101
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Vitale KC, Owens R, Hopkins SR, Malhotra A. Sleep Hygiene for Optimizing Recovery in Athletes: Review and Recommendations. Int J Sports Med 2019; 40:535-543. [PMID: 31288293 DOI: 10.1055/a-0905-3103] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
For elite athletes who exercise at a high level, sleep is critical to overall health. Many studies have documented the effects of sleep deprivation in the general population, but few studies exist regarding specific effects in the athlete. This review summarizes the effects of sleep deprivation and sleep extension on athletic performance, including reaction time, accuracy, strength and endurance, and cognitive function. There are clear negative effects of sleep deprivation on performance, including reaction time, accuracy, vigor, submaximal strength, and endurance. Cognitive functions such as judgment and decision-making also suffer. Sleep extension can positively affect reaction times, mood, sprint times, tennis serve accuracy, swim turns, kick stroke efficiency, and increased free throw and 3-point accuracy. Banking sleep (sleep extension prior to night of intentional sleep deprivation before sporting event) is a new concept that may also improve performance. For sports medicine providers, the negative effects of sleep deprivation cannot be overstated to athletes. To battle sleep deprivation, athletes may seek supplements with potentially serious side effects; improving sleep quality however is simple and effective, benefiting not only athlete health but also athletic performance.
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Affiliation(s)
- Kenneth C Vitale
- Orthopaedic Surgery, University of California San Diego School of Medicine, La Jolla, United States
| | - Roberts Owens
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of California San Diego School of Medicine, La Jolla, United States
| | - Susan R Hopkins
- Medicine and Radiology, University of California San Diego, La Jolla, United States
| | - Atul Malhotra
- Medicine, Division of Pulmonary and Critical Care Medicine, University of California San Diego, La Jolla, United States
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102
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Ogilvie RP, Patel SR. Changing national trends in sleep duration: did we make America sleep again? Sleep 2019; 41:4954024. [PMID: 29590485 DOI: 10.1093/sleep/zsy055] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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103
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Li Y, Gu S, Wang Z, Li H, Xu X, Zhu H, Deng S, Ma X, Feng G, Wang F, Huang JH. Relationship Between Stressful Life Events and Sleep Quality: Rumination as a Mediator and Resilience as a Moderator. Front Psychiatry 2019; 10:348. [PMID: 31191370 PMCID: PMC6545794 DOI: 10.3389/fpsyt.2019.00348] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 05/02/2019] [Indexed: 12/27/2022] Open
Abstract
Purpose: The aim of this study was to investigate the relationship between stressful life events and sleep quality and to probe the role of rumination and resilience in the relationship. Method: The Adolescent Self-Rating Life Events Checklist, Ruminative Responses Scale, Connor-Davidson Resilience Scale, and Pittsburgh Sleep Quality Index were used among 1,065 college students. Statistical Product and Service Solutions (SPSS) 20.0 and the SPSS macro Process, which were specifically developed for assessing complex models including both mediators and moderators, were used to analyze the data. Results: High scores of stressful life events predicted worse sleep quality. Rumination partially mediated the relations between stressful life events and sleep quality. Resilience moderated the direct and indirect paths leading from stressful life events to sleep quality. Conclusions: The results demonstrate that stressful life events can directly affect the sleep quality of college students and indirectly through rumination. Additionally, increasing psychological resilience could decrease both the direct effect and the indirect effect of stressful life events affecting sleep quality. The results of this study may contribute to a better understanding of the effects, as well as the paths and conditions, of stressful life events on sleep quality in college students. Moreover, these findings can provide constructive suggestions for improving college students' sleep quality.
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Affiliation(s)
- Yukun Li
- Department of Psychology, School of Medicine, Jiangsu University, Zhenjiang, China
| | - Simeng Gu
- Department of Psychology, School of Medicine, Jiangsu University, Zhenjiang, China
| | - Zhutao Wang
- Department of Psychology, School of Medicine, Jiangsu University, Zhenjiang, China
| | - Hongfan Li
- Department of Psychology, School of Medicine, Jiangsu University, Zhenjiang, China
| | - Xiayue Xu
- Department of Psychology, School of Medicine, Jiangsu University, Zhenjiang, China
| | - Huan Zhu
- Department of Psychology, School of Medicine, Jiangsu University, Zhenjiang, China
| | - Shiji Deng
- Department of Psychology, School of Medicine, Jiangsu University, Zhenjiang, China
| | - Xianjun Ma
- Department of Encephalopathy, Lianyungang Affiliated Hospital, Nanjing University of Chinese Medicine, Lianyungang, China
| | - Guangkui Feng
- Department of Encephalopathy, Lianyungang Affiliated Hospital, Nanjing University of Chinese Medicine, Lianyungang, China
| | - Fushun Wang
- School of Psychology, Institute of Emotional Studies, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jason H. Huang
- Department of Neurosurgery, Baylor Scott & White Health, Temple, TX, United States
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104
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Mental health in elite athletes: International Olympic Committee consensus statement (2019). Br J Sports Med 2019; 53:667-699. [DOI: 10.1136/bjsports-2019-100715] [Citation(s) in RCA: 349] [Impact Index Per Article: 69.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2019] [Indexed: 11/03/2022]
Abstract
Mental health symptoms and disorders are common among elite athletes, may have sport related manifestations within this population and impair performance. Mental health cannot be separated from physical health, as evidenced by mental health symptoms and disorders increasing the risk of physical injury and delaying subsequent recovery. There are no evidence or consensus based guidelines for diagnosis and management of mental health symptoms and disorders in elite athletes. Diagnosis must differentiate character traits particular to elite athletes from psychosocial maladaptations.Management strategies should address all contributors to mental health symptoms and consider biopsychosocial factors relevant to athletes to maximise benefit and minimise harm. Management must involve both treatment of affected individual athletes and optimising environments in which all elite athletes train and compete. To advance a more standardised, evidence based approach to mental health symptoms and disorders in elite athletes, an International Olympic Committee Consensus Work Group critically evaluated the current state of science and provided recommendations.
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105
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Gildner TE, Salinas-Rodríguez A, Manrique-Espinoza B, Moreno-Tamayo K, Kowal P. Does poor sleep impair cognition during aging? Longitudinal associations between changes in sleep duration and cognitive performance among older Mexican adults. Arch Gerontol Geriatr 2019; 83:161-168. [PMID: 31059924 DOI: 10.1016/j.archger.2019.04.014] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 04/10/2019] [Accepted: 04/28/2019] [Indexed: 11/24/2022]
Abstract
Alterations in sleep patterns are common among older adults; further, short and long sleep durations have been linked with impaired cognitive performance in older individuals. Yet most research examining these relationships has been cross-sectional, limited to high-income nations, and has failed to consider how changes in sleep duration may impact cognitive decline. The present longitudinal study uses nationally-representative data to test whether changes in sleep length among "healthy" baseline sleepers are associated with reduced cognitive function in older Mexican adults (>50 years old) at follow-up. Data were drawn from the first and second waves of the World Health Organization's Study on global AGEing and adult health. Self-report data captured sleep duration over two nights, and five cognitive tests (immediate and delayed verbal recall, forward and backward digit span, and verbal fluency) were used to measure various cognitive domains and create a composite z-score of cognitive performance. Linear regressions were performed to assess associations between sleep length changes and cognitive decline, controlling for relevant lifestyle and health factors. Increased sleep durations at follow-up among individuals who reported intermediate sleep durations (6-9 h/night) at baseline were significantly associated with greater rates of decline in overall cognitive function. Longer sleepers also trended toward greater rates of decline for attention/working memory and executive function. This study suggests that long sleep durations are a risk factor for certain types of impaired cognition among older adults living in a middle-income country. These findings are clinically important given the growing rates of dementia and aging populations globally.
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Affiliation(s)
- Theresa E Gildner
- Department of Anthropology, Dartmouth College, 6047 Hinman Box, 3 Tuck Mall, Hanover, NH, 03755 United States(1).
| | - Aarón Salinas-Rodríguez
- Center for Evaluation Research and Surveys, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Betty Manrique-Espinoza
- Center for Evaluation Research and Surveys, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Karla Moreno-Tamayo
- Epidemiological Research Unit and Health Services Aging Area, National Medical Center XXI Century, Mexican Social Security Institute, Mexico City, Mexico
| | - Paul Kowal
- World Health Organization, Geneva, Switzerland; University of Newcastle Research Centre on Generational Health, and Ageing, Newcastle, NSW, Australia; Chiang Mai University Research Institute for Health Sciences, Thailand
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106
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Nappier MT, Bartl-Wilson L, Shoop T, Borowski S. Sleep Quality and Sleepiness Among Veterinary Medical Students Over an Academic Year. Front Vet Sci 2019; 6:119. [PMID: 31058173 PMCID: PMC6478749 DOI: 10.3389/fvets.2019.00119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 03/29/2019] [Indexed: 11/13/2022] Open
Abstract
Good sleep health is a key component to good personal well-being. It has been postulated that veterinary students have poor sleep health, but few measurements have been undertaken. This study measured Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale values at multiple points throughout an academic year for students in a veterinary medical curriculum. Students were found to have overall poor sleep quality and above average to excessive daytime sleepiness. Further investigation is necessary to determine specific causes as well as what action can be taken to improve student sleep health.
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Affiliation(s)
- Michael T Nappier
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, United States
| | - Lara Bartl-Wilson
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, United States
| | - Tiffany Shoop
- Center for Excellence in Teaching and Learning, Virginia Tech, Blacksburg, VA, United States
| | - Shelby Borowski
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, United States
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107
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Wang S, Meeker JW, Perkins AJ, Gao S, Khan SH, Sigua NL, Manchanda S, Boustani MA, Khan BA. Psychiatric symptoms and their association with sleep disturbances in intensive care unit survivors. Int J Gen Med 2019; 12:125-130. [PMID: 30962706 PMCID: PMC6434907 DOI: 10.2147/ijgm.s193084] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Sleep disturbances in critically ill patients are associated with poorer long-term clinical outcomes and quality of life. Studies are needed to better characterize associations and risk factors for persistent sleep disturbances after intensive care unit (ICU) discharge. Psychiatric disorders are frequently associated with sleep disturbances, but the role of psychiatric symptoms in sleep disturbances in ICU survivors has not been well-studied. Objective To examine the association between psychiatric symptoms and sleep disturbances in ICU survivors. Methods 112 adult ICU survivors seen from July 2011 to August 2016 in the Critical Care Recovery Center, an ICU survivor clinic at the Eskenazi Hospital in Indianapolis, IN, USA, were assessed for sleep disturbances (insomnia, hypersomnia, difficulty with sleep onset, difficulty with sleep maintenance, and excessive daytime sleepiness) and psychiatric symptoms (trauma-related symptoms and moderate to severe depressive symptoms) 3 months after ICU discharge. A multivariate logistic regression model was performed to examine the association between psychiatric symptoms and sleep disturbances. Analyses were controlled for age, hypertension, history of depression, and respiratory failure. Results ICU survivors with both trauma-related and depression symptoms (OR 16.66, 95% CI 2.89–96.00) and trauma-related symptoms alone (OR 4.59, 95% CI 1.11–18.88) had a higher likelihood of sleep disturbances. Depression symptoms alone were no longer significantly associated with sleep disturbances when analysis was controlled for trauma-related symptoms. Conclusion Trauma-related symptoms and trauma-related plus moderate to severe depressive symptoms were associated with a higher likelihood of sleep disturbances. Future studies are needed to determine whether psychiatric symptoms are associated with objective changes on polysomnography and actigraphy and whether adequate treatment of psychiatric symptoms can improve sleep disturbances.
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Affiliation(s)
- Sophia Wang
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46202 USA, .,Center for Health Innovation and Implementation Science, Clinical and Translational Science Institute, Indianapolis, IN, USA, .,Sandra Eskenazi Center for Brain Care Innovation, Eskenazi Hospital, Indianapolis, IN, USA,
| | - Jared W Meeker
- Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Anthony J Perkins
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sujuan Gao
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sikandar H Khan
- Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.,IU Center of Aging Research, Regenstrief Institute, Indianapolis, IN, USA
| | - Ninotchka L Sigua
- Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.,Indiana University Health Sleep Disorders Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Shalini Manchanda
- Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.,Indiana University Health Sleep Disorders Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Malaz A Boustani
- Center for Health Innovation and Implementation Science, Clinical and Translational Science Institute, Indianapolis, IN, USA, .,Sandra Eskenazi Center for Brain Care Innovation, Eskenazi Hospital, Indianapolis, IN, USA, .,IU Center of Aging Research, Regenstrief Institute, Indianapolis, IN, USA.,Division of Geriatrics and General Internal Medicine, Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Babar A Khan
- Sandra Eskenazi Center for Brain Care Innovation, Eskenazi Hospital, Indianapolis, IN, USA, .,Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.,IU Center of Aging Research, Regenstrief Institute, Indianapolis, IN, USA.,Division of Geriatrics and General Internal Medicine, Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
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108
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Wendt A, Costa CS, Machado AKF, Costa FS, Neves RG, Flores TR, Santos I, Wehrmeister FC. Sleep disturbances and daytime fatigue: data from the Brazilian National Health Survey, 2013. CAD SAUDE PUBLICA 2019; 35:e00086918. [PMID: 30864612 DOI: 10.1590/0102-311x00086918] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 10/01/2018] [Indexed: 11/21/2022] Open
Abstract
This study aims to describe the prevalence of sleep disturbances and daytime fatigue and their association with socio-demographic and behavioral factors. Data from the Brazilian National Health Survey conducted in 2013 with 60,202 adults (≥ 18 years old) were used. The outcomes evaluated were self-reported sleep disturbances and daytime fatigue in the last two weeks. Sleep disturbance was defined as the presence of difficulty to fall asleep, frequently waking up during the night or sleeping more than usual; daytime fatigue was defined as the presence of not feeling rested and motivated during the day, feeling tired and lacking energy. Sociodemographic, lifestyle and chronic health aspects were explored as exposures for both outcomes. Prevalence of sleep disturbances and daytime fatigue were 14.9% (14.4-15.4) and 11.9% (11.4-12.3), respectively. Both outcomes were more common in women, older people, people with no formal education, smokers and among physically inactive individuals. The association with education was inverse (the highest the level of education the lower the prevalence ratio - PR - of sleep disturbances and daytime fatigue; adjusted p-value for trend < 0.001). Prevalence of sleep disturbances combined with daytime fatigue was 6.7% (6.4-7.1) and was about 6 times higher among those with three or more chronic health disturbances (PR = 6.2; 95%CI: 5.3-7.2). Strategies to decrease the prevalence of sleep disturbances and daytime fatigue should be encouraged and focused on chronically ill individuals that share other modifiable risk factors.
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Affiliation(s)
- Andrea Wendt
- Universidade Federal de Pelotas, Pelotas, Brasil
| | | | | | | | | | | | - Iná Santos
- Universidade Federal de Pelotas, Pelotas, Brasil
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109
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Deering S, Grade MM, Uppal JK, Foschini L, Juusola JL, Amdur AM, Stepnowsky CJ. Accelerating Research With Technology: Rapid Recruitment for a Large-Scale Web-Based Sleep Study. JMIR Res Protoc 2019; 8:e10974. [PMID: 30664491 PMCID: PMC6360390 DOI: 10.2196/10974] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 08/14/2018] [Accepted: 09/23/2018] [Indexed: 12/23/2022] Open
Abstract
Background Participant recruitment can be a significant bottleneck in carrying out research studies. Connected health and mobile health platforms allow for the development of Web-based studies that can offer improvement in this domain. Sleep is of vital importance to the mental and physical health of all individuals, yet is understudied on a large scale or beyond the focus of sleep disorders. For this reason and owing to the availability of digital sleep tracking tools, sleep is well suited to being studied in a Web-based environment. Objective The aim of this study was to investigate a method for speeding up the recruitment process and maximizing participant engagement using a novel approach, the Achievement Studies platform (Evidation Health, Inc, San Mateo, CA, USA), while carrying out a study that examined the relationship between participant sleep and daytime function. Methods Participants could access the Web-based study platform at any time from any computer or Web-enabled device to complete study procedures and track study progress. Achievement community members were invited to the study and assessed for eligibility. Eligible participants completed an electronic informed consent process to enroll in the study and were subsequently invited to complete an electronic baseline questionnaire. Then, they were asked to connect a wearable device account through their study dashboard, which shared their device data with the research team. The data were used to provide objective sleep and activity metrics for the study. Participants who completed the baseline questionnaires were subsequently sent a daily single-item Sleepiness Checker activity for 7 consecutive days at baseline and every 3 months thereafter for 1 year. Results Overall, 1156 participants enrolled in the study within a 5-day recruitment window. In the 1st hour, the enrollment rate was 6.6 participants per minute (394 per hour). In the first 24 hours, the enrollment rate was 0.8 participants per minute (47 participants per hour). Overall, 1132 participants completed the baseline questionnaires (1132/1156, 97.9%) and 1047 participants completed the initial Sleepiness Checker activity (1047/1156, 90.6%). Furthermore, 1000 participants provided activity-specific wearable data (1000/1156, 86.5%) and 982 provided sleep-specific wearable data (982/1156, 84.9%). Conclusions The Achievement Studies platform allowed for rapid recruitment and high study engagement (survey completion and device data sharing). This approach to carrying out research appears promising. However, conducting research in this way requires that participants have internet access and own and use a wearable device. As such, our sample may not be representative of the general population.
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Affiliation(s)
- Sean Deering
- Veterans Affairs San Diego Healthcare System, Health Services Research & Development Unit, La Jolla, CA, United States.,American Sleep Apnea Association, Washington, DC, United States
| | - Madeline M Grade
- Evidation Health, San Mateo, CA, United States.,Stanford University School of Medicine, Stanford, CA, United States
| | | | | | | | - Adam M Amdur
- American Sleep Apnea Association, Washington, DC, United States
| | - Carl J Stepnowsky
- Veterans Affairs San Diego Healthcare System, Health Services Research & Development Unit, La Jolla, CA, United States.,American Sleep Apnea Association, Washington, DC, United States.,Department of Medicine, University of California at San Diego, La Jolla, CA, United States
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110
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Ogilvie RP, Bazzano LA, Gustat J, Harville EW, Chen W, Patel SR. Sex and race differences in the association between sleep duration and adiposity: the Bogalusa Heart Study. Sleep Health 2018; 5:84-90. [PMID: 30670172 DOI: 10.1016/j.sleh.2018.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 09/13/2018] [Accepted: 10/18/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Short sleep duration has been consistently associated with obesity. However, few studies in adults have assessed whether this association varies by sex and race. METHODS In the 2013-2016 examination of 1116 participants from the biracial Bogalusa Heart Study, habitual sleep duration was measured in categories (<6 hours, 6-7 hours, 7-8 hours, > 8 hours) using self-report. Anthropometry was performed and adiposity was assessed using body mass index (BMI) and waist circumference. Linear regression models estimated the relationship between sleep duration and adiposity adjusting for age, education, employment, bed partner status, depressive symptoms, smoking status, physical activity, and the use of alcohol and sleeping pills. Effect modification by sex and race was examined using cross-product terms in the models and marginal means were reported. RESULTS Of 1116 participants (mean age 48.2 years), 58.3% were female, and 31.7% were Black. In adjusted analyses, women sleeping <6 hours had a 3.2 (95% CI 1.4, 5.0) kg/m2 greater BMI and 6.1 (1.8, 10.4) cm greater waist circumference compared to women sleeping 7-8 hours. In contrast, men had similar BMIs and waist circumferences regardless of sleep duration (p's for interaction = 0.04 & 0.11). There was no effect modification by race. CONCLUSIONS In this sample, lower habitual sleep duration was associated with greater adiposity among women compared to men. Further research is needed to understand the potential mechanisms of the adverse metabolic effects of short sleep in women.
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Affiliation(s)
- Rachel P Ogilvie
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA.
| | - Lydia A Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Jeanette Gustat
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Emily W Harville
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Wei Chen
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Sanjay R Patel
- Department of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
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111
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Hrozanova M, Moen F, Myhre K, Klöckner C, Pallesen S. Habitual sleep patterns of junior elite athletes in cross-country skiing and biathlon: A descriptive study. COGENT MEDICINE 2018. [DOI: 10.1080/2331205x.2018.1548549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Maria Hrozanova
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Frode Moen
- Department of Education and Lifelong Learning, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kenneth Myhre
- Department of Education and Lifelong Learning, Norwegian University of Science and Technology, Trondheim, Norway
| | - Christian Klöckner
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
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112
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Research Needs on Respiratory Health in Migrant and Refugee Populations. An Official American Thoracic Society and European Respiratory Society Workshop Report. Ann Am Thorac Soc 2018; 15:1247-1255. [DOI: 10.1513/annalsats.201807-478st] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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113
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Rayward AT, Murawski B, Plotnikoff RC, Vandelanotte C, Brown WJ, Holliday EG, Duncan MJ. A randomised controlled trial to test the efficacy of an m-health delivered physical activity and sleep intervention to improve sleep quality in middle-aged adults: The Refresh Study Protocol. Contemp Clin Trials 2018; 73:36-50. [PMID: 30149076 DOI: 10.1016/j.cct.2018.08.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 08/17/2018] [Accepted: 08/23/2018] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Poor sleep health is common and has a substantial negative health impact. Physical activity has been shown to improve sleep health. Many sleep interventions do not explicitly target physical activity, potentially limiting changes in activity and also sleep. Few intervention target those with poor sleep health but without a diagnosed disorder. This study aims to examine the efficacy of a combined physical activity and sleep intervention to improve sleep quality in middle-aged adults and its effect on physical activity, depression and quality of life. METHODS A three-arm randomised trial with a three-month primary time-point, will be conducted. Adults (N = 275) aged 40-65 years, who report physical inactivity and poor sleep quality, will be randomly allocated to either a combined Physical Activity and Sleep Health, a Sleep Health-Only or a Wait List Control group. The multi-component m-health intervention will be delivered using a smartphone/tablet "app", supplemented with email and SMS. Participants will use the app to access educational material, set goals, self-monitor and receive feedback about behaviours. Assessments will be conducted at baseline, three-month primary time-point and six-month follow-up. Generalized linear models using an ANCOVA (baseline-adjusted) approach, will be used to identify between-group differences in sleep quality, following an intention-to-treat principle. DISCUSSION This study will determine whether the addition of a physical activity intervention enhances the effectiveness of a sleep intervention to improve sleep quality, relative to a sleep-only intervention, in physically inactive middle-aged adults who report poor sleep health, but without a sleep disorder.
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Affiliation(s)
- Anna T Rayward
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; School of Medicine & Public Health, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Beatrice Murawski
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; School of Medicine & Public Health, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Ronald C Plotnikoff
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; School of Education, Faculty of Education & Arts, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Corneel Vandelanotte
- Physical Activity Research Group, School for Health, Medical and Applied Sciences, CQ University, Rockhampton, QLD 4702, Australia
| | - Wendy J Brown
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD 4072, Australia
| | - Elizabeth G Holliday
- School of Medicine & Public Health, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Mitch J Duncan
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; School of Medicine & Public Health, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
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114
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Zhang L, Fu YH. The molecular genetics of human sleep. Eur J Neurosci 2018; 51:422-428. [PMID: 30144347 DOI: 10.1111/ejn.14132] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 08/15/2018] [Accepted: 08/16/2018] [Indexed: 01/01/2023]
Abstract
It has been known for many years that genetic influences account for some of the individual differences in human sleep parameters, but the underlying molecular mechanisms remain unclear. With major advances of molecular biology and the recognition of heritable sleep behaviors in humans over the past 30 years, a number of genetic variants have been identified to be associated with human sleep timing, duration and quality, both in healthy individuals and under pathological conditions. Some of these variants were further validated and characterized in animal models, shedding light on the mechanism of how these variants likely alter sleep in humans, which may provide new insights into developing more effective treatments to improve human sleep.
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Affiliation(s)
- Luoying Zhang
- Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology and Institute of Brain Research, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ying-Hui Fu
- Department of Neurology, University of California, San Francisco, California
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115
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Grandner MA. The Cost of Sleep Lost: Implications for Health, Performance, and the Bottom Line. Am J Health Promot 2018; 32:1629-1634. [PMID: 30099900 PMCID: PMC6530553 DOI: 10.1177/0890117118790621a] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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116
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Abstract
PURPOSE OF REVIEW To provide an overview of the mechanistic and epidemiologic evidence linking sleep-related exposures, such as short sleep duration, obstructive sleep apnea, shift work, and insomnia, with type 2 diabetes risk in adults. RECENT FINDINGS Both poor sleep habits and sleep disorders are highly prevalent among adults with type 2 diabetes. In observational studies, short sleep duration, obstructive sleep apnea, shift work, and insomnia are all associated with higher risk of incident type 2 diabetes and may predict worse outcomes in those with existing diabetes. However, interventional studies addressing sleep abnormalities in populations with or at high risk for type 2 diabetes are scarce. Although common sleep abnormalities are associated with risk of incident type 2 diabetes and worse prognosis in those with established diabetes, there are few randomized trials evaluating the impact of sleep-focused interventions on diabetes, making it difficult to determine whether the relationship is causal.
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Affiliation(s)
- Rachel P Ogilvie
- Department of Psychiatry, University of Pittsburgh, 3471 Fifth Avenue, Suite 1216, Kaufmann Medical Building, Pittsburgh, PA, 15213, USA.
| | - Sanjay R Patel
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, 3471 Fifth Avenue, Suite 1216, Kaufmann Medical Building, Pittsburgh, PA, 15213, USA
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Sex Differences in Sleep Duration among Older Adults with Self-Reported Diagnosis of Arthritis: National Health and Nutrition Examination Survey, 2009-2012. SLEEP DISORDERS 2018; 2018:5863546. [PMID: 30155315 PMCID: PMC6093049 DOI: 10.1155/2018/5863546] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 07/05/2018] [Accepted: 07/09/2018] [Indexed: 12/21/2022]
Abstract
Objective Sleep is restorative, essential, and beneficial to health. Prevalences of some diseases have been associated with sleep duration. There are few studies in the literature on the relationship of sleep duration and arthritis stratified by sex in older adults. The purpose of this research is to investigate sleep duration among older adults in the United States who have self-reported diagnosis of arthritis. Methods A cross-sectional study design was used. The data source was the National Health and Nutrition Examination 2009-2010 and 2011-2012. Self-reported diagnosis of arthritis and sleep duration were the variables of interest. Results There were 4,888 participants, aged 50 years and above, of whom 41.6% self-reported having a diagnosis of arthritis, and 60.6% were female. Of the people who had a self-reported diagnosis of arthritis, 15.2% reported sleeping 2-5 hours as compared with 10.9% of the people who did not have a self-reported diagnosis of arthritis (P = .0004). In bivariate analysis of self-reported diagnosis of arthritis and sleep stratified by sex, there were significantly more people with self-reported diagnosis of arthritis who slept 2-5 hours for both women (P = 0.0192) and men (P = 0.0231). The overall relationship remained significant in adjusted overall logistic regression comparing for self-reported diagnosis of arthritis for 2-5 hours of sleep (with 6-7 hours of sleep as the reference) (odds ratio: 1.35 [95% CI: 1.08, 1.70; P = 0.0103]); however, when the data were stratified by sex, the association failed to reach significance. Conclusion In this analysis of noninstitutionalized older adults in the United States, the prevalence of a self-reported diagnosis of arthritis was associated with shorter sleep duration in the overall analyses, but the association failed to reach significance when stratified by sex.
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Montserrat JM, Sánchez-de-la Torre M, Terán J, Egea C. Respiratory Disorders During Sleep: A New Dimension for 2018. Arch Bronconeumol 2018; 55:122-123. [PMID: 30054116 DOI: 10.1016/j.arbres.2018.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 05/15/2018] [Accepted: 05/22/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Josep M Montserrat
- Unitat del Son, Servei de Pneumologia, Hospital Clinic, Barcelona, España; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, España; IDIBAPS, Universitat de Barcelona, Barcelona, España.
| | - Manuel Sánchez-de-la Torre
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, España; Hospital Universitari Arnau de Vilanova i Santa Maria, IRB Lleida, Lleida, España; Coordinación CIBER línea Sleep Apnea, España
| | - Joaquín Terán
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, España; Unidad del Sueño, Servicio de Neumología, Hospital de Burgos, Universidad de Burgos, Burgos, España; Coordinación de la Sociedad Española de Sueño, España
| | - Carlos Egea
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, España; Unidad Funcional de Sueño, OSI Araba, Hospital Universitario Araba, Vitoria-Gasteiz, Araba, España; Coordinación Área Sleep Apnea, Sociedad Española de Neumología y Cirugía Torácica (SEPAR), España
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119
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Hunter JC, Hayden KM. The association of sleep with neighborhood physical and social environment. Public Health 2018; 162:126-134. [PMID: 30036811 DOI: 10.1016/j.puhe.2018.05.003] [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: 09/06/2017] [Revised: 05/04/2018] [Accepted: 05/10/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES While sleep is critical for good health, it remains a major public health concern because millions of individuals do not obtain a sufficient amount of sleep at night to reap proper health benefits. When examining factors that contribute to deleterious sleep outcomes, few researchers to date have examined the physical and social environments together. STUDY DESIGN This article is an analytical essay. METHODS In the present study, 18 empirical articles on environmental factors that promote sleep loss were analyzed and synthesized according to the study type, exposure measures, outcome measures, methodology, and findings. RESULTS Data from the literature demonstrate that neighborhood airplane, roadway, and rail noise pollution; air pollution from ozone and particulate matter (PM10); and, to some extent, ambient light, interfere with residents' ability to fall asleep, stay asleep, and wake feeling rested. There is also some evidence that neighborhood green space, walkability, safety, built environment, and other social characteristics, such as neighborhood disorder and ability to trust one's neighbors, dramatically impact residents' sleep. CONCLUSIONS This article provides a critical assessment of the multidimensional relationship between neighborhood physical and social characteristics and sleep, addresses major methodological concerns that limit current empirical knowledge, and suggests steps to shape future research.
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Affiliation(s)
- Jaimie C Hunter
- Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine Winston-Salem, NC, United States.
| | - Kathleen M Hayden
- Department of Social Sciences and Health Policy Division of Public Health Sciences, Wake Forest University School of Medicine Winston-Salem, NC, United States
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Abstract
PURPOSE OF REVIEW Sleep plays many roles in maintenance of cardiovascular health. This review summarizes the literature across several areas of sleep and sleep disorders in relation to cardiometabolic disease risk factors. RECENT FINDINGS Insufficient sleep duration is prevalent in the population and is associated with weight gain and obesity, inflammation, cardiovascular disease, diabetes, and mortality. Insomnia is also highly present and represents an important risk factor for cardiovascular disease, especially when accompanied by short sleep duration. Sleep apnea is a well-characterized risk factor for cardiometabolic disease and cardiovascular mortality. Other issues are relevant as well. For example, sleep disorders in pediatric populations may convey cardiovascular risks. Also, sleep may play an important role in cardiovascular health disparities. SUMMARY Sleep and sleep disorders are implicated in cardiometabolic disease risk. This review addresses these and other issues, concluding with recommendations for research and clinical practice.
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121
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Yang PL, Matthews SW, Ward TM. Sleep Deficiency and Psoriasis: Implications for Clinical Practice. J Nurse Pract 2018. [DOI: 10.1016/j.nurpra.2017.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Suarez-Giron MC, Isetta V, Masa JF, Egea C, Riha RL, Bonsignore MR, Montserrat JM. Sleep breathing disorders: have we reached the tipping point? ERJ Open Res 2018; 4:00172-2017. [PMID: 29670891 PMCID: PMC5900059 DOI: 10.1183/23120541.00172-2017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 02/11/2018] [Indexed: 12/15/2022] Open
Abstract
Sleep medicine: a new approach http://ow.ly/qzVh30iVkWL.
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Affiliation(s)
| | - Valentina Isetta
- Unit of Biophysics and Bioengineering, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Juan F Masa
- Pulmonary Service, Hospital San Pedro de Alcantara, Cáceres, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Carlos Egea
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Sleep Unit, Respiratory Dept, Alava University Hospital IRB, Vitoria, Spain
| | - Renata L Riha
- Dept of Sleep Medicine, Royal Infirmary Edinburgh, Edinburgh, UK
| | - Maria R Bonsignore
- Biomedical Department of Internal and Specialistic Medicine (DiBiMIS), University of Palermo, Palermo, Italy.,Institute of Biomedicine and Molecular Immunology (IBIM), National Research Council (CNR), Palermo, Italy
| | - Josep M Montserrat
- Sleep Unit, Pulmonary Service, Hospital Clinic, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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123
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Younes M. To sleep: perchance to ditch the ventilator. Eur Respir J 2018; 51:51/4/1800624. [DOI: 10.1183/13993003.00624-2018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 04/03/2018] [Indexed: 11/05/2022]
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124
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Beiske KK, Stavem K. Health status in subjects with suspected obstructive sleep apnea and comparison with a general population. Sci Rep 2018; 8:5579. [PMID: 29615753 PMCID: PMC5882801 DOI: 10.1038/s41598-018-23904-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 03/22/2018] [Indexed: 12/18/2022] Open
Abstract
The purpose of this study was to assess health status (HS) in patients with clinical suspicion of obstructive sleep apnea (OSA) in order to estimate the dose response relationship between HS and OSA severity, and to compare HS in this clinical cohort with a general population sample (N = 5000). Patients referred to an overnight sleep study due to suspected OSA, whom also responded to the SF-36 questionnaire, were included (N = 418). Of these, 194 showed normal findings, while 111, 60 and 53 demonstrated mild, moderate and severe OSA, respectively. Mean age was 47.5 (SD 11.9) and 69% were males. Only the mental health scale (p = 0.015) and mental component summary score (p = 0.023) were associated with OSA severity. This association, however, disappeared in multivariable analysis. All SF-36 scores in the sleep study group were lower than that of the general population sample, in both unadjusted and multivariable linear regression analysis. In this study, there was a lack of association between OSA severity and general HS. However, as a whole, patients in this clinical population referred to an overnight sleep study due to suspected OSA had impaired HS on all scales compared to a general population, with greatest differences in the vitality domain.
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Affiliation(s)
- Kornelia K Beiske
- Department of Neurology and Clinical Neurophysiology, Medical Division, Akershus University Hospital, Lørenskog, Norway.
| | - Knut Stavem
- Institute of Clinical Medicine, Campus Akershus University Hospital, University of Oslo, Oslo, Norway
- Department of Pulmonary Medicine, Akershus University Hospital, Lørenskog, Norway
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
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125
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Carriere C, Coste O, Meiffred-Drouet MC, Barat P, Thibault H. Sleep disorders in obese children are not limited to obstructive sleep apnoea syndrome. Acta Paediatr 2018; 107:658-665. [PMID: 29215159 DOI: 10.1111/apa.14178] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 10/04/2017] [Accepted: 12/01/2017] [Indexed: 11/28/2022]
Abstract
AIM This study was to characterise respiratory and nonrespiratory sleep disorders in obese children and evaluate the diagnostic and therapeutic impact of a specific sleep consultation. METHODS A descriptive study was conducted in obese French children who received multidisciplinary care management from the hospital centre for paediatric obesity in Bordeaux. This followed a specific sleep consultation between 2007 and 2015, because their paediatrician had identified symptoms suggestive of sleep disorders. RESULTS The sleep specialist confirmed the presence of a sleep disorder in 98.4% of the 128 obese children, with a mean age of 12.1 ± 3.2 years. These included respiratory sleep disorders, hypersomnolence, insomnia and circadian rhythm sleep-wake disorders. Polysomnography revealed that 46.1% had respiratory sleep disorders and 24.2% had obstructive sleep apnoea syndrome (OSAS). Just under half (47.6%) were referred to an otorhinolaryngologist for sleep care management, 30.5% were referred to an orthodontist, 17.9% had melatonin treatment and 13.3% received continuous positive airway pressure ventilation. CONCLUSION Sleep disorders in obese children were not limited to respiratory sleep disorders including OSAS. A systematic specific consultation with a sleep specialist is essential for the diagnosis and care of such children and would be beneficial when treating paediatric obesity.
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Affiliation(s)
- Caroline Carriere
- Réseau de Prévention et de Prise en charge de l’ Obésité Pédiatrique - RéPPOP - en Aquitaine; Bordeaux France
| | - Olivier Coste
- CHU de Bordeaux; Service d'explorations fonctionnelles du système nerveux; Clinique du sommeil - Place Amélie Raba-Léon; Bordeaux France
| | | | - Pascal Barat
- CHU de Bordeaux; Unité d'endocrinologie et de diabétologie pédiatrique; Hôpital des Enfants - Place Amélie Raba-Léon; Bordeaux France
| | - Hélène Thibault
- Réseau de Prévention et de Prise en charge de l’ Obésité Pédiatrique - RéPPOP - en Aquitaine; Bordeaux France
- CHU de Bordeaux; Unité d'endocrinologie et de diabétologie pédiatrique; Hôpital des Enfants - Place Amélie Raba-Léon; Bordeaux France
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Wearable In-Ear Encephalography Sensor for Monitoring Sleep. Preliminary Observations from Nap Studies. Ann Am Thorac Soc 2018; 13:2229-2233. [PMID: 27684316 DOI: 10.1513/annalsats.201605-342bc] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
RATIONALE To date, EEG is the only quantifiable measure of the neural changes that define sleep. Although it is used widely for clinical testing, scalp-electrode EEG is costly and is poorly tolerated by sleeping patients. OBJECTIVES This was a pilot study to assess the agreement between EEG recordings obtained from a new ear-EEG sensor and those obtained simultaneously from standard scalp electrodes. METHODS Participants were four healthy men, 25 to 36 years of age. During naps, EEG tracings were recorded simultaneously from the ear sensor and from standard scalp electrodes. A clinical expert, blinded to the data collection, analyzed 30-second epochs of recordings from both devices, using standardized criteria. The agreement between scalp- and ear-recordings was assessed. MEASUREMENTS AND MAIN RESULTS We scored 360 epochs (scalp-EEG and ear-EEG), of which 254 (70.6%) were scored as non-REM sleep using scalp-EEG. The ear-EEG sensor had a sensitivity of 0.88 (95% confidence interval [CI], 0.82-0.92) and a specificity of 0.78 (95% CI, 0.70-0.84) in detecting N2/N3 sleep. The kappa coefficient between the scalp- and the ear-EEG was 0.65 (95% CI, 0.58-0.73). As a sleep monitor (all non-REM sleep stages vs. wake), the in-ear sensor had a sensitivity of 0.91 (95% CI, 0.87-0.94) and a specificity of 0.66 (95% CI, 0.56-0.75). The kappa coefficient was 0.60 (95% CI, 0.50-0.69). CONCLUSIONS Substantial agreement was observed between recordings derived from a new ear-EEG sensor and conventional scalp electrodes on four healthy volunteers during daytime naps.
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127
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Melton L. Cognitive Behavioral Therapy for Sleep in Cancer Patients: Research, Techniques, and Individual Considerations. J Adv Pract Oncol 2018; 9:732-740. [PMID: 31249720 PMCID: PMC6570518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
This article reviews cognitive behavioral therapy techniques for sleep in the cancer realm. There are unique factors associated with cancer that can exacerbate sleep issues. Stimulus control, sleep restriction, relaxation, paradoxical intention, and cognitive therapy are discussed as specific components of cognitive behavioral therapy for sleep, and practical techniques for implementation are provided. Individual considerations in implementing these techniques are also discussed, including factors such as age, ethnicity, gender, relationship status, educational level, work status, cancer history, pharmacologic treatments, and health beliefs.
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128
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Hornero R, Kheirandish-Gozal L, Gutiérrez-Tobal GC, Philby MF, Alonso-Álvarez ML, Álvarez D, Dayyat EA, Xu Z, Huang YS, Tamae Kakazu M, Li AM, Van Eyck A, Brockmann PE, Ehsan Z, Simakajornboon N, Kaditis AG, Vaquerizo-Villar F, Crespo Sedano A, Sans Capdevila O, von Lukowicz M, Terán-Santos J, Del Campo F, Poets CF, Ferreira R, Bertran K, Zhang Y, Schuen J, Verhulst S, Gozal D. Nocturnal Oximetry-based Evaluation of Habitually Snoring Children. Am J Respir Crit Care Med 2017; 196:1591-1598. [PMID: 28759260 DOI: 10.1164/rccm.201705-0930oc] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
RATIONALE The vast majority of children around the world undergoing adenotonsillectomy for obstructive sleep apnea-hypopnea syndrome (OSA) are not objectively diagnosed by nocturnal polysomnography because of access availability and cost issues. Automated analysis of nocturnal oximetry (nSpO2), which is readily and globally available, could potentially provide a reliable and convenient diagnostic approach for pediatric OSA. METHODS Deidentified nSpO2 recordings from a total of 4,191 children originating from 13 pediatric sleep laboratories around the world were prospectively evaluated after developing and validating an automated neural network algorithm using an initial set of single-channel nSpO2 recordings from 589 patients referred for suspected OSA. MEASUREMENTS AND MAIN RESULTS The automatically estimated apnea-hypopnea index (AHI) showed high agreement with AHI from conventional polysomnography (intraclass correlation coefficient, 0.785) when tested in 3,602 additional subjects. Further assessment on the widely used AHI cutoff points of 1, 5, and 10 events/h revealed an incremental diagnostic ability (75.2, 81.7, and 90.2% accuracy; 0.788, 0.854, and 0.913 area under the receiver operating characteristic curve, respectively). CONCLUSIONS Neural network-based automated analyses of nSpO2 recordings provide accurate identification of OSA severity among habitually snoring children with a high pretest probability of OSA. Thus, nocturnal oximetry may enable a simple and effective diagnostic alternative to nocturnal polysomnography, leading to more timely interventions and potentially improved outcomes.
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Affiliation(s)
- Roberto Hornero
- 1 Biomedical Engineering Group, University of Valladolid, Valladolid, Spain
| | - Leila Kheirandish-Gozal
- 2 Section of Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, University of Chicago, Chicago, Illinois
| | | | - Mona F Philby
- 2 Section of Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, University of Chicago, Chicago, Illinois
| | - María Luz Alonso-Álvarez
- 3 Unidad Multidisciplinar del Sueño, Centro de Investigación Biomédica en Red Respiratorio, Hospital Universitario de Burgos, Burgos, Spain
| | - Daniel Álvarez
- 1 Biomedical Engineering Group, University of Valladolid, Valladolid, Spain.,4 Sleep-Ventilation Unit, Pneumology Service, Río Hortega University Hospital, Valladolid, Spain
| | - Ehab A Dayyat
- 5 Division of Child Neurology, Department of Pediatrics, LeBonheur Children's Hospital, University of Tennessee Health Science Center, School of Medicine, Memphis, Tennessee
| | - Zhifei Xu
- 6 Sleep Unit, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yu-Shu Huang
- 7 Department of Child Psychiatry and Sleep Center, Chang Gung Memorial Hospital and University, Taoyuan, Taiwan
| | | | - Albert M Li
- 9 Department of Pediatrics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China
| | - Annelies Van Eyck
- 10 Laboratory of Experimental Medicine and Pediatrics and.,11 Department of Pediatrics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Pablo E Brockmann
- 12 Sleep Medicine Center, Department of Pediatric Cardiology and Pulmonology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Zarmina Ehsan
- 13 Division of Pulmonary and Sleep Medicine, Cincinnati Children's Medical Center, Cincinnati, Ohio
| | - Narong Simakajornboon
- 13 Division of Pulmonary and Sleep Medicine, Cincinnati Children's Medical Center, Cincinnati, Ohio
| | - Athanasios G Kaditis
- 14 Pediatric Pulmonology Unit, Sleep Disorders Laboratory, First Department of Pediatrics, National and Kapodistrian University of Athens School of Medicine and Aghia Sophia Children's Hospital, Athens, Greece
| | | | - Andrea Crespo Sedano
- 4 Sleep-Ventilation Unit, Pneumology Service, Río Hortega University Hospital, Valladolid, Spain
| | - Oscar Sans Capdevila
- 15 Sleep Unit, Department of Neurology, Sant Joan de Deu, Barcelona Children's Hospital, Barcelona, Spain
| | - Magnus von Lukowicz
- 16 Department of Neonatology and Sleep Unit, University of Tubingen, Tubingen, Germany; and
| | - Joaquín Terán-Santos
- 3 Unidad Multidisciplinar del Sueño, Centro de Investigación Biomédica en Red Respiratorio, Hospital Universitario de Burgos, Burgos, Spain
| | - Félix Del Campo
- 1 Biomedical Engineering Group, University of Valladolid, Valladolid, Spain.,4 Sleep-Ventilation Unit, Pneumology Service, Río Hortega University Hospital, Valladolid, Spain
| | - Christian F Poets
- 16 Department of Neonatology and Sleep Unit, University of Tubingen, Tubingen, Germany; and
| | - Rosario Ferreira
- 17 Pediatric Respiratory Unit, Department of Pediatrics, Hospital de Santa Maria, Academic Medical Center of Lisbon, Lisbon, Portugal
| | - Katalina Bertran
- 15 Sleep Unit, Department of Neurology, Sant Joan de Deu, Barcelona Children's Hospital, Barcelona, Spain
| | - Yamei Zhang
- 6 Sleep Unit, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China
| | - John Schuen
- 8 Spectrum Health, Michigan State University, Grand Rapids, Michigan
| | - Stijn Verhulst
- 10 Laboratory of Experimental Medicine and Pediatrics and.,11 Department of Pediatrics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - David Gozal
- 2 Section of Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, University of Chicago, Chicago, Illinois
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Sleep and other correlates of high-level health in older adults. Geriatr Nurs 2017; 39:344-349. [PMID: 29248354 DOI: 10.1016/j.gerinurse.2017.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 11/09/2017] [Accepted: 11/13/2017] [Indexed: 12/11/2022]
Abstract
A large sample (N = 1139) of adults ≥75 years from the 2011-2014 NHANES cohorts was used to examine predictors of high-level health. Analyses were done with SAS to control for sample weights and allow results to be reported as population parameters. The majority of participants described their health as high-level (73.6%). Logistic regression found a longer sleep duration, minority status, decreased income, multiple medications, low physical activity, and late stage memory impairment were significant predictors of low-level health (p < .05) while sex, education level, marital status, body mass index, and depression symptoms were not. The assessment of sleep should be expanded to cover dimensions such as sleep quality and sleep disorders to help maintain wellness in older adults. This study supports that the majority of older adults have high-level health and identifies several modifiable factors to maintain wellness.
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130
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Malhotra A, Crocker ME, Willes L, Kelly C, Lynch S, Benjafield AV. Patient Engagement Using New Technology to Improve Adherence to Positive Airway Pressure Therapy: A Retrospective Analysis. Chest 2017; 153:843-850. [PMID: 29154970 DOI: 10.1016/j.chest.2017.11.005] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 10/05/2017] [Accepted: 11/06/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Sleep apnea has major neurocognitive and cardiovascular and metabolic risks. Treatment of sleep apnea is suboptimal because of variable adherence to existing therapies. METHODS This trial compared positive airway pressure adherence among patients who were provided active patient engagement (APE) technology vs those who received usual care monitoring (UCM). The primary outcome was expressed by using the US Medicare definition of adherence. Adherence data from two cloud-based databases (AirView and myAir) were analyzed for patients with sleep apnea. Data were included if a patient's activation date in the APE tool was within 7 days of the therapy start date in the UCM database during a defined time window. Data were propensity matched in a 1:2 ratio (APE:UCM) based on baseline patient characteristics. RESULTS A total of 128,037 patients were analyzed. Baseline characteristics were typical of a sleep clinic cohort. APE was associated with more patients achieving adherence criteria (87.3%) compared with UCM patients (70.4%; P < .0001 for the difference). Average therapy usage was 5.9 h per night in the APE group vs 4.9 h per night in the matched UCM patients (P < .0001). Patients with sleep apnea "struggling" with therapy adherence had a 17.6% absolute improvement in adherence using APE compared with UCM. CONCLUSIONS Robust therapy adherence rates can be achieved by adding modern technology to usual care. Adopting advances in technology in care management may allow clinicians to more effectively and efficiently treat patients who have sleep apnea. Rigorous randomized controlled trials may be required before making strong clinical recommendations.
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Affiliation(s)
- Atul Malhotra
- Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, La Jolla, CA.
| | | | | | | | - Sue Lynch
- ResMed Science Center, ResMed Corp, San Diego, CA
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132
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Grandner MA. Sleep and obesity risk in adults: possible mechanisms; contextual factors; and implications for research, intervention, and policy. Sleep Health 2017; 3:393-400. [PMID: 28923200 DOI: 10.1016/j.sleh.2017.07.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 07/29/2017] [Indexed: 12/21/2022]
Abstract
Obesity is a major public health problem among US adults. Insufficient sleep and sleep disorders are prevalent and may contribute to the public health problem of obesity. This review addresses several key questions regarding sleep and obesity in adults, including the following: (1) What constitutes adequate sleep in adults? (2) What are the consequences of inadequate sleep in adults? (3) What factors influence sleep in adults? (4) How can adults improve their sleep? (5) How can we implement these in adults? (6) How can these issues be addressed in future research and policy decisions? Although a comprehensive review of all of these is beyond the scope of this article, this review brings these concepts together toward a discussion of the role of sleep in the health of US adults.
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Affiliation(s)
- Michael A Grandner
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona, 1501 N Campbell Ave, PO Box 245002, Tucson, AZ 85724-5002.
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133
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Ogilvie RP, Patel SR. The epidemiology of sleep and obesity. Sleep Health 2017; 3:383-388. [PMID: 28923198 DOI: 10.1016/j.sleh.2017.07.013] [Citation(s) in RCA: 174] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 07/26/2017] [Indexed: 12/21/2022]
Abstract
Sleep is a state of consciousness that is preserved across animal species whose exact function is not yet clear but which has a vital impact on health and well-being. Epidemiological evidence suggests sleep duration in both children and adults has been decreasing over the past half-century, while at the same time rates of overweight and obesity have been increasing. Short sleep duration along with other dimensions of poor sleep has been associated with obesity both cross-sectionally and longitudinally. These data suggest a potential causal relationship between poor sleep and greater rates of weight gain that may be related to effects of sleep on dietary intake or physical activity. However, there is also potential for reverse causation as obesity leads to many co-morbidities including sleep apnea that can disrupt sleep. Medium and long term interventional studies are needed to evaluate the potential for healthy sleep interventions to help combat the epidemic of obesity.
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Affiliation(s)
- Rachel P Ogilvie
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA.
| | - Sanjay R Patel
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA
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134
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Ye L, Antonelli MT, Willis DG, Kayser K, Malhotra A, Patel SR. Couples' experiences with continuous positive airway pressure treatment: a dyadic perspective. Sleep Health 2017; 3:362-367. [PMID: 28923193 DOI: 10.1016/j.sleh.2017.07.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 06/03/2017] [Accepted: 07/06/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The majority of adults sleep with a partner, making sleep a dyadic experience. However, interventions to improve sleep have primarily focused on individuals. This qualitative analysis used a dyadic approach to identify facilitators and barriers to successful treatment of one of the most common sleep disorders, obstructive sleep apnea, with continuous positive airway pressure (CPAP). METHODS Twenty joint qualitative interviews were conducted with couples, one couple at a time, with a sample of 20 patients with obstructive sleep apnea and their partners to develop an understanding of couples' experiences with CPAP use. Interviews were audio recorded and transcribed. Conventional qualitative content analysis was used to analyze the interview data. RESULTS Facilitators of CPAP use were the following: the partner aiding diagnosis and treatment, couples working together using CPAP, the perceived benefits of CPAP for both partners, the patient being motivated to use CPAP for the benefit of the partner, and various types of support provided by the partner to encourage CPAP use. Major barriers to CPAP use were the following: anxiety related to CPAP use particularly in the beginning of therapy, bothersome equipment causing disruptions in sleep and bedtime routine, interruptions to intimacy, and concern about image change while wearing CPAP. CONCLUSIONS Findings from this study suggest that couple-directed interventions that advocate for a mutually engaging perspective and promote supportive relationships and positive dyadic coping may be targets for improving CPAP adherence. Further research evaluating the potential of couple-focused interventions to improve sleep health is warranted.
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Affiliation(s)
- Lichuan Ye
- Bouvé College of Health Sciences School of Nursing, Northeastern University, Boston, MA, USA.
| | - Mary T Antonelli
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA, USA
| | - Danny G Willis
- University of Wisconsin-Madison School of Nursing, Madison, WI, USA
| | - Karen Kayser
- Kent School of Social Work, University of Louisville, Louisville, KY, USA
| | - Atul Malhotra
- Division of Pulmonary, Critical Care & Sleep Medicine, University of California San Diego, La Jolla, CA, USA
| | - Sanjay R Patel
- Division of Pulmonary, Critical Care & Sleep Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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135
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Veatch OJ, Keenan BT, Gehrman PR, Malow BA, Pack AI. Pleiotropic genetic effects influencing sleep and neurological disorders. Lancet Neurol 2017; 16:158-170. [PMID: 28102151 DOI: 10.1016/s1474-4422(16)30339-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 10/04/2016] [Accepted: 11/09/2016] [Indexed: 10/20/2022]
Abstract
Research evidence increasingly points to the large impact of sleep disturbances on public health. Many aspects of sleep are heritable and genes influencing traits such as timing, EEG characteristics, sleep duration, and response to sleep loss have been identified. Notably, large-scale genome-wide analyses have implicated numerous genes with small effects on sleep timing. Additionally, there has been considerable progress in the identification of genes influencing risk for some neurological sleep disorders. For restless legs syndrome, implicated variants are typically in genes associated with neuronal development. By contrast, genes conferring risk for narcolepsy function in the immune system. Many genetic variants associated with sleep disorders are also implicated in neurological disorders in which sleep abnormalities are common; for example, variation in genes involved in synaptic homoeostasis are implicated in autism spectrum disorder and sleep-wake control. Further investigation into pleiotropic roles of genes influencing both sleep and neurological disorders could lead to new treatment strategies for a variety of sleep disturbances.
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Affiliation(s)
- Olivia J Veatch
- Department of Neurology, Vanderbilt University, Nashville, TN, USA; Center for Sleep and Circadian Neurobiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
| | - Brendan T Keenan
- Center for Sleep and Circadian Neurobiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Philip R Gehrman
- Center for Sleep and Circadian Neurobiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Beth A Malow
- Department of Neurology, Vanderbilt University, Nashville, TN, USA
| | - Allan I Pack
- Center for Sleep and Circadian Neurobiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Division of Sleep Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Abarcando el problema del síndrome de apneas-hipopneas del sueño desde la gestión en red: unidades asistenciales. Arch Bronconeumol 2017; 53:184-185. [DOI: 10.1016/j.arbres.2016.06.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 06/13/2016] [Accepted: 06/18/2016] [Indexed: 11/22/2022]
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137
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Sound level intensity severely disrupts sleep in ventilated ICU patients throughout a 24-h period: a preliminary 24-h study of sleep stages and associated sound levels. Ann Intensive Care 2017; 7:25. [PMID: 28255956 PMCID: PMC5334329 DOI: 10.1186/s13613-017-0248-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 02/18/2017] [Indexed: 01/23/2023] Open
Abstract
Background It is well recognized that sleep is severely disturbed in patients in intensive care units (ICU) and that this can compromise their rehabilitation potential. However, it is still difficult to objectively assess sleep quantity and quality and the determinants of sleep disturbance remain unclear. The aim of this study was therefore to evaluate carefully the impact of ICU sound intensity levels and their sources on ICU patients’ sleep over a 24-h period.
Methods Sleep and sound levels were recorded in 11 ICU intubated patients who met the criteria. Sleep was recorded using a miniaturized multi-channel ambulatory recording device. Sound intensity levels and their sources were recorded with the Nox-T3 monitor. A 30-s epoch-by-epoch analysis of sleep stages and sound data was carried out. Multinomial and binomial logistic regressions were used to associate sleep stages, wakefulness and sleep–wake transitions with sound levels and their sources.
Results The subjects slept a median of 502.2 [283.2–718.9] min per 24 h; 356.9 [188.6–590.9] min at night (22.00–08.00) and 168.5 [142.5–243.3] during daytime (8 am–10 pm). Median sound intensity level reached 70.2 [65.1–80.3] dBC at night. Sound thresholds leading to disturbed sleep were 63 dBC during the day and 59 dBC during the night. With levels above 77 dBC, the incidence of arousals (OR 3.9, 95% CI 3.0–5.0) and sleep-to-wake transitions (OR 7.6, 95% CI 4.1–14) increased. The most disturbing noises sources were monitor alarms (OR 4.5, 95% CI 3.5–5.6) and ventilator alarms (OR 4.2, 95% CI 2.9–6.1). Conclusions We have shown, in a small group of 11 non-severe ICU patients, that sound level intensity, a major disturbance factor of sleep continuity, should be strictly controlled on a 24-h profile.
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138
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Kawada T. Sleep duration and adiposity in early adolescents. J Public Health (Oxf) 2017; 39:202. [PMID: 26834193 DOI: 10.1093/pubmed/fdw002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo 113-8602, Japan
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139
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Holguin F, Moughrabieh MA, Ojeda V, Patel SR, Peyrani P, Pinedo M, Celedón JC, Douglas IS, Upson DJ, Roman J. Respiratory Health in Migrant Populations: A Crisis Overlooked. Ann Am Thorac Soc 2017; 14:153-159. [PMID: 28146384 PMCID: PMC5427732 DOI: 10.1513/annalsats.201608-592ps] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 11/02/2016] [Indexed: 01/04/2023] Open
Abstract
The crisis in the Middle East has raised awareness about the challenges encountered by migrant populations, in particular, health-care access and delivery. Similar challenges are encountered by migrant populations around the world, including those entering the United States as refugees and/or survivors of torture as well as Mexicans and other Latin Americans crossing the border. During the 2016 International American Thoracic Society Meeting held in San Francisco, California, a group of researchers and health-care providers discussed these challenges at a minisymposium devoted to the respiratory health of migrants. The discussion focused on the increased incidence of airway diseases among individuals migrating to more developed countries, the problems created by sleep disorders and their implications for cardiovascular and mental health, the challenges inherent in the control of infections in refugee populations, and the problems resulting from deportation. The group also discussed the potential impact of novel strategies made available by Internet-based technologies and how these strategies could be deployed to support worldwide efforts in assisting migrants and refugees, even in countries that find themselves in the direst circumstances. These presentations are summarized in this document, which is not meant to be exhaustive, but to improve awareness about the challenges confronted by migrants and their host nations regarding respiratory health-care access and delivery, and about the need for adequate investment of resources to better define these challenges through research and for the development of efficient strategies for intervention.
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Affiliation(s)
- Fernando Holguin
- Pulmonary Sciences, Department of Medicine, University of Colorado, Denver, Colorado
| | - M. Anas Moughrabieh
- Division of Pulmonary and Critical Care, Department of Medicine, Wayne State University, Detroit, Michigan
| | - Victoria Ojeda
- Division of Global Public Health, Department of Medicine, University of California, San Diego, San Diego, California
| | - Sanjay R. Patel
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Paula Peyrani
- Division of Infectious Diseases, Department of Medicine, University of Louisville Health Sciences Center, Louisville, Kentucky
| | - Miguel Pinedo
- Alcohol Research Group, University of California, Berkeley, Berkeley, California
| | - Juan C. Celedón
- Division of Pulmonary Medicine, Allergy and Immunology, Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ivor S. Douglas
- Division of Pulmonary and Critical Care, Department of Medicine, Denver Health Medical Center, University of Colorado, and Anschutz Medical Center, Denver, Colorado
| | - Dona J. Upson
- Division of Pulmonary and Critical Care, Department of Medicine, New Mexico Veterans Affairs Health Care Services, Albuquerque, New Mexico; and
| | - Jesse Roman
- Division of Pulmonary, Critical Care, and Sleep Disorders, Department of Medicine and Department of Pharmacology, University of Louisville Health Sciences Center and Robley Rex Veterans Affairs Medical Center, Louisville, Kentucky
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140
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141
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Boyko Y, Jennum P, Toft P. Sleep quality and circadian rhythm disruption in the intensive care unit: a review. Nat Sci Sleep 2017; 9:277-284. [PMID: 29184454 PMCID: PMC5689030 DOI: 10.2147/nss.s151525] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Sleep and circadian rhythm are reported to be severely abnormal in critically ill patients. Disturbed sleep can lead to the development of delirium and, as a result, can be associated with prolonged stay in the intensive care unit (ICU) and increased mortality. The standard criterion method of sleep assessment, polysomnography (PSG), is complicated in critically ill patients due to the practical challenges and interpretation difficulties. Several PSG sleep studies in the ICU reported the absence of normal sleep characteristics in many critically ill patients, making the standard method of sleep scoring insufficient in this patient group. Watson et al proposed a modified classification for sleep scoring in critically ill patients. This classification has not yet been validated. Sleep disturbance in the ICU is a multifactorial problem. The ICU environment, mechanical ventilation, medication, as well as the critical illness itself have been reported as important sleep disturbing factors. Secretion of sleep hormone, melatonin, expressing circadian rhythmicity was found abolished or phase delayed in critically ill patients. Various interventions have been tested in several studies aiming to improve sleep quality and circadian rhythm in the ICU. The results of these studies were inconclusive due to using the sleep assessment methods other than PSG or the absence of a reliable sleep scoring tool for the analysis of the PSG findings in this patient population. Development of a valid sleep scoring classification is essential for further sleep research in critically ill patients.
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Affiliation(s)
- Yuliya Boyko
- Department of Anesthesia and Intensive Care Medicine, Odense University Hospital, Odense, Denmark
| | - Poul Jennum
- Department of Clinical Neurophysiology, Danish Center for Sleep Medicine, Rigshospitalet, Glostrup, Denmark
| | - Palle Toft
- Department of Anesthesia and Intensive Care Medicine, Odense University Hospital, Odense, Denmark
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142
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Morgenthaler TI, Hashmi S, Croft JB, Dort L, Heald JL, Mullington J. High School Start Times and the Impact on High School Students: What We Know, and What We Hope to Learn. J Clin Sleep Med 2016; 12:1681-1689. [PMID: 27855730 DOI: 10.5664/jcsm.6358] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 10/18/2016] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Several organizations have provided recommendations to ensure high school starts no sooner than 08:30. However, although there are plausible biological reasons to support such recommendations, published recommendations have been based largely on expert opinion and a few observational studies. We sought to perform a critical review of published evidence regarding the effect of high school start times on sleep and other relevant outcomes. METHODS We performed a broad literature search to identify 287 candidate publications for inclusion in our review, which focused on studies offering direct comparison of sleep time, academic or physical performance, behavioral health measures, or motor vehicular accidents in high school students. Where possible, outcomes were combined for meta-analysis. RESULTS After application of study criteria, only 18 studies were suitable for review. Eight studies were amenable to meta-analysis for some outcomes. We found that later school start times, particularly when compared with start times more than 60 min earlier, are associated with longer weekday sleep durations, lower weekday-weekend sleep duration differences, reduced vehicular accident rates, and reduced subjective daytime sleepiness. Improvement in academic performance and behavioral issues is less established. CONCLUSIONS The literature regarding effect of school start time delays on important aspects of high school life suggests some salutary effects, but often the evidence is indirect, imprecise, or derived from cohorts of convenience, making the overall quality of evidence weak or very weak. This review highlights a need for higher-quality data upon which to base important and complex public health decisions.
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Affiliation(s)
| | | | - Janet B Croft
- Centers for Disease Control and Prevention, Atlanta, GA
| | - Leslie Dort
- University of Calgary, Calgary, Alberta, Canada
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143
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Gariépy G, Janssen I, Sentenac M, Elgar FJ. School start time and sleep in Canadian adolescents. J Sleep Res 2016; 26:195-201. [DOI: 10.1111/jsr.12475] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 10/12/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Geneviève Gariépy
- Institute for Health and Social Policy; McGill University; Montreal QC Canada
| | - Ian Janssen
- School of Kinesiology and Health Studies and Department of Public Health Sciences; Queen's University; Kingston ON Canada
| | - Mariane Sentenac
- Institute for Health and Social Policy; McGill University; Montreal QC Canada
| | - Frank J. Elgar
- Institute for Health and Social Policy; McGill University; Montreal QC Canada
- Department of Psychiatry; McGill University; Montreal QC Canada
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144
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Katsagoni CN, Georgoulis M, Papatheodoridis GV, Fragopoulou E, Ioannidou P, Papageorgiou M, Alexopoulou A, Papadopoulos N, Deutsch M, Kontogianni MD. Associations Between Lifestyle Characteristics and the Presence of Nonalcoholic Fatty Liver Disease: A Case-Control Study. Metab Syndr Relat Disord 2016; 15:72-79. [PMID: 27869531 DOI: 10.1089/met.2016.0105] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Dietary and physical activity (PA) habits have been suggested as important factors for nonalcoholic fatty liver disease (NAFLD). Published data are mainly focused on the effect of either diet or exercise, whereas data on other aspects like sleep remain sparse. The aim of this study was to explore potential associations between dietary intake, PA, and sleeping habits, and the presence of NAFLD. METHODS One hundred patients with ultrasound-proven NAFLD and 55 healthy controls matched for age, sex, and body mass index were included. Dietary habits were assessed through a semiquantitative validated food frequency questionnaire. PA level was assessed with a validated questionnaire. Total night sleep hours and duration of midday rest were also recorded. Optimal sleep duration was defined as sleep hours ≥7 and ≤9 hr/day. RESULTS Patients compared to controls consumed less vegetables and nuts, more sweets, drank less coffee and alcohol (all P < 0.05), and exhibited a lower level of PA (P = 0.006). PA level [odds ratio (OR) per 100 metabolic equivalent of task-min/day = 0.74, 95% confidence interval (CI) 0.61-0.89, P = 0.002] was associated with lower probability of having NAFLD, whereas sweets consumption (OR = 2.13, 95% CI 1.22-3.71, P = 0.008) was associated with increased probability, after adjusting for several confounders, including body weight status. Optimal sleep duration was marginally and inversely associated with NAFLD presence (OR = 0.38, 95% CI 0.14-1.01, P = 0.05). CONCLUSION Higher PA level and optimal sleep duration are associated with lower likelihood, whereas sweets consumption is associated with higher likelihood of having NAFLD. These associations are independent of body weight status and energy intake.
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Affiliation(s)
- Christina N Katsagoni
- 1 Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University , Athens, Greece
| | - Michael Georgoulis
- 1 Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University , Athens, Greece
| | - George V Papatheodoridis
- 2 Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens , Laiko General Hospital of Athens, Athens, Greece
| | - Elisabeth Fragopoulou
- 1 Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University , Athens, Greece
| | - Panagiota Ioannidou
- 2 Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens , Laiko General Hospital of Athens, Athens, Greece
| | - Mariviki Papageorgiou
- 2 Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens , Laiko General Hospital of Athens, Athens, Greece
| | - Alexandra Alexopoulou
- 3 Second Department of Internal Medicine, Medical School of National and Kapodistrian University of Athens , Hippokration General Hospital of Athens, Athens, Greece
| | - Nikolaos Papadopoulos
- 3 Second Department of Internal Medicine, Medical School of National and Kapodistrian University of Athens , Hippokration General Hospital of Athens, Athens, Greece
| | - Melanie Deutsch
- 3 Second Department of Internal Medicine, Medical School of National and Kapodistrian University of Athens , Hippokration General Hospital of Athens, Athens, Greece
| | - Meropi D Kontogianni
- 1 Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University , Athens, Greece
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Katsagoni CN, Papatheodoridis GV, Papageorgiou MV, Ioannidou P, Deutsch M, Alexopoulou A, Papadopoulos N, Fragopoulou E, Kontogianni MD. A "healthy diet-optimal sleep" lifestyle pattern is inversely associated with liver stiffness and insulin resistance in patients with nonalcoholic fatty liver disease. Appl Physiol Nutr Metab 2016; 42:250-256. [PMID: 28133993 DOI: 10.1139/apnm-2016-0492] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Several lifestyle habits have been described as risk factors for nonalcoholic fatty liver disease (NAFLD). Given that both healthy and unhealthy habits tend to cluster, the aim of this study was to identify lifestyle patterns and explore their potential associations with clinical characteristics of individuals with NAFLD. One hundred and thirty-six consecutive patients with ultrasound-proven NAFLD were included. Diet and physical activity level were assessed through appropriate questionnaires. Habitual night sleep hours and duration of midday naps were recorded. Optimal sleep duration was defined as sleep hours ≥ 7 and ≤ 9 h/day. Lifestyle patterns were identified using principal component analysis. Eight components were derived explaining 67% of total variation of lifestyle characteristics. Lifestyle pattern 3, namely high consumption of low-fat dairy products, vegetables, fish, and optimal sleep duration was negatively associated with insulin resistance (β = -1.66, P = 0.008) and liver stiffness (β = -1.62, P = 0.05) after controlling for age, sex, body mass index, energy intake, smoking habits, adiponectin, and tumor necrosis factor-α. Lifestyle pattern 1, namely high consumption of full-fat dairy products, refined cereals, potatoes, red meat, and high television viewing time was positively associated with insulin resistance (β = 1.66, P = 0.005), although this association was weakened after adjusting for adiponectin and tumor necrosis factor-α. A "healthy diet-optimal sleep" lifestyle pattern was beneficially associated with insulin resistance and liver stiffness in NAFLD patients independent of body weight status and energy intake.
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Affiliation(s)
- Christina N Katsagoni
- a Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 70 El. Venizelou str, 176 71, Athens, Greece
| | - George V Papatheodoridis
- b Medical School of National and Kapodistrian University of Athens, Laiko General Hospital of Athens, 115 27, Athens, Greece
| | - Maria-Vasiliki Papageorgiou
- b Medical School of National and Kapodistrian University of Athens, Laiko General Hospital of Athens, 115 27, Athens, Greece
| | - Panagiota Ioannidou
- b Medical School of National and Kapodistrian University of Athens, Laiko General Hospital of Athens, 115 27, Athens, Greece
| | - Melanie Deutsch
- b Medical School of National and Kapodistrian University of Athens, Laiko General Hospital of Athens, 115 27, Athens, Greece
| | - Alexandra Alexopoulou
- b Medical School of National and Kapodistrian University of Athens, Laiko General Hospital of Athens, 115 27, Athens, Greece
| | - Nikolaos Papadopoulos
- b Medical School of National and Kapodistrian University of Athens, Laiko General Hospital of Athens, 115 27, Athens, Greece
| | - Elisabeth Fragopoulou
- a Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 70 El. Venizelou str, 176 71, Athens, Greece
| | - Meropi D Kontogianni
- a Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 70 El. Venizelou str, 176 71, Athens, Greece
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Abstract
Sleep is important for regulating many physiologic functions that relate to metabolism. Because of this, there is substantial evidence to suggest that sleep habits and sleep disorders are related to diabetes risk. In specific, insufficient sleep duration and/or sleep restriction in the laboratory, poor sleep quality, and sleep disorders such as insomnia and sleep apnea have all been associated with diabetes risk. This research spans epidemiologic and laboratory studies. Both physiologic mechanisms such as insulin resistance, decreased leptin, and increased ghrelin and inflammation and behavioral mechanisms such as increased food intake, impaired decision-making, and increased likelihood of other behavioral risk factors such as smoking, sedentary behavior, and alcohol use predispose to both diabetes and obesity, which itself is an important diabetes risk factor. This review describes the evidence linking sleep and diabetes risk at the population and laboratory levels.
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Affiliation(s)
- Michael A Grandner
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine, 1501 N Campbell Ave, PO Box 245002, Tucson, AZ, 85724-5002, USA.
- Sarver Heart Center, University of Arizona College of Medicine, Tucson, AZ, USA.
- Department of Medicine, University of Arizona College of Medicine, Tucson, AZ, USA.
| | - Azizi Seixas
- Center for Healthful Behavior Change, Department of Population Health, New York University Langone Medical Center, New York, NY, USA
| | - Safal Shetty
- Department of Medicine, University of Arizona College of Medicine, Tucson, AZ, USA
| | - Sundeep Shenoy
- Department of Medicine, University of Arizona College of Medicine, Tucson, AZ, USA
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Abstract
PURPOSE OF REVIEW Patients with pituitary diseases have decreased quality of life. Sleep disorders are prevalent among patients with pituitary diseases and contribute to decreased quality of life. RECENT FINDINGS Patients previously treated for compression of the optic chiasm by surgery, and in some cases postoperative radiotherapy, suffer from sleep disorders. These are characterized by decreased sleep quality, delayed onset of sleep, and daytime sleepiness. Circumstantial evidence suggests that this may be caused by hypothalamic dysfunction. A challenging speculation is that previous compression of the optic chiasm compromised the function of the retinohypothalamic tract. Through this tract the eyes convey information on day-night cycles to the hypothalamic nuclei. Patients with acromegaly, even despite biochemical control, suffer frequently from obstructive sleep apnea. Patients with Cushing's disease suffer from fragmented sleep, sleep apnea, and snoring. Prolactinomas do not seem to affect sleep characteristics. The association between appropriately substituted pituitary insufficiency and sleep disorders is less clear. The effects of recombinant human growth hormone on sleep characteristics in adults are inconsistent. SUMMARY Pituitary disorders are associated with different sleep disorders. Different studies point to irreversible changes in sleep-wake rhythmicity in patients treated previously for pituitary tumors with chiasm compression. VIDEO ABSTRACT.
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Affiliation(s)
- Johannes A Romijn
- Department of Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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148
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Combs D, Goodwin JL, Quan SF, Morgan WJ, Shetty S, Parthasarathy S. Insomnia, Health-Related Quality of Life and Health Outcomes in Children: A Seven Year Longitudinal Cohort. Sci Rep 2016; 6:27921. [PMID: 27295263 PMCID: PMC4904740 DOI: 10.1038/srep27921] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 05/26/2016] [Indexed: 11/23/2022] Open
Abstract
Insomnia is common in children, and is associated with decreased school performance and increased psychopathology. Although adult insomnia is linked to worsened health-related quality of life (HRQOL), there is insufficient data evaluating insomnia and HRQOL in children. We examined the HRQOL and health associations of insomnia in a longitudinal cohort of 194 children (96 girls, age at study start 8.7 ± 1.6 years, age at data analysis 15.0 ± 1.8 years) over 7 years. International Classification of Sleep Disorders, second edition (ICSD2) derived insomnia was seen intermittently in 27% of children, and was persistent in 4%. Children reporting ICSD2-derived insomnia had lower HRQOL. Additionally, the presence of insomnia was associated with an increased risk of reporting a new medical condition (intermittent insomnia odds ratio 5.9 [95% CI 1.3–26.7, p = 0.04], persistent insomnia odds ratio 8 [95% CI 2.3–27.7, p = 0.001]). Persistent ICSD2-derived insomnia was associated with an increased risk of reporting a new medication (odds ratio 4.9 (95% CI 1.0–23.6), p = 0.049), and reporting a new psychiatric medication (odds ratio 13.7, 95% CI: 2.6–73.5, p = 0.002). These associations were present even after adjusting for socioeconomic factors and the presence of obstructive sleep apnea. Insomnia in children is associated with worsened HRQOL and health outcomes.
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Affiliation(s)
- Daniel Combs
- Department of Pediatrics, University of Arizona, Tucson, AZ, USA.,Department of Medicine, University of Arizona, Tucson, AZ, USA.,Arizona Respiratory Center, University of Arizona, Tucson, AZ, USA
| | - James L Goodwin
- Arizona Respiratory Center, University of Arizona, Tucson, AZ, USA
| | - Stuart F Quan
- Arizona Respiratory Center, University of Arizona, Tucson, AZ, USA.,Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Wayne J Morgan
- Department of Pediatrics, University of Arizona, Tucson, AZ, USA.,Arizona Respiratory Center, University of Arizona, Tucson, AZ, USA
| | - Safal Shetty
- Department of Medicine, University of Arizona, Tucson, AZ, USA.,Arizona Respiratory Center, University of Arizona, Tucson, AZ, USA.,Center for Sleep Disorders and Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Arizona, Tucson, AZ, USA
| | - Sairam Parthasarathy
- Department of Medicine, University of Arizona, Tucson, AZ, USA.,Arizona Respiratory Center, University of Arizona, Tucson, AZ, USA.,Center for Sleep Disorders and Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Arizona, Tucson, AZ, USA
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149
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Liu Y, Croft JB, Wheaton AG, Kanny D, Cunningham TJ, Lu H, Onufrak S, Malarcher AM, Greenlund KJ, Giles WH. Clustering of Five Health-Related Behaviors for Chronic Disease Prevention Among Adults, United States, 2013. Prev Chronic Dis 2016; 13:E70. [PMID: 27236381 PMCID: PMC4885683 DOI: 10.5888/pcd13.160054] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Introduction Five key health-related behaviors for chronic disease prevention are never smoking, getting regular physical activity, consuming no alcohol or only moderate amounts, maintaining a normal body weight, and obtaining daily sufficient sleep. The objective of this study was to estimate the clustering of these 5 health-related behaviors among adults aged 21 years or older in each state and the District of Columbia and to assess geographic variation in clustering. Methods We used data from the 2013 Behavioral Risk Factor Surveillance System (BRFSS) to assess the clustering of the 5 behaviors among 395,343 BRFSS respondents aged 21 years or older. The 5 behaviors were defined as currently not smoking cigarettes, meeting the aerobic physical activity recommendation, consuming no alcohol or only moderate amounts, maintaining a normal body mass index (BMI), and sleeping at least 7 hours per 24-hour period. Prevalence of having 4 or 5 of these behaviors, by state, was also examined. Results Among US adults, 81.6% were current nonsmokers, 63.9% obtained 7 hours or more sleep per day, 63.1% reported moderate or no alcohol consumption, 50.4% met physical activity recommendations, and 32.5% had a normal BMI. Only 1.4% of respondents engaged in none of the 5 behaviors; 8.4%, 1 behavior; 24.3%, 2 behaviors; 35.4%, 3 behaviors; and 24.3%, 4 behaviors; only 6.3% reported engaging in all 5 behaviors. The highest prevalence of engaging in 4 or 5 behaviors was clustered in the Pacific and Rocky Mountain states. Lowest prevalence was in the southern states and along the Ohio River. Conclusion Additional efforts are needed to increase the proportion of the population that engages in all 5 health-related behaviors and to eliminate geographic variation. Collaborative efforts in health care systems, communities, work sites, and schools can promote all 5 behaviors and produce population-wide changes, especially among the socioeconomically disadvantaged.
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Affiliation(s)
- Yong Liu
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, 4770 Buford Hwy, MS F-78, Atlanta, GA 30341
| | - Janet B Croft
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Anne G Wheaton
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Dafna Kanny
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Timothy J Cunningham
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Hua Lu
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Stephen Onufrak
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ann M Malarcher
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kurt J Greenlund
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Wayne H Giles
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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150
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Kawada T, Otsuka T, Nakamura T, Kon Y. Relationship between sleep-disordered breathing and metabolic syndrome after adjustment with cardiovascular risk factors. Diabetes Metab Syndr 2016; 10:92-95. [PMID: 26545634 DOI: 10.1016/j.dsx.2015.10.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 10/16/2015] [Indexed: 10/22/2022]
Abstract
AIMS It is important to identify the risk factors for metabolic syndrome (MetS) in order to prevent the development of cardio-/cerebrovascular diseases. The authors estimated the risk factors for the development of MetS with special emphasis on the severity of sleep-disordered breathing (SDB). METHODS We conducted as a cross-sectional study in subjects undergoing intensive health examination (581 men aged 33-84 years). Diagnosis of MetS was based on the criteria of the National Cholesterol Education Program Expert Panel. RESULTS The prevalence of MetS in subjects with severe SDB, which was defined as an apnea-hypopnea index (AHI) of 30 or higher, was 40.7%, which was significantly higher than that in the subjects without severe SDB (29.3%). The odds ratio (OR) (95% confidence interval [CI]) of the logarithmic-transformed AHI for MetS was 1.6 (1.1-2.4) after adjustments for age, serum uric acid, logarithmic-transformed serum C-reactive protein, smoking history, exercise history and alcohol history. When the subjects were categorized by the severity of SDB, the OR (95% CI) of severe SDB, which was the only category that showed significant association, was 2.2 (1.2-4.0). CONCLUSION A significant association was observed between severe SDB and the presence of MetS in the subjects (all male) of this study.
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Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan.
| | - Toshiaki Otsuka
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan
| | - Takayuki Nakamura
- Division of Health Evaluation & Promotion, Ota Memorial Hospital, Ota, Gunma, Japan
| | - Yoichi Kon
- Division of Health Evaluation & Promotion, Ota Memorial Hospital, Ota, Gunma, Japan
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