = .005). No significant associations were observed between sleep duration and the other physical function outcomes. CONCLUSIONS For older adults, lengthening their sleep duration may be helpful to enhance the grip strength. This result has implications for improving their health by targeting better performance in specific physical functions. Further studies of sleep duration and physical function among older adults should investigate the underlying mechanisms.
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Affiliation(s)
- Wan-Chi Huang
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Chien-Yu Lin
- Graduate School of Sport Sciences, Waseda University, Tokorozawa City, Japan
| | - Fumiharu Togo
- Educational Physiology Laboratory, Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Ting-Fu Lai
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Yung Liao
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Jong-Hwan Park
- Health Convergence Medicine Laboratory, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Ming-Chun Hsueh
- Graduate Institute of Sport Pedagogy, University of Taipei, Taipei, Taiwan
| | - Hyuntae Park
- Department of Health Sciences, Graduate School of Dong-A University, Busan, Korea
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Sleep, Prospective Memory, and Immune Status among People Living with HIV. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020438. [PMID: 33429860 PMCID: PMC7826879 DOI: 10.3390/ijerph18020438] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/22/2020] [Accepted: 12/25/2020] [Indexed: 11/17/2022]
Abstract
Background: Persons living with HIV (PLWH) frequently report sleep complaints, but objective measurements are still lacking regarding sleep continuity, total sleep time per 24 h, and the links with both prospective memory performance and HIV infection parameters. Methods: PLWH (n = 96) and control (n = 96) groups (balanced for gender and age) were monitored by 24h-actigraphy for at least seven consecutive days. The prospective memory performance was assessed through a naturalistic, activity-based task performed twice a day on the actigraph. Results: PLWH had greater sleep latency and worse sleep continuity (higher fragmentation index) for night-time sleep and longest daytime nap (mean duration of the longest nap). Comparable results were reported for the prospective memory task; better performance scores were associated with several sleep parameters in controls but not in PLWH. Finally, within the PLWH group, being a long sleeper per 24 h (total sleep time > 8 h including more and long daytime naps) was associated with a greater severity of the disease (lower CD4 nadir and more frequent history of AIDS-defining events). Conclusions: These findings indicate that PLWH have more fragmented sleep and that the severity of HIV infection is associated with increased sleep duration.
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Romdhani M, Hammouda O, Smari K, Chaabouni Y, Mahdouani K, Driss T, Souissi N. Total Sleep Deprivation and Recovery Sleep Affect the Diurnal Variation of Agility Performance: The Gender Differences. J Strength Cond Res 2021; 35:132-140. [PMID: 29864109 DOI: 10.1519/jsc.0000000000002614] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
ABSTRACT Romdhani, M, Hammouda, O, Smari, K, Chaabouni, Y, Mahdouani, K, Driss, T, and Souissi, N. Total sleep deprivation and recovery sleep affect the diurnal variation of agility performance: The gender differences. J Strength Cond Res 35(1): 132-140, 2021-This study aimed to investigate the effects of time-of-day, 24 and 36 hours of total sleep deprivation (TSD), and recovery sleep (RS) on repeated-agility performances. Twenty-two physical education students (11 male and 11 female students) completed 5 repeated modified agility T-test (RMAT) sessions (i.e., 2 after normal sleep night [NSN] [at 07:00 and 17:00 hours], 2 after TSD [at 07:00 hours, i.e., 24-hour TSD and at 17:00 hours, i.e., 36-hour TSD], and 1 after RS at 17:00 hours). The RMAT index decreased from the morning to the afternoon after NSN (p < 0.05, d = 1.05; p < 0.01, d = 0.73) and after TSD (p < 0.001, d = 0.92; d = 1.08), respectively, for total time (TT) and peak time (PT). This finding indicates a diurnal variation in repeated agility, which persisted after TSD. However, the diurnal increase in PT was less marked in the female group after NSN (2.98 vs. 6.24%). Moreover, TT and PT increased, respectively, after 24-hour TSD (p < 0.001; d = 0.84, d = 0.87) and 36-hour TSD (p < 0.001, d = 1.12; p < 0.01, d = 0.65). Female subjects' PT was less affected by 24-hour TSD (1.76 vs. 6.81%) compared with male subjects' PT. After 36-hour TSD, the amount of decrease was not different between groups, which increased the diurnal amplitude of PT only for male subjects. Total sleep deprivation suppressed the diurnal increase of PT and increased the diurnal amplitude of oral temperature only in women. Nevertheless, RS normalized the sleep-loss-induced performance disruption. Conclusively, sleep loss and RS differently affect repeated-agility performance of men and women during the day. Sleep extension postdeprivation could have potent restorative effect on repeated-agility performances, and female subjects could extract greater benefits.
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Affiliation(s)
- Mohamed Romdhani
- National Observatory of Sports, Exercise Physiology Departement, Tunis, Tunisia
- High Institute of Sport and Physical Education Ksar-Said, Departement of Biology, Manouba University, Manouba, Tunisia
| | - Omar Hammouda
- Research Center on Sport and Movement (CeRSM), UFP STAPS, University of Paris Nanterre, France
- Research Unit, Molecular Bases of Human Pathology, UR12ES17, Faculty of Medicine of Sfax, Sfax University, Sfax, Tunisia
| | - Khawla Smari
- High Institute of Sport and Physical Education Ksar-Said, Departement of Biology, Manouba University, Manouba, Tunisia
- Research Unit, Molecular Bases of Human Pathology, UR12ES17, Faculty of Medicine of Sfax, Sfax University, Sfax, Tunisia
| | - Yassine Chaabouni
- Department of Biochemistry, CHU Ibn Jazzar, Kairouan, Tunisia ; and
- Laboratory of Analysis, Treatment and Valorization of Pollutants of the Environment and Products (LATVEP), Faculty of Pharmacy, University of Monastir, Monastir, Tunisia
| | - Kacem Mahdouani
- Department of Biochemistry, CHU Ibn Jazzar, Kairouan, Tunisia ; and
- Laboratory of Analysis, Treatment and Valorization of Pollutants of the Environment and Products (LATVEP), Faculty of Pharmacy, University of Monastir, Monastir, Tunisia
| | - Tarak Driss
- Research Center on Sport and Movement (CeRSM), UFP STAPS, University of Paris Nanterre, France
| | - Nizar Souissi
- National Observatory of Sports, Exercise Physiology Departement, Tunis, Tunisia
- High Institute of Sport and Physical Education Ksar-Said, Departement of Biology, Manouba University, Manouba, Tunisia
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Krivanek TJ, Gale SA, McFeeley BM, Nicastri CM, Daffner KR. Promoting Successful Cognitive Aging: A Ten-Year Update. J Alzheimers Dis 2021; 81:871-920. [PMID: 33935078 PMCID: PMC8293659 DOI: 10.3233/jad-201462] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2021] [Indexed: 02/07/2023]
Abstract
A decade has passed since we published a comprehensive review in this journal addressing the topic of promoting successful cognitive aging, making this a good time to take stock of the field. Because there have been limited large-scale, randomized controlled trials, especially following individuals from middle age to late life, some experts have questioned whether recommendations can be legitimately offered about reducing the risk of cognitive decline and dementia. Despite uncertainties, clinicians often need to at least make provisional recommendations to patients based on the highest quality data available. Converging lines of evidence from epidemiological/cohort studies, animal/basic science studies, human proof-of-concept studies, and human intervention studies can provide guidance, highlighting strategies for enhancing cognitive reserve and preventing loss of cognitive capacity. Many of the suggestions made in 2010 have been supported by additional research. Importantly, there is a growing consensus among major health organizations about recommendations to mitigate cognitive decline and promote healthy cognitive aging. Regular physical activity and treatment of cardiovascular risk factors have been supported by all of these organizations. Most organizations have also embraced cognitively stimulating activities, a heart-healthy diet, smoking cessation, and countering metabolic syndrome. Other behaviors like regular social engagement, limiting alcohol use, stress management, getting adequate sleep, avoiding anticholinergic medications, addressing sensory deficits, and protecting the brain against physical and toxic damage also have been endorsed, although less consistently. In this update, we review the evidence for each of these recommendations and offer practical advice about behavior-change techniques to help patients adopt brain-healthy behaviors.
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Affiliation(s)
- Taylor J. Krivanek
- Center for Brain/Mind Medicine, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Hale Building for Transformative Medicine, Boston, MA, USA
| | - Seth A. Gale
- Center for Brain/Mind Medicine, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Hale Building for Transformative Medicine, Boston, MA, USA
| | - Brittany M. McFeeley
- Center for Brain/Mind Medicine, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Hale Building for Transformative Medicine, Boston, MA, USA
| | - Casey M. Nicastri
- Center for Brain/Mind Medicine, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Hale Building for Transformative Medicine, Boston, MA, USA
| | - Kirk R. Daffner
- Center for Brain/Mind Medicine, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Hale Building for Transformative Medicine, Boston, MA, USA
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106
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Lin J, Jiang Y, Wang G, Meng M, Zhu Q, Mei H, Liu S, Jiang F. Associations of short sleep duration with appetite-regulating hormones and adipokines: A systematic review and meta-analysis. Obes Rev 2020; 21:e13051. [PMID: 32537891 DOI: 10.1111/obr.13051] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/07/2020] [Accepted: 05/07/2020] [Indexed: 12/12/2022]
Abstract
In the current study, a systematic review and meta-analysis were conducted to summarize and assess whether short sleep duration is associated with appetite-regulating hormones and adipokine levels. Reference databases were searched for studies related to sleep and appetite-regulating hormones and adipokines. Qualitative and quantitative syntheses were conducted to evaluate the relationship between sleep duration and the level of appetite-regulating hormones and adipokines, including leptin, ghrelin, adiponectin, resistin, and orexin. Twenty-one of 3536 studies, covering a total of 2250 participants, met the inclusion criteria. Leptin, ghrelin, and adiponectin were included in the meta-analysis. Ghrelin levels were higher in the short sleep group (standard mean difference [SMD] = 0.14, 95% CI [0.03, 0.25], p = 0.01). Significant differences between the short sleep group and recommended sleep group were also noted in leptin level experimental subgroup studies (SMD = 0.19, 95% CI [0.03, 0.35], p = 0.02) and ghrelin level cross-sectional subgroup studies (SMD = 0.14, 95% CI [0.02, 0.27], p = 0.03). A rise in leptin and ghrelin levels were also observed in sleep deprivation groups (SMD = 0.24, 95% CI [0.10, 0.39], p = 0.001 and SMD = 0.18, 95% CI [0.04, 0.33], p = 0.01, respectively). In conclusion, short sleep duration is associated with an increased ghrelin level, while sleep deprivation had a significant effect on the levels of both leptin and ghrelin.
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Affiliation(s)
- Jianfei Lin
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Children Health Advocacy Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanrui Jiang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Children Health Advocacy Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,MOE and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guanghai Wang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Children Health Advocacy Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,MOE and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Meng
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Children Health Advocacy Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,MOE and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qi Zhu
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Children Health Advocacy Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,MOE and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hao Mei
- Children Health Advocacy Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Data Science, School of Population Health, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Shijian Liu
- Children Health Advocacy Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,MOE and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Children Health Advocacy Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,MOE and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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107
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Kim DJ, Mun SJ, Choi JS, Kim J, Lee GH, Kim HW, Park MG, Cho JW. Beneficial effects of weekend catch-up sleep on metabolic syndrome in chronic short sleepers. Sleep Med 2020; 76:26-32. [PMID: 33069999 DOI: 10.1016/j.sleep.2020.09.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 09/20/2020] [Accepted: 09/22/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Short sleep duration has been known to be related to metabolic syndrome (MetS) . The aim of this study was to investigate the beneficial effects of weekend catch-up sleep (WCUS) on MetS in the Korean middle-aged population. METHODS For this cross-sectional study, 1,812 participants aged 35-60 years were selected from the 2016-2018 Korean National Health and Nutrition Examination Survey (mean age 46.94 years, 49% male). Short sleep duration was defined as <6hrs on weekdays, and participants were divided into two groups: WCUS group and no weekend catch-up sleep group. Multiple logistic regression was performed to determine the association between WCUS and MetS prevalence. The covariates included age, sex, education, income, occupation, smoking, alcohol consumption, and physical activity. RESULTS WCUS was significantly associated with lower MetS prevalence in the unadjusted model and in the model adjusted for socioeconomic and health behavior factors. CONCLUSION These results support the beneficial effects of WCUS on lowering the risk of MetS among middle-aged chronic short sleepers.
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Affiliation(s)
- Dae Jin Kim
- Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Sue Jean Mun
- Department of Otorhinolaryngology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Jeong Su Choi
- Department of Health and Safety Convergence Science, Graduate School, Korea University, Seoul, South Korea
| | - Jiyoung Kim
- Department of Neurology, Pusan National University Hospital, Busan, South Korea
| | - Gha-Hyun Lee
- Department of Neurology, Pusan National University Hospital, Busan, South Korea
| | - Hyun-Woo Kim
- Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Min-Gyu Park
- Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Jae Wook Cho
- Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, South Korea.
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108
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Ruiz FS, Rosa DS, Zimberg IZ, Dos Santos Quaresma MV, Nunes JO, Apostolico JS, Weckx LY, Souza AR, Narciso FV, Fernandes-Junior SA, Gonçalves B, Folkard S, Bittencourt L, Tufik S, Tulio de Mello M. Night shift work and immune response to the meningococcal conjugate vaccine in healthy workers: a proof of concept study. Sleep Med 2020; 75:263-275. [PMID: 32866895 DOI: 10.1016/j.sleep.2020.05.032] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 05/21/2020] [Accepted: 05/22/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND It is well-established that sleep regulates immune functions. Immunological functions are dependent on circadian rhythms and regular sleep as both have an impact on the magnitude of immune responses following antigenic challenge (eg, in vaccination). Here we investigated whether nocturnal shift work can influence post-vaccination response. METHODS Thirty-four healthy workers (23 females) working either nocturnal or diurnal shifts (17 in each group) received the meningococcal C meningitis vaccine. Sleep was recorded polysomnographically (PSG) and with actigraphy. Humoral and cellular responses were assessed after vaccination. RESULTS Night workers showed decreased N3 stage and REM sleep duration, increased inflammatory mediators (TNF-α and IL-6 levels), and a weak specific humoral response to vaccination associated with reduced CD4 T lymphocytes, reduced plasmacytoid dendritic cells, reduced prolactin levels, increased TReg and increased IL-10 levels. In addition, the decrease in total sleep time and circadian rhythm alterations were associated with a reduced humoral response post-vaccination. CONCLUSIONS Our findings provide novel evidence concerning immune alterations of shift work on workers' health based on real-life circumstances. In association with circadian components, sufficient sleep time and rhythm synchronization were important for the development of the Ag-specific immune response, suggesting that the humoral response to vaccination may be impaired in individuals with chronic sleep restriction and circadian misalignment.
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Affiliation(s)
- Francieli S Ruiz
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil; Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK.
| | - Daniela S Rosa
- Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Ioná Z Zimberg
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | | | - Jethe Of Nunes
- Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Juliana S Apostolico
- Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Lily Y Weckx
- Departamento de Pediatria, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Alessandra R Souza
- Departamento de Pediatria, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Fernanda V Narciso
- Escola de Educação Física, Fisioterapia e Terapia Ocupacional (EEFFTO), Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Bruno Gonçalves
- Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, Brazil
| | | | - Lia Bittencourt
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Marco Tulio de Mello
- Escola de Educação Física, Fisioterapia e Terapia Ocupacional (EEFFTO), Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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109
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Lee HW, Yoon HS, Yang JJ, Song M, Lee JK, Lee SA, Choi JY, Kang D. Association of sleep duration and quality with elevated hs-CRP among healthy Korean adults. PLoS One 2020; 15:e0238053. [PMID: 32841297 PMCID: PMC7446961 DOI: 10.1371/journal.pone.0238053] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 08/08/2020] [Indexed: 01/21/2023] Open
Abstract
This study aimed to investigate the association of sleep duration and quality with high-sensitivity C-reactive protein (hs-CRP) among middle-aged and elderly Koreans. Among a total of 74,867 participants (25,069 men and 49,798 women) recruited for the Health Examinees (HEXA) study, adjusted geometric means of hs-CRP level were compared across categories of sleep duration (<6, 6–7, 8–9, and ≥10 hours) and sleep quality (difficulty in initiating sleep and maintaining sleep) using ANCOVA models. Odds ratios (ORs) and 95% confidence intervals (CIs) for elevated hs-CRP (>3 mg/L) associated with sleep characteristics were estimated using multivariable-adjusted logistic regression models. Men who slept ≥10 hours per day were significantly associated with elevated hs-CRP (OR = 1.47, 95% CI 1.11–1.95). Whereas in women, difficulty in initiating sleep (OR = 1.28, 95% CI 1.04–1.57 for “Always”), and maintaining sleep was significantly associated with elevated hs-CRP levels (OR = 1.13, 95% CI 1.02–1.26 for “Often”; OR = 1.11, 95% CI 0.97–1.28 for “Always”). Additionally, women who experienced poor sleep quality presented an elevated level of hs-CRP (OR = 1.13, 95% CI 1.03–1.23). Our findings suggest that excessive sleep duration and poor sleep quality are significantly associated with the elevated inflammatory marker, specifically hs-CRP. Further research is needed to examine the effect of sleep interventions focused on these factors.
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Affiliation(s)
- Hwi-Won Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - Hyung-Suk Yoon
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Jeong Yang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Minkyo Song
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jong-koo Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sang-Ah Lee
- Department of Preventive Medicine, Kangwon National University School of Medicine, Gangwon, Korea
| | - Ji-Yeob Choi
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - Daehee Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
- * E-mail:
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110
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Knauert MP, Murphy TE, Doyle MM, Pisani MA, Redeker NS, Yaggi HK. Pilot Observational Study to Detect Diurnal Variation and Misalignment in Heart Rate Among Critically Ill Patients. Front Neurol 2020; 11:637. [PMID: 32760341 PMCID: PMC7373742 DOI: 10.3389/fneur.2020.00637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 05/28/2020] [Indexed: 11/21/2022] Open
Abstract
Circadian disruption is common in critically ill patients admitted to the intensive care unit (ICU). Understanding and treating circadian disruption in critical illness has significant potential to improve critical illness outcomes through improved cognitive, immune, cardiovascular, and metabolic function. Measurement of circadian alignment (i.e., circadian phase) can be resource-intensive as it requires frequent blood or urine sampling over 24 or more hours. Less cumbersome methods of assessing circadian alignment would advance investigations in this field. Thus, the objective of this study is to examine the feasibility of using continuous telemetry to assess diurnal variation in heart rate (HR) among medical ICU patients as a proxy for circadian alignment. In exploratory analyses, we tested for associations between misalignment of diurnal variation in HR and death during hospital admission. This was a prospective observational cohort study embedded within a prospective medical ICU biorepository. HR data were continuously collected (every 5 s) via telemetry systems for the duration of the medical ICU admission; the first 24 h of this data was analyzed. Patients were extensively characterized via medical record chart abstraction and patient interviews. Of the 56 patients with complete HR data, 48 (86%) had a detectable diurnal variation. Of these patients with diurnal variation, 39 (81%) were characterized as having the nadir of their HR outside of the normal range of 02:00–06:00 (“misalignment”). Interestingly, no deaths occurred in the patients with normally aligned diurnal variation; in contrast, there were seven deaths (out of 39 patients) in patients who had misaligned diurnal variation in HR. In an exploratory analysis, we found that the odds ratio of death for misaligned vs. aligned patients was increased at 4.38; however, this difference was not statistically significant (95% confidence interval 0.20–97.63). We conclude that diurnal variation in HR can be detected via continuous telemetric monitoring of critically ill patients. A majority of these patients with diurnal variation exhibited misalignment in their first 24 h of medical ICU admission. Exploratory analyses suggest possible associations between misalignment and death.
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Affiliation(s)
- Melissa P Knauert
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Terrence E Murphy
- Section of Geriatrics, Yale School of Medicine, New Haven, CT, United States
| | - Margaret M Doyle
- Section of Geriatrics, Yale School of Medicine, New Haven, CT, United States
| | - Margaret A Pisani
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT, United States
| | | | - Henry K Yaggi
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT, United States
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111
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Mello MTD, Silva A, Guerreiro RDC, da-Silva FR, Esteves AM, Poyares D, Piovezan R, Treptow E, Starling M, Rosa DS, Pires GN, Andersen ML, Tufik S. Sleep and COVID-19: considerations about immunity, pathophysiology, and treatment. Sleep Sci 2020; 13:199-209. [PMID: 33381288 PMCID: PMC7755266 DOI: 10.5935/1984-0063.20200062] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/02/2020] [Indexed: 12/29/2022] Open
Abstract
The fear and uncertainty caused by the coronavirus disease 2019 (COVID-19) pandemic, threats to survival are one of the main problems of everyday life; however, mental health care must also be considered a priority. During social isolation also called self-quarantine, the restricted mobility and social contact, concern about financial resources and availability of supplies, fear of infection, questions about the duration of self-quarantine, cause anxiety, depression, stress, insomnia and reduced the quality and quantity of sleep, that may present a greater risk to the health of the general population. Sleep disorders are increasingly becoming a major health issue in modern society, and are influenced by retinal stimulation by electronic devices, as well extended and/or night shift-work, which may aggravate the systemic and lung inflammation during viral infections. Sleep disorders can induce pro-inflammatory states and be harmful during the COVID-19 pandemic. The possible interactions between many drugs used to treat COVID-19, and those used to treat sleep disorders are unknown, mostly due to the lack of a standard protocol to treat these patients. Insufficient sleep or irregular sleep-wake cycles may impair health, immune system, induce pro-inflammation state, and may lead to increased vulnerability to viral infections, involving inflammatory and oxidative/antioxidant imbalance. In this sense, obstructive sleep apnea has been associated with recognized COVID-19 risk comorbidities and considered a risk factor for COVID-19. During the COVID-19 pandemic, health care cannot stop, and telemedicine has presented itself as an alternative method of delivering services. When a face-to-face visit is mandatory, or in locations with minimal community transmission where sleep centers have resumed activities, it is important that the sleep center facilities are properly prepared to receive the patients during the COVID-19 pandemic, and follow all relevant safety rules. In this work we gathered a group of researchers, specialists in aspects related to chronobiology, sleep, sleep disorders, and the immune system. Thus, we conducted a narrative review in order to address the relationship between COVID-19 and sleep, as well as its immunological aspects and strategies that may be applied in order to mitigate the harmful effects on health that affects everyone during the pandemic.
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Affiliation(s)
- Marco Túlio De Mello
- Universidade Federal de Minas Gerais, Departamento de Esportes - Belo Horizonte - Minas Gerais - Brazil
| | - Andressa Silva
- Universidade Federal de Minas Gerais, Departamento de Esportes - Belo Horizonte - Minas Gerais - Brazil
| | | | - Flavia Rodrigues da-Silva
- Universidade Federal de Minas Gerais, Departamento de Esportes - Belo Horizonte - Minas Gerais - Brazil
| | - Andrea Maculano Esteves
- Universidade Estadual de Campinas, Faculdade de Ciências Aplicadas - Limeira - São Paulo - Brazil
| | - Dalva Poyares
- Universidade Federal de São Paulo, Departamento de Psicobiologia - São Paulo - São Paulo - Brazil
| | - Ronaldo Piovezan
- Universidade Federal de São Paulo, Departamento de Psicobiologia - São Paulo - São Paulo - Brazil
| | - Erika Treptow
- Universidade Federal de São Paulo, Departamento de Psicobiologia - São Paulo - São Paulo - Brazil
| | - Marcelo Starling
- Universidade Federal de Minas Gerais, Departamento de Esportes - Belo Horizonte - Minas Gerais - Brazil
| | - Daniela Santoro Rosa
- Federal University of São Paulo, Departament of Microbiology, Imunology and Parasitology - São Paulo - São Paulo - Brazil
| | - Gabriel Natan Pires
- Universidade Federal de São Paulo, Departamento de Psicobiologia - São Paulo - São Paulo - Brazil
- Santa Casa de São Paulo School of Medical Sciences, Department of Physiological Sciences - São Paulo - São Paulo - Brazil
| | - Monica Levy Andersen
- Universidade Federal de São Paulo, Departamento de Psicobiologia - São Paulo - São Paulo - Brazil
| | - Sergio Tufik
- Universidade Federal de São Paulo, Departamento de Psicobiologia - São Paulo - São Paulo - Brazil
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112
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The immune-sleep crosstalk in inflammatory bowel disease. Sleep Med 2020; 73:38-46. [PMID: 32769031 DOI: 10.1016/j.sleep.2020.04.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 04/20/2020] [Accepted: 04/22/2020] [Indexed: 02/07/2023]
Abstract
Sleep disorders are progressively common and sometimes are associated with aberrant regulation of the adaptive and innate immune responses. Sleep interruption can increase the inflammatory burden by enhancing the pro-inflammatory cytokines particularly in patients with chronic diseases such as inflammatory bowel disease (IBD). IBD is a chronic inflammatory disease characterized by immune dysregulation, dysbiosis of gut microbiome, and poor-quality life. Therefore, this review highlights the crosstalk between sleep and immune responses during the progression of IBD.
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113
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Slavish DC, Taylor DJ, Lichstein KL. Intraindividual variability in sleep and comorbid medical and mental health conditions. Sleep 2020; 42:5370458. [PMID: 30843059 DOI: 10.1093/sleep/zsz052] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 01/28/2019] [Indexed: 12/17/2022] Open
Abstract
STUDY OBJECTIVES Intraindividual variability (IIV) in sleep may be a risk factor for disease above the influence of mean sleep. Associations between IIV in sleep and risk for a comprehensive set of common medical and mental health conditions have not been assessed in a representative sample. METHODS This study examined mean and IIV in total sleep time (TST), sleep quality (SQ), sleep efficiency (SE), and circadian midpoint (CM) in 771 adults recruited for an epidemiological study. Participants completed 14 days of sleep diaries to assess TST, SQ, SE, and CM, after which they reported on medical conditions and mental health symptoms. Data were analyzed using logistic regression, and models controlled for gender, body mass index, age, and race. RESULTS Lower mean TST, SQ, and SE were related to increased odds of having gastrointestinal problems, depression, and anxiety. IIV in TST was related to increased odds of having neurological, breathing, and gastrointestinal problems, as well as pain and depression; all results held controlling for mean sleep and adjusting for false discovery rate. IIV in SQ and SE was not associated with odds of having any medical or mental health conditions after adjusting for false discovery rate, nor was IIV in CM or mean CM. CONCLUSIONS Confirming previous research, mean TST, SQ, and SE are related to risk for gastrointestinal problems, depression, and anxiety. IIV in TST may be a unique facet of disturbed sleep that is associated with increased risk for a diverse cluster of medical and mental health conditions.
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Affiliation(s)
| | - Daniel J Taylor
- Department of Psychology, University of North Texas, Denton, TX
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114
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Stroemel-Scheder C, Kundermann B, Lautenbacher S. The effects of recovery sleep on pain perception: A systematic review. Neurosci Biobehav Rev 2020; 113:408-425. [PMID: 32275917 DOI: 10.1016/j.neubiorev.2020.03.028] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 03/13/2020] [Accepted: 03/29/2020] [Indexed: 01/04/2023]
Abstract
Experimental studies highlight profound effects of sleep disruptions on pain, showing that sleep deprivation (SD) leads to hyperalgesic pain changes. On the other hand, given that sleep helps normalizing bodily functions, a crucial role of restorative sleep in the overnight restoration of the pain system seems likely. Thus, a systematic review of experimental studies on effects of recovery sleep (RS; subsequently to SD) on pain was performed with the aim to check whether RS resets hyperalgesic pain changes occurring due to SD. Empirical animal and human studies including SD-paradigms, RS and pain assessments were searched in three databases (PubMed, Web of Science, PsycINFO) using a predefined algorithm. 29 studies were included in this review. Most results indicated a reset of enhanced pain sensitivity and vulnerability following RS, especially when total SD was implemented and pressure pain or painful symptoms (human studies) were assessed. Further research should focus on whether and how recovery is altered in chronic pain patients, as this yields implications for pain treatment by enhancing or stabilizing RS.
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Affiliation(s)
| | - Bernd Kundermann
- Vitos Clinic for Psychiatry and Psychotherapy Giessen, Giessen, Germany; Department of Psychiatry and Psychotherapy, Philipps-University of Marburg, Marburg, Germany.
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115
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Mishra I, Pullum KB, Thayer DC, Plummer ER, Conkright BW, Morris AJ, O'Hara BF, Demas GE, Ashley NT. Chemical sympathectomy reduces peripheral inflammatory responses to acute and chronic sleep fragmentation. Am J Physiol Regul Integr Comp Physiol 2020; 318:R781-R789. [PMID: 32130024 DOI: 10.1152/ajpregu.00358.2019] [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] [Indexed: 12/19/2022]
Abstract
Sleep loss contributes to the development of cardiovascular, metabolic, and neurological disorders by promoting a systemic proinflammatory phenotype. The neuroendocrine-immune mechanisms contributing to such pathologies are poorly understood. The sympathetic nervous system (SNS) regulates immunity and is often activated following sleep disturbances. The aims of this study were to determine 1) the effect of SNS inhibition on inflammatory responses to sleep fragmentation (SF) and 2) whether homeostasis can be restored after 1 wk of recovery sleep. We measured stress responses (norepinephrine and corticosterone), gene expression levels of pro- and anti-inflammatory cytokines in peripheral (heart, liver, and spleen) tissues, and protein levels of cytokines and chemokines in serum of female mice that were subjected to acute SF for 24 h, chronic SF for 8 wk, or 7 days of recovery after chronic SF. In each experiment, SF and control mice were chemically sympathectomized with 6-hydroxydopamine (6-OHDA) or injected with vehicle. Both acute and chronic SF elevated mRNA and protein levels of cytokines in peripheral tissues. Changes in inflammatory responses mirrored stress-axes activation, with increased corticosterone and norepinephrine in SF mice. 6-OHDA treatment significantly alleviated SF-induced inflammation, thus providing evidence of SNS regulation of peripheral inflammation from SF. Effects of chronic SF were more severe than acute SF, and 1 wk of recovery from SF sufficiently alleviated peripheral inflammatory responses but not NE responses.
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Affiliation(s)
- Ila Mishra
- Department of Biology, Western Kentucky University, Bowling Green, Kentucky
| | - Keelee B Pullum
- Department of Biology, Western Kentucky University, Bowling Green, Kentucky
| | - Domnique C Thayer
- Department of Biology, Western Kentucky University, Bowling Green, Kentucky
| | - Erica R Plummer
- Department of Biology, Western Kentucky University, Bowling Green, Kentucky
| | | | - Andrew J Morris
- Department of Pharmacology, University of Kentucky, Lexington, Kentucky
| | - Bruce F O'Hara
- Department of Biology, University of Kentucky, Lexington, Kentucky
| | - Gregory E Demas
- Department of Biology, Indiana University, Bloomington, Indiana
| | - Noah T Ashley
- Department of Biology, Western Kentucky University, Bowling Green, Kentucky
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116
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Zhang L, Wu H, Zhang X, Wei X, Hou F, Ma Y. Sleep heart rate variability assists the automatic prediction of long-term cardiovascular outcomes. Sleep Med 2020; 67:217-224. [PMID: 31972509 PMCID: PMC7281861 DOI: 10.1016/j.sleep.2019.11.1259] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 11/11/2019] [Accepted: 11/27/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We aimed to investigate the association between sleep HRV and long-term cardiovascular disease (CVD) outcomes, and further explore whether HRV features can assist the automatic CVD prediction. METHODS We retrospectively analyzed polysomnography (PSG) data obtained from 2111 participants in the Sleep Heart Health Study, who were followed up for a median of 11.8 years after PSG acquisition. During follow-up, 1252 participants suffered CVD events (CVD group) and 859 participants remained CVD-free (non-CVD group). HRV measures, derived from time-domain and frequency-domain, were calculated. Regression models were created to determine the independent predictor for long-term CVD outcomes, and to explore the association between HRV and CVD latency. Furthermore, based on HRV and other clinical features, a model was trained to automatically predict CVD outcomes using the eXtreme Gradient Boosting algorithm. RESULTS Compared with the non-CVD group, decreased HRV during sleep was found in the CVD group. HRV, particularly its component of high frequency (HF), was demonstrated to be independent predictor of CVD outcomes. Moreover, normalized HF was positively correlated with CVD latency. The proposed prediction model achieved a total accuracy of 75.3%, in which sleep HRV features served as a supplement to the well-recognized CVD risk factors, such as aging, adiposity and sleep disorders. CONCLUSIONS Association between sleep HRV and long-term CVD outcomes was demonstrated here, suggesting that altered HRV during sleep might occur many years prior to the onset of CVD. Machine learning models, combining sleep HRV and other clinical characteristics, should be promising in the early prediction of CVD outcomes.
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Affiliation(s)
- Lulu Zhang
- Key Laboratory of Biomedical Functional Materials, School of Science, China Pharmaceutical University, Nanjing 210009, China
| | - Huili Wu
- ENT Sleep Monitoring Center, Coal General Hospital, Beijing 100028, China
| | - Xiangyu Zhang
- SEU-lenovo S-H-E Wearable Intelligent Monitoring Lab, State Key Laboratory of Bioelectronics, The School of Instrument Science and Engineering, Southeast University, Nanjing 210096, China
| | - Xinfa Wei
- Department of Otolaryngology, Coal General Hospital, Beijing 100028, China
| | - Fengzhen Hou
- Key Laboratory of Biomedical Functional Materials, School of Science, China Pharmaceutical University, Nanjing 210009, China.
| | - Yan Ma
- Division of Interdisciplinary Medicine and Biotechnology, Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, United States
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117
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Abstract
PURPOSE OF REVIEW Sleep is an essential component of human health, and suboptimal sleep duration has been associated with increased cardiovascular morbidity and mortality. This review summarizes physiological and pathological effects of sleep duration on the cardiovascular system. RECENT FINDINGS Both decreased and increased duration of sleep lead to increased cardiovascular mortality and has a U-shaped curve. Sleep apnea is an independent risk factor for atherosclerosis and hypertension, and its treatment with continuous positive airway pressure (CPAP) results in increased survival. Estimated sleep duration of 6-8 h is associated with decreased mortality and major cardiovascular events and should be addressed by clinicians during routine visits.
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118
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Faraut B, Andrillon T, Drogou C, Gauriau C, Dubois A, Servonnet A, Van Beers P, Guillard M, Gomez-Merino D, Sauvet F, Chennaoui M, Léger D. Daytime Exposure to Blue-Enriched Light Counters the Effects of Sleep Restriction on Cortisol, Testosterone, Alpha-Amylase and Executive Processes. Front Neurosci 2020; 13:1366. [PMID: 31998056 PMCID: PMC6961531 DOI: 10.3389/fnins.2019.01366] [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] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 12/03/2019] [Indexed: 01/01/2023] Open
Abstract
Sleep debt is becoming a better acknowledged cause of physiological stress and neurobehavioral deficits with major public-health concerns. We investigated whether exposure to blue light during daytime could be an efficient countermeasure to limit sleep restriction’s impact on relevant behavioral (stress, sleepiness, sustained attention, and memory performance) and physiological (saliva cortisol, testosterone, and alpha-amylase) markers. Our semi-ecological, crossover, randomized design included 17 young men that underwent two sleep-restricted nights (3 h each) followed or not by blue light exposure (30-min-long sessions at 100 lux repeated four times throughout the day). Behavioral and physiological measurements were performed in the lab but outside these periods the participants kept following their usual routine. After sleep restriction, morning cortisol and testosterone, and afternoon alpha-amylase levels decreased. In parallel, subjective ratings of stress and sleepiness increased while performance on the sustained attention and memory tasks deteriorated. In contrast, after periods of blue light exposure, all these parameters were largely restored to baseline levels, despite an identical sleep restriction procedure, although this restorative effect was reduced for the memory task. Our findings suggest that even short exposure to blue light could trigger persistent beneficial effects throughout the day and could be potentially efficient in real-life settings.
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Affiliation(s)
- Brice Faraut
- EA 7330 VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Université de Paris, Paris, France.,Consultation de Pathologie Professionnelle Sommeil Vigilance et Travail, Centre du Sommeil et de la Vigilance, Hôtel-Dieu, APHP-5, Paris, France
| | - Thomas Andrillon
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Catherine Drogou
- EA 7330 VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Université de Paris, Paris, France.,Unité Fatigue et Vigilance, IRBA - Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
| | - Caroline Gauriau
- Consultation de Pathologie Professionnelle Sommeil Vigilance et Travail, Centre du Sommeil et de la Vigilance, Hôtel-Dieu, APHP-5, Paris, France
| | - Alexandre Dubois
- Consultation de Pathologie Professionnelle Sommeil Vigilance et Travail, Centre du Sommeil et de la Vigilance, Hôtel-Dieu, APHP-5, Paris, France
| | - Aurélie Servonnet
- Unité Fatigue et Vigilance, IRBA - Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
| | - Pascal Van Beers
- EA 7330 VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Université de Paris, Paris, France.,Unité Fatigue et Vigilance, IRBA - Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
| | - Mathias Guillard
- EA 7330 VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Université de Paris, Paris, France.,Unité Fatigue et Vigilance, IRBA - Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
| | - Danielle Gomez-Merino
- EA 7330 VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Université de Paris, Paris, France.,Unité Fatigue et Vigilance, IRBA - Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
| | - Fabien Sauvet
- EA 7330 VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Université de Paris, Paris, France.,Unité Fatigue et Vigilance, IRBA - Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
| | - Mounir Chennaoui
- EA 7330 VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Université de Paris, Paris, France.,Unité Fatigue et Vigilance, IRBA - Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
| | - Damien Léger
- EA 7330 VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Université de Paris, Paris, France.,Consultation de Pathologie Professionnelle Sommeil Vigilance et Travail, Centre du Sommeil et de la Vigilance, Hôtel-Dieu, APHP-5, Paris, France
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119
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Liu X, Li Z, Zhang J, Chen S, Tao L, Luo Y, Xu X, Fine JP, Li X, Guo X. A Novel Risk Score for Type 2 Diabetes Containing Sleep Duration: A 7-Year Prospective Cohort Study among Chinese Participants. J Diabetes Res 2020; 2020:2969105. [PMID: 31998805 PMCID: PMC6964717 DOI: 10.1155/2020/2969105] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 10/08/2019] [Accepted: 12/05/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Sleep duration is associated with type 2 diabetes (T2D). However, few T2D risk scores include sleep duration. We aimed to develop T2D scores containing sleep duration and to estimate the additive value of sleep duration. METHODS We used data from 43,404 adults without T2D in the Beijing Health Management Cohort study. The participants were surveyed approximately every 2 years from 2007/2008 to 2014/2015. Sleep duration was calculated from the self-reported usual time of going to bed and waking up at baseline. Logistic regression was employed to construct the risk scores. Integrated discrimination improvement (IDI) and net reclassification improvement (NRI) were used to estimate the additional value of sleep duration. RESULTS After a median follow-up of 6.8 years, we recorded 2623 (6.04%) new cases of T2D. Shorter (both 6-8 h/night and <6 h/night) sleep durations were associated with an increased risk of T2D (odds ratio (OR) = 1.43, 95% confidence interval (CI) = 1.30-1.59; OR = 1.98, 95%CI = 1.63-2.41, respectively) compared with a sleep duration of >8 h/night in the adjusted model. Seven variables, including age, education, waist-hip ratio, body mass index, parental history of diabetes, fasting plasma glucose, and sleep duration, were selected to form the comprehensive score; the C-index was 0.74 (95% CI: 0.71-0.76) for the test set. The IDI and NRI values for sleep duration were 0.017 (95% CI: 0.012-0.022) and 0.619 (95% CI: 0.518-0.695), respectively, suggesting good improvement in the predictive ability of the comprehensive nomogram. The decision curves showed that women and individuals older than 50 had more net benefit. CONCLUSIONS The performance of T2D risk scores developed in the study could be improved by containing the shorter estimated sleep duration, particularly in women and individuals older than 50.
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Affiliation(s)
- Xiangtong Liu
- School of Public Health, Capital Medical University, Beijing 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Zhiwei Li
- School of Public Health, Capital Medical University, Beijing 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Jingbo Zhang
- Beijing Physical Examination Center, Beijing 100077, China
| | - Shuo Chen
- Beijing Physical Examination Center, Beijing 100077, China
| | - Lixin Tao
- School of Public Health, Capital Medical University, Beijing 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yanxia Luo
- School of Public Health, Capital Medical University, Beijing 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xiaolin Xu
- The University of Queensland, Brisbane, Australia
| | | | - Xia Li
- La Trobe University, Melbourne, Australia
| | - Xiuhua Guo
- School of Public Health, Capital Medical University, Beijing 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
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120
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Irwin C, Khalesi S, Desbrow B, McCartney D. Effects of acute caffeine consumption following sleep loss on cognitive, physical, occupational and driving performance: A systematic review and meta-analysis. Neurosci Biobehav Rev 2020; 108:877-888. [DOI: 10.1016/j.neubiorev.2019.12.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 12/06/2019] [Accepted: 12/06/2019] [Indexed: 12/17/2022]
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121
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Pisani MA, D'Ambrosio C. Sleep and Delirium in Adults Who Are Critically Ill: A Contemporary Review. Chest 2019; 157:977-984. [PMID: 31874132 DOI: 10.1016/j.chest.2019.12.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 10/28/2019] [Accepted: 12/09/2019] [Indexed: 01/09/2023] Open
Abstract
Sleep is important to health and well-being, and studies in healthy adults have demonstrated that sleep deprivation impacts respiratory, immune, and cognitive function. Historically, because of the nature of critical illness, sleep has not been considered a priority for patient care in the ICU. More recently, research has demonstrated that sleep is markedly abnormal in patients who are critically ill. In addition, there is often disruption of circadian rhythms. Delirium is a syndrome of acute alteration in mental status that occurs in the setting of contributing factors such as serious illness, medication, and drug or alcohol intoxication or withdrawal. Delirium is a frequent occurrence in critical illness, and research has demonstrated several adverse outcomes associated with delirium including persistent cognitive impairment and increased mortality. Sleep deprivation and delirium share many common symptoms. The similarity in symptoms between sleep disruption and delirium have prompted experts to draw links between the two and question both the relationship and its direction. In addition, the inclusion of sleep disturbance to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition in its constellation of symptoms used in diagnosing delirium has increased awareness of the link between sleep and delirium. This paper will review the literature on sleep in critical illness and the potential mechanisms and pathways that may connect sleep and delirium.
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122
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Abstract
Sleep disordered breathing (SDB) may be associated with sleep bruxism and periodontal diseases. Through a review of the current literature, this article aims to describe the characteristics of sleep bruxism and its relationship with SDB as well as the current evidence supporting an association between periodontal diseases and SDB. Sleep bruxism is characterized by muscle clenching and tooth grinding during sleep, typically during N2 sleep stage and in association with micro-arousals. The probability of observing sleep bruxism is almost 4 times higher in the presence of SDB, with a close temporal relationship between the episode of upper airway obstruction or oxygen desaturation and the episode of bruxism, which most often occurs in the 0-10 seconds following the obstruction. These findings support the hypothesis that sleep bruxism is triggered by SDB and may have a "protective" role being a muscular activity that helps restore the permeability of the upper airways. On the other hand, SDB have been linked to periodontal diseases. Periodontal diseases are inflammatory and dysbiotic disorders that can have a negative impact on oral health (leading to the destruction of the periodontium and tooth loss) and on general health. Recently, it has been observed that SDB patients have a 1.6 to 4-fold higher risk of having or developing severe periodontitis, suggesting that SDB may be a new risk factor for periodontal diseases. Dentists, who are part of the team of sleep medicine specialists, have a key role in the detection, prevention and treatment of SDB and their relationship with sleep bruxism and periodontal diseases.
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Affiliation(s)
- Maria Clotilde Carra
- Département de Parodontologie, Hôpital Rothschild, AP-HP, 5 rue Santerre, 75012 Paris, France UFR d'Odontologie, Université de Paris, 5 rue Garancière, 75005 Paris, France
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Hwang L, Ko IG, Jin JJ, Kim SH, Kim CJ, Chang B, Rho JH, Moon EJ, Yi JW. Dexmedetomidine ameliorates memory impairment in sleep-deprived mice. Anim Cells Syst (Seoul) 2019; 23:371-379. [PMID: 31853373 PMCID: PMC6913667 DOI: 10.1080/19768354.2019.1688185] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 10/27/2019] [Accepted: 10/28/2019] [Indexed: 02/08/2023] Open
Abstract
The selective α2-adrenergic receptor agonist dexmedetomidine acts as an analgesic, sedative, and anesthetic adjuvant. The most common consequence of sleep deprivation is memory impairment. We investigated whether dexmedetomidine can counteract memory impairment caused by sleep deprivation and suppress the production of inflammatory factors. For inducing sleep deprivation, adult male mice were placed inside a water cage containing 15 platforms immersed in water up to 1 cm for 7 days. One day after sleep deprivation, dexmedetomidine at the respective dosage (5, 10, and 20 μg/kg) and α2-adrenoceptor antagonist atipamezole (250 μg/kg) were intraperitoneally injected into the mice, once per day for six days. The step-down avoidance task and the Morris water maze test were performed. Western blot analysis was performed to determine the levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-6, brain-derived neurotrophic factor (BDNF), tyrosine kinase B (TrkB), nuclear transcription factor-κB (NF-κB), inhibitor of κBα (IκBα), and ionized calcium binding adapter molecule I (Iba-1) in the hippocampus. Immunohistochemistry was performed for the determination of Ki-67 and glial fibrillary acidic protein (GFAP) expression in the hippocampal dentate gyrus. Dexmedetomidine ameliorated sleep deprivation-induced deterioration of short-term memory and spatial learning ability. Dexmedetomidine inhibited production of inflammatory mediators caused by sleep deprivation. Dexmedetomidine also prevented the decrease in BDNF, TrkB expression, and cell proliferation induced by sleep deprivation. Dexmedetomidine could be used to counteract the neuropathological effects of sleep deprivation.
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Affiliation(s)
- Lakkyong Hwang
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Il-Gyu Ko
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Jun-Jang Jin
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sang-Hoon Kim
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Chang-Ju Kim
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Boksoon Chang
- Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Jeong Ho Rho
- Department of Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Eun-Jin Moon
- Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Jae-Woo Yi
- Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
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Szentirmai É, Kapás L. Sleep and body temperature in TNFα knockout mice: The effects of sleep deprivation, β3-AR stimulation and exogenous TNFα. Brain Behav Immun 2019; 81:260-271. [PMID: 31220563 PMCID: PMC6754767 DOI: 10.1016/j.bbi.2019.06.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 06/06/2019] [Accepted: 06/16/2019] [Indexed: 01/09/2023] Open
Abstract
Increased production of pro-inflammatory cytokines is assumed to mediate increased sleep under inflammatory conditions, such as systemic infections or recovery from sleep loss. The role of cytokines in sleep regulation under normal conditions is less clear. In the present study, we investigated the role of endogenous tumor necrosis factor alpha (TNFα) in sleep regulation using TNFα knockout (KO) mice. Under control conditions at thermoneutral ambient temperature, total sleep time did not differ between TNFα KO and wild-type (WT) mice, but TNFα KO mice had increased rapid-eye-movement sleep (REMS), accompanied by decreased motor activity and body temperature. Exposure to 17 °C induced decreases in total sleep time similarly in both genotypes. Sleep deprivation by gentle handling elicited robust rebound increases in non-rapid-eye movement sleep (NREMS), REMS and electroencephalographic (EEG) slow-wave activity (SWA), accompanied by suppressed motor activity and decreased body temperature; there was no significant difference between the responses of WT and KO mice. Systemic injection of the beta3-adrenergic receptor (β3-AR) agonist CL-316,243 induced increases in NREMS and body temperature. The temperature response, but not the sleep effect, was attenuated in the KO animals. Systemic injection of TNFα induced increased NREMS, reduced REMS and biphasic temperature responses in both genotypes. In the KO mice, the NREMS-promoting effects of exogenously administered TNFα was decreased, while REMS suppression was enhanced, and the first, hypothermic, phase of temperature response was attenuated. Overall, TNFα KO mice did not show any deficiency in sleep regulation which suggests that the role of endogenous TNFα in sleep regulation is less pronounced than previously suggested.
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Affiliation(s)
- Éva Szentirmai
- Elson S. Floyd College of Medicine, Department of Biomedical Sciences, Washington State University, Spokane, WA, USA; Sleep and Performance Research Center, Washington State University, Spokane, WA, USA.
| | - Levente Kapás
- Elson S. Floyd College of Medicine, Department of Biomedical Sciences, Washington State University, Spokane, WA, USA; Sleep and Performance Research Center, Washington State University, Spokane, WA, USA
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Association between sleep duration and attention-deficit hyperactivity disorder: A systematic review and meta-analysis of observational studies ✰. J Affect Disord 2019; 256:62-69. [PMID: 31158717 DOI: 10.1016/j.jad.2019.05.071] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 05/17/2019] [Accepted: 05/28/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Several previous meta-analyses have investigated the association between sleep quality and attention-deficit/hyperactivity disorder (ADHD). To examine the relationship between short or long sleep duration and ADHD, a meta-analysis of observational studies was conducted. METHODS The PubMed, EMBASE, and Cochrane Library databases were systematically searched in March 2019 to retrieve observational studies. A random-effects model was used to analyze meta-estimates of sleep duration. Three evaluators independently reviewed and selected the articles based on pre-determined selection criteria. RESULTS Of 1466 articles retrieved, 10 observational epidemiological studies, comprising six case-control studies and four prospective cohort studies, were included in the final analysis. Short sleep duration was significantly linked to ADHD compared with average sleep duration (odds ratio [OR] or relative risk [RR] 1.28 [95% confidence interval (CI) 1.16-1.41]), and especially with hyperactivity (OR/RR 1.60 [95% CI 1.18-2.17]). Subgroup meta-analyses according to various factors, such as study design, number of participants, methodological quality, and adjustment for smoking status and education, yielded consistent results. A significant association between long sleep duration and ADHD was not observed. LIMITATIONS Publication bias and substantial heterogeneity due to the diverse measurement tools used to determine ADHD were observed. Lack of prospective cohort studies was another limitation. CONCLUSION Short sleep duration was associated with ADHD in the current meta-analysis. Clinicians may need to be more aware of this association.
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Hu S, Jing S, Gao Y. Sleep Restriction Effects on BP: Systematic Review & Meta-analysis of RCTs. West J Nurs Res 2019; 42:567-576. [PMID: 31455197 DOI: 10.1177/0193945919868143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This systematic review and meta-analysis aimed to examine the effect of sleep restriction on blood pressure (BP) among healthy adults. Randomized controlled trials (RCTs) using partial sleep deprivation were included. The pooled effect size was calculated by the inverse variance method, and forest plot was used. Six studies were included (n = 10-43). Only one study obtained continuous BP readings. Overall, sleep restriction did not result in significant changes in systolic blood pressure (SBP) or diastolic blood pressure (DBP) and heart rate (HR). The respective weighted mean difference (MD) was 1.0 mmHg (95%CI, -2.3-4.2; p = 0.57), -0.4 mmHg (95%CI, -3.2-2.4; p = 0.80), and 2.0 bpm (95%CI, -2.2-6.2; p = 0.34). There is preliminary evidence suggesting that sleep restriction might affect sympathetic/parasympathetic modulation of cardiac autonomy and the inflammatory system. In this review, we did not find significant effects of sleep restriction on BP or HR measured by cross-sectional methods. More studies are warranted to confirm these findings by using continuous monitoring.
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Affiliation(s)
- Shan Hu
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Songbo Jing
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Yixuan Gao
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
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Papantoniou K, Massa J, Devore E, Munger KL, Chitnis T, Ascherio A, Schernhammer ES. Rotating night shift work and risk of multiple sclerosis in the Nurses' Health Studies. Occup Environ Med 2019; 76:733-738. [PMID: 31405910 DOI: 10.1136/oemed-2019-106016] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/24/2019] [Accepted: 07/30/2019] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Night shift work has been suggested as a possible risk factor for multiple sclerosis (MS). The objective of the present analysis was to prospectively evaluate the association of rotating night shift work history and MS risk in two female cohorts, the Nurses' Health Study (NHS) and NHSII. METHODS A total of 83 992 (NHS) and 114 427 (NHSII) women were included in this analysis. We documented 579 (109 in NHS and 470 in NHSII) incident physician-confirmed MS cases (moderate and definite diagnosis), including 407 definite MS cases. The history (cumulative years) of rotating night shifts (≥3 nights/month) was assessed at baseline and updated throughout follow-up. Cox proportional hazards models were used to estimate HRs and 95% CIs for the association between rotating night shift work and MS risk adjusting for potential confounders. RESULTS We observed no association between history of rotating night shift work and MS risk in NHS (1-9 years: HR 1.03, 95% CI 0.69 to 1.54; 10+ years: 1.15, 0.62 to 2.15) and NHSII (1-9 years: HR 0.90, 95% CI 0.74 to 1.09; 10+ years: 1.03, 0.72 to 1.49). In NHSII, rotating night shift work history of 20+ years was significantly associated with MS risk, when restricting to definite MS cases (1-9 years: HR 0.88, 95% CI 0.70 to 1.11; 10-19 years: 0.98, 0.62 to 1.55; 20+ years: 2.62, 1.06 to 6.46). CONCLUSIONS Overall, we found no association between rotating night shift work history and MS risk in these two large cohorts of nurses. In NHSII, shift work history of 20 or more years was associated with an increased risk of definite MS diagnosis.
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Affiliation(s)
- Kyriaki Papantoniou
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Jennifer Massa
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Elizabeth Devore
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kassandra L Munger
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Tanuja Chitnis
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Alberto Ascherio
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Eva S Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
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Zhao C, Noble JM, Marder K, Hartman JS, Gu Y, Scarmeas N. Dietary Patterns, Physical Activity, Sleep, and Risk for Dementia and Cognitive Decline. Curr Nutr Rep 2019; 7:335-345. [PMID: 30413973 DOI: 10.1007/s13668-018-0247-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Diet, physical activity, and sleep are three major modifiable lifestyle factors. This selective review examines the evidence for strong and reliable associations between these three lifestyle factors and risk of dementia and cognitive decline, in an effort to assist clinicians with providing more informed answers to the common questions they face from patients. RECENT FINDINGS Certain aspects of nutrition can decrease risk for dementia. Physical activity has also been associated with delayed or slower age-related cognitive decline. In addition, emerging evidence links sleep dysfunction and dementia, with amyloid deposition being a possible mediator. Data from further clinical trials are needed before more definitive conclusions can be drawn regarding the efficacy of these lifestyle interventions for lowering the risk of incident dementia and cognitive decline. Nevertheless, it is reasonable to make recommendations to our patients to adopt certain dietary changes and to engage in regular physical activity to improve cardiovascular risk factors for dementia. It is also reasonable to include questions on sleep during cognitive evaluations of the elderly, given the common co-occurrence of sleep dysfunction and cognitive impairment in the elderly population.
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Affiliation(s)
- Chen Zhao
- Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA. .,Taub Institute for Research of Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA.
| | - James M Noble
- Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA.,Taub Institute for Research of Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA.,Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
| | - Karen Marder
- Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA.,Taub Institute for Research of Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA.,Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
| | - Jacob S Hartman
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | - Yian Gu
- Taub Institute for Research of Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA.,Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA.,Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Nikolaos Scarmeas
- Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA.,Taub Institute for Research of Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA.,Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA.,1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
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129
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Besedovsky L, Lange T, Haack M. The Sleep-Immune Crosstalk in Health and Disease. Physiol Rev 2019; 99:1325-1380. [PMID: 30920354 PMCID: PMC6689741 DOI: 10.1152/physrev.00010.2018] [Citation(s) in RCA: 666] [Impact Index Per Article: 133.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 10/29/2018] [Accepted: 10/29/2018] [Indexed: 02/08/2023] Open
Abstract
Sleep and immunity are bidirectionally linked. Immune system activation alters sleep, and sleep in turn affects the innate and adaptive arm of our body's defense system. Stimulation of the immune system by microbial challenges triggers an inflammatory response, which, depending on its magnitude and time course, can induce an increase in sleep duration and intensity, but also a disruption of sleep. Enhancement of sleep during an infection is assumed to feedback to the immune system to promote host defense. Indeed, sleep affects various immune parameters, is associated with a reduced infection risk, and can improve infection outcome and vaccination responses. The induction of a hormonal constellation that supports immune functions is one likely mechanism underlying the immune-supporting effects of sleep. In the absence of an infectious challenge, sleep appears to promote inflammatory homeostasis through effects on several inflammatory mediators, such as cytokines. This notion is supported by findings that prolonged sleep deficiency (e.g., short sleep duration, sleep disturbance) can lead to chronic, systemic low-grade inflammation and is associated with various diseases that have an inflammatory component, like diabetes, atherosclerosis, and neurodegeneration. Here, we review available data on this regulatory sleep-immune crosstalk, point out methodological challenges, and suggest questions open for future research.
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Affiliation(s)
- Luciana Besedovsky
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen , Tübingen , Germany ; Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School , Boston, Massachusetts ; and Department of Rheumatology and Clinical Immunology, University of Lübeck , Lübeck , Germany
| | - Tanja Lange
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen , Tübingen , Germany ; Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School , Boston, Massachusetts ; and Department of Rheumatology and Clinical Immunology, University of Lübeck , Lübeck , Germany
| | - Monika Haack
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen , Tübingen , Germany ; Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School , Boston, Massachusetts ; and Department of Rheumatology and Clinical Immunology, University of Lübeck , Lübeck , Germany
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130
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Abstract
Sleep is a behavioral phenomenon conserved among mammals and some invertebrates, yet the biological functions of sleep are still being elucidated. In humans, sleep time becomes shorter, more fragmented, and of poorer quality with advancing age. Epidemiologically, the development of age-related neurodegenerative diseases such as Alzheimer's and Parkinson's disease is associated with pronounced sleep disruption, whereas emerging mechanistic studies suggest that sleep disruption may be causally linked to neurodegenerative pathology, suggesting that sleep may represent a key therapeutic target in the prevention of these conditions. In this review, we discuss the physiology of sleep, the pathophysiology of neurodegenerative disease, and the current literature supporting the relationship between sleep, aging, and neurodegenerative disease.
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Affiliation(s)
- Thierno M Bah
- Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - James Goodman
- Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Jeffrey J Iliff
- Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon, USA.
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA.
- Veterans Integrated Service Network 20 Mental Illness Research, Education and Clinical Center, Puget Sound Health Care System, Mail Stop 116-MIRECC, 1660 South Columbian Way, Seattle, Washington, 98108, USA.
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA.
- Department of Neurology, University of Washington School of Medicine, Seattle, Washington, USA.
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131
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Knauert MP, Pisani M, Redeker N, Murphy T, Araujo K, Jeon S, Yaggi H. Pilot study: an intensive care unit sleep promotion protocol. BMJ Open Respir Res 2019; 6:e000411. [PMID: 31258916 PMCID: PMC6561389 DOI: 10.1136/bmjresp-2019-000411] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 04/22/2019] [Accepted: 05/02/2019] [Indexed: 01/01/2023] Open
Abstract
Purpose Disturbances, such as in-room activity and sound, are significant sources of sleep disruption among critically ill patients. These factors are potentially modifiable. We tested the impact of an intensive care unit (ICU) sleep promotion protocol on overnight in-room disturbance. Methods Our protocol restricted non-urgent bedside care from 00:00 to 03:59. Patients were assigned to usual care (n=30) or the sleep protocol (n=26). The primary outcomes were measures of in-room activity, sound and light. These three types of disturbance were compared between arms during a baseline time block (20:00–23:59) and a rest time block (00:00–03:59). We assessed the sleep protocol effect with generalised linear models. Results Usual care and sleep protocol patients had equivalent levels of in-room activity, sound and light during the baseline time block (20:00–23:59). In contrast, during the rest time block (00:00–03:59), the sleep protocol arm had 32% fewer room entries (rate ratio (RR) 0.68, p=0.001) and 9.1 fewer minutes of in-room activity (p=0.0002). Also, the length of time between room entrances increased from 26.4 to 45.8 min (p=0.0004). The sleep protocol arm also had lower sound during the rest time block. Mean A-weighted sound was 2.5 decibels lower (p=0.02), and there were 36% fewer peaks (RR 0.64, p=0.02). Light levels were highly variable and not changed by the sleep protocol. Conclusions Sleep promotion protocols can improve in-room activity and sound. This provides a better sleep opportunity and may, therefore, improve ICU sleep. Trial registration number 1112009428
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Affiliation(s)
- Melissa P Knauert
- Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Margaret Pisani
- Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Nancy Redeker
- Division of Acute Care/Health Systems, Yale School of Nursing, Yale University, New Haven, Connecticut, USA
| | - Terry Murphy
- Section of Geriatrics, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Katy Araujo
- Section of Geriatrics, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Sangchoon Jeon
- Division of Acute Care/Health Systems, Yale School of Nursing, Yale University, New Haven, Connecticut, USA
| | - Henry Yaggi
- Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
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Kroshus E, Wagner J, Wyrick D, Athey A, Bell L, Benjamin HJ, Grandner MA, Kline CE, Mohler JM, Roxanne Prichard J, Watson NF, Hainline B. Wake up call for collegiate athlete sleep: narrative review and consensus recommendations from the NCAA Interassociation Task Force on Sleep and Wellness. Br J Sports Med 2019; 53:731-736. [DOI: 10.1136/bjsports-2019-100590] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2019] [Indexed: 12/13/2022]
Abstract
Sleep is an important determinant of collegiate athlete health, well-being and performance. However, collegiate athlete social and physical environments are often not conducive to obtaining restorative sleep. Traditionally, sleep has not been a primary focus of collegiate athletic training and is neglected due to competing academic, athletic and social demands. Collegiate athletics departments are well positioned to facilitate better sleep culture for their athletes. Recognising the lack of evidence-based or consensus-based guidelines for sleep management and restorative sleep for collegiate athletes, the National Collegiate Athletic Association hosted a sleep summit in 2017. Members of the Interassociation Task Force on Sleep and Wellness reviewed current data related to collegiate athlete sleep and aimed to develop consensus recommendations on sleep management and restorative sleep using the Delphi method. In this paper, we provide a narrative review of four topics central to collegiate athlete sleep: (1) sleep patterns and disorders among collegiate athletes; (2) sleep and optimal functioning among athletes; (3) screening, tracking and assessment of athlete sleep; and (4) interventions to improve sleep. We also present five consensus recommendations for colleges to improve their athletes’ sleep.
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Dres M, Younes M, Rittayamai N, Kendzerska T, Telias I, Grieco DL, Pham T, Junhasavasdikul D, Chau E, Mehta S, Wilcox ME, Leung R, Drouot X, Brochard L. Sleep and Pathological Wakefulness at the Time of Liberation from Mechanical Ventilation (SLEEWE). A Prospective Multicenter Physiological Study. Am J Respir Crit Care Med 2019; 199:1106-1115. [DOI: 10.1164/rccm.201811-2119oc] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
- Martin Dres
- Keenan Research Centre, Li Ka Shing Knowledge Institute, and
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
- Service de Pneumologie, Médecine Intensive—Réanimation, Département R3S AP-HP, Groupe Hospitalier Pitié–Salpétrière Charles Foix, Paris, France
| | - Magdy Younes
- YRT Ltd., Winnipeg, Manitoba, Canada
- Sleep Disorders Centre, Winnipeg, Manitoba, Canada
| | - Nuttapol Rittayamai
- Keenan Research Centre, Li Ka Shing Knowledge Institute, and
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Respiratory Diseases and Tuberculosis, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Tetyana Kendzerska
- Division of Respirology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Irene Telias
- Keenan Research Centre, Li Ka Shing Knowledge Institute, and
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Domenico Luca Grieco
- Keenan Research Centre, Li Ka Shing Knowledge Institute, and
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Tai Pham
- Keenan Research Centre, Li Ka Shing Knowledge Institute, and
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Detajin Junhasavasdikul
- Keenan Research Centre, Li Ka Shing Knowledge Institute, and
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Edmond Chau
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sangeeta Mehta
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
- Intensive Care Unit, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - M. Elizabeth Wilcox
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
- Critical Care, Department of Medicine, Toronto Western Hospital, Toronto, Ontario, Canada; and
| | - Richard Leung
- Division of Respirology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Xavier Drouot
- Neurophysiologie Clinique et Explorations Fonctionnelles, CHU de Poitiers, Poitiers, France
| | - Laurent Brochard
- Keenan Research Centre, Li Ka Shing Knowledge Institute, and
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
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Devine JK, Burke TM, Skeiky L, Choynowski JJ, Quartana PJ, Balkin TJ, Capaldi VF, Brager AJ, Simonelli G. Objective changes in activity levels following sleep extension as measured by wrist actigraphy. Sleep Med 2019; 60:173-177. [PMID: 31213393 DOI: 10.1016/j.sleep.2019.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 04/02/2019] [Accepted: 04/04/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE/BACKGROUND It is widely established that insufficient sleep can lead to adverse health outcomes. Paradoxically, epidemiologic research suggests that individuals who report habitual nightly sleep greater than 9 h also are at risk for adverse health outcomes. Further, studies have shown that long sleepers have decreased activity levels, which may partially explain the relationship between long sleep duration and mortality. The influence of sleep extension (longer time in bed) on levels of daily activity has not yet been established. The current study examined whether a week of sleep extension altered activity levels within the subsequent daily waking active and sleep period in order to determine whether increased time in bed indeed is related to decreased activity levels. METHODS A total of 26 healthy volunteers wore wrist accelerometer devices (Actiwatch 2.0, Philips) in order to objectively measure sleep and activity for six days during their normal schedules and for six days during a sleep extension (10 h time in bed) intervention. RESULTS There were no significant or clinically-relevant differences in 24-h activity or activity during the active or sleep period between baseline and sleep extension conditions. There were no main or interaction effects of day and condition when daily activity counts were compared between baseline and sleep extension conditions for the 24 h period (Day: F(5, 21) = 1.92, p = 0.12; Condition: F(1,25) = 2.93, p = 0.09; Day by Condition: F(5,21) = 0.32, p = 0.83), Active Waking Period (Day: F(5,25) = 1.53, p = 0.18; Condition: F(1,25) = 0.26, p = 0.61; Day by Condition: F(5,21) = 0.55, p = 0.74) or Nightly Sleep (Day: F(5,21) = 0.86, p = 0.51; Condition: F(1,25) = 1.78, p = 0.19; Day by Condition: F(5,21) = 0.79, p = 0.56) periods. In contrast, there was a main effect of condition when examining sleep duration by day between conditions (Day: F(5,21) = 1.60, p = 0.16; Condition: F(1,25) = 167.31, p < 0.001; Day by Condition: F(5,21) = 2.31, p = 0.07), such that sleep duration was longer during the sleep extension condition. DISCUSSION Sleep duration increased during six days of a sleep extension protocol but activity levels remained similar to their baseline (normal) sleep schedule. The current findings suggest that extending time in bed alone does not alter waking activity counts in young healthy adults. The link between extended sleep and adverse health outcomes may be attributable to other phenotypic factors, or other biological correlates of extended sleep and poor health.
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Affiliation(s)
- Jaime K Devine
- Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Tina M Burke
- Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Lillian Skeiky
- Sleep and Performance Research Center, Washington State University, Spokane, WA, USA
| | - Jake J Choynowski
- Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Phillip J Quartana
- Military Psychiatry Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Thomas J Balkin
- Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Vincent F Capaldi
- Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Allison J Brager
- Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Guido Simonelli
- Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
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Haddad S, Dennis CL, Shah PS, Stremler R. Sleep in parents of preterm infants: A systematic review. Midwifery 2019; 73:35-48. [PMID: 30877909 DOI: 10.1016/j.midw.2019.01.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 01/09/2019] [Accepted: 01/13/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND Sleep disruption during the first postpartum year is associated with several negative health outcomes including postpartum depression. Such disruption may be a greater issue for parents of preterm neonates, yet literature on this subject has not been critically reviewed. OBJECTIVE To synthesize literature on sleep quantity, sleep quality, and factors influencing sleep among parents of preterm infants during infant hospitalization and following discharge. DESIGN A systematic review. DATA SOURCES Medline, EMBASE, CINAHL, PsycINFO, Scopus, and Cochrane Database of Systematic Reviews were searched from their inception to February 2017. METHODS Potentially eligible citations were reviewed by two independent reviewers. Both quantitative and qualitative studies were eligible for inclusion. Data on eligible studies and review outcomes were extracted using a customized form. FINDINGS Eighteen reports from 16 studies met inclusion criteria. Four studies included a control group of parents of full-term infants. Three studies reported sleep quantity means, of which only one provided values for an exclusive sample of mothers of preterm infants and found on average, mothers obtained 6.3 h of sleep/day in the first 5-10 days. Twelve studies reported on sleep quality; most (n = 10) relied on self-reported measures and identified poor subjective sleep quality whereas two studies objectively measured sleep of poor quality. Parental stress was the most consistent factor associated with sleep quality. CONCLUSION AND IMPLICATIONS Quality and quantity of sleep among parents of preterm infants is inadequate and may negatively influence family health outcomes. Further research on correlates and changes in sleep is required to identify at-risk parents and inform targeted clinical recommendations and interventions aimed at maximizing sleep for parents of preterm infants.
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Affiliation(s)
- Summer Haddad
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada; The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada.
| | - Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Prakesh S Shah
- Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Robyn Stremler
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada; The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
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136
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Frech A, Damaske S. Men's Income Trajectories and Physical and Mental Health at Midlife. AJS; AMERICAN JOURNAL OF SOCIOLOGY 2019; 124:1372-1412. [PMID: 34176948 PMCID: PMC8231310 DOI: 10.1086/702775] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Using time-varying, prospectively measured income in a nationally representative sample of Baby-Boomer men (the National Longitudinal Survey of Youth - 1979 [NLSY79]), we identify eight group-based trajectories of income between ages 25-49 and use multinomial treatment models to describe the associations between group-based income trajectories and mental and physical health at midlife. We find remarkable rigidity in income trajectories: less than 25% of our sample experiences significant upward or downward mobility between the ages of 25 to 49 and most who move remain or move into poverty. Men's physical and mental health at age fifty is strongly associated with their income trajectories, and some upwardly mobile men achieve the same physical and mental health as the highest earning men after adjusting for selection. The worse physical and mental health of men on other income trajectories is largely attributable to their early life disadvantages, health behaviors, and cumulative work experiences.
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137
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Neher M, Nygårdh A, Nilsen P, Broström A, Johansson P. Implementing internet-delivered cognitive behavioural therapy for patients with cardiovascular disease and psychological distress: a scoping review. Eur J Cardiovasc Nurs 2019; 18:346-357. [PMID: 30795698 DOI: 10.1177/1474515119833251] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Comorbid psychological distress (i.e. insomnia and depression) is experienced by 20-40% of patients with cardiovascular disease. This has a considerable impact on their health and quality of life, leading to frequent re-hospitalisations, higher healthcare costs and a shorter life expectancy. Internet-based cognitive behavioural therapy shows great potential for treating psychological distress in cardiovascular disease. Effective and feasible treatments can, however, only benefit patients if they are fully implemented in clinical care. AIM This scoping review aimed to explore the literature for internet-based cognitive behavioural therapy in cardiovascular disease and for strategies to implement the intervention. METHODS We searched electronic databases, journals and internet sources to find original studies about internet-based cognitive behavioural therapy in cardiovascular disease, adhering to scoping methodology guidelines. After identifying 267 titles, we screened 40 abstracts and chose 11 full-text articles for full-text screening. The results sections in four articles were searched for outcomes that related to the effectiveness and implementation of internet-based cognitive behavioural therapy by directed qualitative content analysis using an implementation framework. RESULTS Three of the four articles fulfilling the inclusion criteria concerned internet-based cognitive behavioural therapy for treating mild to moderate depressive symptoms in cardiovascular disease, and none focused on insomnia. The studies showed evidence for the effectiveness of internet-based cognitive behavioural therapy, and/or described patient factors influencing clinical effectiveness. Our qualitative content analysis showed that many implementation aspects and stakeholder perspectives remain unexplored. CONCLUSIONS Internet-based cognitive behavioural therapy promises to alleviate patient suffering in cardiovascular disease. There is, however, little research about internet-based cognitive behavioural therapy for cardiovascular disease, and about how this evidence-based intervention is implemented.
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Affiliation(s)
- Margit Neher
- 1 Department of Medical and Health Sciences, Linköping University, Sweden
| | - Annette Nygårdh
- 2 Department of Nursing Sciences, Jönköping University, Sweden
| | - Per Nilsen
- 1 Department of Medical and Health Sciences, Linköping University, Sweden
| | - Anders Broström
- 2 Department of Nursing Sciences, Jönköping University, Sweden.,3 Department of Clinical Neurophysiology, Linköping University Hospital, Sweden
| | - Peter Johansson
- 4 Department of Social and Welfare Studies, Linköping University, Sweden.,5 Department of Internal Medicine, Linköping University, Sweden
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138
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Chen TY, Winkelman JW, Mao WC, Yeh CB, Huang SY, Kao TW, Yang CCH, Kuo TBJ, Chen WL. Short Sleep Duration Is Associated With Increased Serum Homocysteine: Insights From a National Survey. J Clin Sleep Med 2019; 15:139-148. [PMID: 30621835 DOI: 10.5664/jcsm.7588] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 10/05/2018] [Indexed: 12/17/2022]
Abstract
STUDY OBJECTIVES Both short sleep duration and increased serum homocysteine levels are associated with cardiovascular events. However, research on the relationship between sleep duration and serum homocysteine levels is sparse. The aim of this study is to examine the association between sleep duration and serum homocysteine levels from a national database. METHODS In total, 4,480 eligible participants older than 20 years who had serum homocysteine data and reported sleep duration were enrolled from the US National Health and Nutrition Examination Survey of 2005 to 2006. The association between sleep duration and serum homocysteine levels was analyzed using multivariate regression models for covariate adjustment. RESULTS Serum homocysteine level was lowest in individuals with a sleep duration of 7 hours and increased in those with both shorter and longer self-reported total sleep time (groups were categorized into ≤ 5 hours, 6 hours, 7 hours, 8 hours, and ≥ 9 hours). After adjustment for covariates, those in the group sleeping ≤ 5 hours had significantly higher serum homocysteine levels than the reference group (sleep duration of 7 hours). In subgroup analyses by sex, body mass index (BMI), and ethnicity, the association between short sleep duration (≤ 5 hours) and higher serum homocysteine levels persisted in women, individuals with obesity (BMI ≥ 30 kg/m2), and non-Hispanic whites. CONCLUSIONS This study highlighted that short sleep duration was associated with higher serum homocysteine levels in women, individuals with obesity (BMI ≥ 30 kg/m2), and non-Hispanic whites; this finding might suggest increased vulnerability to cardiovascular risk or other atherothrombotic events in these groups in the context of short sleep.
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Affiliation(s)
- Tien-Yu Chen
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan.,School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
| | - John W Winkelman
- Departments of Psychiatry and Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Wei-Chung Mao
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Chin-Bin Yeh
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - San-Yuan Huang
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Tung-Wei Kao
- School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Division of Family Medicine and Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan
| | - Cheryl C H Yang
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Terry B J Kuo
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Sleep Research Center, National Yang-Ming University, Taipei, Taiwan.,Graduate Institute of Biomedical informatics, Taipei Medical University, Taipei, Taiwan
| | - Wei-Liang Chen
- School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan.,Division of Family Medicine and Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan
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139
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Paixão DL, Poyares D, de Paula MS, Duarte JW, Castelo PM, Ambrogini-Júnior O, Miszputen SJ, Oshima CTF, Chagas JR, Paiotti APR. Evaluation of Home Polysomnography Findings, Quality of Sleep, and Fatigue in Inflammatory Bowel Disease: A Case Series. J Clin Sleep Med 2019; 15:39-45. [PMID: 30621826 DOI: 10.5664/jcsm.7566] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 08/30/2018] [Indexed: 12/18/2022]
Abstract
STUDY OBJECTIVES The pathogenesis of inflammatory bowel disease (IBD) is not well understood, and sleep disorders may be potential triggers for IBD. Thus, an evaluation of the sleep characteristics, fatigue symptoms, and cytokine levels was performed in patients with IBD during periods of active disease and remission. METHODS A total of 20 participants presenting with Crohn's disease or ulcerative colitis, with active disease (n = 7) or in remission (n = 13), underwent home polysomnography (H-PSG). Pittsburgh Sleep Quality Index (PSQI) and Modified Fatigue Impact Scale (MFIS) were applied, in addition to the evaluation of interleukin (IL)-6, IL-10, and tumor necrosis factor alpha (TNF-α) serum levels. Exploratory analysis, t test and Mann-Whitney U test were used. RESULTS The mean sleep latency in patients with active disease was 133.07 minutes and 106.79 minutes in those in remission. The sleep efficiency and sleep fragmentation in patients with active disease and those in remission were 80.90% and 84.20% (median), and 76.36/min and 69.82/min (mean), respectively, although the H-PSG parameters did not differ between the groups. The PSQI scores indicated poor sleep quality (global score above 5) in all participants with IBD, and the participants with active disease presented more symptoms of fatigue (P = .032). IL-6 and TNF-α average levels were higher in the participants with disease remission, although with a larger dispersion of the data. CONCLUSIONS No significant difference in the H-PSG characteristics was observed between the patients with IBD with active disease and those in remission; however, the perception of the participants with IBD showed significant effect on the sleep quality and fatigue symptoms.
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Affiliation(s)
- Deise Lun Paixão
- Department of Pathology, Universidade Federal de São Paulo, Escola Paulista de Medicina, UNIFESP, São Paulo, Brazil
| | - Dalva Poyares
- Department of Psychobiology, Universidade Federal de São Paulo, Escola Paulista de Medicina, UNIFESP, São Paulo, Brazil.,Sleep Institute, Universidade Federal de São Paulo, Escola Paulista de Medicina, UNIFESP, São Paulo, Brazil
| | - Marta Sevilh de Paula
- Sleep Institute, Universidade Federal de São Paulo, Escola Paulista de Medicina, UNIFESP, São Paulo, Brazil
| | - Joselmo Willamy Duarte
- Department of Pathology, Universidade Federal de São Paulo, Escola Paulista de Medicina, UNIFESP, São Paulo, Brazil
| | - Paula Midor Castelo
- Department of Pharmaceutical Sciences, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil
| | - Orlando Ambrogini-Júnior
- Department of Medicine, Discipline of Gastroenterology, Universidade Federal de São Paulo, Escola Paulista de Medicina, UNIFESP, São Paulo, Brazil
| | - Sender Jankie Miszputen
- Department of Medicine, Discipline of Gastroenterology, Universidade Federal de São Paulo, Escola Paulista de Medicina, UNIFESP, São Paulo, Brazil
| | - Celina Tizuko Fujiyam Oshima
- Department of Pathology, Universidade Federal de São Paulo, Escola Paulista de Medicina, UNIFESP, São Paulo, Brazil.,Department of Medicine, Discipline of Gastroenterology, Universidade Federal de São Paulo, Escola Paulista de Medicina, UNIFESP, São Paulo, Brazil
| | - Jair Ribeir Chagas
- Department of Psychobiology, Universidade Federal de São Paulo, Escola Paulista de Medicina, UNIFESP, São Paulo, Brazil
| | - Ana Paula Ribeir Paiotti
- Department of Pathology, Universidade Federal de São Paulo, Escola Paulista de Medicina, UNIFESP, São Paulo, Brazil.,Department of Medicine, Discipline of Gastroenterology, Universidade Federal de São Paulo, Escola Paulista de Medicina, UNIFESP, São Paulo, Brazil
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140
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Cooper LN, Mishra I, Ashley NT. Short-Term Sleep Loss Alters Cytokine Gene Expression in Brain and Peripheral Tissues and Increases Plasma Corticosterone of Zebra Finch (Taeniopygia guttata). Physiol Biochem Zool 2019; 92:80-91. [DOI: 10.1086/701170] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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141
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Rampes S, Ma K, Divecha YA, Alam A, Ma D. Postoperative sleep disorders and their potential impacts on surgical outcomes. J Biomed Res 2019; 34:271-280. [PMID: 32519977 PMCID: PMC7386412 DOI: 10.7555/jbr.33.20190054] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Postoperative sleep disturbance is a common occurrence with significant adverse effects on patients including delayed recovery, impairment of cognitive function, pain sensitivity and cardiovascular events. The development of postoperative sleep disturbance is multifactorial and involves the surgical inflammatory response, the severity of surgical trauma, pain, anxiety, the use of anesthetics and environmental factors such as nocturnal noise and light levels. Many of these factors can be managed perioperatively to minimize the deleterious impact on sleep. Pharmacological and non-pharmacological treatment strategies for postoperative sleep disturbance include dexmedetomidine, zolpidem, melatonin, enhanced recovery after surgery (ERAS) protocol and controlling of environmental noise and light levels. It is likely that a combination of pharmacological and non-pharmacological therapies will have the greatest impact; however, further research is required before their use can be routinely recommended.
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Affiliation(s)
- Sanketh Rampes
- Faculty of Life Sciences & Medicine, King's College London, London SE1 1UL, UK
| | - Katie Ma
- Faculty of Life Sciences & Medicine, King's College London, London SE1 1UL, UK
| | - Yasmin Amy Divecha
- Faculty of Life Sciences & Medicine, King's College London, London SE1 1UL, UK
| | - Azeem Alam
- Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London SW10 9NH, UK
| | - Daqing Ma
- Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London SW10 9NH, UK
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142
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Erçen Diken Ö, Arslan M, Deniz H. NEUTROPHIL TO LYMPHOCYTE RATIO IN OBSTRUCTIVE SLEEP APNEA SYNDROME. ACTA ACUST UNITED AC 2018. [DOI: 10.16919/bozoktip.373792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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143
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Li X, Pang X, Liu Z, Zhang Q, Sun C, Yang J, Li Y. Joint effect of less than 1 h of daytime napping and seven to 8 h of night sleep on the risk of stroke. Sleep Med 2018; 52:180-187. [DOI: 10.1016/j.sleep.2018.05.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 05/09/2018] [Accepted: 05/15/2018] [Indexed: 12/12/2022]
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144
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145
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Shaver JL, Iacovides S. Sleep in Women with Chronic Pain and Autoimmune Conditions: A Narrative Review. Sleep Med Clin 2018; 13:375-394. [PMID: 30098754 DOI: 10.1016/j.jsmc.2018.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Chronic pain and sleep disturbances are intricately intertwined. This narrative review provides comments on observations related to pain, stress-immunity, and sleep. Sleep evidence is reviewed from studies of select conditions involving pain (ie, functional somatic syndromes and autoimmune) that are predominant in women. Chronic pain and poor sleep encompass persistent stress-immune activation with systemic inflammation, cellular oxidative stress, and sick behavior indicators that increase morbidity and threaten quality of life. In painful conditions, sleep impairments are nearly ubiquitous, and exaggerated combined effects should not be underestimated or ignored, nor should crucial implications for clinical practice and research.
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Affiliation(s)
- Joan L Shaver
- Biobehavioral Health Science Division, University of Arizona College of Nursing, 1305 North Martin Avenue, Tucson, AZ 85721, USA.
| | - Stella Iacovides
- Faculty of Health Sciences, Brain Function Research Group, School of Physiology, University of the Witwatersrand, 7 York Road, Parktown 2193, Johannesburg, South Africa
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146
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Fan Z, Lu X, Long H, Li T, Zhang Y. The association of hemocyte profile and obstructive sleep apnea. J Clin Lab Anal 2018; 33:e22680. [PMID: 30246267 DOI: 10.1002/jcla.22680] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 08/20/2018] [Accepted: 08/27/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The hemocyte profile is one of the most frequently requested clinical laboratory tests. However, the analysis of blood cell indexes of obstructive sleep apnea (OSA) patients in previous studies was not comprehensive. And, this study aimed to fully analyze the blood routine in OSA patients. METHODS A retrospective study was conducted on 1087 male patients, who were admitted to the sleep center of Nanfang Hospital from May 2013 to February 2018. According to the apnea hypopnea index (AHI), patients were divided into four groups: control group (AHI < 5, n = 135), mild OSA (5 ≦ AHI < 15, n = 185), moderate OSA (15 ≦ AHI < 30, n = 171), and severe OSA (AHI ≧ 30, n = 596). Data collected included sleep parameters, complete blood routine, body mass index (BMI), age, and comorbidities. RESULTS In our study, leukocytes, neutrophils, lymphocytes, monocytes, eosinophils, basophils, erythrocytes, hemoglobin, hematocrit, platelets, MPV, and PDW-SD were statistically significant among the four groups based on AHI (P < 0.05), but no significant differences were found in MCV, RDW-SD, N/L, and P/L ratio (P > 0.05). Neutrophils, lymphocytes, monocytes, eosinophils, basophils, hemoglobin, hematocrit, platelets, and MPV were significantly correlated with AHI. Moreover, multiple linear regression analysis demonstrated that hematocrit (β = 73.254, P = 0.001), neutrophils (β = 1.414, P = 0.012), and lymphocytes (β = 4.228, P < 0.001) were independently associated with AHI. CONCLUSION Neutrophils, lymphocytes, and hematocrit were independently associated with OSA severity. And combining these three blood cell indicators could contribute to the diagnosis of OSA.
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Affiliation(s)
- Zeqin Fan
- Sleep Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaoxia Lu
- Sleep Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hong Long
- Sleep Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Taoping Li
- Sleep Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yanhong Zhang
- Health Care Center, Guangdong Entry-exit Inspection and Quarantine Bureau, Guangzhou, China
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147
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Lima MG, Barros MBDA, Ceolim MF, Zancanella E, Cardoso TAMDO. Sleep duration, health status, and subjective well-being: a population-based study. Rev Saude Publica 2018; 52:82. [PMID: 30183844 PMCID: PMC6122876 DOI: 10.11606/s1518-8787.2018052000602] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 12/20/2017] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE To evaluate, in a population-based approach, the association of extreme sleep duration with sociodemographic factors, health, and well-being. METHODS We analyzed the data from the 2014/2015 Health Survey in the city of Campinas, State of São Paulo, Brazil (ISACamp), performed with 1,969 individuals (≥ 20 years old). Associations between the independent variable and short (≤ 6 hours) and long (≥ 9 hours) sleep were determined using the Rao-Scott chi-square test. The analyses were adjusted with multinomial logistic regression models. RESULTS Men, individuals aged 40 to 59, those with higher schooling, those who have one (OR = 1.47, 95%CI 1.02–2.12), two (OR = 1.73, 95%CI 1.07–2.80), or three or more (OR = 1.62, 95%CI 1.16–2.28) chronic diseases, and those with three or more health problems (OR = 1.96, 95%CI 1.22–3.17) were more likely to have a short sleep. The chance of long sleep was higher in widowers and lower in those who have more years of schooling, with higher income, worked, lived with more residents at home, and reported three or more diseases (OR = 0.68, 95%CI 0.48–0.97) and health problems. The chance of either short (OR = 2.41, 95%CI 1.51–3.87) or long sleep (OR = 2.07, 95%CI 1.23–3.48) was higher in unhappy individuals. CONCLUSIONS These findings highlight the higher chance of short sleep duration among men, among persons in productive age, and among those with a higher level of schooling in a Brazilian city. The association of short sleep with comorbidities and the association of happiness with extremes of sleep duration were also important results to understand the relation of sleep duration with health and well-being.
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Affiliation(s)
- Margareth Guimarães Lima
- Universidade Estadual de Campinas. Faculdade de Ciências Médicas. Departamento de Saúde Coletiva. Campinas, SP, Brasil
| | | | | | - Edilson Zancanella
- Universidade Estadual de Campinas. Faculdade de Ciências Médicas. Departamento de Oftalmologia/Otorrinolaringologia. Campinas, SP, Brasil
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Faraut B, Malmartel A, Ghosn J, Duracinsky M, Leger D, Grabar S, Viard JP. Sleep Disturbance and Total Sleep Time in Persons Living with HIV: A Cross-Sectional Study. AIDS Behav 2018; 22:2877-2887. [PMID: 29855973 DOI: 10.1007/s10461-018-2179-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Short and long sleep durations have been associated with inflammation and chronic diseases. To study the association between sleep duration/quality and HIV disease severity, a cross-sectional study was conducted in patients living with HIV (PLWHs) using self-administered questionnaires assessing total sleep time, insomnia (ICSD-3 criteria), and poor sleep quality (PSQI > 5). Multivariable logistic regression identified the factors associated with sleep disorders and with HIV features. 640 Parisian ambulatory PLWHs were included. The prevalence of insomnia was 50 and 68% of patients had a PSQI > 5. Patients with CD4 count < 500 cells/mm3 were more likely to be long sleepers (> 8 h/day) (OR 1.49; 95% CI [1.10-1.99]: p < 0.01), and less likely to be short sleepers (< 6 h/day) (OR 0.69; 95% CI[0.50-0.96]; p = 0.04) or to experience insomnia (OR 0.59; 95% CI[0.40-0.86]; p < 0.01). HIV features were not associated with a PSQI > 5. Thus, insomnia and impaired sleep quality were highly prevalent in well-controlled PLWHs and the severity of HIV infection was associated with long sleep times.
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149
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Sex-Specific Associations Between Self-reported Sleep Duration, Cardiovascular Disease, Hypertension, and Mortality in an Elderly Population. J Cardiovasc Nurs 2018; 33:422-428. [DOI: 10.1097/jcn.0000000000000393] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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150
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Hu L, Zhou Y, Huang X, Liang Q, You C, Zhou W, Li J, Li P, Wu Y, Wu Q, Wang Z, Gao R, Bao H, Cheng X. Association between subjective sleep duration on workdays or non-workdays and uncontrolled blood pressure in Southern China. ACTA ACUST UNITED AC 2018; 12:742-750. [PMID: 30145322 DOI: 10.1016/j.jash.2018.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 06/23/2018] [Accepted: 07/27/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To examine the association between sleep duration on workdays or non-workdays and unsatisfactory blood pressure (BP) control in Southern China. METHODS We analyzed 4370 hypertensive patients, including their self-reported sleep duration on workdays or non-workdays and their BP. Unsatisfactory BP control was defined as systolic BP of ≥140 mm Hg or diastolic BP of ≥90 mm Hg. Multivariate logistic regression analyses were performed to evaluate the association between sleep duration and unsatisfactory BP control. RESULTS Overall, the multivariable-adjusted odds ratios of unsatisfactory BP control risk were 1.59 (95% confidence interval, 1.14-2.22) for 9-10 hours of sleep on workdays and 1.47 (95% confidence interval, 1.07-2.03) for ≥10 hours of sleep on non-workdays compared with a sleep duration of 5-9 hours. No association between a short sleep duration and unsatisfactory BP control was noted. The association between a longer sleep duration (≥10 hours) and unsatisfactory BP control was more pronounced among women aged 65-70 years, with a body mass index ≥ 24 kg/m2. CONCLUSION People with hypertension who slept 9-10 hours on workdays and ≥10 hours on non-workdays were more likely to have unsatisfactory BP control compared with those with a sleep duration of 5-9 hours; these associations tended to vary by age, sex, and body mass index. These findings indicate that a longer sleep duration might be a way to predict uncontrolled BP in hypertensive adults.
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Affiliation(s)
- Lihua Hu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Yihua Zhou
- Department of ICU, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Xiao Huang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Qian Liang
- Jiangxi Key Laboratory of Molecular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Chunjiao You
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Wei Zhou
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Juxiang Li
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Ping Li
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Yanqing Wu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Qinghua Wu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Zengwu Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Runlin Gao
- Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Huihui Bao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China; Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China.
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China; Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China.
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