151
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Mai QD, Jacobs AW, Schieman S. Precarious sleep? Nonstandard work, gender, and sleep disturbance in 31 European countries. Soc Sci Med 2019; 237:112424. [PMID: 31400590 DOI: 10.1016/j.socscimed.2019.112424] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 07/09/2019] [Accepted: 07/15/2019] [Indexed: 11/30/2022]
Abstract
Despite the advent of precarious work, little is known about how this form of employment can generate disparities in sleep outcomes. We extend existing work by providing a theoretical framework linking different measures of work precarity to sleep problems. We argue that the association between objective precarious working conditions and sleep disturbance is channeled through and mediated by subjective work precarity. We further argue that gender moderates the relationship between objective and subjective work precarity. We test this theoretical framework using the 2010 European Working Conditions Survey. Our results indicate that objective precarious working conditions undermine sleep by promoting the subjective experience of insecurity. Furthermore, the indirect effect of objective precarious work on sleep disturbance through subjective employment insecurity varies by gender: compared to women in similar working conditions, men report higher levels of subjective precarity. This research makes important contributions to the literatures on the health consequences of nonstandard work and social determinants of well-being.
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152
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Adrian AL, Skeiky L, Burke TM, Gutierrez IA, Adler AB. Sleep problems and functioning during initial training for a high-risk occupation. Sleep Health 2019; 5:651-657. [PMID: 31377248 DOI: 10.1016/j.sleh.2019.06.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 06/06/2019] [Accepted: 06/18/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVES The current study sought to characterize the sleep problems of soldiers entering Basic Combat Training and to identify the link between sleep problems and subsequent performance, psychological distress, anger reactions, and attention. DESIGN Soldiers were surveyed at 4 time points throughout the standard 10 weeks of Basic Combat Training. Surveys were administered at weeks 1, 3, 6, and 9. Sleep problems were identified as either present or absent at each time point using a sleep problem screening questionnaire. Four sleep patterns were identified and then used to evaluate outcomes throughout training (n = 1577). RESULTS When compared to those who never had a sleep problem ("healthy "; 60.6%), those who recovered from their initial sleep problem ("recovered"; 12.8%) started training with higher psychological distress and anger reactions and lower attention but steadily improved throughout training. Those who developed a sleep problem during training ("new onset"; 20.0%) and those who had a sleep problem throughout training ("chronic"; 6.6%) also started off significantly worse than the healthy group. The new-onset and chronic groups saw slower psychological distress improvement and a decline in attention throughout the course compared to the healthy group. The chronic group also significantly increased their anger reactions throughout training compared to the healthy group. CONCLUSION Sleep problems during Basic Combat Training may be an indicator for difficulties managing entry into the military. These findings highlight the importance of improving sleep health for soldiers throughout Basic Combat Training and for others with similar training in high-risk occupations.
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Affiliation(s)
- Amanda L Adrian
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
| | - Lillian Skeiky
- Behavioral Biology Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Tina M Burke
- Behavioral Biology Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Ian A Gutierrez
- Research Transition Office, Center for Enhancing Capabilities, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Amy B Adler
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD, USA
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153
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Veale D. Against the stream: intermittent nurse observations of in-patients at night serve no purpose and cause sleep deprivation. BJPsych Bull 2019; 43:174-176. [PMID: 30739621 PMCID: PMC6642991 DOI: 10.1192/bjb.2018.116] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/07/2018] [Accepted: 12/11/2018] [Indexed: 11/23/2022] Open
Abstract
This paper argues that intermittent nursing observations of in-patients at night do not reduce the risk of suicide or severe self-harm. Suicides between 23.00 h and 07.00 h are rare, and these overwhelmingly occur under intermittent observations. Such observation is purely a defensive intervention to document that a patient is safe at a particular time, as there is no engagement. For the large majority of in-patients, it has the unintended consequence of causing sleep deprivation. The intervention may cause harm to in-patients by making their disorder worse and increase their risk during the day. If patients are judged to be at immediate risk, then they should be placed on constant observation. If they are not, then optimising sleep is important for treating a psychiatric disorder and they should be placed on general observations.Declaration of interestNone.
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Affiliation(s)
- David Veale
- South London and Maudsley NHS Trust
- Institute of Psychiatry, Psychology and Neuroscience
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154
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Lombardero A, Hansen CD, Richie AE, Campbell DG, Joyce AW. A Narrative Review of the Literature on Insufficient Sleep, Insomnia, and Health Correlates in American Indian/Alaska Native Populations. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2019; 2019:4306463. [PMID: 31360174 PMCID: PMC6644264 DOI: 10.1155/2019/4306463] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 06/18/2019] [Indexed: 12/26/2022]
Abstract
Insufficient sleep and insomnia promote chronic disease in the general population and may combine with social and economic factors to increase rates of chronic health conditions among AI/AN people. Given that insufficient sleep and insomnia can be addressed via behavioral interventions, it is critical to understand the prevalence and correlates of these disorders among AI/AN individuals in order to elucidate the mechanisms associated with health disparities and provide guidance for subsequent treatment research and practice. We reviewed the available literature on insufficient sleep and insomnia in the AI/AN population. PubMed, PsycINFO, Google Scholar, and ProQuest were searched between June 12th and October 28th of 2018. Prevalence of insufficient sleep ranged from 15% to 40%; insomnia prevalence ranged from 25% to 33%. Insufficient sleep was associated with unhealthy diet, low physical activity levels, higher BMI, worse self-reported health, increased risk for diabetes mellitus, cardiovascular disease, frequent mental distress, smoking, binge drinking, depression, and chronic pain. Insomnia was associated with depression, childhood abuse, PTSD, anxiety, alcohol use, low social support, and low trait-resilience levels. Research on evidence-based treatment and implementation practices targeting insufficient sleep and insomnia was lacking, and only one study described the development/validation of a measure of insufficient sleep among AI/AN people. There is a need for rigorous sleep research including testing and implementation of evidence-based treatment for insufficient sleep and insomnia in this population in an effort to help eliminate health disparities. We present recommendations for research and clinical practice based on the current review.
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155
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Wolfson M, Germain A. We Snooze, Clients Lose: Time for Social Workers to Join Sleep Promotion Efforts. SOCIAL WORK 2019; 64:270-272. [PMID: 31190076 DOI: 10.1093/sw/swz021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 08/01/2018] [Accepted: 08/16/2018] [Indexed: 06/09/2023]
Affiliation(s)
- Megan Wolfson
- University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Anne Germain
- University of Pittsburgh School of Medicine, Pittsburgh, PA
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156
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Gao X, Meng LX, Ma KL, Liang J, Wang H, Gao Q, Wang T. The bidirectional causal relationships of insomnia with five major psychiatric disorders: A Mendelian randomization study. Eur Psychiatry 2019; 60:79-85. [PMID: 31234011 DOI: 10.1016/j.eurpsy.2019.05.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 05/09/2019] [Accepted: 05/17/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Several observational studies have investigated the association of insomnia with psychiatric disorders. Such studies yielded mixed results, and whether these associations are causal remains unclear. Thus, we aimed to identify the causal relationships between insomnia and five major psychiatric disorders. METHODS The analysis was implemented with six genome-wide association studies; one for insomnia and five for psychiatric disorders (attention-deficit/hyperactivity disorder, autism spectrum disorder, major depressive disorder, schizophrenia, and bipolar disorder). A heterogeneity in dependent instrument (HEIDI) approach was used to remove the pleiotropic instruments, Mendelian randomization (MR)-Egger regression was adopted to test the validity of the screened instruments, and bidirectional generalized summary data-based MR was performed to estimate the causal relationships between insomnia and these major psychiatric disorders. RESULTS We observed significant causal effects of insomnia on the risk of autism spectrum disorder and bipolar disorder, with odds ratios of 1.739 (95% confidence interval: 1.217-2.486, p = 0.002) and 1.786 (95% confidence interval: 1.396-2.285, p = 4.02 × 10-6), respectively. There was no convincing evidence of reverse causality for insomnia with these two disorders (p = 0.945 and 0.546, respectively). When insomnia was considered as either the exposure or outcome variable, causal estimates for the remaining three psychiatric disorders were not significant. CONCLUSIONS Our results suggest a causal role of insomnia in autism spectrum disorder and bipolar disorder. Future disease models should include insomnia as a factor for these two disorders to develop effective interventions. More detailed mechanism studies may also be inspired by this causal inference.
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Affiliation(s)
- Xue Gao
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 Xinjiannanlu Street, Taiyuan, Shanxi, 030001, China.
| | - Ling-Xian Meng
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 Xinjiannanlu Street, Taiyuan, Shanxi, 030001, China.
| | - Kai-Li Ma
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 Xinjiannanlu Street, Taiyuan, Shanxi, 030001, China.
| | - Jie Liang
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 Xinjiannanlu Street, Taiyuan, Shanxi, 030001, China.
| | - Hui Wang
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 Xinjiannanlu Street, Taiyuan, Shanxi, 030001, China.
| | - Qian Gao
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 Xinjiannanlu Street, Taiyuan, Shanxi, 030001, China.
| | - Tong Wang
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 Xinjiannanlu Street, Taiyuan, Shanxi, 030001, China.
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157
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Brupbacher G, Straus D, Porschke H, Zander-Schellenberg T, Gerber M, von Känel R, Schmidt-Trucksäss A. The acute effects of aerobic exercise on sleep in patients with depression: study protocol for a randomized controlled trial. Trials 2019; 20:352. [PMID: 31196147 PMCID: PMC6567535 DOI: 10.1186/s13063-019-3415-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 05/08/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Unipolar depression is one of the most important mental disorders. Insomnia is a symptom of cardinal importance in depression. It increases the risk to develop depression, negatively affects disease trajectory, is the most common symptom after remission, increases the risk of relapse, and is associated with higher suicide rates. Existing therapies for insomnia in depression have limitations. Further adjuvant therapies are therefore needed. Acute aerobic exercise has been shown to have beneficial effects on sleep in healthy individuals and patients with insomnia. We therefore hypothesize that a single session of aerobic exercise has a positive impact on sleep in patients with unipolar depression. This trial aims to investigate the effects of a single bout of aerobic exercise on the subsequent night's sleep in patients with depression. METHODS/DESIGN This is a two-arm parallel group, randomized, outcome assessor blinded, controlled, superiority trial. Patients between 18 and 65 years of age with a primary diagnosis of unipolar depression (without a psychotic episode) are included. Exclusion criteria are regular use of hypnotic agents, opioids, and certain beta-blockers, as well as the presence of factors precluding exercise, history of epilepsy, restless legs syndrome, moderate obstructive sleep apnea, and a BMI > 40. The intervention is a single bout of aerobic exercise, performed for 30 min on a bicycle ergometer at 80% individual anaerobic threshold. The control group sits and reads for 30 min. The primary outcome is sleep efficiency measured by polysomnography. Secondary outcomes include further polysomnographic variables, subjective pre-sleep arousal, nocturnal cardiovascular autonomic modulation, subjective sleep quality, daytime sleepiness, and adverse events. According to the sample size calculation, a total of 92 patients will be randomized using minimization. DISCUSSION This trial will add new information to the body of knowledge concerning the treatment of insomnia in patients with depression. Thereby, the results will inform decision makers on the utility of acute aerobic exercise. TRIAL REGISTRATION Clinicaltrials.gov, NCT03673397 . Protocol version 1 registered on 17 September 2018.
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Affiliation(s)
- Gavin Brupbacher
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052, Basel, Switzerland.
- OBERWAID AG, Rorschacher Strasse 311, 9016, St. Gallen, Switzerland.
| | - Doris Straus
- OBERWAID AG, Rorschacher Strasse 311, 9016, St. Gallen, Switzerland
| | | | - Thea Zander-Schellenberg
- Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
| | - Markus Gerber
- Division of Sport and Psychosocial Health, Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052, Basel, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Culmannstrasse 8, 8091, Zurich, Switzerland
| | - Arno Schmidt-Trucksäss
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052, Basel, Switzerland
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158
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Seidi PAM, Mohammadi H, Khazaie H, Abas NQ, Jaff D. Psychometric properties of the Kurdish version of Pittsburgh Sleep Quality Index. Sleep Med 2019; 63:75-81. [PMID: 31606652 DOI: 10.1016/j.sleep.2019.04.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 03/25/2019] [Accepted: 04/24/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND The Pittsburgh Sleep Quality Index (PSQI) is a standardized questionnaire that used for subjective assessment of sleep quality. It has been translated into several languages and is widely used in clinical research settings. Since there is no sleep-related scale standardized in the Kurdish language, the present study aimed to translate and validate the PSQI into Kurdish. METHODS First, the PSQI was successfully translated into Kurdish then back-translated into English by independent professional bilingual translators. The translated version of PSQI was tested with 230 participants, 150 healthy subjects, 40 subjects with insomnia, and 40 subjects with physical symptoms. Internal consistency was calculated by the Cronbach Alpha method using SPSS-20 software. Spearman correlation via a test-retest process was used for reliability. The General Health Questionnaire (GHQ28) was used to analyze criterion validity. The construct validity of the scale was tested by exploratory factor analysis (EFA). Factor weight was checked by confirmatory factor analysis (CFA) using LISREL software version 8.8. RESULTS The internal consistency and reliability for PSQI global score was acceptable (Cronbach's alpha = 0.70). The result showed a strong correlation between test and retest after six weeks (r = 0.83). Correlations between the global score and components of the PSQI with the GHQ28 were all statistically significant (r = 0.23-0.72, p < 0.05). Exploratory factor analysis revealed three factors with a significant correlation between the PSQI global score and these factors. All factor weights were above 0.40. CONCLUSION The results of this study support the PSQI's validity and reliability. This study offers a foundation for further studies in Kurdish populations.
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Affiliation(s)
- Pegah A M Seidi
- Department of Psychology, College of Education, Garmian University, Kalar, Kurdistan, Iraq
| | - Hiwa Mohammadi
- Sleep Disorders Research Center, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran; Department of Neurology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Habibolah Khazaie
- Sleep Disorders Research Center, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nazdar Qudrat Abas
- Department of Psychology, College of Education, Garmian University, Kalar, Kurdistan, Iraq
| | - Dilshad Jaff
- Research, Innovation, and Global Solutions, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, USA; Department of Maternal & Child Health, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, USA
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159
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Facer-Childs ER, Middleton B, Skene DJ, Bagshaw AP. Resetting the late timing of 'night owls' has a positive impact on mental health and performance. Sleep Med 2019; 60:236-247. [PMID: 31202686 DOI: 10.1016/j.sleep.2019.05.001] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 05/01/2019] [Accepted: 05/03/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND There is conflict between living according to our endogenous biological rhythms and our external environment, with disruptions resulting in negative consequences to health and performance. This is often documented in shift work and jet lag, but 'societal norms' (eg, typical working hours) can create profound issues for 'night owls', people whose internal biological timing predisposes them to follow an unusually late sleep-wake cycle. Night owls have also been associated with health issues, mood disturbances, poorer performance and increased mortality rates. METHODS This study used a randomized control trial design aimed to shift the late timing of night owls to an earlier time (phase advance), using non-pharmacological, practical interventions in a real-world setting. These interventions targeted light exposure (through earlier wake up/sleep times), fixed meals times, caffeine intake and exercise. RESULTS Overall, participants demonstrated a significant advance of ∼2 h in sleep/wake timings as measured by actigraphy and circadian phase markers (dim light melatonin onset and peak time of the cortisol awakening response), whilst having no adverse effect on sleep duration. Notably, the phase advance was accompanied by significant improvements to self-reported depression and stress, as well as improved cognitive (reaction time) and physical (grip strength) performance measures during the typical 'suboptimal' morning hours. CONCLUSIONS Our findings propose a novel strategy for shifting clock timing towards a pattern that is more aligned to societal demands that could significantly improve elements of performance, mental health and sleep timing in the real world.
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Affiliation(s)
- Elise R Facer-Childs
- School of Biosciences, University of Birmingham, Birmingham, B15 2TT, UK; Centre for Human Brain Health, University of Birmingham, Birmingham, B15 2TT, UK; School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK.
| | - Benita Middleton
- Faculty of Health & Medical Sciences, University of Surrey, Guildford, GU2 7XH, UK
| | - Debra J Skene
- Faculty of Health & Medical Sciences, University of Surrey, Guildford, GU2 7XH, UK
| | - Andrew P Bagshaw
- Centre for Human Brain Health, University of Birmingham, Birmingham, B15 2TT, UK; School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
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160
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Brupbacher G, Gerger H, Wechsler M, Zander-Schellenberg T, Straus D, Porschke H, Gerber M, von Känel R, Schmidt-Trucksäss A. The effects of aerobic, resistance, and meditative movement exercise on sleep in individuals with depression: protocol for a systematic review and network meta-analysis. Syst Rev 2019; 8:105. [PMID: 31027509 PMCID: PMC6486698 DOI: 10.1186/s13643-019-1018-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 04/05/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The main objective of this review is to assess the effects of aerobic, resistance, and meditative movement exercise on sleep quality in patients with unipolar depression. A secondary goal is to ascertain the effects on sleep duration, sleepiness, daytime functioning, use of hypnotics, and adverse events. METHODS A systematic computerized search will be performed in the following online databases: PubMed, EMBASE (on Ovid), Cochrane Library, PsycINFO (on Ovid), SPORTDiscus (on EBSCOhost), CINHAL (on EBSCOhost), Clinicaltrials.gov , WHO International Clinical Trials Registry, OpenGrey, and ProQuest Dissertations and Theses. Bibliographies of all included studies as well as any other relevant reviews identified via the search will be screened. Randomized trials using aerobic, resistance, or meditative movement exercise interventions which target sleep as a primary or secondary outcome will be included. The primary outcome will be differences in sleep quality at post-intervention. Secondary outcomes will be adverse events, differences in sleep duration, daytime sleepiness and functioning, and the use of hypnotics at post-intervention. Two authors will independently screen the identified records. Disagreement will be resolved by consensus or if no consensus can be reached by adjudication of a designated third reviewer. Data extraction will be done independently by two authors using a standardized and piloted data extraction sheet. Bias in individual studies will be assessed using the revised Cochrane risk of bias tool. The certainty of evidence across all outcomes will be evaluated using the CINeMA (Confidence in Network Meta-Analysis) framework. A frequentist network meta-analysis will be conducted. The systematic review and network meta-analysis will be presented according to the PRISMA for Network Meta-Analyses (PRISMA-NMA) guideline. DISCUSSION This systematic review and network meta-analysis will provide a synthesis of the currently available evidence concerning the effects of aerobic, resistance, and meditative movement exercises on sleep in patients with unipolar depression. Thereby, we hope to accelerate the consolidation of evidence and inform decision-makers on potential benefits and harms. SYSTEMATIC REVIEW REGISTRATION The protocol has been registered at the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42019115705).
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Affiliation(s)
- Gavin Brupbacher
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052, Basel, Switzerland.
- Oberwaid AG, Rorschacher Strasse 311, 9016, St. Gallen, Switzerland.
| | - Heike Gerger
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Missionsstrasse 62a, 4055, Basel, Switzerland
| | - Monika Wechsler
- University Medical Library Basel, Spiegelgasse 5, 4051, Basel, Switzerland
| | - Thea Zander-Schellenberg
- Division of Clinical Psychology and Epidemiology, Faculty of Psychology, University of Basel, Missionsstrasse 62a, 4055, Basel, Switzerland
| | - Doris Straus
- Oberwaid AG, Rorschacher Strasse 311, 9016, St. Gallen, Switzerland
| | | | - Markus Gerber
- Division of Sport and Psychosocial Health, Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052, Basel, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zürich, University of Zurich, Culmannstrasse 8, 8091, Zurich, Switzerland
| | - Arno Schmidt-Trucksäss
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052, Basel, Switzerland
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161
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Chan KKS, Fung WTW. The impact of experienced discrimination and self-stigma on sleep and health-related quality of life among individuals with mental disorders in Hong Kong. Qual Life Res 2019; 28:2171-2182. [DOI: 10.1007/s11136-019-02181-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2019] [Indexed: 01/12/2023]
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162
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Noda M, Iwamoto I, Tabata H, Yamagata T, Ito H, Nagata KI. Role of Per3, a circadian clock gene, in embryonic development of mouse cerebral cortex. Sci Rep 2019; 9:5874. [PMID: 30971765 PMCID: PMC6458147 DOI: 10.1038/s41598-019-42390-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 03/21/2019] [Indexed: 02/04/2023] Open
Abstract
Per3 is one of the primary components of circadian clock system. While circadian dysregulation is known to be involved in the pathogenesis of several neuropsychiatric diseases. It remains largely unknown whether they participate in embryonic brain development. Here, we examined the role of clock gene Per3 in the development of mouse cerebral cortex. In situ hybridization analysis revealed that Per3 is expressed in the developing mouse cortex. Acute knockdown of Per3 with in utero electroporation caused abnormal positioning of cortical neurons, which was rescued by RNAi-resistant Per3. Per3-deficient cells showed abnormal migration phenotypes, impaired axon extension and dendritic arbor formation. Taken together, Per3 was found to play a pivotal role in corticogenesis via regulation of excitatory neuron migration and synaptic network formation.
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Affiliation(s)
- Mariko Noda
- Department of Molecular Neurobiology, Institute for Developmental Research, Aichi Human Service Center, Kasugai, Japan
| | - Ikuko Iwamoto
- Department of Molecular Neurobiology, Institute for Developmental Research, Aichi Human Service Center, Kasugai, Japan
| | - Hidenori Tabata
- Department of Molecular Neurobiology, Institute for Developmental Research, Aichi Human Service Center, Kasugai, Japan
| | | | - Hidenori Ito
- Department of Molecular Neurobiology, Institute for Developmental Research, Aichi Human Service Center, Kasugai, Japan
| | - Koh-Ichi Nagata
- Department of Molecular Neurobiology, Institute for Developmental Research, Aichi Human Service Center, Kasugai, Japan.
- Department of Neurochemistry, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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163
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Jahrami H, Dewald-Kaufmann J, Faris MAI, AlAnsari AMS, Taha M, AlAnsari N. Prevalence of sleep problems among medical students: a systematic review and meta-analysis. J Public Health (Oxf) 2019. [DOI: 10.1007/s10389-019-01064-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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164
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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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165
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Mu P, Huang YH. Cholinergic system in sleep regulation of emotion and motivation. Pharmacol Res 2019; 143:113-118. [PMID: 30894329 DOI: 10.1016/j.phrs.2019.03.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 02/28/2019] [Accepted: 03/15/2019] [Indexed: 01/22/2023]
Abstract
Sleep profoundly regulates our emotional and motivational state of mind. Human brain imaging and animal model studies are providing initial insights on the underlying neural mechanisms. Here, we focus on the brain cholinergic system, including cholinergic neurons in the basal forebrain, ventral striatum, habenula, and brain stem. Although much is learned about cholinergic regulations of emotion and motivation, less is known on their interactions with sleep. Specifically, we present an anatomical framework that highlights cholinergic signaling in the integrated reward-arousal/sleep circuitry, and identify the knowledge gaps on the potential roles of cholinergic system in sleep-mediated regulation of emotion and motivation. Sleep impacts every aspect of brain functions. It not only restores cognitive control, but also retunes emotional and motivational regulation [1]. Sleep disturbance is a comorbidity and sometimes a predicting factor for various psychiatric diseases including major depressive disorder, anxiety, post-traumatic stress disorder, and drug addiction [2-9]. Although it is well recognized that sleep prominently shapes emotional and motivational regulation, the underlying neural mechanisms remain elusive. The brain cholinergic system is essential for a diverse variety of functions including cognition, learning and memory, sensory and motor processing, sleep and arousal, reward processing, and emotion regulation [10-14]. Although cholinergic functions in cognition, learning and memory, motor control, and sleep and arousal have been well established, its interaction with sleep in regulating emotion and motivation has not been extensively studied. Here we review current evidence on sleep-mediated regulation of emotion and motivation, and reveal knowledge gaps on potential contributions from the cholinergic system.
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Affiliation(s)
- Ping Mu
- College of Life Sciences, Ludong University, 186 Hongqi Middle Road, Yantai, Shandong, 264025, China.
| | - Yanhua H Huang
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, 15219, PA, United States.
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166
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Kiriyama K, Goto T, Yamamoto H, Ara T, Takahashi H, Jheng HF, Nomura W, Inoue H, Nakata R, Kawada T. Lactobacillus helveticus-MIKI-020 enhances hepatic FGF21 expression and decreases the core body temperature during sleep in mice. J Funct Foods 2019. [DOI: 10.1016/j.jff.2019.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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167
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Winsky-Sommerer R, de Oliveira P, Loomis S, Wafford K, Dijk DJ, Gilmour G. Disturbances of sleep quality, timing and structure and their relationship with other neuropsychiatric symptoms in Alzheimer’s disease and schizophrenia: Insights from studies in patient populations and animal models. Neurosci Biobehav Rev 2019; 97:112-137. [DOI: 10.1016/j.neubiorev.2018.09.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 08/31/2018] [Accepted: 09/30/2018] [Indexed: 02/06/2023]
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168
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Karthikeyan R, Spence DW, Pandi-Perumal SR. The contribution of modern 24-hour society to the development of type 2 diabetes mellitus: the role of insufficient sleep. ACTA ACUST UNITED AC 2019; 12:227-231. [PMID: 31890100 PMCID: PMC6932842 DOI: 10.5935/1984-0063.20190061] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Epidemiological studies since 1980 have shown significant increases in the incidence of type 2 diabetes mellitus (T2DM). The public health burden generated by the growing prevalence of T2DM, which, in its fully developed form, is a lifelong illness, has been associated with further social and economic costs in affected countries. Recent studies have suggested that chronic sleep insufficiency or disrupted or poor quality sleep could contribute to the development of T2DM. Although many research findings have now shown that sleep plays a key role in glucose metabolism, the full implications of these findings have not been translated into clinical programs for improving patients' sleep quality as a means for addressing the treatment of T2DM. The purpose of this brief overview is to focus on the clinical significance of sleep in the onset and treatment of T2DM. We suggest here that physician education should emphasize the importance of sufficient sleep for overall health, including the management of T2DM, and that steps should be taken to incorporate this perspective into clinical practice. The promotion of sleep hygiene techniques as a clinical intervention could improve the regulation of glucose metabolism and thus the longevity of T2DM patients. Moreover, it may prevent secondary complications accruing from the illness and consequently reduce the significant medical costs of treating T2DM patients.
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Affiliation(s)
- Ramanujam Karthikeyan
- Madurai Kamaraj Univesity, Dept. of Animal Behavior & Physiology, School of Biological Sciences, - Madurai - 625021, Tamil Nadu - India
| | - David Warren Spence
- Independent Researcher, Department of Sleep Medicine - Toronto - Ontario - Canada
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169
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Hao Y, Hu Y, Wang H, Paudel D, Xu Y, Zhang B. The Effect Of Fluvoxamine On Sleep Architecture Of Depressed Patients With Insomnia: An 8-Week, Open-Label, Baseline-Controlled Study. Nat Sci Sleep 2019; 11:291-300. [PMID: 31807102 PMCID: PMC6839582 DOI: 10.2147/nss.s220947] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 10/07/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND AIMS Fluvoxamine can markedly increase the serum melatonin level, which regulates human circadian rhythm. However, only limited research has evaluated the effects of fluvoxamine on sleep architecture. Thus, the current study aims to investigate the effect of fluvoxamine on PSG characteristics and the impact of persistent insomnia on the prognosis of depression in the depressed individual with insomnia over the course of 8 weeks. METHODS Thirty-one clinically depressed patients with insomnia were enrolled in this 8-week, open-label, baseline-controlled study, and 23 patients completed the study. All participants were assigned to receive fluvoxamine for 8 weeks. They were assessed by the PSG, Hamilton Rating Scale for Depression (17 items) (HRSD-17), Clinical Global Index, Pittsburgh Sleep Quality Index, and Epworth Sleepiness Scale at baseline and the following visits, which were at day 14, day 28, and day 56. A patient with an ≥4 HRSD-17 sleep disturbance factor score at both baseline and endpoint (day 56) was defined as a patient with persistent insomnia. RESULTS Compared with baseline, the percentage of stage 3 sleep had significantly (F=11.630, P=0.001) increased in all 3 visits. Moreover, the percentage of rapid eye movement sleep was reduced during the study, with only a significant difference (F=3.991, P=0.027) between baseline and day 14. Finally, 47.8% (11/23) of the participants were in remission, and 60.9% (14/23) of them did not report insomnia. The clinical remission ratio of the persistent insomnia group (11.1% [1/9]) (χ2 =8.811, P=0.004) was significantly lower than that of the non-insomnia group (71.4% [10/14]) at the endpoint. Additionally, during the first clinical evaluation (day 14), patients without insomnia had significantly higher final remission ratios than patients with insomnia (80% [8/10] versus 30.8% [4/13]; χ2 =5.79; P=0.016). CONCLUSION Fluvoxamine improved PSG parameters and ameliorated complaints of insomnia simultaneously during this 8-week study. Moreover, depressed individuals who reported persistent insomnia were at higher risk of remaining depressed by the end of the trial, which might be forecasted by the sleep status on day 14. TRIAL REGISTRATION The Effect of Fluvoxamine on Polysomnogram in Depressed Patients with Insomnia; https://clinicaltrials.gov/ct2/show/NCT02442713. Registry identifier: NCT02442713. Registry date: May 13, 2015.
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Affiliation(s)
- Yanli Hao
- Department of Human Anatomy, Guangzhou Medical University, Guangzhou 511436, People's Republic of China
| | - Yuanyuan Hu
- Zhongshan Third People's Hospital, Zhongshan, People's Republic of China
| | - Haili Wang
- Ganzhou Third People's Hospital, Ganzhou, People's Republic of China
| | - Dhirendra Paudel
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China.,Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangzhou, People's Republic of China
| | - Yan Xu
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China.,Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangzhou, People's Republic of China.,Guangdong Provincial Mental Health Institute, Guangzhou, People's Republic of China
| | - Bin Zhang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China.,Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangzhou, People's Republic of China.,Guangdong Provincial Mental Health Institute, Guangzhou, People's Republic of China
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170
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Kiwan N, Mahfoud Z, Ghuloum S, Yehya A, Hammoudeh S, Hani Y, Chamali R, Amro I, Mook-Kanamori D, Al-Amin H. Relationships between sleep patterns and metabolic profile in patients maintained on antipsychotics: a cross-sectional comparative study. Neuropsychiatr Dis Treat 2019; 15:2035-2047. [PMID: 31410007 PMCID: PMC6650465 DOI: 10.2147/ndt.s207987] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 06/10/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Disturbances in sleep duration and quality have been associated with obesity and other metabolic changes. Patients with mental disorders (MD) are known to have more sleep problems, and antipsychotics (AP), used in the treatment of these patients, can also cause weight gain. This study aimed to compare the self-reported sleep patterns between psychiatric patients (on or off AP) and controls. We also evaluated the associations between the clinical and metabolic profiles with short or long sleep duration. METHODS A total of 339 subjects was recruited: Mentally ill patients maintained on AP for at least six months (MD+AP, n=112), patients not taking AP for at least the last six months before enrollment (MD/noAP, n=101), and non-psychiatry controls (HC, n=126). Multinomial regression analysis was applied to find the predictors of irregular sleep duration in this sample. RESULTS More mentally ill patients (MD+AP and MD/noAP) reported a sleep duration of >8 hrs than HC. Patients from MD/noAP showed more insomnia than HC. Sleep disturbances were significantly more frequent in MD+AP than HC. Participants who reported sleeping >8 hrs had higher body mass index and waist circumference than those who slept <7 hrs. CONCLUSION Female gender, central obesity and being mentally ill were independently associated with long sleep duration (>8h) in the population of Qatar.
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Affiliation(s)
- Nancy Kiwan
- Department of Research, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Ziyad Mahfoud
- Department of Health Policy and Research, Weill Cornell Medicine - Qatar, Doha, Qatar.,Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY, USA
| | | | - Arij Yehya
- Department of Research, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Samer Hammoudeh
- Department of Research, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Yahya Hani
- Psychiatry Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Rifka Chamali
- Department of Research, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Iman Amro
- Department of Research, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Dennis Mook-Kanamori
- Department of Physiology and Biophysics, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Hassen Al-Amin
- Department of Psychiatry, Weill Cornell Medicine - Qatar, Doha, Qatar
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171
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Li Q, Li Q, Liu C, Shashikumar SP, Nemati S, Clifford GD. Deep learning in the cross-time frequency domain for sleep staging from a single-lead electrocardiogram. Physiol Meas 2018; 39:124005. [PMID: 30524025 PMCID: PMC8325056 DOI: 10.1088/1361-6579/aaf339] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE This study classifies sleep stages from a single lead electrocardiogram (ECG) using beat detection, cardiorespiratory coupling in the time-frequency domain and a deep convolutional neural network (CNN). APPROACH An ECG-derived respiration (EDR) signal and synchronous beat-to-beat heart rate variability (HRV) time series were derived from the ECG using previously described robust algorithms. A measure of cardiorespiratory coupling (CRC) was extracted by calculating the coherence and cross-spectrogram of the EDR and HRV signal in 5 min windows. A CNN was then trained to classify the sleep stages (wake, rapid-eye-movement (REM) sleep, non-REM (NREM) light sleep and NREM deep sleep) from the corresponding CRC spectrograms. A support vector machine was then used to combine the output of CNN with the other features derived from the ECG, including phase-rectified signal averaging (PRSA), sample entropy, as well as standard spectral and temporal HRV measures. The MIT-BIH Polysomnographic Database (SLPDB), the PhysioNet/Computing in Cardiology Challenge 2018 database (CinC2018) and the Sleep Heart Health Study (SHHS) database, all expert-annotated for sleep stages, were used to train and validate the algorithm. MAIN RESULTS Ten-fold cross validation results showed that the proposed algorithm achieved an accuracy (Acc) of 75.4% and a Cohen's kappa coefficient of [Formula: see text] = 0.54 on the out of sample validation data in the classification of Wake, REM, NREM light and deep sleep in SLPDB. This rose to Acc = 81.6% and [Formula: see text] = 0.63 for the classification of Wake, REM sleep and NREM sleep and Acc = 85.1% and [Formula: see text] = 0.68 for the classification of NREM sleep versus REM/wakefulness in SLPDB. SIGNIFICANCE The proposed ECG-based sleep stage classification approach that represents the highest reported results on non-electroencephalographic data and uses datasets over ten times larger than those in previous studies. By using a state-of-the-art QRS detector and deep learning model, the system does not require human annotation and can therefore be scaled for mass analysis.
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Affiliation(s)
- Qiao Li
- Department of Biomedical Informatics, Emory University, Atlanta, GA, United States of America
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172
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Guo L, Luo M, Wang WX, Huang GL, Xu Y, Gao X, Lu CY, Zhang WH. Association between problematic Internet use, sleep disturbance, and suicidal behavior in Chinese adolescents. J Behav Addict 2018; 7:965-975. [PMID: 30474380 PMCID: PMC6376369 DOI: 10.1556/2006.7.2018.115] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS This large-scale study aimed to test (a) associations of problematic Internet use (PIU) and sleep disturbance with suicidal ideation and suicide attempts among Chinese adolescents and (b) whether sleep disturbance mediates the association between PIU and suicidal behavior. METHODS Data were drawn from the 2017 National School-based Chinese Adolescents Health Survey. A total of 20,895 students' questionnaires were qualified for analysis. The Young's Internet Addiction Test was used to assess PIU, and level of sleep disturbance was measured by the Pittsburgh Sleep Quality Index. Multilevel logistic regression models and path models were utilized in analyses. RESULTS Of the total sample, 2,864 (13.7%) reported having suicidal ideation, and 537 (2.6%) reported having suicide attempts. After adjusting for control variables and sleep disturbance, PIU was associated with an increased risk of suicidal ideation (AOR = 1.04, 95% CI = 1.03-1.04) and suicide attempts (AOR = 1.03, 95% CI = 1.02-1.04). Findings of the path models showed that the standardized indirect effects of PIU on suicidal ideation (standardized β estimate = 0.092, 95% CI = 0.082-0.102) and on suicide attempts (standardized β estimate = 0.082, 95% CI = 0.068-0.096) through sleep disturbance were significant. Conversely, sleep disturbance significantly mediated the association of suicidal behavior on PIU. DISCUSSION AND CONCLUSIONS There may be a complex transactional association between PIU, sleep disturbance, and suicidal behavior. The estimates of the mediator role of sleep disturbance provide evidence for the current understanding of the mechanism of the association between PIU and suicidal behavior. Possible concomitant treatment services for PIU, sleep disturbance, and suicidal behavior were recommended.
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Affiliation(s)
- Lan Guo
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China,Department of Nutrition, Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, People’s Republic of China
| | - Min Luo
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China,Department of Nutrition, Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, People’s Republic of China
| | - Wan-Xin Wang
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China,Department of Nutrition, Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, People’s Republic of China
| | - Guo-Liang Huang
- Department of Drug Abuse Control, Center for ADR monitoring of Guangdong, Guangzhou, People’s Republic of China
| | - Yan Xu
- Department of Drug Abuse Control, Center for ADR monitoring of Guangdong, Guangzhou, People’s Republic of China
| | - Xue Gao
- Department of Drug Abuse Control, Center for ADR monitoring of Guangdong, Guangzhou, People’s Republic of China
| | - Ci-Yong Lu
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China,Department of Nutrition, Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, People’s Republic of China,Corresponding author: Ci-Yong Lu, MD, PhD; Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, People’s Republic of China; Phone: +86 20 87332477; Fax: +86 20 87331882; E-mail:
| | - Wei-Hong Zhang
- School of Public Health, Université Libre de Bruxelles (ULB), Bruxelles, Belgium,Research Center for Public Health, Tsinghua University, Beijing, People’s Republic of China
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173
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Weaver MD, Vetter C, Rajaratnam SM, O’Brien CS, Qadri S, Benca RM, Rogers AE, Leary EB, Walsh JK, Czeisler CA, Barger LK. Sleep disorders, depression and anxiety are associated with adverse safety outcomes in healthcare workers: A prospective cohort study. J Sleep Res 2018; 27:e12722. [PMID: 30069960 PMCID: PMC6314290 DOI: 10.1111/jsr.12722] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 05/13/2018] [Accepted: 05/25/2018] [Indexed: 11/29/2022]
Abstract
The objective of the study was to determine if sleep disorder, depression or anxiety screening status was associated with safety outcomes in a diverse population of hospital workers. A sample of shift workers at four hospitals participated in a prospective cohort study. Participants were screened for five sleep disorders, depression and anxiety at baseline, then completed prospective monthly surveys for the next 6 months to capture motor vehicle crashes, near-miss crashes, occupational exposures and medical errors. We tested the associations between sleep disorders, depression and anxiety and adverse safety outcomes using incidence rate ratios adjusted for potentially confounding factors in a multivariable negative binomial regression model. Of the 416 hospital workers who participated, two in five (40.9%) screened positive for a sleep disorder and 21.6% screened positive for depression or anxiety. After multivariable adjustment, screening positive for a sleep disorder was associated with 83% increased incidence of adverse safety outcomes. Screening positive for depression or anxiety increased the risk by 63%. Sleep disorders and mood disorders were independently associated with adverse outcomes and contributed additively to risk. Our findings suggest that screening for sleep disorders and mental health screening can help identify individuals who are vulnerable to adverse safety outcomes. Future research should evaluate sleep and mental health screening, evaluation and treatment programmes that may improve safety.
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Affiliation(s)
- Matthew D. Weaver
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital
- Division of Sleep Medicine, Harvard Medical School
| | - Céline Vetter
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital
- Division of Sleep Medicine, Harvard Medical School
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Shantha M.W. Rajaratnam
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital
- Division of Sleep Medicine, Harvard Medical School
- School of Psychology and Psychiatry, Monash University
| | - Conor S. O’Brien
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital
| | - Salim Qadri
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital
| | - Ruth M. Benca
- Department of Psychiatry & Human Behavior, University of California, Irvine
| | - Ann E. Rogers
- Nell Hodgson Woodruff School of Nursing, Emory University
| | - Eileen B. Leary
- The Stanford Center for Sleep Sciences and Medicine, Stanford University School of Medicine
| | - James K. Walsh
- Sleep Medicine and Research Center, St. Luke’s Hospital, St. Louis Missouri
| | - Charles A. Czeisler
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital
- Division of Sleep Medicine, Harvard Medical School
| | - Laura K. Barger
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital
- Division of Sleep Medicine, Harvard Medical School
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174
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Kuo HY, Liu FC. Molecular Pathology and Pharmacological Treatment of Autism Spectrum Disorder-Like Phenotypes Using Rodent Models. Front Cell Neurosci 2018; 12:422. [PMID: 30524240 PMCID: PMC6262306 DOI: 10.3389/fncel.2018.00422] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 10/29/2018] [Indexed: 12/13/2022] Open
Abstract
Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental disorder with a high prevalence rate. The core symptoms of ASD patients are impaired social communication and repetitive behavior. Genetic and environmental factors contribute to pathophysiology of ASD. Regarding environmental risk factors, it is known that valproic acid (VPA) exposure during pregnancy increases the chance of ASD among offspring. Over a decade of animal model studies have shown that maternal treatment with VPA in rodents recapitulates ASD-like pathophysiology at a molecular, cellular and behavioral level. Here, we review the prevailing theories of ASD pathogenesis, including excitatory/inhibitory imbalance, neurotransmitter dysfunction, dysfunction of mTOR and endocannabinoid signaling pathways, neuroinflammation and epigenetic alterations that have been associated with ASD. We also describe the evidence linking neuropathological changes to ASD-like behavioral abnormalities in maternal VPA-treated rodents. In addition to obtaining an understanding of the neuropathological mechanisms, the VPA-induced ASD-like animal models also serve as a good platform for testing pharmacological reagents that might be use treating ASD. We therefore have summarized the various pharmacological studies that have targeted the classical neurotransmitter systems, the endocannabinoids, the Wnt signal pathway and neuroinflammation. These approaches have been shown to often be able to ameliorate the ASD-like phenotypes induced by maternal VPA treatments.
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Affiliation(s)
- Hsiao-Ying Kuo
- Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan
| | - Fu-Chin Liu
- Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
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175
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Snyder E, Cai B, DeMuro C, Morrison MF, Ball W. A New Single-Item Sleep Quality Scale: Results of Psychometric Evaluation in Patients With Chronic Primary Insomnia and Depression. J Clin Sleep Med 2018; 14:1849-1857. [PMID: 30373688 DOI: 10.5664/jcsm.7478] [Citation(s) in RCA: 161] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 06/05/2018] [Indexed: 12/19/2022]
Abstract
STUDY OBJECTIVES A single-item sleep quality scale (SQS) was developed as a simple and practical sleep quality assessment and psychometrically evaluated. METHODS SQS measurement characteristics were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and morning questionnaire-insomnia (MQI) according to prespecified analysis plans in separate clinical studies of patients with insomnia and depression. Patients with insomnia (n = 70) received 4 weeks' usual care with an FDA-approved hypnotic agent; patients with depression (n = 651) received 8 weeks' active or experimental therapy. RESULTS Concurrent criterion validity (correlation with measures of a similar construct) was demonstrated by strong (inverse) correlations between the SQS and MQI (week 1 Pearson correlation -.76) and PSQI (week 8 Goodman-Kruskal correlation -.92) sleep quality items in populations with insomnia and depression, respectively. In patients with depression, stronger correlations between the SQS and PSQI core sleep quality components versus other items supported convergent/divergent construct validity (similarity/dissimilarity to related/unrelated measures). Known-groups validity was evidenced by decreasing mean SQS scores across those who sleep normally, those borderline to having sleep problems, and those with problems sleeping. Test-retest reliability (intraclass correlation coefficient) was .62 during a 4-week period of sleep stability in patients with insomnia and .74 in stable patients with depression (1 week). Effect sizes (standardized response means) for change from baseline were 1.32 (week 1) and .67 (week 8) in populations with insomnia and depression, respectively. Mean SQS changes from baseline to week 8 convergently decreased across groups of patients with depression categorized by level of PSQI sleep quality improvement. CONCLUSIONS The SQS possesses favorable measurement characteristics relative to lengthier or more frequently administered sleep questionnaires in patients with insomnia and depression. CLINICAL TRIAL REGISTRATION Registry: ClincalTrials.gov, Title: Treatment of Patients With Major Depressive Disorder With MK0869, Identifier: NCT00034983, URL: https://clinicaltrials.gov/ct2/show/NCT00034983.
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Affiliation(s)
| | - Bing Cai
- Merck & Co., Inc., Kenilworth, New Jersey
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176
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Sargin D. The role of the orexin system in stress response. Neuropharmacology 2018; 154:68-78. [PMID: 30266600 DOI: 10.1016/j.neuropharm.2018.09.034] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/18/2018] [Accepted: 09/21/2018] [Indexed: 11/30/2022]
Abstract
Orexins are neuropeptides that are exclusively produced by hypothalamic neurons, which project throughout the entire brain. Orexin, also known as hypocretins, were initially identified to play a fundamental role in food intake, arousal and the regulation of sleep and wakefulness. Recent studies identified orexins to be critical for diverse physiological processes including motivation, reward, attention, emotional regulation, stress and anxiety. Here, I review recent findings that indicate orexin has an important role in acute and chronic stress. I also summarize the recent optogenetic and chemogenetic studies that have advanced our understanding of the orexin system. I will conclude by discussing clinical studies that implicate orexins in mental health disorders. This article is part of the Special Issue entitled 'Hypothalamic Control of Homeostasis'.
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Affiliation(s)
- Derya Sargin
- Hotchkiss Brain Institute and the Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada.
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177
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McCall CA, Winkelman JW. Respiratory-Related Leg Movements of Sleep Are Associated With Serotonergic Antidepressants But Not Bupropion. J Clin Sleep Med 2018; 14:1569-1576. [PMID: 30176966 PMCID: PMC6134249 DOI: 10.5664/jcsm.7338] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 05/15/2018] [Accepted: 06/01/2018] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Respiratory-related leg movements (RRLMs) may contribute to the cardiovascular risk associated with obstructive sleep apnea (OSA). Selective serotonin reuptake inhibitors (SSRIs), but not bupropion, increase periodic leg movements in sleep. This study examines whether patients with OSA using SSRIs have more RRLMs than those taking bupropion or no antidepressant. METHODS Patients with an apnea-hypopnea index (AHI) of at least 10 events/h during a full-night diagnostic study or split-night study, who were taking bupropion (n = 32), an SSRI (n = 31), or no antidepressant (n = 31), were selected from a database of prestudy questionnaires. RRLMs were scored according to World Association of Sleep Medicine 2016 standards. RESULTS Patients using SSRIs had significantly greater overall RRLM% (defined as the percentage of respiratory events associated with a leg movement, including apneas, hypopneas, and respiratory effort-related arousals), RRLM index, and periodic limb movement index relative to patients using bupropion and control patients. The difference between the RRLM% in the SSRI and bupropion groups was limited to patients undergoing split-night studies, and that of the SSRI and control groups was limited to patients undergoing full-night diagnostic studies. CONCLUSIONS The greater number of RRLMs and PLMs in the SSRI group may contribute to treatment-emergent insomnia often seen with SSRI use. Fragmented sleep and elevated autonomic nervous system activation associated with increased RRLMs in patients with OSA taking SSRIs might also limit the tolerability of antidepressant treatment, as well as increase the risk for cardiovascular disease.
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Affiliation(s)
| | - John W. Winkelman
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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178
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Punjani N, Flannigan R, Oliffe JL, McCreary DR, Black N, Goldenberg SL. Unhealthy Behaviors Among Canadian Men Are Predictors of Comorbidities: Implications for Clinical Practice. Am J Mens Health 2018; 12:2183-2193. [PMID: 30222015 PMCID: PMC6199435 DOI: 10.1177/1557988318799022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Men's poor health behaviors are an increasingly prevalent issue with long-term consequences. This study broadly samples Canadian men to obtain information regarding health behaviors as a predictor of downstream medical comorbidities. A survey of Canadian men included questions regarding demographics, comorbidities, and health behaviors (smoking and alcohol consumption, sleep and exercise behaviors, and dietary habits). Health behaviors were classified as either healthy or unhealthy based upon previous studies and questionnaire thresholds. Multivariate regression was performed to determine predictors for medical comorbidities. The 2,000 participants were aged 19-94 (median 48, interquartile range 34-60). Approximately half (47.4%) were regular smokers, 38.7% overused alcohol, 53.9% reported unhealthy sleep, 48.9% had low levels of exercise, and 61.8% had unhealthy diets. On multivariate analysis, regular smoking predicted heart disease (OR 2.08, p < .01), elevated cholesterol (OR 1.35, p = .02), type 2 diabetes (OR 1.57, p = .02), osteoarthritis (OR 1.43, p = .04), and depression (OR 1.62, p < .01). Alcohol overuse predicted hypertension (OR 1.40, p < .01) and protected against type 2 diabetes (OR 0.61, p < .01). Unhealthy sleep predicted hypertension (OR 1.46, p < .01), erectile dysfunction (OR 1.50, p = .04), and depression (OR 1.87, p < .01). Low levels of exercise predicted hypertension (OR 1.30, p = .03) and elevated cholesterol (OR 1.27, p = .05). Finally, unhealthy diet predicted depression (OR 1.65, p < .01). This study confirms the association of poor health behaviors and comorbidities common to middle-aged and older men. The results emphasize the potential scope of targeted gender-sensitized public awareness campaigns and interventions to reduce common male disease, morbidity, and mortality.
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Affiliation(s)
- Nahid Punjani
- Division of Urology, Western University, London, ON, Canada
| | - Ryan Flannigan
- Weill Cornell Medicine, Department of Urology, Male Reproduction & Microsurgery, New York, NY, USA
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
- Canadian Men’s Health Foundation, Vancouver, BC, Canada
| | - John L. Oliffe
- Canadian Men’s Health Foundation, Vancouver, BC, Canada
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | | | - Nick Black
- Intensions Consulting, Vancouver, BC, Canada
| | - S. Larry Goldenberg
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
- Canadian Men’s Health Foundation, Vancouver, BC, Canada
- S. Larry Goldenberg, CM, OBC, MD, FRCSC, FACS, FCAHS, Department of Urologic Sciences, University of British Columbia, 2775 Laurel Street, 6th floor, Vancouver, BC V5Z1M9, Canada.
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179
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Kabel AM, Al Thumali AM, Aldowiala KA, Habib RD, Aljuaid SS, Alharthi HA. Sleep disorders in adolescents and young adults: Insights into types, relationship to obesity and high altitude and possible lines of management. Diabetes Metab Syndr 2018; 12:777-781. [PMID: 29673929 DOI: 10.1016/j.dsx.2018.04.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 04/09/2018] [Indexed: 01/03/2023]
Abstract
A sleep disorder is a medical disorder of the sleep pattern of a person that may be serious enough to interfere with normal physical, mental and emotional functioning. Disruptions in sleep can be caused by a variety of causes, from teeth grinding to night terrors. Sleep disorders are usually prevalent among adolescents and young adults, possibly due to factors related to life style, dietary habits, hormonal and emotional disturbances. Other factors that may precipitate sleep disorders include environmental, psychological and genetic factors. Sleep disorders may lead to serious psychological and mood disorders and may even affect the immune system. Management of sleep disorders depends on amelioration of the precipitating factors and the use of certain drugs that may help to restore the normal sleep-wake cycle. This review sheds light on sleep disorders in adolescents and young adults regarding their types, etiology, dangers and possible lines of management.
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Affiliation(s)
- Ahmed M Kabel
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Saudi Arabia; Pharmacology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
| | | | | | - Raghad D Habib
- Pharm D, College of Pharmacy, Taif University, Taif, Saudi Arabia
| | - Shoroq S Aljuaid
- Pharm D, College of Pharmacy, Taif University, Taif, Saudi Arabia
| | - Huda A Alharthi
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Saudi Arabia
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180
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Mai QD, Hill TD, Vila-Henninger L, Grandner MA. Employment insecurity and sleep disturbance: Evidence from 31 European countries. J Sleep Res 2018; 28:e12763. [PMID: 30156336 DOI: 10.1111/jsr.12763] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 07/11/2018] [Accepted: 08/01/2018] [Indexed: 12/22/2022]
Abstract
For nearly half a century, jobs have become increasingly characterized by employment insecurity. We examined the implications for sleep disturbance with cross-sectional data from the European Working Conditions Survey (2010). A group of 24,553 workers between the ages of 25 and 65 years in 31 European countries were asked to indicate whether they suffered from "insomnia or general sleep difficulties" in the past 12 months. We employed logistic regression to model the association between employment insecurity and sleep disturbance for all countries combined and each individual country. For all countries combined, employment insecurity increased the odds of reporting insomnia or general sleep difficulties in the past 12 months. Each unit increase in employment insecurity elevated the odds of sleep disturbance by approximately 47%. This finding was remarkably consistent across 27 of 31 European countries, including Albania, Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, the Netherlands, Norway, Slovakia, Slovenia, Spain, Sweden, Turkey and UK. These results persisted with adjustments for age, gender, immigrant status, household size, partnership status, number of children, child care, elder care, education, earner status, precarious employment status, workplace sector, workplace tenure and workplace size. Employment insecurity was unrelated to sleep disturbance in four European countries: Malta, Poland, Portugal and Romania. Our research continues recent efforts to reveal the human costs associated with working in neoliberal postindustrial labour markets. Our analyses contribute to the external validity of previous research by exploring the impact of employment insecurity across European countries.
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Affiliation(s)
- Quan D Mai
- Department of Sociology, Rutgers University, New Brunswick, New Jersey
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181
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Drews HJ, Wiesner CD, Bethke-Jaenicke C, Weinhold SL, Baier PC, Göder R. Slow-wave sleep predicts long-term social functioning in severe mental illness. PLoS One 2018; 13:e0202198. [PMID: 30157190 PMCID: PMC6114721 DOI: 10.1371/journal.pone.0202198] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 07/29/2018] [Indexed: 11/18/2022] Open
Abstract
Sleep's relevance for long-term social functioning in psychiatric disorders has been widely overlooked so far. Here, we investigate social functioning in a transdiagnostic sample of 31 patients with severe mental illness, namely schizophrenia (n = 15) or major depression (n = 16), in relation to their polysomnographic sleep characteristics 6 (± 2.4) years earlier. In addition, cognitive performance at follow-up and clinical characteristics (i.e., severity of disorder-related symptoms and number of hospitalizations between baseline and follow-up) are assessed. Multiple regression analysis results in a model with slow-wave sleep (SWS) and number of hospitalizations as significant predictors accounting for 50% (R2 = 0.507; p <0.001) of the variance in social functioning. SWS remains a significant predictor of long-term social functioning throughout a series of refining analyses which also identify baseline functioning as an additional significant predictor, whereas diagnosis is non-significant. Also, the effect of SWS on social functioning is not mediated by number of hospitalizations as assessed by a bootstrapped mediation analysis. We thus conclude that duration of slow-wave sleep is a powerful predictor of long-term social outcome in psychiatric disorders. Also, we discuss the relevance of verbal memory, symptom severity, and diagnostic category for social functioning. Future studies should test this finding by using a prospective design, a bigger sample, optimized predictor variables, and a more diverse set of diagnoses. Moreover, it should be explored whether or not treating sleep disturbances in psychiatric illnesses independently improves long-term social functioning.
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Affiliation(s)
- Henning Johannes Drews
- Department of Psychiatry and Psychotherapy, Christian-Albrechts-University Kiel, Kiel, Schleswig-Holstein, Germany
- * E-mail:
| | - Christian Dirk Wiesner
- Department of Psychology, Christian-Albrechts-University Kiel, Kiel, Schleswig-Holstein, Germany
| | - Christina Bethke-Jaenicke
- Department of Psychiatry and Psychotherapy, Christian-Albrechts-University Kiel, Kiel, Schleswig-Holstein, Germany
| | - Sara Lena Weinhold
- Department of Psychiatry and Psychotherapy, Christian-Albrechts-University Kiel, Kiel, Schleswig-Holstein, Germany
| | - Paul Christian Baier
- Department of Psychiatry and Psychotherapy, Christian-Albrechts-University Kiel, Kiel, Schleswig-Holstein, Germany
| | - Robert Göder
- Department of Psychiatry and Psychotherapy, Christian-Albrechts-University Kiel, Kiel, Schleswig-Holstein, Germany
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182
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Morchiladze MM, Silagadze TK, Silagadze ZK. Visceral theory of sleep and origins of mental disorders. Med Hypotheses 2018; 120:22-27. [PMID: 30220335 DOI: 10.1016/j.mehy.2018.07.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 07/12/2018] [Accepted: 07/25/2018] [Indexed: 10/28/2022]
Abstract
Visceral theory of sleep states that the same brain neurons, which process external information in wakefulness, during sleep switch to the processing of internal information coming from various visceral systems. Here we hypothesize that a failure in the commutation of exteroceptive and interoceptive information flows in the brain can manifest itself as a mental illness.
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Affiliation(s)
| | | | - Zurab K Silagadze
- Novosibirsk State University and Budker Institute of Nuclear Physics, 630 090 Novosibirsk, Russia.
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183
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Liu Y, Peng T, Zhang S, Tang K. The relationship between depression, daytime napping, daytime dysfunction, and snoring in 0.5 million Chinese populations: exploring the effects of socio-economic status and age. BMC Public Health 2018; 18:759. [PMID: 29914433 PMCID: PMC6007059 DOI: 10.1186/s12889-018-5629-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 05/29/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Daytime napping has been postulated as both a protective and a risk factor for depression in previous studies. In addition to these conflicting results, research gaps also exist with regard to controlling confounding bias between daytime napping and depression and examining the potential association within the Chinese population. To facilitate the prevention and diagnosis of depression, this study aims to provide insight into the association of daytime napping and depression in 0.5 million Chinese adults by fully controlling confounders, and further examine the modifying effects of socio-economic status (SES) and age. METHODS Data were drawn from the baseline of a Chinese cohort study of 0.5 million adults. Depressive status was measured by the Composite International Diagnostic Inventory (CIDI). Logistic regression models were used to examine the association between depression and daytime napping adjusted for SES, sleep-related factors, lifestyle factors and related diseases. Further stratified analyses were conducted to identify the modifying effects of socio-economic status and age. RESULTS The odds ratio of depression by daytime napping was 1.15 (95% CI: 1.01-1.31) in females and 1.42 (95% CI: 1.18-1.71) in males. Factors including living in a rural area (OR = 1.31, 95% CI: 1.13-1.52), receiving less education (OR = 1.42, 95% CI: 1.22-1.66), getting married (OR = 1.24, 95% CI: 1.10-1.40) and being 45-65 years old (OR = 1.29, 95% CI: 1.12-1.49) had a modifying effect on daytime napping and depression that could strengthen the association. CONCLUSIONS A significantly positive association was found between depression and daytime napping, as well as daytime dysfunction, snoring and both shorter and longer sleep duration. Lower SES and age could possibly modify the association. Further clinical or epidemiological studies are needed to investigate the mechanism and facilitate the prevention of depression.
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Affiliation(s)
- Yuning Liu
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Tingting Peng
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Siqiao Zhang
- Department of Global Health, Emory University Rollins School of Public Health, Atlanta, USA
| | - Kun Tang
- School of Public Health, Peking University Health Science Center, 38th Xueyuan Road, Haidian District, Beijing, China
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184
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Morales-Muñoz I, Koskinen S, Partonen T. Differences in sleep functioning between individuals with seasonal affective disorder and major depressive disorder in Finland. Sleep Med 2018; 48:16-22. [PMID: 29843023 DOI: 10.1016/j.sleep.2018.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 04/16/2018] [Accepted: 04/18/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Sleep problems are commonly reported in seasonal affective disorder (SAD) and major depressive disorder (MDD). However, the specific characteristics of sleep difficulties differ. Frequent sleep problems in MDD are insomnia and night awakenings, whereas SAD patients complain of hypersomnia and daytime sleepiness. No previous studies have reported differences in sleep functioning between these two disorders. METHODS We interviewed 4554 subjects from the Health 2011 survey and included 4153 individuals in this study. We selected participants who fulfilled the criteria for SAD (n = 223), nonseasonal-MDD (n = 238), SAD + MDD (n = 65), and controls (n = 3627). They completed the World Health Organization Composite International Diagnostic Interview, Munich version (M-CIDI), the Seasonal Pattern Assessment Questionnaire (SPAQ), The Beck Depression Inventory (BDI), the EuroQoL (EQ-5), the Alcohol Use Disorders Identification Test (AUDIT) and several questions about sleeping, based on the Basic Nordic Sleep Questionnaire (BNSQ). RESULTS We found Significant differences between groups for "enough sleep", "breathing interruptions during sleep", "tiredness during the day", and "sleeping difficulties". Controls reported better functioning in all sleep variables. SAD + MDD individuals showed more problems in "enough sleep" than SAD, more "breathing interruptions during sleep" than SAD and nonseasonal-MDD, felt more "tired during the day" than SAD and nonseasonal-MDD, and reported more "sleeping difficulties" than SAD and nonseasonal-MDD. Finally, nonseasonal-MDD individuals felt more "tired during the day" than SAD. CONCLUSION Individuals with SAD + MDD show generalized sleeping problems. However, when SAD and nonseasonal-MDD appear separately, similar sleep functioning is observed. Nonseasonal-MDD subjects report to be more tired during the day than SAD.
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Affiliation(s)
- Isabel Morales-Muñoz
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland.
| | - Seppo Koskinen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Timo Partonen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
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185
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Jones DL, Rodriguez VJ, De La Rosa A, Dietch J, Kumar M. The role of sleep dysfunction in the relationship between trauma, neglect and depression in methamphetamine using men. ACTA ACUST UNITED AC 2018; 30:30-34. [PMID: 30643354 DOI: 10.1016/j.npbr.2018.05.002] [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] [Indexed: 01/18/2023]
Abstract
Background Childhood abuse and neglect, or childhood trauma (CT), has been associated with methamphetamine use, HIV, and depression. This study explored the potential for sleep dysfunction to influence the relationship between CT and depression in methamphetamine using men. Methods A total of N = 347 men were enrolled: 1) HIV-uninfected, non-methamphetamine (MA) using heterosexual and homosexual men (HIV- MA-; n = 148), 2) MA-using MSM living with HIV (HIV + MA +; n = 147) and 3) HIV-uninfected, MA using MSM (HIV- MA +; n = 52). Participants completed measures of demographic characteristics, sleep dysfunction, childhood trauma, and depression. Results Participants were on average 37 years old (SD = 9.65). Half of participants were Hispanic, and 48.1% had a monthly personal income of less than USD$500. Controlling for sleep dysfunction and control variables, the impact of CT on depression decreased significantly, b = 0.203, p < 0.001, and the indirect effect of CT on depression was significant according to a 95% bCI, b = 0.091, bCI (95% CI 0.057, 0.130). That is, sleep dysfunction partially explained the relationship between CT on depression. Limitations Important limitations included the cross-sectional design of the study, and the self-reported measure of sleep. Conclusions Results highlight the use of sleep interventions to prevent and treat depression, and the utility of assessing sleep disturbances in clinical care.
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Affiliation(s)
- Deborah L Jones
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1400 NW 10th Ave., Miami, FL, USA
| | - Violeta J Rodriguez
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1400 NW 10th Ave., Miami, FL, USA.,Department of Psychology, University of Georgia, Athens, GA, 30605, USA
| | - Aileen De La Rosa
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1400 NW 10th Ave., Miami, FL, USA
| | - Jessica Dietch
- Department of Psychology, University of North Texas, Denton, TX 76201, USA
| | - Mahendra Kumar
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1400 NW 10th Ave., Miami, FL, USA
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186
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Reinertsen E, Clifford GD. A review of physiological and behavioral monitoring with digital sensors for neuropsychiatric illnesses. Physiol Meas 2018; 39:05TR01. [PMID: 29671754 PMCID: PMC5995114 DOI: 10.1088/1361-6579/aabf64] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Physiological, behavioral, and psychological changes associated with neuropsychiatric illness are reflected in several related signals, including actigraphy, location, word sentiment, voice tone, social activity, heart rate, and responses to standardized questionnaires. These signals can be passively monitored using sensors in smartphones, wearable accelerometers, Holter monitors, and multimodal sensing approaches that fuse multiple data types. Connection of these devices to the internet has made large scale studies feasible and is enabling a revolution in neuropsychiatric monitoring. Currently, evaluation and diagnosis of neuropsychiatric disorders relies on clinical visits, which are infrequent and out of the context of a patient's home environment. Moreover, the demand for clinical care far exceeds the supply of providers. The growing prevalence of context-aware and physiologically relevant digital sensors in consumer technology could help address these challenges, enable objective indexing of patient severity, and inform rapid adjustment of treatment in real-time. Here we review recent studies utilizing such sensors in the context of neuropsychiatric illnesses including stress and depression, bipolar disorder, schizophrenia, post traumatic stress disorder, Alzheimer's disease, and Parkinson's disease.
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Affiliation(s)
- Erik Reinertsen
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, United States of America
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187
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Simeone S, Pucciarelli G, Perrone M, Teresa R, Gargiulo G, Guillari A, Castellano G, Tommaso LD, Niola M, Iannelli G. Delirium in ICU patients following cardiac surgery: An observational study. J Clin Nurs 2018; 27:1994-2002. [DOI: 10.1111/jocn.14324] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Silvio Simeone
- Department of Cardiology, Cardiac Surgery and Emergency; University of Naples Federico II; Naples Italy
| | - Gianluca Pucciarelli
- Department of Biomedicine and Prevention; University of Rome Tor Vergata; Rome Italy
| | - Marco Perrone
- Department of Cardiology, Cardiac Surgery and Emergency; University of Naples Federico II; Naples Italy
| | - Rea Teresa
- Department of Hygiene; University of Naples Federico II; Naples Italy
| | - Gianpaolo Gargiulo
- Pediatric Cardiac Surgery; University of Naples Federico II; Naples Italy
| | - Assunta Guillari
- Department of Hygiene; University of Naples Federico II; Naples Italy
| | - Gaetano Castellano
- Department of Clinical Neuroscience, Anaesthesiology; University of Naples Federico II; Naples Italy
| | - Luigi Di Tommaso
- Department of Cardiac Surgery; University of Naples Federico II; Naples Italy
| | - Massimo Niola
- Department of Advanced Biomedical Sciences; University of Naples Federico II; Naples Italy
| | - Gabriele Iannelli
- Department of Cardiology, Cardiac Surgery and Cardiovascular Emergency; University of Naples Federico II; Naples Italy
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188
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Religious involvement as a social determinant of sleep: an initial review and conceptual model. Sleep Health 2018; 4:325-330. [PMID: 30031524 DOI: 10.1016/j.sleh.2018.04.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 03/26/2018] [Accepted: 04/02/2018] [Indexed: 01/20/2023]
Abstract
Although numerous empirical studies show that religious involvement is associated with better health and longer life expectancies, researchers have virtually ignored possible links between religious involvement and sleep. To spark greater attention to this important and understudied area of sleep research, we review previous population-based studies, propose an initial conceptual model of the likely pathways for these associations, and offer several avenues for future research. Our review and critical examination suggest that religious involvement is indeed a social determinant of sleep in the United States. More religious adults in particular tend to exhibit healthier sleep outcomes than their less religious counterparts. This general pattern can be seen across large population-based studies using a narrow range of religion measurements and sleep outcomes. Our conceptual model, grounded in the broader religion and health literature, suggests that religious involvement may be associated with healthier sleep outcomes by limiting mental, chemical, and physiological arousal associated with psychological distress, substance use, stress exposure, and allostatic load. As we move forward, researchers should incorporate (1) more rigorous longitudinal research designs, (2) more sophisticated sleep measurements, (3) more complex conceptual models, (4) more comprehensive measurements of religion and related concepts, and (5) more measures of religious struggles to better assess the "dark side" of religion. Research along these lines would provide a more thorough understanding of the intersection of religious involvement and population sleep.
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189
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Afonso P, Fonseca M, Pires JF. Impact of working hours on sleep and mental health. Occup Med (Lond) 2018; 67:377-382. [PMID: 28575463 DOI: 10.1093/occmed/kqx054] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background The number of hours people are required to work has a pervasive influence on both physical and mental health. Excessive working hours can also negatively affect sleep quality. The impact at work of mental health problems can have serious consequences for individuals' as well as for organizations' productivity. Aims To evaluate differences in sleep quality and anxiety and depression symptoms between longer working hours group (LWHG) and regular working hours group (RWHG). To examine factors influencing weekly working hours, sleep quality and anxiety and depressive symptoms. Methods Participants were divided into two groups, RWHG and LWHG, based on working hours, with a cut-off of 48 h per week. We used the Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depression symptoms and the Pittsburgh Sleep Quality Index (PSQI) to measure the quality and patterns of sleep. Results The response rate was 23%. Among the 429 study participants, those in the LWHG group (n = 256, 53%) had significantly more depressive and anxiety symptoms and worse sleep quality than those in RWHG (n = 223, 47%). Working time was significantly positively correlated with higher corporate position and HADS scores. Moreover, HADS scores were positively correlated with PSQI scores and negatively correlated with age. Conclusions This study suggests that longer working hours are associated with poorer mental health status and increasing levels of anxiety and depression symptoms. There was a positive correlation between these symptoms and sleep disturbances.
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Affiliation(s)
- P Afonso
- Department of Psychiatry, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - M Fonseca
- Center of Mathematics and Applications, Faculty of Sciences and Technology, Nova University of Lisbon, Lisbon, Portugal
| | - J F Pires
- Human Behaviour Department, AESE-Business School, Lisbon, Portugal
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190
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Akers KG, Chérasse Y, Fujita Y, Srinivasan S, Sakurai T, Sakaguchi M. Concise Review: Regulatory Influence of Sleep and Epigenetics on Adult Hippocampal Neurogenesis and Cognitive and Emotional Function. Stem Cells 2018; 36:969-976. [DOI: 10.1002/stem.2815] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 02/02/2018] [Accepted: 02/17/2018] [Indexed: 12/20/2022]
Affiliation(s)
| | - Yoan Chérasse
- International Institute for Integrative Sleep Medicine, University of Tsukuba; Tsukuba Ibaraki Japan
| | - Yuki Fujita
- Department of Molecular Neuroscience, Graduate School of Medicine; Osaka University; Suita Osaka Japan
| | - Sakthivel Srinivasan
- International Institute for Integrative Sleep Medicine, University of Tsukuba; Tsukuba Ibaraki Japan
| | - Takeshi Sakurai
- International Institute for Integrative Sleep Medicine, University of Tsukuba; Tsukuba Ibaraki Japan
| | - Masanori Sakaguchi
- International Institute for Integrative Sleep Medicine, University of Tsukuba; Tsukuba Ibaraki Japan
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191
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Jagannath A, Taylor L, Wakaf Z, Vasudevan SR, Foster RG. The genetics of circadian rhythms, sleep and health. Hum Mol Genet 2018; 26:R128-R138. [PMID: 28977444 PMCID: PMC5886477 DOI: 10.1093/hmg/ddx240] [Citation(s) in RCA: 126] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 06/21/2017] [Indexed: 11/12/2022] Open
Abstract
Circadian rhythms are 24-h rhythms in physiology and behaviour generated by molecular clocks, which serve to coordinate internal time with the external world. The circadian system is a master regulator of nearly all physiology and its disruption has major consequences on health. Sleep and circadian rhythm disruption (SCRD) is a ubiquitous feature in today's 24/7 society, and studies on shift-workers have shown that SCRD can lead not only to cognitive impairment, but also metabolic syndrome and psychiatric illness including depression (1,2). Mouse models of clock mutants recapitulate these deficits, implicating mechanistic and causal links between SCRD and disease pathophysiology (3-5). Importantly, treating clock disruption reverses and attenuates these adverse health states in animal models (6,7), thus establishing the circadian system as a novel therapeutic target. Significantly, circadian and clock-controlled gene mutations have recently been identified by Genome-Wide Association Studies (GWAS) in the aetiology of sleep, mental health and metabolic disorders. This review will focus upon the genetics of circadian rhythms in sleep and health.
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Affiliation(s)
- Aarti Jagannath
- Sleep and Circadian Neuroscience Institute, OMPI-G, Sir William Dunn School of Pathology, University of Oxford, Oxford OX1 3RE, UK
| | - Lewis Taylor
- Sleep and Circadian Neuroscience Institute, OMPI-G, Sir William Dunn School of Pathology, University of Oxford, Oxford OX1 3RE, UK
| | - Zeinab Wakaf
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford OX1 3QT, UK
| | - Sridhar R Vasudevan
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford OX1 3QT, UK
| | - Russell G Foster
- Sleep and Circadian Neuroscience Institute, OMPI-G, Sir William Dunn School of Pathology, University of Oxford, Oxford OX1 3RE, UK
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192
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Assessment and Treatment of Pediatric Sleep Problems: Knowledge, Skills, Attitudes and Practices in a Group of Community Child Psychiatrists. Med Sci (Basel) 2018; 6:medsci6010018. [PMID: 29473880 PMCID: PMC5872175 DOI: 10.3390/medsci6010018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 02/19/2018] [Accepted: 02/20/2018] [Indexed: 11/17/2022] Open
Abstract
As part of a university-based quality improvement project, we aimed to evaluate child psychiatrists’ knowledge, skills, attitudes, and practices regarding assessment and treatment of pediatric sleep problems. We developed a nine-question survey of knowledge, skills, attitudes, and practices regarding assessing for and treating sleep complaints in pediatric patients, and administered this survey to child psychiatrists in training and in practice in the state of Missouri. Respondents reported sleep hygiene as the first-line treatment strategy, followed by the use of supplements or over-the-counter remedies. The most common barriers to evidence-based assessment and treatment of sleep problems were the lack of ability to obtain reliable history, and parental preference for medications over behavioral approaches for sleep concerns. These results suggest potential opportunities for enhancing knowledge regarding validated assessment tools and non-pharmacological treatment options for sleep problems. Additional research is needed to further assess the quality and type of sleep education provided in child psychiatry training programs.
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193
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Sherwood A, Ulmer CS, Beckham JC. Waking up to the importance of sleeping well for cardiovascular health. J Clin Hypertens (Greenwich) 2018; 20:606-608. [PMID: 29457356 DOI: 10.1111/jch.13243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Andrew Sherwood
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Christi S Ulmer
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Jean C Beckham
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
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194
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Seow LSE, Verma SK, Mok YM, Kumar S, Chang S, Satghare P, Hombali A, Vaingankar J, Chong SA, Subramaniam M. Evaluating DSM-5 Insomnia Disorder and the Treatment of Sleep Problems in a Psychiatric Population. J Clin Sleep Med 2018; 14:237-244. [PMID: 29394962 DOI: 10.5664/jcsm.6942] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 10/25/2017] [Indexed: 12/17/2022]
Abstract
STUDY OBJECTIVES With the introduction of insomnia disorder in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), greater emphasis has been placed on the diagnosis and treatment of sleep disorder even in the presence of a coexisting mental disorder. The current study seeks to explore the clinical picture of insomnia in the context of psychiatric disorders commonly associated with sleep complaints by assessing the prevalence and correlates of DSM-5 insomnia disorder, and examining the extent to which insomnia symptoms have been addressed in this population. METHODS Four hundred treatment-seeking outpatients suffering from depressive, bipolar affective, anxiety, and schizophrenia spectrum disorders were recruited. DSM-5 insomnia was established using the modified Brief Insomnia Questionnaire. Differences in sociodemographic factors, clinical status, impairment outcomes, and mental health services utilization were compared. Information on patients' help-seeking experiences for insomnia-related symptoms was collected to determine the treatment received and treatment effectiveness. RESULTS Almost one-third of our sample (31.8%) had DSM-5 insomnia disorder. Those with insomnia disorder had significantly higher impairment outcomes than their counterparts but no group difference was observed for mental health services utilization. Findings based on past treatment contact for sleep problems suggest that diagnosis and treatment of insomnia is lacking in this population. CONCLUSIONS With the new calling from DSM-5, clinicians treating psychiatric patients should view insomnia less as a symptom of their mental illnesses and treat clinical insomnia as a primary disorder. Patients should also be educated on the importance of reporting and treating their sleep complaints. Nonmedical (cognitive and behavioral) interventions for insomnia need to be further explored given their proven clinical effectiveness.
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Affiliation(s)
| | | | - Yee Ming Mok
- Department of General Psychiatry, Institute of Mental Health, Singapore
| | - Sunita Kumar
- Division of Pulmonary and Critical Care Medicine, Loyola University, Chicago, Illinois
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, Singapore
| | | | - Aditi Hombali
- Research Division, Institute of Mental Health, Singapore
| | | | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
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195
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Mondal G, Bajaj V, Goyal BL, Mukherjee N. Prevalence of sleep disorders and severity of insomnia in psychiatric outpatients attending a tertiary level mental health care facility in Punjab, India. Asian J Psychiatr 2018; 32:8-13. [PMID: 29197711 DOI: 10.1016/j.ajp.2017.11.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 10/26/2017] [Accepted: 11/26/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Sleep disorders are frequently associated with psychiatric disorders and can be both cause and effect of the same. AIM To study the prevalence of sleep disorders and the severity of insomnia in psychiatric outpatients. METHODS 500 patients were randomly selected using purposive sampling from patients attending a tertiary level mental health care facility were evaluated for the presence of any sleep disorder along with their sleep quality. In patients having insomnia, severity of the same was determined. RESULTS 83.4% of the population had some type of sleep disorder. Symptoms of insomnia were reported by 78.2% of the population and 29.2% had moderate to severe insomnia. 78.4% of the population had poor sleep quality. Significant difference was noted among the different psychiatric groups when insomnia severity index (ISI) was compared. In multinomial logistic regression, chance of severe insomnia is more if the diagnosis is depression, but less if mania or ocd, compared to psychosis. CONCLUSION This study was the first in India to assess the prevalence of sleep disorders in psychiatric outpatients. Our study underscores the importance of careful evaluation of sleep problems for proper management of the patients.
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Affiliation(s)
- Gargi Mondal
- Institute of Mental Health, Amritsar, Punjab, 143001, India.
| | - Vikrant Bajaj
- Institute of Mental Health, Amritsar, Punjab, 143001, India.
| | - B L Goyal
- Institute of Mental Health, Amritsar, Punjab, 143001, India
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196
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Stangenes KM, Hysing M, Fevang SK, Elgen IB, Halvorsen T, Markestad T, Bjorvatn B. Prenatal and Neonatal Factors Predicting Sleep Problems in Children Born Extremely Preterm or With Extremely Low Birthweight. Front Pediatr 2018; 6:178. [PMID: 29974046 PMCID: PMC6019468 DOI: 10.3389/fped.2018.00178] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 05/31/2018] [Indexed: 12/17/2022] Open
Abstract
Objective: Prematurely born children have been reported to have more sleep problems throughout childhood than children born at term. The aim of this study was to explore if prenatal or neonatal factors can predict sleep problems at age 11 years in children born extremely preterm (EPT). Method: A prospective observational study of all infants who were born EPT in Norway in 1999 and 2000. Prenatal and neonatal data were collected by all Norwegian obstetric and pediatric departments. Parental questionnaire mapped sleep problems and sleep habits at the age of 11 years. Results: Of the 372 eligible children, 221 participated. Of those, 28.1% snored, 27.5% had difficulty falling asleep or frequent awakenings and 17.2% suffered from daytime sleepiness. The mean sleep duration was 9.4 h (range 4.3-11.0 h). Smoking in pregnancy predicted snoring (odds ratio 4.3). Neonatal cerebral hemorrhage and being born small for gestational age predicted difficulty falling asleep or frequent awakenings (odds ratio 2.2 and 2.3). Other morbidities during pregnancy or the newborn period, gestational age or the burden of treatment in the neonatal intensive care unit did not predict sleep problems. None of the studied prenatal or neonatal factors predicted daytime sleepiness or sleep duration <9 h. Conclusion: Of numerous prenatal and neonatal factors, only smoking during pregnancy, being born small for gestational age and cerebral hemorrhage predicted sleep problems at 11 years of age among these children born EPT.
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Affiliation(s)
| | - Mari Hysing
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway
| | - Silje K Fevang
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Irene B Elgen
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Thomas Halvorsen
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Trond Markestad
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
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197
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Wiese S, Elson L, Feldmeier H. Tungiasis-related life quality impairment in children living in rural Kenya. PLoS Negl Trop Dis 2018; 12:e0005939. [PMID: 29309411 PMCID: PMC5757912 DOI: 10.1371/journal.pntd.0005939] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 09/06/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Tungiasis (sand flea disease) is a neglected tropical skin disease caused by female sand fleas (Tunga spp.) embedded in the skin of the host. The disease is common in sub-Saharan Africa and predominantly affects children living in impoverished rural communities. In these settings tungiasis is associated with important morbidity. Whether tungiasis impairs life quality has never been studied. METHODS The study was performed in 50 children with tungiasis, living in resource-poor communities in coastal Kenya. Based on the Dermatology Life Quality Index (DLQI) a tool was developed to determine life quality impairment associated with tungiasis in children, the tungiasis-related Dermatology of Life Quality Index (tungiasis-related-DLQI). Pain and itching were assessed using visual scales ranging from 0-3 points. The intensity of infection and the acute and chronic severity of tungiasis were determined using standard methods. RESULTS Seventy eight percent of the patients reported a moderate to very large effect of tungiasis on life quality at the time of the diagnosis. The degree of impairment correlated with the number of viable sand fleas present in the skin (rho = 0.64, p < 0.001), the severity score of acute clinical pathology (rho = 0.74, p < 0.001), and the intensity of pain (rho = 0.82, p < 0.001). Disturbance of sleep and concentration difficulties were the most frequent restriction categories (86% and 84%, respectively). Four weeks after curative treatment, life quality had improved significantly. On the individual level the amelioration of life quality correlated closely with the regression of clinical pathology (rho = 0.61, p < 0.001). CONCLUSION The parasitic skin disease tungiasis considerably impairs life quality in children in rural Kenya. After effective treatment, life quality improves rapidly.
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Affiliation(s)
- Susanne Wiese
- Institute of Microbiology and Hygiene, University Medicine Berlin, Germany
| | - Lynne Elson
- WAJIMIDA Jigger Campaign, Dabaso Tujengane CBO, Watamu, Kenya
| | - Hermann Feldmeier
- Institute of Microbiology and Hygiene, University Medicine Berlin, Germany
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198
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Schlaf bei psychischen Erkrankungen. SOMNOLOGIE 2017. [DOI: 10.1007/s11818-017-0141-5] [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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199
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Tu TTH, Miura A, Shinohara Y, Mikuzuki L, Kawasaki K, Sugawara S, Suga T, Watanabe T, Watanabe M, Umezaki Y, Yoshikawa T, Motomura H, Takenoshita M, Toyofuku A. Evaluating Burning Mouth Syndrome as a Comorbidity of Atypical Odontalgia: The Impact on Pain Experiences. Pain Pract 2017; 18:580-586. [PMID: 28972293 DOI: 10.1111/papr.12647] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 09/20/2017] [Accepted: 09/26/2017] [Indexed: 01/03/2023]
Abstract
OBJECTIVE This study aimed (1) to investigate the differences in clinical characteristics of patients between 2 groups, those who have atypical odontalgia (AO) only and those who have AO with burning mouth syndrome (BMS), and (2) to assess the influence of psychiatric comorbidity factors on patients' experiences. METHOD Medical records and psychiatric referral forms of patients visiting the Psychosomatic Dentistry Clinic of Tokyo Medical and Dental University between 2013 and 2016 were reviewed. The final sample included 2 groups of 355 patients: those who have AO only (n = 272) and those who have AO with BMS (AO-BMS; n = 83). Clinicodemographic variables (gender, age, comorbid psychiatric disorders, and history of headache or sleep disturbances) and pain variables (duration of illness, pain intensity, and severity of accompanying depression) were collected. Initial pain assessment was done using the Short-Form McGill Pain Questionnaire, and depressive state was determined using the Zung Self-Rating Depression Scale. RESULTS The average age, female ratio, and sleep disturbance prevalence in the AO-only group were significantly lower than those in AO-BMS group. AO-BMS patients rated overall pain score and present pain intensity significantly higher than did the AO-only patients (P = 0.033 and P = 0.034, respectively), emphasizing sharp (P = 0.049), hot-burning (P = 0.000), and splitting (P = 0.003) characteristics of pain. Patients having comorbid psychiatric disorders had a higher proportion of sleep disturbance in both groups and a higher proportion of depressive state in the AO-only group. CONCLUSIONS AO-BMS patients have different epidemiological characteristics, sleep quality, and pain experiences compared to AO-only patients. The presence of psychiatric comorbidities in both groups may exacerbate sleep quality. We suggest that BMS as a comorbid oral disorder in AO patients contributes to a more intensively painful experience.
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Affiliation(s)
- Trang T H Tu
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Anna Miura
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yukiko Shinohara
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Lou Mikuzuki
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kaoru Kawasaki
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shiori Sugawara
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takayuki Suga
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeshi Watanabe
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Motoko Watanabe
- Department of Oral and Maxillofacial Radiology, Tokyo Dental College, Tokyo, Japan
| | - Yojiro Umezaki
- Department of Geriatric Dentistry, Fukuoka Dental College, Fukuoka, Japan
| | - Tatsuya Yoshikawa
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Haruhiko Motomura
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Miho Takenoshita
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Akira Toyofuku
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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200
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Olinto MTA, Garcez A, Henn RL, Macagnan JBA, Paniz VMV, Pattussi MP. Sleep-related problems and minor psychiatric disorders among Brazilian shift workers. Psychiatry Res 2017; 257:412-417. [PMID: 28837929 DOI: 10.1016/j.psychres.2017.08.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 07/07/2017] [Accepted: 08/12/2017] [Indexed: 01/24/2023]
Abstract
The aim of this study was to explore the association between sleep-related problems with the occurrence of minor psychiatric disorders in shift workers of southern Brazil. A cross-sectional study with 1202 workers (785 females) aged 18-50 years was carried out. Minor psychiatric disorders were assessed using the Self-Reporting Questionnaire (SRQ-20), and four sleep problems were collected and analyzed: sleep deprivation (≤ 5h), difficulty falling asleep, waking up during sleep, and sleep medication use. Results show that the overall prevalence of minor psychiatric disorders was 26.8%, but it was more prevalent among females than males (30.2% vs. 20.4%). Nightshift work was significantly associated with the occurrence of sleep-related problems. After adjusting for confounding factors, the number of sleep-related problems showed a positive linear trend with psychiatric disorders in both sexes. Having two or more sleep-related problems was associated with increased probability of psychiatric disorders approximately three-fold among males and two-fold among females, when compared with those without sleep problems. In conclusion, this study demonstrated that sleep-related problems have a strong and independent association with psychiatric disorders among shift workers. Furthermore, the prevalence of both conditions was higher among females than males; however, the strength of these associations was higher in males.
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Affiliation(s)
- Maria Teresa Anselmo Olinto
- Post-graduate Program in Collective Health, University of Vale do Rio dos Sinos, São Leopoldo, RS, Brazil; Department of Nutrition, Federal University of Health Science of Porto Alegre, Porto Alegre, RS, Brazil.
| | - Anderson Garcez
- Post-graduate Program in Collective Health, University of Vale do Rio dos Sinos, São Leopoldo, RS, Brazil
| | - Ruth Liane Henn
- Post-graduate Program in Collective Health, University of Vale do Rio dos Sinos, São Leopoldo, RS, Brazil
| | | | - Vera Maria Vieira Paniz
- Post-graduate Program in Collective Health, University of Vale do Rio dos Sinos, São Leopoldo, RS, Brazil
| | - Marcos Pascoal Pattussi
- Post-graduate Program in Collective Health, University of Vale do Rio dos Sinos, São Leopoldo, RS, Brazil
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