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Ballestar-Tarín ML, Ibáñez-del Valle V, Mafla-España MA, Cauli O, Navarro-Martínez R. Increased Salivary IL-1 Beta Level Is Associated with Poor Sleep Quality in University Students. Diseases 2023; 11:136. [PMID: 37873780 PMCID: PMC10594478 DOI: 10.3390/diseases11040136] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 09/29/2023] [Accepted: 10/02/2023] [Indexed: 10/25/2023] Open
Abstract
Poor sleep quality is a major public health concern for all ages. In particular, university students often face stress levels and changes in social life habits that negatively influence their quality of sleep. This could be associated with psychological well-being in terms of anxiety and depressive symptoms, stress levels, and a poor self-perceived health status. The increases in the pro-inflammatory cytokine interleukin 6 (IL-6), IL-1 beta (IL-1β), and tumor necrosis factor alpha (TNFα), in blood have been linked to poor sleep quality in many diseases, but data on salivary cytokine levels in students are missing or are seldom analyzed. In this study we determined the quality of sleep in a sample of university students and the role of psychological assessment and factors affecting sleep (alcohol intake, tobacco, consumption of stimulant drinks, exercise, and body mass index). We also aimed to shed new light on the associations between sleep quality and salivary inflammatory cytokines (IL-1β, IL-6, and TNFα). Sleep quality was measured with the Athens Insomnia Scale (AIS) and Pittsburgh Sleep Quality Index (PSQI). Perceived stress was assessed using Cohen's Perceived Stress Scale (PSS), and the Goldberg Anxiety and Depression Scale (GADS) was used to assess the level of anxiety or depression. Perceived health status was measured with a visual analogue. Saliva samples was taken in the morning and the inflammatory cytokines was measured via enzyme-linked immunoassay. There was a direct and significant association between the salivary IL-1β concentration and AIS score (r = 0.248; p = 0.038, Pearson correlation) and Pittsburgh scale score (r = 0.274; p = 0.022, Pearson correlation). The relationship between IL-1β and AIS controlling for sex, age, and chronic disease, is still significant (r = 0.260; p = 0.033). The relationship between IL-1β and PSQI controlling for the influence of these variables is also significant (r = 0.279; p = 0.022). Salivary IL-1β concentrations were not significantly associated with any of the scores of the other psychological assessments (PSS, anxiety, depression symptoms, or self-perceived health). Salivary TNFα was significantly and inversely associated with self-perceived health (r = -0.259; p = 0.033, Pearson correlation), but the salivary IL-6 concentration was not associated with any of the sleep quality scale or psychological assessment scores. Our results provide a novel relationship between pro-inflammatory cytokine IL-1β in saliva and poor sleep quality. However, the role of inflammation in poor sleep quality requires further study to identify strategies that could lower inflammation and thus, likely improve sleep quality.
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Affiliation(s)
- María Luisa Ballestar-Tarín
- Department of Nursing, University of Valencia, 46010 Valencia, Spain; (M.L.B.-T.); (V.I.-d.V.); (M.A.M.-E.); (R.N.-M.)
- Nursing Care and Education Research Group (GRIECE), GIUV2019-456, Nursing Department, Universitat de Valencia, 46010 Valencia, Spain
| | - Vanessa Ibáñez-del Valle
- Department of Nursing, University of Valencia, 46010 Valencia, Spain; (M.L.B.-T.); (V.I.-d.V.); (M.A.M.-E.); (R.N.-M.)
- Frailty Research Organized Group (FROG), University of Valencia, 46010 Valencia, Spain
| | - Mayra Alejandra Mafla-España
- Department of Nursing, University of Valencia, 46010 Valencia, Spain; (M.L.B.-T.); (V.I.-d.V.); (M.A.M.-E.); (R.N.-M.)
| | - Omar Cauli
- Department of Nursing, University of Valencia, 46010 Valencia, Spain; (M.L.B.-T.); (V.I.-d.V.); (M.A.M.-E.); (R.N.-M.)
- Frailty Research Organized Group (FROG), University of Valencia, 46010 Valencia, Spain
| | - Rut Navarro-Martínez
- Department of Nursing, University of Valencia, 46010 Valencia, Spain; (M.L.B.-T.); (V.I.-d.V.); (M.A.M.-E.); (R.N.-M.)
- Frailty Research Organized Group (FROG), University of Valencia, 46010 Valencia, Spain
- Department of Hematology, University General Hospital, 46014 Valencia, Spain
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202
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Matre D, Sallinen M, Phillips AJK, Moen LV, Nilsen KB, Haugen F. Night work, season and alertness as occupational safety hazards in the Arctic: protocol for the Noralert observational crossover study among Norwegian process operators. BMJ Open 2023; 13:e075107. [PMID: 37793926 PMCID: PMC10551971 DOI: 10.1136/bmjopen-2023-075107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 09/11/2023] [Indexed: 10/06/2023] Open
Abstract
INTRODUCTION The objective of this study is to determine the effects of night work, Arctic seasonal factors and cold working environments on human functions relevant to safety. The study aims to quantify the contribution of (1) several consecutive night shifts, (2) seasonal variation on sleepiness, alertness and circadian rhythm and (3) whether a computational model of sleep, circadian rhythms and cognitive performance can accurately predict the observed sleepiness and alertness. METHODS AND ANALYSIS In an observational crossover study of outdoor and indoor workers (n=120) on a three-shift schedule from an industrial plant in Norway (70 °N), measurements will be conducted during the summer and winter. Sleep duration and quality will be measured daily by smartphone questionnaire, aided by actigraphy and heart rate measurements. Sleepiness and alertness will be assessed at regular intervals by the Karolinska Sleepiness Scale and the psychomotor vigilance test, respectively. Saliva samples will assess melatonin levels, and a blood sample will measure circadian time. Thermal exposures and responses will be measured by sensors and by thermography. ETHICS AND DISSEMINATION All participants will give written informed consent to participate in the study, which will be conducted in accordance with the Declaration of Helsinki. The Norwegian Regional Committee for Medical Research Ethics South-East D waivered the need for ethics approval (reference 495816). Dissemination plans include academic and lay publications, and partnerships with national and regional policymakers.
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Affiliation(s)
- Dagfinn Matre
- National Institute of Occupational Health, Oslo, Norway
| | - Mikael Sallinen
- Finnish Institute of Occupational Health, Työterveyslaitos, Finland
| | | | | | | | - Fred Haugen
- National Institute of Occupational Health, Oslo, Norway
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203
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Engert LC, Mullington JM, Haack M. Prolonged experimental sleep disturbance affects the inflammatory resolution pathways in healthy humans. Brain Behav Immun 2023; 113:12-20. [PMID: 37369338 PMCID: PMC10528069 DOI: 10.1016/j.bbi.2023.06.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/26/2023] [Accepted: 06/22/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Sleep disturbances, as manifested in insomnia symptoms of difficulties falling asleep or frequent nighttime awakenings, are a strong risk factor for a diverse range of diseases involving immunopathology. Low-grade systemic inflammation has been frequently found associated with sleep disturbances and may mechanistically contribute to increased disease risk. Effects of sleep disturbances on inflammation have been observed to be long lasting and remain after recovery sleep has been obtained, suggesting that sleep disturbances may not only affect inflammatory mediators, but also the so-called specialized pro-resolving mediators (SPMs) that actively resolve inflammation. The goal of this investigation was to test for the first time whether the omega-3 fatty acid-derived D- (RvD) and E-series (RvE) resolvins are impacted by prolonged experimental sleep disturbance (ESD). METHODS Twenty-four healthy participants (12 F, age 20-42 years) underwent two 19-day in-hospital protocols (ESD/control), separated by > 2 months. The ESD protocol consisted of repeated nights of short and disrupted sleep with intermittent nights of undisturbed sleep, followed by three nights of recovery sleep at the end of the protocol. Under the control sleep condition, participants had an undisturbed sleep opportunity of 8 h/night throughout the protocol. The D- and E-series resolvins were measured in plasma using liquid chromatography-tandem mass spectrometry (LC-MS/MS). RESULTS The precursor of the D-series resolvins, 17-HDHA, was downregulated in the ESD compared to the control sleep condition (p <.001 for condition), and this effect remained after the third night of recovery sleep has been obtained. This effect was also observed for the resolvins RvD3, RvD4, and RvD5 (p <.001 for condition), while RvD1 was higher in the ESD compared to the control sleep condition (p <.01 for condition) and RvD2 showed a mixed effect of a decrease during disturbed sleep followed by an increase during recovery sleep in the ESD condition (p <.001 for condition*day interaction). The precursor of E-series resolvins, 18-HEPE, was downregulated in the ESD compared to the control sleep condition (p <.01 for condition) and remained low after recovery sleep has been obtained. This effect of downregulation was also observed for RvE2 (p <.01 for condition), while there was no effect for RvE1 (p >.05 for condition or condition*day interaction). Sex-differential effects were found for two of the D-series resolvins, i.e., RvD2 and RvD4. CONCLUSION This first investigation on the effects of experimental sleep disturbance on inflammatory resolution processes shows that SPMs, particularly resolvins of the D-series, are profoundly downregulated by sleep disturbances and remain downregulated after recovery sleep has been obtained, suggesting a longer lasting impact of sleep disturbances on these mediators. These findings also suggest that sleep disturbances contribute to the development and progression of a wide range of diseases characterized by immunopathology by interfering with processes that actively resolve inflammation. Pharmacological interventions aimed at promoting inflammatory resolution physiology may help to prevent future disease risk as a common consequence of sleep disturbances. TRIAL REGISTRATION ClinicalTrials.gov NCT02484742.
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Affiliation(s)
- Larissa C Engert
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Janet M Mullington
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Monika Haack
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
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204
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Jiang K, Spira AP, Gottesman RF, Full KM, Lin FR, Lutsey PL, Garcia Morales EE, Punjabi NM, Reed NS, Sharrett AR, Deal JA. Associations of sleep characteristics in late midlife with late-life hearing loss in the Atherosclerosis Risk in Communities-Sleep Heart Health Study (ARIC-SHHS). Sleep Health 2023; 9:742-750. [PMID: 37550152 PMCID: PMC10592398 DOI: 10.1016/j.sleh.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVES This study investigated associations of late midlife sleep characteristics with late-life hearing, which adds to the existing cross-sectional evidence and is novel in examining polysomnographic sleep measures and central auditory processing. METHODS A subset of Atherosclerosis Risk in Communities Study participants underwent sleep assessment in the Sleep Heart Health Study in 1996-1998 and hearing assessment in 2016-2017. Peripheral hearing thresholds (0.5-4kHz) assessed by pure-tone audiometry were averaged to calculate speech-frequency pure-tone average in better-hearing ear (higher pure-tone average=worse hearing). Central auditory processing was measured by the Quick Speech-in-Noise Test (lower score=worse performance). Sleep was measured using polysomnography (time spent in stage 1, stage 2, stage 3/4, rapid eye movement sleep; sleep-disordered breathing [apnea-hypopnea index ≥5]) and self-report (habitual sleep duration; excessive daytime sleepiness [Epworth Sleepiness Scale 10]). Linear regression models adjusted for demographic and lifestyle factors with additional adjustment for cardiovascular factors. RESULTS Among 719 Atherosclerosis Risk in Communities-Sleep Heart Health Study participants (61 ± 5years, 54% female, 100% White), worse speech-frequency pure-tone average was found with sleep-disordered breathing (2.51dB, 95% confidence interval: 0.27, 4.75) and excessive daytime sleepiness (3.35 dB, 95% confidence interval: 0.81, 5.90). Every additional hour of sleep when sleeping >8 hours was associated with worse Quick Speech-in-Noise score (1.61 points, 95% confidence interval: 0.03, 3.19). Every 10-minute increase in rapid eye movement sleep was associated with 0.14-point better Quick Speech-in-Noise score (95% confidence interval: 0.02, 0.25). CONCLUSIONS Sleep abnormalities might be risk factors for late-life hearing loss. Future longitudinal studies are needed to confirm these novel findings and clarify the mechanisms.
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Affiliation(s)
- Kening Jiang
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA; Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Rebecca F Gottesman
- National Institute of Neurological Disorders and Stroke Intramural Research Program, Bethesda, Maryland, USA
| | - Kelsie M Full
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Frank R Lin
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA; Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Emmanuel E Garcia Morales
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Naresh M Punjabi
- Division of Pulmonary, Critical Care, and Sleep Medicine, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Nicholas S Reed
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - A Richey Sharrett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Jennifer A Deal
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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205
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Zhai S, Li T, Zhang D, Qu Y, Xie Y, Wu X, Zou L, Tao F, Tao S. Insomnia trajectories predict chronic inflammation over 2 years at the transition to adulthood. J Sleep Res 2023; 32:e13906. [PMID: 37062708 DOI: 10.1111/jsr.13906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 03/01/2023] [Accepted: 03/29/2023] [Indexed: 04/18/2023]
Abstract
Insomnia in adolescents is an important public health concern, as its impacts on both their current and future physical and mental health has been discussed. However, few longitudinal studies have examined insomnia and chronic inflammation at the transition from adolescence to adulthood. This study aimed to examine the predictive effects of insomnia and insomnia trajectories on inflammation in college students by using a prospective design. Using data from the College Student Behaviour and Health Cohort Study, which was conducted between April 2019 and April 2021, with an interval of 6 months. We investigated the associations between insomnia trajectories from Year 1 to Year 3 and five inflammatory biomarkers (C-reactive protein [CRP], tumour necrosis factor [TNF]-α, interleukin [IL]-6, IL-1β, IL-10) at Year 3. The association of insomnia symptoms at baseline, Wave 1 or Wave 2 with inflammatory biomarkers at Wave 4 were also assessed. A total of 312 college students (males: 51.6%) aged 16-26 years (mean [SD] 18.82 [1.22] years) were analysed. We identified two insomnia trajectory classes: increasing insomnia (n = 63 [20.2%]) and decreasing insomnia (n = 249 [79.8%]). Generalised linear model analysis revealed that insomnia symptoms at Wave 1 were associated with significantly elevated CRP and TNF-α levels at Wave 4. Increasing insomnia trajectories predicted consistently higher levels of CRP, TNF-α and IL-10. However, after adjusting for potential confounders, these associations were significantly attenuated. Overall, the findings suggest that insomnia symptoms affect chronic inflammation at the transition to adulthood. Our study needs to be replicated in larger cohorts to further explore how inflammation interacts with insomnia to increase the susceptibility to adverse health conditions.
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Affiliation(s)
- Shuang Zhai
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Tingting Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Dan Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Yang Qu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Yang Xie
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Xiaoyan Wu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, People's Republic of China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, Anhui, People's Republic of China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Liwei Zou
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, Anhui, People's Republic of China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, People's Republic of China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, Anhui, People's Republic of China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Shuman Tao
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, Anhui, People's Republic of China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, People's Republic of China
- Department of Ophthalmology, The Second Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
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206
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O CK, Siu BWH, Leung VWS, Lin YY, Ding CZ, Lau ESH, Luk AOY, Chow EYK, Ma RCW, Chan JCN, Chan RNY, Wing YK, Kong APS. Association of insomnia with incident chronic cognitive impairment in older adults with type 2 diabetes mellitus: A prospective study of the Hong Kong Diabetes Register. J Diabetes Complications 2023; 37:108598. [PMID: 37716256 DOI: 10.1016/j.jdiacomp.2023.108598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/14/2023] [Accepted: 08/28/2023] [Indexed: 09/18/2023]
Abstract
AIMS To examine the risk association of insomnia with incident chronic cognitive impairment in older adults with type 2 diabetes mellitus (T2D). METHODS Between July 2010 and June 2015, patients with T2D aged ≥60 years enrolled in the Hong Kong Diabetes Register completed the Insomnia Severity Index (ISI) questionnaire. Patients were considered having insomnia if they had ISI score > 14. We prospectively followed up the cohort and censored outcome through reviewing diagnoses and clinical notes entered by attending physicians in electronic medical record to identify incident cases of mild cognitive impairment and dementia. RESULTS After excluding shift workers and those with established chronic cognitive impairment at baseline, we included 986 patients with T2D in this study (58.3 % men, mean age ± standard deviation: 62.5 ± 2.6 years, disease duration of diabetes: 10.7 ± 8.2 years, HbA1c: 7.4 ± 1.3 %, insulin users: 28.7 %, insomnia: 9.1 %). After a median follow-up of 7.6 (interquartile range = 2.0) years, 41 (4.2 %) developed chronic cognitive impairment. Using Cox regression analysis, insomnia (hazard ratio, HR 2.909, p = 0.012) and HbA1c ≥ 7 % (HR 2.300, p = 0.038) were positively associated with incident chronic cognitive impairment while insulin use (HR 0.309, p = 0.028) showed negative association. CONCLUSIONS Insomnia, suboptimal glycemic control and non-insulin use are independent risk factors for incident chronic cognitive impairment in older adults with T2D.
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Affiliation(s)
- Chun-Kwan O
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
| | - Brian Wai-Hei Siu
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
| | - Vanessa Wai-Shan Leung
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
| | - Yuan-Yuan Lin
- Department of Statistics, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
| | - Chen-Zhao Ding
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Eric Siu-Him Lau
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
| | - Andrea On-Yan Luk
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China; Li Ka Shing Institute of Health Sciences, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
| | - Elaine Yee-Kwan Chow
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China; Li Ka Shing Institute of Health Sciences, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
| | - Ronald Ching-Wan Ma
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China; Li Ka Shing Institute of Health Sciences, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
| | - Juliana Chung-Ngor Chan
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China; Li Ka Shing Institute of Health Sciences, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
| | - Rachel Ngan-Yin Chan
- Department of Psychiatry, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
| | - Yun Kwok Wing
- Department of Psychiatry, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
| | - Alice Pik-Shan Kong
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China; Li Ka Shing Institute of Health Sciences, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
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Lim DC, Najafi A, Afifi L, Bassetti CLA, Buysse DJ, Han F, Högl B, Melaku YA, Morin CM, Pack AI, Poyares D, Somers VK, Eastwood PR, Zee PC, Jackson CL. The need to promote sleep health in public health agendas across the globe. Lancet Public Health 2023; 8:e820-e826. [PMID: 37777291 PMCID: PMC10664020 DOI: 10.1016/s2468-2667(23)00182-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 10/02/2023]
Abstract
Healthy sleep is essential for physical and mental health, and social wellbeing; however, across the globe, and particularly in developing countries, national public health agendas rarely consider sleep health. Sleep should be promoted as an essential pillar of health, equivalent to nutrition and physical activity. To improve sleep health across the globe, a focus on education and awareness, research, and targeted public health policies are needed. We recommend developing sleep health educational programmes and awareness campaigns; increasing, standardising, and centralising data on sleep quantity and quality in every country across the globe; and developing and implementing sleep health policies across sectors of society. Efforts are needed to ensure equity and inclusivity for all people, particularly those who are most socially and economically vulnerable, and historically excluded.
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Affiliation(s)
- Diane C Lim
- Miami Veterans Affairs Healthcare System, Miami, FL, USA; Division of Pulmonary, Critical Care and Sleep Medicine, University of Miami, Miami, FL, USA
| | - Arezu Najafi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran; Sleep Breathing Disorders Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Lamia Afifi
- Clinical Neurophysiology Unit, School of Medicine, Cairo University Hospitals, Cairo, Egypt
| | | | - Daniel J Buysse
- Center for Sleep and Circadian Science, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Fang Han
- Department of Sleep Medicine, Peking University People's Hospital, Beijing, China
| | - Birgit Högl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Yohannes Adama Melaku
- Flinders Health and Medical Research Institute: Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia; Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Charles M Morin
- Department of Psychology, and CERVO Brain Research Center, Université Laval, Quebec City, QC, Canada
| | - Allan I Pack
- Sleep Division, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Dalva Poyares
- Psychobiology Department, Sleep Medicine Division, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Virend K Somers
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Peter R Eastwood
- Health Futures Institute, Murdoch University, Perth, WA, Australia
| | - Phyllis C Zee
- Division of Sleep Medicine, Center for Circadian and Sleep Medicine, Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, US Department of Health and Human Services, Research Triangle Park, NC, USA; Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA.
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208
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Strumberger MA, Häberling I, Emery S, Albermann M, Baumgartner N, Bucher N, Erb S, Bachmann S, Wöckel L, Müller-Knapp U, Contin-Waldvogel B, Rhiner B, Walitza S, Berger G, Cajochen C, Schmeck K. Sleep disturbance, but not depression severity, is associated with inflammation in children and adolescents. J Clin Sleep Med 2023; 19:1775-1784. [PMID: 37323001 PMCID: PMC10545993 DOI: 10.5664/jcsm.10678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 06/05/2023] [Accepted: 06/08/2023] [Indexed: 06/17/2023]
Abstract
STUDY OBJECTIVES We aimed to examine the association between self-rated and clinician-rated sleep disturbances and C-reactive protein (CRP), an objective marker of inflammation, in pediatric depression. METHODS Two hundred fifty-six children and adolescents (15.2 ± 1.6 y, 72.3% female) with moderate to severe symptoms of depression participated in the study. Sleep disturbances were assessed by self-reports (Insomnia Severity Index) and clinician ratings (Kiddie-Schedule for Affective Disorder and Schizophrenia), inflammation by plasma CRP levels. RESULTS Higher levels of CRP correlated positively with clinician-rated middle insomnia and hypersomnia. After adjusting for control variables (body mass index, tobacco, alcohol, stress, age, sex, antidepressants, sleep medication, depression severity), regression models confirmed the significant association of clinician-rated hypersomnia and middle insomnia symptoms with elevated CRP levels. In the adjusted regression models, other clinician-rated manifestations of sleep disturbance (eg, initial insomnia) and insomnia self-ratings were not significantly associated with CRP. Body mass index correlated positively with CRP, but body mass index had no mediating effect on the associations between sleep disturbances and CRP. We did not find an association between depression severity, assessed by the Children's Depression Rating Scale-Revised, and CRP. CONCLUSIONS Results of the present study indicate a significant association of hypersomnia and middle insomnia symptoms with CRP in pediatric depression, not linked to alterations in the body mass index. CITATION Strumberger MA, Häberling I, Emery S, et al. Sleep disturbance, but not depression severity, is associated with inflammation in children and adolescents. J Clin Sleep Med. 2023;19(10):1775-1784.
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Affiliation(s)
- Michael A. Strumberger
- Research Department of Child and Adolescent Psychiatry, Psychiatric Hospital of the University of Basel, Basel, Switzerland
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerland
| | - Isabelle Häberling
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Sophie Emery
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Mona Albermann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | | | - Naïma Bucher
- Research Department of Child and Adolescent Psychiatry, Psychiatric Hospital of the University of Basel, Basel, Switzerland
| | - Suzanne Erb
- Child and Adolescent Psychiatric Services St. Gallen, St. Gallen, Switzerland
| | - Silke Bachmann
- Department of Psychiatry, University Hospitals of Geneva, Thônex, Switzerland
- Department of Psychiatry Psychotherapy, Psychosomatic Medicine, Medical Faculty of Martin Luther University, Halle, Germany
| | - Lars Wöckel
- Research Department of Child and Adolescent Psychiatry, Psychiatric Hospital of the University of Basel, Basel, Switzerland
- Clienia Littenheid AG, Littenheid, Switzerland
| | | | | | - Bruno Rhiner
- Child and Adolescent Psychiatric Services Thurgau, Münsterlingen, Switzerland
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Gregor Berger
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Christian Cajochen
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerland
| | - Klaus Schmeck
- Research Department of Child and Adolescent Psychiatry, Psychiatric Hospital of the University of Basel, Basel, Switzerland
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Jones EJ, Feinberg ME, Graham-Engeland JE, Jones DE, Schreier HMC. A perinatal coparenting intervention: Effects of a randomized trial on parent cardiometabolic risk and self-reported health. Biol Psychol 2023; 183:108664. [PMID: 37625684 PMCID: PMC10592003 DOI: 10.1016/j.biopsycho.2023.108664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/21/2023] [Accepted: 08/21/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND The transition to parenthood is a common yet stressful experience faced by many young and midlife adults, and the risk of cardiometabolic conditions also begins to rise at this time. Consequently, parenthood represents an opportune time to intervene with adults to support their psychological and physical health. PURPOSE We examined whether the benefits of the Family Foundations program, a perinatal preventative intervention promoting positive coparenting, extend beyond documented mental health and family relationship outcomes to better cardiometabolic risk factors among parents. METHODS We analyzed data from 183 couples (n = 366 participants) who, eight years prior, were randomly assigned to the 9-session perinatal preventative intervention program or a control condition. We collected dried blood spots to measure C-reactive protein (CRP), interleukin-6 (IL-6), and cholesterol; parents also reported on their self-rated health. RESULTS Randomization to the intervention condition was associated with lower cholesterol (B=-.081, p = .049). Among parents who demonstrated more negative communication styles at pretest (during pregnancy), the intervention was further associated with better self-rated health (B=.181, p = .018). Participation in the intervention program was also marginally associated with lower CRP (B=-.261, p = .077), particularly among mothers (B=-.428, p = .076). CONCLUSIONS These findings indicate that coparenting-focused interventions, such as Family Foundations, can lead to benefits beyond psychosocial and behavioral outcomes, and suggest that Family Foundations may improve parents' longer-term physical health, with potentially more benefits among couples who demonstrated more negative communication styles during pregnancy.
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Affiliation(s)
- Emily J Jones
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Mark E Feinberg
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA 16802, USA
| | | | - Damon E Jones
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA 16802, USA
| | - Hannah M C Schreier
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA 16802, USA.
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210
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Diao T, Liu K, Wang Q, Lyu J, Zhou L, Yuan Y, Wang H, Yang H, Wu T, Zhang X. Bedtime, sleep pattern, and incident cardiovascular disease in middle-aged and older Chinese adults: The dongfeng-tongji cohort study. Sleep Med 2023; 110:82-88. [PMID: 37544277 DOI: 10.1016/j.sleep.2023.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/12/2023] [Accepted: 08/01/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVES To investigate the associations of bedtime and a low-risk sleep pattern with incident cardiovascular disease (CVD). METHODS A total of 31,500 retirees were included from the Dongfeng-Tongji cohort in 2008-2010 and 2013. Sleep information was collected by questionnaires. CVD events were identified through the health care system until December 31, 2018. Cox proportional hazards regression models were performed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS During an average follow-up of 7.2 years, 8324 cases of incident CVD, including 6557 coronary heart disease (CHD) and 1767 stroke, were documented. U-shaped associations of bedtime with the risks of incident CVD and stroke were observed. Compared with bedtime between 10:01 p.m.-11:00 p.m., the HR (95% CI) for CVD was 1.10 (1.01-1.20) for ≤9:00 p.m., 1.07 (1.01-1.13) for 9:01 p.m.-10:00 p.m., and 1.32 (1.11-1.58) for >12:00 a.m., respectively, mainly driven by stroke risk (22%, 14%, and 70% higher for ≤9:00 p.m., 9:01 p.m.-10:00 p.m., and >12:00 a.m., respectively). The number of low-risk sleep factors, namely bedtime between 10:01 p.m.-12:00 a.m., sleep duration of 7-< 8 h/night, good/fair sleep quality, and midday napping ≤60 min, exhibited dose-dependent relationships with CVD, CHD, and stroke risks. Participants with 4 low-risk sleep factors had a respective 24%, 21%, and 30% lower risk of CVD, CHD, and stroke than those with 0-1 low-risk sleep factor. CONCLUSIONS Individuals with early or late bedtimes had a higher CVD risk, especially stroke. Having low-risk sleep habits is associated with lower CVD risks.
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Affiliation(s)
- Tingyue Diao
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kang Liu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Qiuhong Wang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junrui Lyu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lue Zhou
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Yuan
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Wang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Handong Yang
- Department of Cardiovascular Diseases, Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan, China
| | - Tangchun Wu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Xiaomin Zhang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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211
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Wang Y, Li X, Zhang Y, Ma Y, Xu S, Shuai Z, Pan F, Cai G. Association of Sleep Disturbance With Catastrophizing and Knee Pain: Data From the Osteoarthritis Initiative. Arthritis Care Res (Hoboken) 2023; 75:2134-2141. [PMID: 37038964 PMCID: PMC10524285 DOI: 10.1002/acr.25127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 02/15/2023] [Accepted: 04/04/2023] [Indexed: 04/12/2023]
Abstract
OBJECTIVE To investigate the relationship between sleep disturbance, catastrophizing, and knee pain in middle-aged and older individuals. METHODS Data from the Osteoarthritis Initiative cohort from months 48 to 96 were used, where month 48 was treated as baseline. Knee pain (Western Ontario and McMaster Universities Osteoarthritis Index pain scale score ≥5 [range 0-20]), catastrophizing (extracted from Coping Strategies Questionnaire score ≥3 [range 0-6]), and sleep quality (extracted from Center for Epidemiologic Studies Depression Scale [range 1-4]) were assessed annually. We described the association of sleep disturbance with the presence and risk of knee pain and catastrophizing. The mediation effect of knee pain and catastrophizing on the sleep-catastrophizing and sleep-pain association was evaluated, respectively. RESULTS Catastrophizing and knee pain were reported in 346 (10%) and 917 (24%) of the 3,813 participants (mean 64.9 years, 58% female) at baseline. Participants with worse sleep disturbance were more likely to have knee pain (prevalence ratio [PR] 1.4-2.0, P for trend <0.001) and catastrophizing (PR 1.4-3.1, P for trend <0.001). Sleep disturbance at baseline predicted the risk of knee pain (risk ratio [RR] 1.1, P for trend <0.001) and catastrophizing (RR 1.2-1.7, P for trend <0.001) during follow-up. No statistically significant interactions between sleep disturbance and knee pain or catastrophizing were observed. Knee pain and catastrophizing mediated the sleep-catastrophizing and sleep-pain association, respectively, at baseline, and knee pain negatively mediated the sleep-catastrophizing association longitudinally. CONCLUSION Sleep disturbance was associated with the presence and risk of catastrophizing and knee pain. Sleep interventions may have a universal and independent effect in preventing incident knee pain.
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Affiliation(s)
- Yining Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei 230032, Anhui, China
| | - Xiaoxi Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei 230032, Anhui, China
| | - Youyou Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei 230032, Anhui, China
| | - Yubo Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei 230032, Anhui, China
| | - Shengqian Xu
- Department of Rheumatism and Immunity, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, China
| | - Zongwen Shuai
- Department of Rheumatism and Immunity, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, China
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei 230032, Anhui, China
| | - Guoqi Cai
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei 230032, Anhui, China
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212
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Dikeos D, Wichniak A, Ktonas PY, Mikoteit T, Crönlein T, Eckert A, Kopřivová J, Ntafouli M, Spiegelhalder K, Hatzinger M, Riemann D, Soldatos C. The potential of biomarkers for diagnosing insomnia: Consensus statement of the WFSBP Task Force on Sleep Disorders. World J Biol Psychiatry 2023; 24:614-642. [PMID: 36880792 DOI: 10.1080/15622975.2023.2171479] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/30/2022] [Accepted: 01/17/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVES Thus far, the diagnosis of insomnia is based on purely clinical criteria. Although a broad range of altered physiological parameters has been identified in insomniacs, the evidence to establish their diagnostic usefulness is very limited. Purpose of this WFSBP Task Force consensus paper is to systematically evaluate a series of biomarkers as potential diagnostic tools for insomnia. METHODS A newly created grading system was used for assessing the validity of various measurements in establishing the diagnosis of insomnia; these measurements originated from relevant studies selected and reviewed by experts. RESULTS The measurements with the highest diagnostic performance were those derived from psychometric instruments. Biological measurements which emerged as potentially useful diagnostic instruments were polysomnography-derived cyclic alternating pattern, actigraphy, and BDNF levels, followed by heart rate around sleep onset, deficient melatonin rhythm, and certain neuroimaging patterns (mainly for the activity of frontal and pre-frontal cortex, hippocampus and basal ganglia); yet, these findings need replication, as well as establishment of commonly accepted methodology and diagnostic cut-off points. Routine polysomnography, EEG spectral analysis, heart rate variability, skin conductance, thermoregulation, oxygen consumption, HPA axis, and inflammation indices were not shown to be of satisfactory diagnostic value. CONCLUSIONS Apart from psychometric instruments which are confirmed to be the gold standard in diagnosing insomnia, six biomarkers emerge as being potentially useful for this purpose.
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Affiliation(s)
- Dimitris Dikeos
- First Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Adam Wichniak
- Third Department of Psychiatry, Sleep Medicine Center, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Periklis Y Ktonas
- First Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Department of Electrical and Computer Engineering, University of Houston, Houston, TX, USA
| | - Thorsten Mikoteit
- Psychiatric Services Solothurn, Faculty of Medicine, University of Basel, Solothurn, Switzerland
| | - Tatjana Crönlein
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Anne Eckert
- Neurobiology Lab for Brain Aging and Mental Health, Transfaculty Research Platform Molecular & Cognitive Neuroscience (MCN), University of Basel, Basel, Switzerland
| | - Jana Kopřivová
- National Institute of Mental Health, Klecany, Czechia
- Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Maria Ntafouli
- First Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Centre, University of Freiburg, Freiburg, Germany
| | - Martin Hatzinger
- Psychiatric Services Solothurn, Faculty of Medicine, University of Basel, Solothurn, Switzerland
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Centre, University of Freiburg, Freiburg, Germany
| | - Constantin Soldatos
- First Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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213
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Diao T, Zhou L, Yang L, Yuan Y, Liu K, Peng R, Wang Q, Wang H, Niu R, Long P, Yang H, Guo H, He M, Wu T, Zhang X. Bedtime, sleep duration, and sleep quality and all-cause mortality in middle-aged and older Chinese adults: The Dongfeng-Tongji cohort study. Sleep Health 2023; 9:751-757. [PMID: 37648645 DOI: 10.1016/j.sleh.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/09/2023] [Accepted: 07/08/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE This study aims to investigate the associations of bedtime and its combination with sleep duration and sleep quality with all-cause mortality. METHODS We conducted a prospective cohort study using data collected from 2008 to 2018 in the Dongfeng-Tongji cohort. Among 40,097 participants aged 62.1 on average at baseline, we applied Cox regression models to assess hazard ratios and 95% confidence intervals for mortality risk. RESULTS During a mean follow-up of 8.2years, 4345 deaths were documented. U-shaped associations of bedtime and sleep duration with all-cause mortality were observed. Compared with bedtime between 10:01 PM and 11:00 PM, the hazard ratio (95% confidence interval) for all-cause mortality was 1.34 (1.20-1.49) for ≤9:00 PM, 1.18 (1.09-1.27) for 9:01-10:00 PM, and 1.50 (1.13-2.00) for >12:00 AM, respectively. Participants with sleep duration of <6, 6-<7, 8-<9, and ≥9 h/night had a respective 39%, 21%, 11%, and 25% higher all-cause mortality risk than those sleeping 7-<8 h/night. Additionally, participants with a healthy sleep score of 3, characterized as proper bedtime (10:01 PM-12:00 AM), moderate sleep duration (7-<8h/night), and good/fair sleep quality, had a significantly 36% (hazard ratio, 0.64; 95% confidence interval, 0.56-0.74) lower all-cause mortality risk than those with a score of 0. CONCLUSIONS Individuals with early or late bedtimes and short or long sleep duration were at higher all-cause mortality risks. Having healthy sleep habits may significantly reduce death risk.
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Affiliation(s)
- Tingyue Diao
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lue Zhou
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Liangle Yang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Yuan
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kang Liu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Rong Peng
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qiuhong Wang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Wang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rundong Niu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Pinpin Long
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Handong Yang
- Department of Cardiovascular Diseases, Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan, China
| | - Huan Guo
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meian He
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tangchun Wu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Xiaomin Zhang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Whittaker AC, De Nys L, Brindle RC, Drayson MT. Physical activity and sleep relate to antibody maintenance following naturalistic infection and/or vaccination in older adults. Brain Behav Immun Health 2023; 32:100661. [PMID: 37456624 PMCID: PMC10344668 DOI: 10.1016/j.bbih.2023.100661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 06/23/2023] [Indexed: 07/18/2023] Open
Abstract
Health behaviours such as being physically active and having good quality sleep have been associated with decreased susceptibility to infection and stronger antibody responses to vaccination. Less is known about how such factors might influence the maintenance of immunity following naturalistic infection and/or prior vaccination, particularly among older adults who may have formed initial antibodies some time ago. This analysis explored antibody levels against a range of common infectious diseases in 104 older adults (60 women) aged 65+ years, and whether these relate to self-reported physical activity (PA) and sleep. PA and sleep were measured subjectively through standardized questions. Antibody levels to a range of common pathogens, including pneumococcal (Pn) and meningococcal (Men) serotypes, Haemophilus influenza type b, diphtheria, and tetanus were assayed using Multiplex technology. Higher PA at baseline related to higher antibody levels against three Pn serotypes and MenY, and higher PA at one month with higher levels against six Pn serotypes. Longer time in bed related to higher antibody levels against Pn4, and longer sleep related to higher levels against Pn19f. More difficulty staying awake in the day related to lower antibodies against Pn19a, Pn19f, MenA and MenY, and more frequent daytime napping related to lower levels against three Pn serotypes and MenY. Using clinically protective antibody thresholds as an outcome showed similar results for PA, but effects for sleep became non-significant, with the exception of time in bed. This extends beyond existing literature demonstrating associations between PA and sleep and peak antibody response to vaccination to antibody maintenance. Longitudinal research with objective measures of health behaviours is warranted.
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Affiliation(s)
| | - Len De Nys
- Faculty of Health Sciences and Sport, University of Stirling, UK
| | - Ryan C. Brindle
- Department of Cognitive and Behavioural Science & Neuroscience Program, Washington and Lee University, USA
| | - Mark T. Drayson
- Institute of Immunology and Immunotherapy, University of Birmingham, UK
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Zhao X, Cai Q, Dong L, Zhang X, Wang C, Wang S, Liu L, Hu A. Association between length of daily siesta and brachial-ankle pulse wave velocity (baPWV): a community-based cross sectional study in North China. Sleep Breath 2023; 27:1819-1828. [PMID: 36826736 DOI: 10.1007/s11325-023-02791-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 01/25/2023] [Accepted: 02/06/2023] [Indexed: 02/25/2023]
Abstract
INTRODUCTION To date, many studies have shown a link between siesta and cardiovascular events. Little is known regarding the connection between siesta and brachial-ankle pulse wave velocity (baPWV) levels, even though baPWV can determine the degree of atherosclerosis and vascular stiffness. Thus, we examined the relationship between siesta time and baPWV in a cross-sectional study. METHODS Interviews, physical examinations, lab testing, and electron beam computed tomography were all part of the baseline evaluation for participants aged older than 35. Baseline data were compared for 3 different siesta habits: irregular or no siestas, daily short siestas (1 h or less), and daily long siestas (> 1 h). Utilizing logistic regression models and multivariate linear regression, the link between siesta time and baPWV was determined. RESULTS Among all 6566 participants, the different siesta groups had a significant difference of the degrees of AS (P < 0.001). The same outcome was true for both males (P < 0.001) and females (P < 0.001). Numerous cardiovascular risk variables and markers of subclinical atherosclerosis were positively correlated with daily extended siestas. Results from the fully adjusted model showed that long siestas (> 60 min, OR = 1.18, 95%CI: 1.06-1.31, P = 0.002) were linked to a more severe level of the baPWV. For age or gender stratification, we found significant differences between non-siesta and > 60 min siesta groups. Multiple linear regression analysis revealed a positive connection between siesta duration and baPWV (β = 0.197, P = 0.038). CONCLUSIONS An elevated risk of atherosclerosis was shown to accompany prolonged siestas. These results need to be followed up on with prospective studies and additional lab work.
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Affiliation(s)
- Xiaolei Zhao
- Center for Non-Communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Qiujing Cai
- Center for Non-Communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Liguang Dong
- Peking University Shougang Hospital, Beijing, 100144, China
| | - Xinmin Zhang
- Center for Non-Communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Chenglong Wang
- Center for Non-Communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Shuyu Wang
- Beijing Hypertension League Institute, Beijing, 100039, China
| | - Lisheng Liu
- Beijing Hypertension League Institute, Beijing, 100039, China
| | - Aihua Hu
- Center for Non-Communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
- Beijing Hypertension League Institute, Beijing, 100039, China
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El-Solh AA, Lawson Y, Wilding GE. The risk of major adverse cardiovascular events associated with the use of hypnotics in patients with insomnia. Sleep Health 2023; 9:717-725. [PMID: 37393143 DOI: 10.1016/j.sleh.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/19/2023] [Accepted: 05/05/2023] [Indexed: 07/03/2023]
Abstract
OBJECTIVES To examine whether hypnotic use in patients with insomnia reduces major adverse cardiovascular events, including all-cause mortality and nonfatal major adverse cardiovascular events. METHODS Using the Veterans Affairs Corporate Data Warehouse, we conducted a retrospective cohort study of 16,064 patients who were newly diagnosed with insomnia between January 1, 2010, and December 31, 2019. A pair of 3912 hypnotic users and nonusers were selected based on a 1:1 propensity score methodology. The primary outcome was extended major adverse cardiovascular events, a composite of the first occurrence of all-cause mortality or nonfatal major adverse cardiovascular events. RESULTS During the median follow-up of 4.8 years, a total of 2791 composite events occurred, including 2033 deaths and 762 nonfatal major adverse cardiovascular events. Although the incidence rates of major adverse cardiovascular events were comparable between hypnotic users and nonusers in the propensity-matched cohort, users of benzodiazepines and Z-drugs had a higher risk of all-cause mortality (hazard ratio 1.47 [95% CI, 1.17-1.88] and 1.20 [95% CI, 1.03-1.39], respectively), while serotonin antagonist and reuptake inhibitors users had a survival advantage (hazard ratio 0.79 [95% CI, 0.69-0.91]) compared with nonusers. There were no differences in the risk of nonfatal major adverse cardiovascular events between all classes of hypnotics. Male patients and those aged 60 years or younger who were using benzodiazepines or Z-drugs experienced higher major adverse cardiovascular events than their counterparts. CONCLUSIONS In patients with newly diagnosed insomnia, treatment with hypnotics resulted in higher extended major adverse cardiovascular events but not nonfatal major adverse cardiovascular events with benzodiazepine and Z-drug users compared with nonusers. The use of serotonin antagonist and reuptake inhibitors agents had a protective effect against major adverse cardiovascular events warranting further investigation.
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Affiliation(s)
- Ali A El-Solh
- The Veterans Affairs Western New York Healthcare System, Western New York Respiratory Research Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Buffalo, NY, USA; Department of Medicine, Jacobs School of Medicine and Biomedical Sciences and School of Public Health and Health Professions, Buffalo, NY, USA; Department of Epidemiology and Environmental Health, Jacobs School of Medicine and Biomedical Sciences and School of Public Health and Health Professions, Buffalo, NY, USA.
| | - Yolanda Lawson
- The Veterans Affairs Western New York Healthcare System, Western New York Respiratory Research Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Buffalo, NY, USA.
| | - Gregory E Wilding
- Department of Biostatistics; Jacobs School of Medicine and Biomedical Sciences and School of Public Health and Health Professions, Buffalo, CY, USA.
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Stager LM, Thompson-Phillips K, Morgan CH, Watson CS, Grant M, Fobian AD. The Impact of Longitudinal Patterns of Adolescent Sleep Duration on Adult C-Reactive Protein (CRP), Waist-To-Height Ratio, and Body Mass Index (BMI) Among Black and White Individuals. J Adolesc Health 2023; 73:776-783. [PMID: 37395694 PMCID: PMC10524665 DOI: 10.1016/j.jadohealth.2023.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 04/05/2023] [Accepted: 05/14/2023] [Indexed: 07/04/2023]
Abstract
PURPOSE To assess the impact of longitudinal adolescent sleep duration on adult C-reactive protein (CRP), waist-to-height ratio (WtHR), and body mass index (BMI) by race. METHODS Participants (N = 2,399; Mage = 15.7; 40.2% male; 79.2% White, 20.8% Black; Grades 7-12 at Wave I) from the Add Health database provided self-reported sleep duration in Waves I-IV. During Wave V, CRP, WtHR, and BMI were objectively measured. Trajectory analysis was performed using a group-based modeling approach. Chi-square test determined racial differences between groups. General linear models determined relationships between trajectory group, race, and group/race interaction with Wave V CRP, WtHR, and BMI. RESULTS Three sleep trajectories emerged: Group 1 "shortest" (24.4%), Group 2 "stable recommended" (67.6%), and Group 3 "varied" (8%). Black individuals and older individuals were more likely to be in Group 1 compared with Group 2. Regardless of race, individuals with patterns of sleep duration increasing to above what is recommended across waves (Group 3) had elevated CRP. Individuals with stable patterns of adequate sleep (Group 2) had lower WtHR. Black individuals with consistently stable patterns of adequate sleep duration had lower BMI compared to those with low sleep duration. DISCUSSION Black individuals were more likely to obtain chronically short sleep during the transition from adolescence to adulthood, highlighting a significant health disparity. Poor longitudinal sleep predicted elevated CRP and WtHR. Sleep only impacted BMI for Black individuals. This may relate to racial differences in BMI measurement.
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Affiliation(s)
- Lindsay M Stager
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Kathryn Thompson-Phillips
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama; Children's Behavioral Health, Children's of Alabama, Birmingham, Alabama
| | - Casie H Morgan
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Caroline S Watson
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Merida Grant
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Aaron D Fobian
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama.
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Tani S, Atsumi W, Yagi T, Imatake K, Suzuki Y, Takahashi A, Monden M, Matsumoto N, Okumura Y. Higher frequency of fish intake and healthy lifestyle behaviors may be associated with a lower platelet count in Japan: Implication for the anti-atherosclerotic effect of fish intake. Prev Med 2023; 175:107682. [PMID: 37625651 DOI: 10.1016/j.ypmed.2023.107682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Habitual fish intake and healthier lifestyles are associated with a lower risk of atherosclerotic cardiovascular disease (ASCVD). Higher platelet counts (PLCs) are reportedly associated with higher ASCVD events. We aimed to investigate the association between fish intake and lifestyle with PLCs. METHODS We conducted a cross-sectional study in a cohort of 9329 participants (average age: 46.9 ± 12.9 years; 58.9% men) with no history of ASCVD registered at the Health Planning Center of Nihon University Hospital in 2019. RESULTS The average fish intake frequency was 2.15 ± 1.28 days/week. As fish intake frequency increased (0, 1, 2, 3, 4, 5, 6, and 7 days), PLC decreased significantly (p < 0.0001). Multivariable logistic regression analysis showed that higher fish intake frequency tended to be a determinant of lower PLC. Aerobic exercise habits and sleep duration were independent negative determinants of PLC. Cigarette smoking habits were a positive independent determinant of PLC. Furthermore, with increasing fish intake frequency, the proportion of participants with habitual aerobic exercise, non-smoking habits, and longer sleep duration increased (p < 0.0001 for all). Higher n-3 polyunsaturated fatty acid (n-3 PUFA), calculated based on data from the Japanese National Health and Nutrition Survey, intake was associated with a lower PLC. CONCLUSION Higher fish intake and healthier lifestyle behaviors may be comprehensively associated with lower PLCs. The intake of N-3 PUFA with anti-inflammatory effects, rich in fish, may also be related to the lower PLC. This association may explain the preventive effects of fish intake on ASCVD risk.
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Affiliation(s)
- Shigemasa Tani
- Department of Health Planning Center, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan; Department of Cardiology, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan; Department of Medicine, Division of Cardiology, Nihon University School of Medicines, 30-1 Oyaguchi-kamimachi, Itabashi-ku, 173-8610 Tokyo, Japan.
| | - Wataru Atsumi
- Department of Cardiology, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan; Department of Medicine, Division of Cardiology, Nihon University School of Medicines, 30-1 Oyaguchi-kamimachi, Itabashi-ku, 173-8610 Tokyo, Japan
| | - Tsukasa Yagi
- Department of Cardiology, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan; Department of Medicine, Division of Cardiology, Nihon University School of Medicines, 30-1 Oyaguchi-kamimachi, Itabashi-ku, 173-8610 Tokyo, Japan
| | - Kazuhiro Imatake
- Department of Health Planning Center, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan
| | - Yasuyuki Suzuki
- Department of Health Planning Center, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan; Department of Cardiology, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan; Department of Medicine, Division of Cardiology, Nihon University School of Medicines, 30-1 Oyaguchi-kamimachi, Itabashi-ku, 173-8610 Tokyo, Japan
| | - Atsuhiko Takahashi
- Department of Health Planning Center, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan
| | - Masaki Monden
- Department of Cardiology, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan; Department of Medicine, Division of Cardiology, Nihon University School of Medicines, 30-1 Oyaguchi-kamimachi, Itabashi-ku, 173-8610 Tokyo, Japan
| | - Naoya Matsumoto
- Department of Cardiology, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan; Department of Medicine, Division of Cardiology, Nihon University School of Medicines, 30-1 Oyaguchi-kamimachi, Itabashi-ku, 173-8610 Tokyo, Japan
| | - Yasuo Okumura
- Department of Medicine, Division of Cardiology, Nihon University School of Medicines, 30-1 Oyaguchi-kamimachi, Itabashi-ku, 173-8610 Tokyo, Japan
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Drozdowicz-Jastrzębska E, Mach A, Skalski M, Januszko P, Jabiry-Zieniewicz Z, Siwek M, Wawrzyniak ZM, Radziwoń-Zaleska M. Depression, anxiety, insomnia and interleukins in the early postpartum period. Front Psychiatry 2023; 14:1266390. [PMID: 37840785 PMCID: PMC10569220 DOI: 10.3389/fpsyt.2023.1266390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/12/2023] [Indexed: 10/17/2023] Open
Abstract
Background Some new mothers have been shown to suffer from anxiety and depression associated with insomnia during the postpartum period. Our study assessed the impact of demographic, psychopathological, and biochemical factors on the incidence of depression in women during the early postpartum period. Methods A total of 119 women were evaluated at 24-48 h postpartum with the following psychometric scales: Hamilton Depression Rating Scale (HDRS), Edinburgh Postnatal Depression Scale (EPDS), Hamilton Anxiety Rating Scale (HARS) and Athens Insomnia Scale (AIS). In addition, blood was drawn to assay interleukin 6 (IL-6) and interleukin 10 (IL-10). Results The factors that had the greatest impact on the risk of postpartum depression detected with the HDRS were high HARS scores and evidence of insomnia in the AIS. There were no significant differences in IL-6 or IL-10 levels in women with and without depression (based on either HDRS or EPDS scores) and insomnia (based on AIS) after childbirth. Considering demographic factors, divorced and single women were shown to be at higher risk of postpartum depression (based on EPDS scores). Limitations Small sample size and short observation span. Conclusion This study highlights the relationship between postpartum depression and both anxiety and insomnia and emphasises the importance to assess symptoms of anxiety and sleep quality as part of screening in women at risk of postpartum depression.
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Affiliation(s)
| | - Anna Mach
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Michał Skalski
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Januszko
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | | | - Marcin Siwek
- Department of Affective Disorders, Jagiellonian University Medical College, Cracow, Poland
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220
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Chou FY, Chiu TF, Huang FW, Hsu TY, Liu CY, Lin CH, Huang PY, Lin KM, Wu SH. The effect of exercise on the risk of metabolic syndrome associated with sleep insufficiency: a cross-sectional study. Front Cardiovasc Med 2023; 10:1192241. [PMID: 37808885 PMCID: PMC10556234 DOI: 10.3389/fcvm.2023.1192241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 09/06/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Sleep disturbance and insufficient sleep have been linked to metabolic syndrome, increasing cardiovascular disease and mortality risk. However, few studies investigate the joint effect of sleep and exercise on metabolic syndrome. We hypothesized that regular exercise can mitigate the exacerbation of metabolic syndrome by sleep insufficiency. Objective The aim of this study was to investigate whether exercise can attenuate or eliminate the relationship between sleep insufficiency and metabolic syndrome. Method A total of 6,289 adults (mean age = 33.96 years; women: 74.81%) were included in the study, a cross-sectional study conducted based on the results of employee health screening questionnaires and databases from a large healthcare system in central Taiwan. Participants reported sleep insufficiency or not. Self-reported exercise habits were classified into 3 levels: no exercise, exercise <150 min/week, and exercise ≧150 min/week. Multiple logistic regression and sensitivity analyses were conducted to understand the joint associations of sleep patterns and exercise with metabolic syndrome with exposure variables combining sleep duration/disturbances and PA. Results Compared with the reference group (sufficient sleep), individuals with sleep insufficiency had a higher risk for metabolic syndrome [adjusted odds ratio (AOR) = 1.40, 95% confidence interval (95% CI): 1.01-1.94, p < 0.05] in females aged 40-64 years, but not in other populations. Sleep insufficiency was not associated with the risk of metabolic syndrome among individuals achieving an exercise level of <150 min/week, and in particular among those achieving ≧150 min/week in all populations in our study. Conclusion Sleep insufficiency was related to a higher risk of metabolic syndrome in female healthcare staff aged 40-64 years. Being physically active with exercise habits in these individuals, the risk of metabolic syndrome was no longer significant.
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Affiliation(s)
- Fan-Ya Chou
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Te-Fa Chiu
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Fen-Wei Huang
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Tai-Yi Hsu
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Chien-Yu Liu
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
| | - Chin-Han Lin
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Po-Yao Huang
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Kuei-Ming Lin
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Shih-Hao Wu
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
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Zhuang Z, Dong X, Jia J, Liu Z, Huang T, Qi L. Sleep Patterns, Plasma Metabolome, and Risk of Incident Type 2 Diabetes Mellitus. J Clin Endocrinol Metab 2023; 108:e1034-e1043. [PMID: 37084357 DOI: 10.1210/clinem/dgad218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/06/2023] [Accepted: 04/11/2023] [Indexed: 04/23/2023]
Abstract
CONTEXT A healthy sleep pattern has been related to a lower risk of type 2 diabetes mellitus (T2DM). OBJECTIVE We aimed to identify the metabolomic signature for the healthy sleep pattern and assess its potential causality with T2DM. METHODS This study included 78 659 participants with complete phenotypic data (sleep information and metabolomic measurements) from the UK Biobank study. Elastic net regularized regression was applied to calculate a metabolomic signature reflecting overall sleep patterns. We also performed genome-wide association analysis of the metabolomic signature and one-sample mendelian randomization (MR) with T2DM risk. RESULTS During a median of 8.8 years of follow-up, we documented 1489 incident T2DM cases. Compared with individuals who had an unhealthy sleep pattern, those with a healthy sleep pattern had a 49% lower risk of T2DM (multivariable-adjusted hazard ratio [HR], 0.51; 95% CI, 0.40-0.63). We further constructed a metabolomic signature using elastic net regularized regressions that comprised 153 metabolites, and robustly correlated with sleep pattern (r = 0.19; P = 3×10-325). In multivariable Cox regressions, the metabolomic signature showed a statistically significant inverse association with T2DM risk (HR per SD increment in the signature, 0.56; 95% CI, 0.52-0.60). Additionally, MR analyses indicated a significant causal relation between the genetically predicted metabolomic signature and incident T2DM (P for trend < .001). CONCLUSION In this large prospective study, we identified a metabolomic signature for the healthy sleep pattern, and such a signature showed a potential causality with T2DM risk independent of traditional risk factors.
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Affiliation(s)
- Zhenhuang Zhuang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Xue Dong
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Jinzhu Jia
- Department of Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Zhonghua Liu
- Department of Biostatistics, Columbia University, New York, NY 10027-6902, USA
| | - Tao Huang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
- Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing 100191, China
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70118, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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Spina R, Ropars A, Bouazzi S, Dadi S, Lemiere P, Dupire F, Khiralla A, Yagi S, Frippiat JP, Laurain-Mattar D. Screening of Anti-Inflammatory Activity and Metabolomics Analysis of Endophytic Fungal Extracts; Identification and Characterization of Perylenequinones and Terpenoids from the Interesting Active Alternaria Endophyte. Molecules 2023; 28:6531. [PMID: 37764307 PMCID: PMC10534442 DOI: 10.3390/molecules28186531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/24/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Patients suffering from inflammatory chronic diseases are classically treated with anti-inflammatory drugs but unfortunately are highly susceptible to becoming resistant to their treatment. Finding new drugs is therefore crucial and urgent and research on endophytic fungi is a promising way forward. Endophytic fungi are microorganisms that colonize healthy plants and live within their intercellular tissues. They are able to produce a large variety of secondary metabolites while allowing their host to stay healthy. A number of these molecules are endowed with antioxidant or antimicrobial as well as cytotoxic properties, making them very interesting/promising in the field of human therapy. The aim of our study was to investigate whether extracts from five endophytic fungi isolated from plants are endowed with anti-inflammatory activity. Extracts of the endophytic fungi Alternaria alternata from Calotropis procera leaves and Aspergillus terreus from Trigonella foenum-graecum seeds were able to counteract the lipopolysaccharide (LPS) pro-inflammatory effect on THP-1 cells differentiated into macrophages. Moreover, they were able to induce an anti-inflammatory state, rendering them less sensitive to the LPS pro-inflammatory stimulus. Taken together, these results show that these both endophytic fungi could be interesting alternatives to conventional anti-inflammatory drugs. To gain more detailed knowledge of their chemical richness, phytochemical analysis of the ethyl acetate extracts of the five endophytic fungi studied was performed using HPTLC, GC-MS and LC-MS with the Global Natural Products Social (GNPS) platform and the MolNetEnhancer tool. A large family of metabolites (carboxylic acids and derivatives, steroid derivatives, alkaloids, hydroxyanthraquinones, valerolactones and perylenequinones) were detected. The purification of endophytic fungus extract of Alternaria alternate, which diminished TNF-α production of 66% at 20 µg/mL, incubated one hour before LPS addition, led to the characterization of eight pure compounds. These molecules are altertoxins I, II, III, tricycloalternarenes 3a, 1b, 2b, anthranilic acid, and o-acetamidobenzoic acid. In the future, all these pure compounds will be evaluated for their anti-inflammatory activity, while altertoxin II has been shown in the literature as the most active mycotoxin in terms of anti-inflammatory activity.
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Affiliation(s)
- Rosella Spina
- Université de Lorraine, INRAE, LAE, F-54000 Nancy, France;
| | - Armelle Ropars
- Université de Lorraine, SIMPA, F-54000 Nancy, France; (A.R.); (J.-P.F.)
| | - Sihem Bouazzi
- Université de Lorraine, CNRS, L2CM, F-54000 Nancy, France; (S.B.); (S.D.); (P.L.); (F.D.)
| | - Safa Dadi
- Université de Lorraine, CNRS, L2CM, F-54000 Nancy, France; (S.B.); (S.D.); (P.L.); (F.D.)
| | - Pascal Lemiere
- Université de Lorraine, CNRS, L2CM, F-54000 Nancy, France; (S.B.); (S.D.); (P.L.); (F.D.)
| | - François Dupire
- Université de Lorraine, CNRS, L2CM, F-54000 Nancy, France; (S.B.); (S.D.); (P.L.); (F.D.)
| | - Afra Khiralla
- Botany Department, Faculty of Sciences and Technologies, Shendi University, Shendi 11111, Sudan;
| | - Sakina Yagi
- Department of Botany, Faculty of Science, University of Khartoum, Khartoum 11115, Sudan;
| | - Jean-Pol Frippiat
- Université de Lorraine, SIMPA, F-54000 Nancy, France; (A.R.); (J.-P.F.)
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Megawati G, Indraswari N, Johansyah AA, Kezia C, Herawati DMD, Gurnida DA, Musfiroh I. Comparison of hs-CRP in Adult Obesity and Central Obesity in Indonesia Based on Omega-3 Fatty Acids Intake: Indonesian Family Life Survey 5 (IFLS 5) Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6734. [PMID: 37754594 PMCID: PMC10530835 DOI: 10.3390/ijerph20186734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/28/2023]
Abstract
Obesity and central obesity are associated with dire conditions, such as metabolic syndrome, in which low-grade inflammation plays a part. C-reactive protein (CRP) is an inflammatory marker found to be elevated in those conditions. Omega-3 fatty acids work against inflammation and lower CRP levels in obese individuals. This study compared high-sensitivity CRP (hs-CRP) in adult obesity and central obesity in Indonesia based on omega-3 fatty acid intake using Indonesian Family Life Survey (IFLS) 5 data. Secondary data from household questionnaires were obtained from the IFLS 5 online database. Data from 3152 subjects were used; 76.65% of the subjects were female, with a mean age of 45.27 ± 15.77 years. Subjects were classified into five modified categories of obesity and central obesity based on body mass index (BMI) and waist circumference (WC). Omega-3 fatty acid intake was categorized into "low" and "adequate" based on dietary recommendations from the Mediterranean Diet Foundation (2011). There is a significant difference in hs-CRP based on modified obesity categories (p < 0.05). There was no significant difference in hs-CRP between low and adequate omega-3 intake (p > 0.05). These data suggest that hs-CRP is related to overweight, obesity, and central obesity. Meanwhile, omega-3 fatty acids are unrelated to hs-CRP. Further studies are needed to confirm these results.
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Affiliation(s)
- Ginna Megawati
- Doctoral Study Program, Faculty of Medicine, Universitas Padjadjaran, Bandung 40161, Indonesia;
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Sumedang 45363, Indonesia
| | - Noormarina Indraswari
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Sumedang 45363, Indonesia
| | | | - Capella Kezia
- Medical Undergraduate Program, Faculty of Medicine, Universitas Padjadjaran, Sumedang 45363, Indonesia
| | | | - Dida Achmad Gurnida
- Department of Child Health, Faculty of Medicine, Hasan Sadikin Hospital, Universitas Padjadjaran, Bandung 40161, Indonesia
| | - Ida Musfiroh
- Department of Pharmaceutical Analysis dan Medicinal Chemistry, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang 45363, Indonesia
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Chung J, Goodman M, Huang T, Wallace ML, Lutsey PL, Chen JT, Castro-Diehl C, Bertisch S, Redline S. Multi-dimensional sleep and mortality: The Multi-Ethnic Study of Atherosclerosis. Sleep 2023; 46:zsad048. [PMID: 37523657 PMCID: PMC10848217 DOI: 10.1093/sleep/zsad048] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/30/2023] [Indexed: 08/02/2023] Open
Abstract
STUDY OBJECTIVES Multiple sleep characteristics are informative of health, sleep characteristics cluster, and sleep health can be described as a composite of positive sleep attributes. We assessed the association between a sleep score reflecting multiple sleep dimensions, and mortality. We tested the hypothesis that more favorable sleep (higher sleep scores) is associated with lower mortality. METHODS The Multi-Ethnic Study of Atherosclerosis (MESA) is a racially and ethnically-diverse multi-site, prospective cohort study of US adults. Sleep was measured using unattended polysomnography, 7-day wrist actigraphy, and validated questionnaires (2010-2013). 1726 participants were followed for a median of 6.9 years (Q1-Q3, 6.4-7.4 years) until death (171 deaths) or last contact. Survival models were used to estimate the association between the exposure of sleep scores and the outcome of all-cause mortality, adjusting for socio-demographics, lifestyle, and medical comorbidities; follow-up analyses examined associations between individual metrics and mortality. The exposure, a sleep score, was constructed by an empirically-based Principal Components Analysis on 13 sleep metrics, selected a priori. RESULTS After adjusting for multiple confounders, a 1 standard deviation (sd) higher sleep score was associated with 25% lower hazard of mortality (Hazard Ratio [HR]: 0.75; 95% Confidence interval: [0.65, 0.87]). The largest drivers of this association were: night-to-night sleep regularity, total sleep time, and the Apnea-Hypopnea Index. CONCLUSION More favorable sleep across multiple characteristics, operationalized by a sleep score, is associated with lower risk of death in a diverse US cohort of adults. Results suggest that interventions that address multiple dimensions may provide novel approaches for improving health.
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Affiliation(s)
- Joon Chung
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Matthew Goodman
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Tianyi Huang
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | | | - Pamela L Lutsey
- Division of Epidemiology and Community Health, School of Public Health, the University of Minnesota, Minneapolis, MN, USA
| | - Jarvis T Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Suzanne Bertisch
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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225
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Kristbergsdottir H, Schmitz L, Arnardottir ES, Islind AS. Evaluating User Compliance in Mobile Health Apps: Insights from a 90-Day Study Using a Digital Sleep Diary. Diagnostics (Basel) 2023; 13:2883. [PMID: 37761250 PMCID: PMC10528147 DOI: 10.3390/diagnostics13182883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/31/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
Sleep diaries are the gold standard for subjective assessment of sleep variables in clinical practice. Digitization of sleep diaries is needed, as paper versions are prone to human error, memory bias, and difficulties monitoring compliance. METHODS 45 healthy eligible participants (Mage = 50.3 years, range 23-74, 56% female) were asked to use a sleep diary mobile app for 90 consecutive days. Univariate and bivariate analysis was used for group comparison and linear regression for analyzing reporting trends and compliance over time. RESULTS Overall compliance was high in the first two study months but tended to decrease over time (p < 0.001). Morning and evening diary entries were highly correlated (r = 0.932, p < 0.001) and participants significantly answered on average 4.1 days (95% CI [1.7, 6.6]) more often in the morning (M = 60.2, sd = 22.1) than evening ((M = 56.1, sd = 22.2), p < 0.001). CONCLUSION Using a daily diary assessment in a longitudinal sleep study with a sleep diary delivered through a mobile application was feasible, and compliance in this study was satisfactory.
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Affiliation(s)
- Hlín Kristbergsdottir
- Department of Psychology, Reykjavik University, 102 Reykjavík, Iceland
- Reykjavik University Sleep Institute, 102 Reykjavík, Iceland; (E.S.A.); (A.S.I.)
| | - Lisa Schmitz
- Reykjavik University Sleep Institute, 102 Reykjavík, Iceland; (E.S.A.); (A.S.I.)
- Department of Computer Science, Reykjavik University, 102 Reykjavík, Iceland
| | - Erna Sif Arnardottir
- Reykjavik University Sleep Institute, 102 Reykjavík, Iceland; (E.S.A.); (A.S.I.)
| | - Anna Sigridur Islind
- Reykjavik University Sleep Institute, 102 Reykjavík, Iceland; (E.S.A.); (A.S.I.)
- Department of Computer Science, Reykjavik University, 102 Reykjavík, Iceland
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226
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Chen RW, Ulsa MC, Li P, Gao C, Zheng X, Xu J, Luo Y, Shen S, Lane J, Scheer FAJL, Hu K, Gao L. Sleep behavior traits and associations with opioid-related adverse events: a cohort study. Sleep 2023; 46:zsad118. [PMID: 37075812 PMCID: PMC10485566 DOI: 10.1093/sleep/zsad118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 04/02/2023] [Indexed: 04/21/2023] Open
Abstract
STUDY OBJECTIVES Opioid-related adverse events (OAEs), including opioid use disorders, overdose, and death, are serious public health concerns. OAEs are often associated with disrupted sleep, but the long-term relationship between poor sleep and subsequent OAE risk remains unknown. This study investigates whether sleep behavior traits are associated with incident OAEs in a large population cohort. METHODS 444 039 participants (mean age ± SD 57 ± 8 years) from the UK Biobank reported their sleep behavior traits (sleep duration, daytime sleepiness, insomnia-like complaints, napping, and chronotype) between 2006 and 2010. The frequency/severity of these traits determined a poor sleep behavior impacts score (0-9). Incident OAEs were obtained from hospitalization records during 12-year median follow-up. Cox proportional hazards models examined the association between sleep and OAEs. RESULTS Short and long sleep duration, frequent daytime sleepiness, insomnia symptoms, and napping, but not chronotype, were associated with increased OAE risk in fully adjusted models. Compared to the minimal poor sleep behavior impacts group (scores of 0-1), the moderate (4-5) and significant (6-9) groups had hazard ratios of 1.47 (95% confidence interval [1.27, 1.71]), p < 0.001, and 2.19 ([1.82, 2.64], p < 0.001), respectively. The latter risk magnitude is greater than the risk associated with preexisting psychiatric illness or sedative-hypnotic medication use. In participants with moderate/significant poor sleep impacts (vs. minimal), subgroup analysis revealed that age <65 years was associated with a higher OAE risk than in those ≥65 years. CONCLUSIONS Certain sleep behavior traits and overall poor sleep impacts are associated with an increased risk for opioid-related adverse events.
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Affiliation(s)
- Rudy W Chen
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Ma Cherrysse Ulsa
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
| | - Peng Li
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Chenlu Gao
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
| | - Xi Zheng
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
| | - Jiawei Xu
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Yong Luo
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Shiqian Shen
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Jacqueline Lane
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Frank A J L Scheer
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Kun Hu
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Lei Gao
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
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227
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Zapata-Lamana R, Ibarra-Mora J, Carrasco-Marín F, Durán-Agüero S, Cuevas-Aburto J, Parra-Rizo MA, Cigarroa I. Low Sleep Hygiene Is Associated with Less Adherence to the Mediterranean Diet in Chilean Schoolchildren from Rural Public Schools-A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1499. [PMID: 37761460 PMCID: PMC10529217 DOI: 10.3390/children10091499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/11/2023] [Accepted: 08/17/2023] [Indexed: 09/29/2023]
Abstract
The Mediterranean diet stands as a widely acknowledged and health-promoting dietary pattern, renowned for its notable linkage to the mitigation of noncommunicable chronic maladies. Nonetheless, the existing body of evidence concerning the potential interrelation between sleep hygiene and this dietary regimen remains circumscribed. The main objective was to determine the association between sleep hygiene and adherence to the Mediterranean diet in Chilean schoolchildren from rural public schools in southern Chile. A non-experimental study was carried out, with an analytical, cross-sectional design. A total of 265 students (56.6% women, mean age 13.5 ± 1.8) from a rural community in southern Chile were recruited. Sleep habits were evaluated using Section 6 of the Life Habits and Adolescence Questionnaire, Sleep and Rest, and adherence to the Mediterranean diet was assessed with the KIDMED Mediterranean Diet Adherence Questionnaire. The main results indicated that 52.8% of schoolchildren need to improve adherence to the Mediterranean diet and 16.6% have a low-quality Mediterranean diet. A high percentage of schoolchildren have behaviors related to poor sleep hygiene (going to bed late (46%), waking up tired and wanting to continue sleeping (63.8%), and having problems falling asleep (42.6%)). Schoolchildren who got up after 8:30 a.m., those who fell asleep after midnight, upon conducting a comparative analysis of the students based on their sleep patterns, those who woke up tired and those who had trouble falling asleep had a lower level of adherence to the Mediterranean diet compared to schoolchildren who got up earlier than 8:30 a.m., fell asleep before midnight, did not wake up tired, and those who did not find it difficult to fall asleep, respectively. In conclusion, having poor sleep patterns including difficulties in both awakening and falling asleep are associated with less adherence to the Mediterranean diet in schoolchildren from rural public schools in southern Chile. Monitoring these variables and promoting healthy lifestyle habits within the educational community are essential measures.
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Affiliation(s)
| | - Jessica Ibarra-Mora
- Departamento de Educación Física, Deportes y Recreación, Universidad Metropolitana de Ciencias de la Educación, Santiago 8330106, Chile;
| | | | - Samuel Durán-Agüero
- Escuela de Nutrición y Dietética, Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián, Santiago 8330106, Chile;
| | | | - Maria Antonia Parra-Rizo
- Faculty of Health Sciences, Valencian International University (VIU), 46002 Valencia, Spain
- Department of Health Psychology, Faculty of Social and Health Sciences, Campus of Elche, Miguel Hernandez University (UMH), 03202 Elche, Spain
| | - Igor Cigarroa
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Los Ángeles 4440000, Chile
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228
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Åkerstedt T, Schwarz J, Theorell-Haglöw J, Lindberg E. What do women mean by poor sleep? A large population-based sample with polysomnographical indicators, inflammation, fatigue, depression, and anxiety. Sleep Med 2023; 109:219-225. [PMID: 37478658 DOI: 10.1016/j.sleep.2023.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/23/2023]
Abstract
Survey studies indicate that reports of disturbed sleep are prevalent and may be prospectively linked to several major diseases. However, it is not clear what self-reported disturbed sleep represents, since the link with objective sleep measures (polysomnography; PSG) seems very weak. The purpose of the present study was to try to investigate what combination of variables (PSG, inflammation, fatigue, anxiety, depression) that would characterize those who complain of disturbed sleep. This has never been done before. Participants were 319 women in a population-based sample, who gave ratings of sleep quality, fatigue, depression, and anxiety, then had their sleep recorded at home, and had blood drawn the following morning for analysis of immune parameters. Correlations and hierarchical multivariable regression analyses were applied to the data. For ratings of difficulties initiating sleep, the associations in the final step were ß = .22, (p < .001) for fatigue, ß = 0.22 (p < .001) for anxiety, and ß = 0.17 (p < .01) for sleep latency, with R2 = 0.14. The rating of repeated awakenings was associated with fatigue (ß = 0.35, p < .001) and C-reactive protein (CRP) (ß = 0.12, p < .05), with R2 = 0.19. The rating of early morning awakenings was associated with fatigue (ß = 0.31, p < .001), total sleep time (TST) (ß = -0.20, p < .01), and CRP (ß = 0.15, p < .05), with R2 = 0.17. Interleukin-6 and Tumour Necrosis Factor were not associated with ratings of sleep problems. The results indicate that subjective fatigue, rather than objective sleep variables, is central in the perception of poor sleep, together with CRP.
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Affiliation(s)
- Torbjörn Åkerstedt
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden; Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden.
| | - Johanna Schwarz
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden; Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Jenny Theorell-Haglöw
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Sweden
| | - Eva Lindberg
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Sweden
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229
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Irwin MR, Straub RH, Smith MT. Heat of the night: sleep disturbance activates inflammatory mechanisms and induces pain in rheumatoid arthritis. Nat Rev Rheumatol 2023; 19:545-559. [PMID: 37488298 DOI: 10.1038/s41584-023-00997-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2023] [Indexed: 07/26/2023]
Abstract
Sleep has a homeostatic role in the regulation of the immune system and serves to constrain activation of inflammatory signalling and expression of cellular inflammation. In patients with rheumatoid arthritis (RA), a misaligned inflammatory profile induces a dysregulation of sleep-wake activity, which leads to excessive inflammation and the induction of increased sensitivity to pain. Given that multiple biological mechanisms contribute to sleep disturbances (such as insomnia), and that the central nervous system communicates with the innate immune system via neuroendocrine and neural effector pathways, potential exists to develop prevention opportunities to mitigate the risk of insomnia in RA. Furthermore, understanding these risk mechanisms might inform additional insomnia treatment strategies directed towards steering and reducing the magnitude of the inflammatory response, which together could influence outcomes of pain and disease activity in RA.
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Affiliation(s)
- Michael R Irwin
- Department of Psychiatry and Behavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience and Human Behaviour, Los Angeles, CA, USA.
| | - Rainer H Straub
- Laboratory of Experimental Rheumatology and Neuroendocrine Immunology, Department of Internal Medicine I, University Hospital, Regensburg, Germany
| | - Michael T Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
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230
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Zhou M, Li DL, Kai JY, Zhang XF, Pan CW. Sleep duration and the risk of major eye disorders: a systematic review and meta-analysis. Eye (Lond) 2023; 37:2707-2715. [PMID: 36683054 PMCID: PMC10482926 DOI: 10.1038/s41433-023-02403-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 11/29/2022] [Accepted: 01/16/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND To assess the relationship between sleep duration and the risk of major eye disorders including myopia, glaucoma, cataract, age-related macular degeneration (AMD), and diabetic retinopathy (DR). METHODS Databases including PubMed, Embase, Web of Science, and Cochrane library were searched for eligible publications before July 2021. Studies assessing the relationship between sleep duration and any one of the major eye disorders were identified. Pooled odds ratios (ORs) and their corresponding 95% confidence intervals (95% CIs) were estimated using random-effects models. RESULTS We identified 21 relevant articles including 777348 participants, and 17 were cross-sectional, 3 were longitudinal, and 1 was case-control. Pooled results indicated that long sleep duration was significantly associated with the risk of DR (OR = 1.84, 95% CI 1.24, 2.73), and short sleep duration was significantly associated with the risk of cataract (OR = 1.20, 95% CI 1.05, 1.36). Besides, a significant relationship was observed between the risk of DR and long sleep duration per day (i.e., nighttime sleep plus daytime napping, OR = 1.74, 95% CI 1.23, 2.44) rather than per night (OR = 2.17, 95% CI 0.95, 4.99). The extreme of long sleep duration (i.e., >10 h per night) increased the risk of myopia (OR = 1.02, 95% CI 1.01, 1.04). CONCLUSIONS Inappropriate sleep duration might increase the risk of major eye disorders. The findings could contribute to the growing knowledge on the possible relationship between circadian rhythms and eye disorders.
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Affiliation(s)
- Miao Zhou
- School of Public Health, Medical College of Soochow University, Suzhou, China
- Department of Ophthalmology, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Dan-Lin Li
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Jia-Yan Kai
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Xiao-Feng Zhang
- Department of Ophthalmology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China.
| | - Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, Suzhou, China.
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231
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Abstract
Epidemiologic studies have demonstrated that short sleep duration is associated with an increased risk of cardio-metabolic health outcomes including cardiovascular disease mortality, coronary heart disease, type 2 diabetes mellitus, hypertension, and metabolic syndrome. Experimental sleep restriction studies have sought to explain these findings. This review describes the main evidence of these associations and possible mechanisms explaining them. Whether sleep extension reverses these now widely acknowledged adverse health effects and the feasibility of implementing such strategies on a public health level is discussed.
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Affiliation(s)
- Roo Killick
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia
| | - Lachlan Stranks
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia; The University of Adelaide, Faculty of Health and Medical Sciences, Adelaide, Australia
| | - Camilla M Hoyos
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia; The University of Sydney, Faculty of Science, School of Psychology and Brain and Mind Centre, Sydney, Australia.
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232
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Chang YH, Chen YC, Ku LJE, Chou YT, Chen HY, Su HC, Liu CH, Wu YL, Cheng HJ, Yang YC, Li CY. Association between sleep health and intrinsic capacity among older adults in Taiwan. Sleep Med 2023; 109:98-103. [PMID: 37423025 DOI: 10.1016/j.sleep.2023.06.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/11/2023] [Accepted: 06/17/2023] [Indexed: 07/11/2023]
Abstract
Although the association between poor sleep quality and frailty has been previously reported, the relationship between sleep health and intrinsic capacity (IC) remains largely unknown. We aimed to examine the association between sleep health and IC among older adults. This was a cross-sectional study, and 1268 eligible participants completed a questionnaire collecting information on demographic, socioeconomic, lifestyle, sleep health, and IC. Sleep health was measured by the RU-SATED V2.0 scale. High, moderate, and low levels of IC were defined using the Integrated Care for Older People Screening Tool for Taiwanese. The ordinal logistic regression model estimated the odds ratio and corresponding 95% confidence interval. Low IC was significantly associated with age of 80 years or above, female, currently unmarried, uneducated, currently not working, financially dependent, and having emotional disorders. A one-point increase in sleep health was significantly associated with a 9% reduction in the odds of poor IC. An increase in daytime alertness was related to the greatest reduction in poor IC (aOR, 0.64; 95% CI, 0.52-0.79). In addition, the subitems sleep regularity (aOR, 0.77; 95% CI, 0.60-0.99), sleep timing (aOR, 0.80; 95% CI, 0.65-0.99), and sleep duration (aOR, 0.77; 95% CI, 0.61-0.96) were associated with a reduced OR of poor IC but with marginal statistical significance. Our findings showed that sleep health across multiple dimensions is related to IC, particularly daytime alertness in older adults. We suggest developing interventions to improve sleep health and prevent IC decline, which is crucial in causing poor health outcomes.
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Affiliation(s)
- Ya-Hui Chang
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Surgery, Massachusetts General Hospital, Boston, MA, United States
| | - Yen-Chin Chen
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Li-Jung Elizabeth Ku
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Tsung Chou
- Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hung-Yu Chen
- Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hui-Chen Su
- Department of Neurology, National Cheng-Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chieh-Hsiu Liu
- Department of Family Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Yi-Lin Wu
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsiang-Ju Cheng
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Ching Yang
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan; Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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233
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Han J, Shi M, Bi LN, Wang LL, Cai YX. Efficacy of mind-body therapies for sleep disturbance in patients with early-stage cancer: A systematic review and network meta-analysis. Psychooncology 2023; 32:1315-1338. [PMID: 37395137 DOI: 10.1002/pon.6187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 05/30/2023] [Accepted: 06/16/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVE To evaluate and compare the efficacy of different mind-body therapies (MBTs) for sleep disturbance in patients with early-stage cancer. METHODS Randomised controlled trials that included patients (aged ≥18 years) with early stage cancer who underwent MBTs (mindfulness, hypnosis, relaxation, yoga, and qigong) were searched in the CINAHL via the EBSCO Host, Cochrane Library, Embase, MEDLINE, PsycINFO, PubMed, and Scopus databases, from the date of database inception to October 2022. The outcomes were subjective sleep disturbance and objective sleep efficiency. Network meta-analysis (NMA) and comparative effects ranking were performed using STATA (v14.0; STATACorp, College Station, TX, USA). RESULTS Forty-seven studies investigating five MBTs were included in the NMA. For cancer patients receiving active treatment, mindfulness demonstrated the largest effect size in reducing subjective sleep disturbance (standardised mean difference [SMD]: 0.85; 95% confidence intervals [CI]: 0.20-1.50; Grading of Recommendations Assessment, Development, and Evaluation assessment: moderate), and had the highest cumulative probability compared to usual care or waitlist. For cancer patients who had completed active treatment, qigong demonstrated the largest effect size in reducing subjective sleep disturbance (SMD: 0.99; 95% CI: 0.35-1.63; GRADE: low), followed by hypnosis (SMD: 0.87; 95% CI: 0.32-1.42; GRADE: moderate), and mindfulness (SMD: 0.42; 95% CI: 0.24-0.59; GRADE: moderate). Qigong also demonstrated the largest effect size in improving objective sleep efficiency (weighted mean differences: 10.76; 95% CI: 2.01-19.50; GRADE: low); however, the effect of qigong was tested in only one study in this NMA. Among the eight different treatment conditions, cognitive behavioral therapy (CBT) showed the highest cumulative probability (surface under the cumulative ranking curve: 96.3%) in reducing subjective sleep disturbance and the second highest cumulative probability (SUCRA: 83.3%) in improving objective sleep efficiency. CONCLUSION There is no evidence supporting the use of MBTs to replace or be comparable to CBT. Mindfulness can be recommended as an optional treatment for reducing sleep disturbance in patients with early-stage cancer. Some support was observed for qigong and hypnosis in reducing sleep disturbances in patients with early-stage cancer who had completed active treatment. More rigorous trials are warranted to confirm whether different forms of MBTs have different effects on sleep in patients with cancer.
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Affiliation(s)
- Jing Han
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Ming Shi
- National and Local Joint Engineering Laboratory of Tumor Biotherapy, The First Clinical College of Xuzhou Medical University, Xuzhou, China
| | - Liu-Na Bi
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Lin-Lin Wang
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Yan-Xiu Cai
- School of Nursing, Xuzhou Medical University, Xuzhou, China
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Gueye-Ndiaye S, Williamson AA, Redline S. Disparities in Sleep-Disordered Breathing: Upstream Risk Factors, Mechanisms, and Implications. Clin Chest Med 2023; 44:585-603. [PMID: 37517837 PMCID: PMC10513750 DOI: 10.1016/j.ccm.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Sleep-disordered breathing (SDB) refers to a spectrum of disorders ranging from habitual snoring without frank episodes of obstructed breathing or desaturation during sleep to obstructive sleep apnea, where apneas and hypopneas repetitively occur with resultant intermittent hypoxia, arousal, and sleep disruption. Disparities in SDB reflect its overall high prevalence in children and adults from racially and ethnically minoritized or low socioeconomic status backgrounds coupled with high rates of underdiagnosis and suboptimal treatment.
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Affiliation(s)
- Seyni Gueye-Ndiaye
- Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA
| | - Ariel A Williamson
- Children's Hospital of Philadelphia, 2716 South Street Boulevard, Philadelphia, PA 19104, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Susan Redline
- Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA.
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235
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Nobari H, Azarian S, Saedmocheshi S, Valdés-Badilla P, García Calvo T. Narrative review: The role of circadian rhythm on sports performance, hormonal regulation, immune system function, and injury prevention in athletes. Heliyon 2023; 9:e19636. [PMID: 37809566 PMCID: PMC10558889 DOI: 10.1016/j.heliyon.2023.e19636] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 08/21/2023] [Accepted: 08/29/2023] [Indexed: 10/10/2023] Open
Abstract
Objectives This study was a narrative review of the importance of circadian rhythm (CR), describes the underlying mechanisms of CR in sports performance, emphasizes the reciprocal link between CR, endocrine homeostasis and sex differences, and the unique role of the circadian clock in immune system function and coordination. Method As a narrative review study, a comprehensive search was conducted in PubMed, Scopus, and Web of Science (core collection) databases using the keywords "circadian rhythm", "sports performance", "hormonal regulation", "immune system", and "injury prevention". Inclusion criteria were studies published in English and peer-reviewed journals until July 2023. Studies that examined the role of CR in sports performance, hormonal status, immune system function, and injury prevention in athletes were selected for review. Results CR is followed by almost all physiological and biochemical activities in the human body. In humans, the superchiasmatic nucleus controls many daily biorhythms under solar time, including the sleep-wake cycle. A body of literature indicates that the peak performance of essential indicators of sports performance is primarily in the afternoon hours, and the evening of actions occurs roughly at the peak of core body temperature. Recent studies have demonstrated that the time of day that exercise is performed affects the achievement of good physical performance. This review also shows various biomarkers of cellular damage in weariness and the underlying mechanisms of diurnal fluctuations. According to the clock, CR can be synchronized with photonic and non-photonic stimuli (i.e., temperature, physical activity, and food intake), and feeding patterns and diet changes can affect CR and redox markers. It also emphasizes the reciprocal links between CR and endocrine homeostasis, the specific role of the circadian clock in coordinating immune system function, and the relationship between circadian clocks and sex differences. Conclusion The interaction between insufficient sleep and time of day on performance has been established in this study because it is crucial to balance training, recovery, and sleep duration to attain optimal sports performance.
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Affiliation(s)
- Hadi Nobari
- Faculty of Sport Sciences, University of Extremadura, 10003, Cáceres, Spain
- Department of Exercise Physiology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, 56199-11367, Iran
| | - Somayeh Azarian
- Department of Exercise Physiology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, 56199-11367, Iran
| | - Saber Saedmocheshi
- Department of Physical Education and Sport Sciences, Faculty of Humanities and Social Sciences, University of Kurdistan, Sanandaj, 66177-15175, Iran
| | - Pablo Valdés-Badilla
- Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca, 3530000, Chile
- Sports Coach Career, School of Education, Universidad Viña del Mar, Viña del Mar, 2520000, Chile
| | - Tomás García Calvo
- Faculty of Sport Sciences, University of Extremadura, 10003, Cáceres, Spain
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236
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Jeong D, Lee H, Kim J. Effects of sleep pattern, duration, and quality on premenstrual syndrome and primary dysmenorrhea in korean high school girls. BMC Womens Health 2023; 23:456. [PMID: 37641079 PMCID: PMC10464156 DOI: 10.1186/s12905-023-02600-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 08/14/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Sleep deprivation is known to be a risk factor for premenstrual syndrome and primary dysmenorrhea in adults. However, it has rarely been investigated in adolescents. The aim of this study was to investigate whether sleep pattern, duration, and quality independently affect premenstrual syndrome and primary dysmenorrhea in adolescent girls. An additional purpose was to investigate the sleep status in Korean adolescent girls during the COVID-19 pandemic. METHODS A cross-sectional survey study was conducted in 519 high school girls aged 15 to 18 years in Gyeonggido, South Korea, in 2021 during the COVID-19 lockdown. Menstrual pain intensity and menstrual symptoms were assessed using the visual analogue scale (VAS) and Cox menstrual symptom scale (CMSS), respectively. Premenstrual syndrome was assessed by the premenstrual symptoms screening tool (PSST). Sleep was assessed by the Pittsburgh Sleep Quality Index (PSQI). The known risk factors of dysmenorrhea, including menstrual and lifestyle characteristics and stress, were assessed as covariates. RESULTS During the pandemic, approximately 68% of girls slept 7 h or less, while about 60% reported poor sleep quality. Additionally, 64% of participants had a bedtime later after 1AM, and 34% woke up later after 8AM. Late bedtime significantly affected VAS (P = 0.05), CMSS severity and frequency (both P < 0.01), and PSST symptom (P < 0.01). Waking up late affected CMSS severity (P < 0.05), PSST symptom (P = 0.05), and PSST function (P < 0.05). However, the significance of these effects disappeared after controlling for covariates. Sleeping less than 5 h affected CMSS frequency (P < 0.05) and PSST symptoms (P < 0.001). After controlling for covariates, the significance of the effect on PSST symptom remained (P < 0.05). General sleep quality and PSQI components, including subjective sleep quality, sleep latency, sleep disturbance, use of sleeping medication, and daytime dysfunction, significantly affected CMSS frequency and severity and PSST symptom after controlling for covariates (P < 0.05, P < 0.01, or P < 0.001). The multiple regression analysis revealed that among sleep characteristics, sleep quality was the most important risk factor of premenstrual syndrome and dysmenorrhea. CONCLUSION Our study result heightens the importance of healthy sleep hygiene, especially sleep quality in the management of premenstrual syndrome and dysmenorrhea in adolescent girls.
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Affiliation(s)
- Daye Jeong
- Graduate School of Alternative Medicine, Kyonggi University (Seoul Campus), 24, Kyonggidae- ro 9-gil, Seodaemun-gu, Seoul, 03746, Republic of Korea
| | - Heakyong Lee
- Graduate School of Alternative Medicine, Kyonggi University (Seoul Campus), 24, Kyonggidae- ro 9-gil, Seodaemun-gu, Seoul, 03746, Republic of Korea
| | - Jaehee Kim
- Graduate School of Alternative Medicine, Kyonggi University (Seoul Campus), 24, Kyonggidae- ro 9-gil, Seodaemun-gu, Seoul, 03746, Republic of Korea.
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237
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Liang YY, Ai S, Xue H, Chen Y, Zhou J, Shu X, Weng F, Zhou M, Ma H, Zhang J, Geng Q, Wing YK. Joint Associations of Device-Measured Sleep Duration and Efficiency With All-Cause and Cause-Specific Mortality: A Prospective Cohort Study of 90 398 UK Biobank Participants. J Gerontol A Biol Sci Med Sci 2023; 78:1717-1724. [PMID: 37186145 DOI: 10.1093/gerona/glad108] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Both sleep duration and efficiency are essential for health outcomes. However, few studies have considered the effects of both sleep duration and efficiency on predicting the risks of mortality. This study investigated the independent and joint associations of accelerometer-measured sleep duration and efficiency with all-cause and cause-specific mortality. METHODS The UK Biobank is a cohort study of over 500 000 individuals recruited between 2006 and 2010. This study included participants wearing wrist accelerometers for 7 consecutive days between February 2013 and December 2015. Mortality was ascertained by the national death registries. RESULTS Of the 90 398 participants (age, 62.4 [7.8] years, 43.5% male) who were included, 2 685 deaths were reported within a median follow-up duration of 6.4 years. Both accelerometer-measured short (adjusted hazard ratios, 1.27; 95% confidence interval [CI]: 1.11-1.45) and long sleep duration (adjusted hazard ratios, 1.16; 95% CI: 1.06-1.28) were positively associated with the risks of all-cause mortality. Lower sleep efficiency was associated with an increased risk of all-cause and cause-specific mortality. Significant interaction existed between accelerometer-measured sleep duration and efficiency for the risk of all-cause mortality (Pinteraction = .001), participants with long sleep duration and lower sleep efficiency had a double mortality risk compared with those with higher sleep efficiency and normal sleep duration (adjusted hazard ratios = 2.11; 95% CI: 1.44-3.09). CONCLUSIONS Accelerometer-measured short/long sleep duration and lower sleep efficiency were associated with increased risks of mortality. Sleep efficiency modified the effects of long sleep duration on survival.
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Affiliation(s)
- Yannis Yan Liang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Institute of Psycho-neuroscience, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Sizhi Ai
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
- Department of Cardiology, Heart Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan, China
| | - Huachen Xue
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yilin Chen
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jiajin Zhou
- The Affiliated Hospital of Kunming University of Science and Technology, The First People's Hospital of Yunnan Province. Kunming, Yunnan, China
| | - Xinyue Shu
- School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Foqian Weng
- School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Mingqing Zhou
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Huan Ma
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Jihui Zhang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
| | - Qingshan Geng
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Department of Geriatrics, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong, China
| | - Yun-Kwok Wing
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
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Lei S, Liu Z, Li H. Sleep duration and age-related macular degeneration: a cross-sectional and Mendelian randomization study. Front Aging Neurosci 2023; 15:1247413. [PMID: 37674785 PMCID: PMC10477604 DOI: 10.3389/fnagi.2023.1247413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 08/08/2023] [Indexed: 09/08/2023] Open
Abstract
Purpose To investigate the association between sleep duration and age-related macular degeneration (AMD). Design Cross-sectional study, bidirectional two-sample Mendelian randomization (MR). For cross-sectional analysis, we used survey data of 5,481 participants aged ≥40 years from the 2005 to 2008 National Health and Nutrition Examination Survey (NHANES). For MR analysis, we used sleep- and AMD-associated genome-wide association studies (GWAS) data involving large populations. Methods The association between sleep duration and AMD was assessed using logistic regression models. For MR analysis, the primary approach for MR analysis was the inverse-variance weighted (IVW) method. Results In cross-sectional analysis, after adjusting for multiple covariates, short sleep duration (SSD) was found to be associated with increased risk of early AMD [odds ratio (OR) = 1.364, P = 0.036). MR analysis supported the results of cross-sectional analysis: SSD increases the risk of early AMD (β = 0.102, IVW-P = 0.003). Conclusion Our findings provide the evidence supporting the association between sleep deficiency and higher risk of AMD. Further studies are required to confirm our findings and elucidate the mechanisms underlying this association.
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Affiliation(s)
- Shizhen Lei
- Department of Ophthalmology, The First Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhouyang Liu
- Department of Neurology, The Third People’s Hospital of Chengdu, Chengdu, Sichuan, China
| | - Haihui Li
- Department of Ophthalmology, Yan’an People’s Hospital, Yan’an, Shaanxi, China
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Gangitano E, Martinez-Sanchez N, Bellini MI, Urciuoli I, Monterisi S, Mariani S, Ray D, Gnessi L. Weight Loss and Sleep, Current Evidence in Animal Models and Humans. Nutrients 2023; 15:3431. [PMID: 37571368 PMCID: PMC10420950 DOI: 10.3390/nu15153431] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/24/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
Sleep is a vital process essential for survival. The trend of reduction in the time dedicated to sleep has increased in industrialized countries, together with the dramatic increase in the prevalence of obesity and diabetes. Short sleep may increase the risk of obesity, diabetes and cardiovascular disease, and on the other hand, obesity is associated with sleep disorders, such as obstructive apnea disease, insomnia and excessive daytime sleepiness. Sleep and metabolic disorders are linked; therefore, identifying the physiological and molecular pathways involved in sleep regulation and metabolic homeostasis can play a major role in ameliorating the metabolic health of the individual. Approaches aimed at reducing body weight could provide benefits for both cardiometabolic risk and sleep quality, which indirectly, in turn, may determine an amelioration of the cardiometabolic phenotype of individuals. We revised the literature on weight loss and sleep, focusing on the mechanisms and the molecules that may subtend this relationship in humans as in animal models.
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Affiliation(s)
- Elena Gangitano
- OCDEM Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford OX3 7LE, UK
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Noelia Martinez-Sanchez
- OCDEM Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford OX3 7LE, UK
| | | | - Irene Urciuoli
- Department of Surgery, Sapienza University of Rome, 00161 Rome, Italy
| | - Stefania Monterisi
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford OX1 3PT, UK
| | - Stefania Mariani
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - David Ray
- OCDEM Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford OX3 7LE, UK
| | - Lucio Gnessi
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
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Ballesio A. Inflammatory hypotheses of sleep disturbance - depression link: Update and research agenda. Brain Behav Immun Health 2023; 31:100647. [PMID: 37408788 PMCID: PMC10319168 DOI: 10.1016/j.bbih.2023.100647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/23/2023] [Accepted: 06/03/2023] [Indexed: 07/07/2023] Open
Abstract
Studies in human and experimental animal models support a role of inflammation in the aetiology of depression, yet the precise role played by sleep disturbance (i.e., difficulties falling or maintaining sleep) is poorly understood. Consistent evidence from prospective epidemiological studies suggests sleep disturbance as a predictor of major depression episodes and depression recurrence. In parallel, up to 20% of individuals with sleep disturbance have low-grade peripheral inflammation (i.e., CRP>3 mg/l), and preliminary longitudinal evidence showed that sleep disturbance may even predict the levels of inflammation. Therefore, it is possible that sleep disturbance may increase inflammation, which in turn may contribute (i.e., mediate) to the onset - or worsening - of depression. Alternatively, sleep disturbance may serve as a vulnerability factor and increase the risk of developing depressive symptoms when facing an immune challenge. The aim of this review was to summarise the state of the science on the role of sleep disturbance in contributing to depression-related inflammation. A research agenda is also proposed to advance the study of sleep disturbance in the psychoneuroimmunology of depression.
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Affiliation(s)
- Andrea Ballesio
- Department of Psychology, Sapienza University of Rome, Italy
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241
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Ma S, Li P, Li D, Zhou M, Li L, Yin W, Wang P, Zhang Y, Zhu D, Zhu P. Increasing systemic chronic inflammation mediated the association between poor sleep during pregnancy and gestational cardiovascular health. Sleep Health 2023; 9:460-466. [PMID: 37088599 DOI: 10.1016/j.sleh.2023.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 12/30/2022] [Accepted: 01/21/2023] [Indexed: 04/25/2023]
Abstract
OBJECTIVES This study aimed to examine the association between sleep behaviors and cardiovascular health (CVH) during pregnancy and test whether high-sensitivity C-reactive protein (hs-CRP) mediates this association. METHODS The study included 4204 pregnant women from the Maternal and Infant Health cohort study in Hefei (MIH-Hefei). Information on sleep (chronotype, sleep duration, snoring, daytime sleepiness, and insomnia) was collected through a touch-screen structured questionnaire at 16-23 weeks' gestation. CVH (body mass index, blood pressure, total cholesterol, glucose, and smoking) and hs-CRP were measured at 24-28 weeks' gestation. The role of hs-CRP in the association between sleep and CVH was explored in a mediation analysis, while adjusting for multiple confounding factors. RESULTS Poor sleep score was significantly associated with poor gestational CVH metrics, including an RR of 0.872 (95% CI, 0.810, 0.938) for having all ideal (vs. any nonideal) CVH metrics; hs-CRP level was significantly associated with poor gestational CVH metrics, including an RR of 0.531 (95% CI, 0.432, 0.609) for having all ideal (vs. any nonideal) CVH metrics. Sleep scores were positively correlated with hs-CRP level (β, 0.020, 95% CI, 0.006, 0.034). Mediation analysis revealed that the association between sleep and CVH mediated by hs-CRP was 12.31% (indirect effect, -0.0095, 95% CI, -0.0167, -0.0042). CONCLUSIONS Poor sleep during pregnancy, particularly late chronotype and snoring, may worsen CVH by increasing systemic chronic inflammation.
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Affiliation(s)
- Shuangshuang Ma
- Department of Sleep Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China; Fourth People's Hospital of Hefei, Hefei, Anhui, China; Anhui Mental Health Center, Hefei, Anhui, China; Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Pei Li
- Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui, China
| | - Deqin Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Department of Nephrology, High-tech Zone, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Meiting Zhou
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China
| | - Lei Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China
| | - Wanjun Yin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China
| | - Peng Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China
| | - Yimo Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Daomin Zhu
- Department of Sleep Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China; Fourth People's Hospital of Hefei, Hefei, Anhui, China; Anhui Mental Health Center, Hefei, Anhui, China.
| | - Peng Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China.
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Sawadogo W, Adera T, Alattar M, Perera R, Burch JB. Association Between Insomnia Symptoms and Trajectory With the Risk of Stroke in the Health and Retirement Study. Neurology 2023; 101:e475-e488. [PMID: 37286360 PMCID: PMC10401688 DOI: 10.1212/wnl.0000000000207449] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 04/10/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Insomnia is a common condition affecting more than a third of the US population. However, the link between insomnia symptoms and stroke is understudied and the underlying mechanism remains unclear. This study aimed to investigate the relationship between insomnia symptoms and the incidence of stroke. METHODS The Health and Retirement Study, a survey of Americans older than 50 years and their spouses, from 2002 to 2020 was used as the data source. Only those who were stroke-free at baseline were included in this study. The exposure variable was insomnia symptoms and was derived from self-reported sleep-related factors including difficulty initiating sleep, difficulty maintaining sleep, waking up too early, and nonrestorative sleep. Repeated-measures latent class analysis was used to identify insomnia trajectories over time. To investigate the relationship between insomnia symptoms and stroke events reported during the follow-up period, Cox proportional hazards regression models were used. Mediation analyses of comorbidities were performed using causal mediation within a counterfactual framework. RESULTS A total of 31,126 participants were included with a mean follow-up of 9 years. The mean age was 61 years (SD = 11.1) and 57% were females. Insomnia symptom trajectories remained constant over time. Compared with those with no insomnia symptoms, an increased risk of stroke was observed for those with insomnia symptom scores ranging from 1 to 4 and 5 to 8 (hazard ratio (HR) = 1.16, 95% confidence interval (CI) 1.02-1.33) and (HR = 1.51, 95% CI 1.29-1.77), respectively, indicating a dose-response relationship. The association was stronger in participants younger than 50 years (HR = 3.84, 95% CI 1.50-9.85) than in those aged 50 years and older (HR = 1.38, 95% CI 1.18-1.62), comparing those with insomnia symptoms ranging from 5 to 8 with those with no insomnia symptoms. This association was mediated by diabetes, hypertension, heart disease, and depression. DISCUSSION Insomnia symptoms were associated with an increased risk of stroke, especially in adults younger than 50 years, and the risk was mediated by certain comorbidities. Increased awareness and management of insomnia symptoms may contribute to the prevention of stroke occurrence.
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Affiliation(s)
- Wendemi Sawadogo
- From the Division of Epidemiology (W.S., T.A., J.B.B.), Department of Family Medicine and Population Health, and Division of Adult Neurology (M.A.), Sleep Medicine, Vascular Neurology, Department of Neurology; and Department of Biostatistics (R.P.), Virginia Commonwealth University, School of Medicine, Richmond.
| | - Tilahun Adera
- From the Division of Epidemiology (W.S., T.A., J.B.B.), Department of Family Medicine and Population Health, and Division of Adult Neurology (M.A.), Sleep Medicine, Vascular Neurology, Department of Neurology; and Department of Biostatistics (R.P.), Virginia Commonwealth University, School of Medicine, Richmond
| | - Maha Alattar
- From the Division of Epidemiology (W.S., T.A., J.B.B.), Department of Family Medicine and Population Health, and Division of Adult Neurology (M.A.), Sleep Medicine, Vascular Neurology, Department of Neurology; and Department of Biostatistics (R.P.), Virginia Commonwealth University, School of Medicine, Richmond
| | - Robert Perera
- From the Division of Epidemiology (W.S., T.A., J.B.B.), Department of Family Medicine and Population Health, and Division of Adult Neurology (M.A.), Sleep Medicine, Vascular Neurology, Department of Neurology; and Department of Biostatistics (R.P.), Virginia Commonwealth University, School of Medicine, Richmond
| | - James B Burch
- From the Division of Epidemiology (W.S., T.A., J.B.B.), Department of Family Medicine and Population Health, and Division of Adult Neurology (M.A.), Sleep Medicine, Vascular Neurology, Department of Neurology; and Department of Biostatistics (R.P.), Virginia Commonwealth University, School of Medicine, Richmond
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Stewart JC, Patel JS, Polanka BM, Gao S, Nurnberger JI, MacDonald KL, Gupta SK, Considine RV, Kovacs RJ, Vrany EA, Berntson J, Hsueh L, Shell AL, Rollman BL, Callahan CM. Effect of modernized collaborative care for depression on depressive symptoms and cardiovascular disease risk biomarkers: eIMPACT randomized controlled trial. Brain Behav Immun 2023; 112:18-28. [PMID: 37209779 PMCID: PMC10527905 DOI: 10.1016/j.bbi.2023.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/21/2023] [Accepted: 05/13/2023] [Indexed: 05/22/2023] Open
Abstract
Although depression is a risk and prognostic factor for cardiovascular disease (CVD), clinical trials treating depression in patients with CVD have not demonstrated cardiovascular benefits. We proposed a novel explanation for the null results for CVD-related outcomes: the late timing of depression treatment in the natural history of CVD. Our objective was to determine whether successful depression treatment before, versus after, clinical CVD onset reduces CVD risk in depression. We conducted a single-center, parallel-group, assessor-blinded randomized controlled trial. Primary care patients with depression and elevated CVD risk from a safety net healthcare system (N = 216, Mage = 59 years, 78% female, 50% Black, 46% with income <$10,000/year) were randomized to 12 months of the eIMPACT intervention (modernized collaborative care involving internet cognitive-behavioral therapy [CBT], telephonic CBT, and/or select antidepressants) or usual primary care for depression (primary care providers supported by embedded behavioral health clinicians and psychiatrists). Outcomes were depressive symptoms and CVD risk biomarkers at 12 months. Intervention participants, versus usual care participants, exhibited moderate-to-large (Hedges' g = -0.65, p < 0.01) improvements in depressive symptoms. Clinical response data yielded similar results - 43% of intervention participants, versus 17% of usual care participants, had a ≥ 50% reduction in depressive symptoms (OR = 3.73, 95% CI: 1.93-7.21, p < 0.01). However, no treatment group differences were observed for the CVD risk biomarkers - i.e., brachial flow-mediated dilation, high-frequency heart rate variability, interleukin-6, high-sensitivity C-reactive protein, β-thromboglobulin, and platelet factor 4 (Hedges' gs = -0.23 to 0.02, ps ≥ 0.09). Our modernized collaborative care intervention - which harnessed technology to maximize access and minimize resources - produced clinically meaningful improvements in depressive symptoms. However, successful depression treatment did not lower CVD risk biomarkers. Our findings indicate that depression treatment alone may not be sufficient to reduce the excess CVD risk of people with depression and that alternative approaches are needed. In addition, our effective intervention highlights the utility of eHealth interventions and centralized, remote treatment delivery in safety net clinical settings and could inform contemporary integrated care approaches. Trial Registration:ClinicalTrials.gov Identifier: NCT02458690.
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Affiliation(s)
- Jesse C Stewart
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, IN, USA.
| | - Jay S Patel
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Brittanny M Polanka
- Division Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Sujuan Gao
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA
| | - John I Nurnberger
- Department of Psychiatry and Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Krysha L MacDonald
- Sandra Eskenazi Mental Health Center, Eskenazi Health, Indianapolis, IN, USA
| | - Samir K Gupta
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Robert V Considine
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Richard J Kovacs
- Division of Cardiovascular Disease, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Elizabeth A Vrany
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | | | - Loretta Hsueh
- Department of Psychology, University of Illinois Chicago, Chicago, IL, USA
| | - Aubrey L Shell
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, IN, USA
| | - Bruce L Rollman
- Center for Behavioral Health, Media, and Technology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Christopher M Callahan
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Sandra Eskenazi Center for Brain Care Innovation, Eskenazi Health, Indianapolis, IN, USA
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Wallace DA, Gallagher JP, Peterson SR, Ndiaye-Gueye S, Fox K, Redline S, Johnson DA. Is exposure to chemical pollutants associated with sleep outcomes? A systematic review. Sleep Med Rev 2023; 70:101805. [PMID: 37392613 PMCID: PMC10528206 DOI: 10.1016/j.smrv.2023.101805] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/25/2023] [Accepted: 06/08/2023] [Indexed: 07/03/2023]
Abstract
Environmental exposures may influence sleep; however, the contributions of environmental chemical pollutants to sleep health have not been systematically investigated. We conducted a systematic review to identify, evaluate, summarize, and synthesize the existing evidence between chemical pollutants (air pollution, exposures related to the Gulf War and other conflicts, endocrine disruptors, metals, pesticides, solvents) and dimensions of sleep health (architecture, duration, quality, timing) and disorders (sleeping pill use, insomnia, sleep-disordered breathing)). Of the 204 included studies, results were mixed; however, the synthesized evidence suggested associations between particulate matter, exposures related to the Gulf War, dioxin and dioxin-like compounds, and pesticide exposure with worse sleep quality; exposures related to the Gulf War, aluminum, and mercury with insomnia and impaired sleep maintenance; and associations between tobacco smoke exposure with insomnia and sleep-disordered breathing, particularly in pediatric populations. Possible mechanisms relate to cholinergic signaling, neurotransmission, and inflammation. Chemical pollutants are likely key determinants of sleep health and disorders. Future studies should aim to evaluate environmental exposures on sleep across the lifespan, with a particular focus on developmental windows and biological mechanisms, as well as in historically marginalized or excluded populations.
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Affiliation(s)
- Danielle A Wallace
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Jayden Pace Gallagher
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Shenita R Peterson
- Woodruff Health Sciences Center Library, Emory University, Atlanta, GA, USA
| | - Seyni Ndiaye-Gueye
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Kathleen Fox
- Woodruff Health Sciences Center Library, Emory University, Atlanta, GA, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Dayna A Johnson
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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245
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Alawady A, Alharbi A, Alharbi H, Almesbah S, Alshammari N, Alkandari A, Alhazmi H, Alqaderi H. Association between sleep duration and dental caries in a nationally representative U.S. population. BMC Oral Health 2023; 23:497. [PMID: 37464351 DOI: 10.1186/s12903-023-03147-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 06/19/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Dental caries is considered one of the most prevalent chronic diseases worldwide despite all dental public health efforts. Short sleep duration has been established as a risk factor for several medical conditions. In this study, we aimed to examine the relationship between sleep duration and dental caries. METHODS Data were collected from the 2017-2018 cycle of the National Health and Nutrition Examination Survey, a nationally representative health survey conducted in the United States. Participants who completed sleep questionnaires were examined by dentists using standardized clinical criteria. Analysis was limited to Individuals aged ≥ 16 years with complete clinical oral examination data and who completed the sleep questionnaire (N = 5,205). The data were weighted to provide a national estimate, and multiple potential covariates were included in the analysis to account for the complex sample design. The main outcomes of the study were untreated dental caries and dental caries experience. The main predictor variables were average sleep hours/night and a binary variable with 7 h/night as a cut off. Multiple weighted Poisson and logistic regression analyses were conducted to test the hypothesis that people with short sleep duration are more likely to exhibit dental caries. RESULTS This study showed a statistically significant negative relationship between sleep duration and dental caries amongst all weighted adjusted analyses conducted. For a one hour increase in average sleep hours, the Adjusted Odds Ratio (AOR) of having a dental caries experience might decrease by 0.86 (AOR = 0.86, 95% CI = 0.75-0.98, P < 0.05). Individuals who reported an average sleep of ≥ 7 h were less likely to have a dental caries experience compared to individuals who reported an average sleep of < 7 h (AOR = 0.52, 95% CI = 0.33-0.82, P < 0.05). For a one hour increase in average sleep hours, the Adjusted Mean Ratio (AMR) of having a dental caries experience might decrease by 0.97 (AMR = 0.97, 95% CI = 0.96-0.99, P < 0.05), and was lower for those who reported sleeping ≥ 7 h/night than individuals who reported sleeping < 7 h/night (AMR = 0.92, 95% CI = 0.87-0.99, P < 0.05). CONCLUSION Findings of this cross-sectional representative study of the U.S. population revealed a statistically significant negative association between sleep duration and dental caries. In this study, individuals who slept < 7 h/night were more likely to exhibit dental caries.
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Affiliation(s)
| | | | | | | | | | | | - Hesham Alhazmi
- Department of Preventive Dentistry, Faculty of Dentistry, Division of Pediatric Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, United States of America
| | - Hend Alqaderi
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, United States of America
- Dasman Diabetes Institute, Dasman, 1180, Kuwait
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246
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Wang X, Zhao C, Feng H, Li G, He L, Yang L, Liang Y, Tan X, Xu Y, Cui R, Sun Y, Guo S, Zhao G, Zhang J, Ai S. Associations of Insomnia With Insulin Resistance Traits: A Cross-sectional and Mendelian Randomization Study. J Clin Endocrinol Metab 2023; 108:e574-e582. [PMID: 36794917 DOI: 10.1210/clinem/dgad089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/17/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023]
Abstract
CONTEXT Insomnia is associated with insulin resistance (IR) in observational studies; however, whether insomnia is causally associated with IR remains unestablished. OBJECTIVE This study aims to estimate the causal associations of insomnia with IR and its related traits. METHODS In primary analyses, multivariable regression (MVR) and 1-sample Mendelian randomization (1SMR) analyses were performed to estimate the associations of insomnia with IR (triglyceride-glucose index and triglyceride to high-density lipoprotein cholesterol [TG/HDL-C] ratio) and its related traits (glucose level, TG, and HDL-C) in the UK Biobank. Thereafter, 2-sample MR (2SMR) analyses were used to validate the findings from primary analyses. Finally, the potential mediating effects of IR on the pathway of insomnia giving rise to type 2 diabetes (T2D) were examined using a 2-step MR design. RESULTS Across the MVR, 1SMR, and their sensitivity analyses, we found consistent evidence suggesting that more frequent insomnia symptoms were significantly associated with higher values of triglyceride-glucose index (MVR, β = 0.024, P < 2.00E-16; 1SMR, β = 0.343, P < 2.00E-16), TG/HDL-C ratio (MVR, β = 0.016, P = 1.75E-13; 1SMR, β = 0.445, P < 2.00E-16), and TG level (MVR, β = 0.019 log mg/dL, P < 2.00E-16, 1SMR: β = 0.289 log mg/dL, P < 2.00E-16) after Bonferroni adjustment. Similar evidence was obtained by using 2SMR, and mediation analysis suggested that about one-quarter (25.21%) of the association between insomnia symptoms and T2D was mediated by IR. CONCLUSIONS This study provides robust evidence supporting that more frequent insomnia symptoms are associated with IR and its related traits across different angles. These findings indicate that insomnia symptoms can be served as a promising target to improve IR and prevent subsequent T2D.
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Affiliation(s)
- Xiaoyu Wang
- Department of Cardiology, Life Science Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui 453100, China
| | - Chenhao Zhao
- Department of Cardiology, Life Science Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui 453100, China
| | - Hongliang Feng
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510000, China
| | - Guohua Li
- Department of Cardiology, Life Science Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui 453100, China
| | - Lei He
- Department of Cardiology, Life Science Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui 453100, China
| | - Lulu Yang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510000, China
| | - Yan Liang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510000, China
| | - Xiao Tan
- Department of Neuroscience (Sleep Science, BMC), Uppsala University, Uppsala SE-75105, Sweden
| | - Yanmin Xu
- Department of Cardiology, Life Science Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui 453100, China
| | - Ruixiang Cui
- Department of Cardiology, Life Science Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui 453100, China
| | - Yujing Sun
- Department of Cardiology, Life Science Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui 453100, China
| | - Sheng Guo
- Department of Cardiology, Life Science Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui 453100, China
| | - Guoan Zhao
- Department of Cardiology, Life Science Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui 453100, China
| | - Jihui Zhang
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510370, China
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR 999077, China
- The Second School of Clinical Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
| | - Sizhi Ai
- Department of Cardiology, Life Science Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui 453100, China
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510370, China
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247
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Singh SK, Jaiswal AK, Verma M. Is there a ubiquitous association between sleep disorder and frailty? findings from LASI (2017-18). BMC Geriatr 2023; 23:429. [PMID: 37438687 DOI: 10.1186/s12877-023-04148-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/03/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Relatively little is known about how sleep disorders affect frailty of seniors. The study uses Fried's frailty index, to investigate the relationship between sleep disorder and frailty among older Indian adults. METHODS The study analysed Longitudinal Ageing Study in India (2017-18) data which uses a multistage stratified area probability cluster sampling design. The association between frailty was studied for which the total sample size was 31,902. The principal dependent variable was frailty. Descriptive statistics and cross-tabulation were presented in the study. A binary logistic regression analysis was used to fulfil the study objectives to find the possible association. RESULTS The prevalence of frailty in India was 21.3 percent. Older adults with sleep disorder had 66 percent higher likelihood to be frail than their counterparts. The benefits of physical activity in containing frailty is huge, the association were quite high. Poor Self-rated health was significantly associated with higher frailty (OR = 1.73; CI = 1.47-2.04). CONCLUSIONS Frailty is an enormously growing public health issue and has bi-directional relation with sleep disorders. The study has clinical relevance since sleep complaints offer a means for identifying those who are vulnerable to frailty and through appropriate intervention, the causes of sleep disorder would help to delay and in some cases reverse frailty.
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Affiliation(s)
- S K Singh
- Department of Survey Research and Data Analytics, International Institute for Population Sciences, Mumbai, India
| | - Ajit K Jaiswal
- Department of Fertility Studies, International Institute for Population Sciences, Mumbai, India
| | - Madhur Verma
- Assistant Professor of Community/Family Medicine, All India Institute of Medical Sciences Bathinda (Punjab), Punjab, India
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248
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Lin YN, Zhou LN, Liu ZR, Wang Y, Li SQ, Lu FY, Zhang L, Li QY. Short Sleep Duration is Associated with Prolonged Virus Shedding in SARS-CoV-2 Omicron-Infected Patients. Nat Sci Sleep 2023; 15:547-554. [PMID: 37441268 PMCID: PMC10335320 DOI: 10.2147/nss.s411677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
Purpose Sleep disturbance has been implicated in poor prognosis of coronavirus disease 2019 (COVID-19), but less is known about the influence of short sleep duration on COVID-19 outcomes. We aim to investigate whether short sleep duration is associated with prolonged virus shedding duration in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron-infected patients. Patients and Methods A total of 270 patients with a laboratory confirmed COVID-19 diagnosis during SARS-CoV-2 Omicron-predominant period were recruited. Self-reported sleep duration of the patients was collected. The two-way analysis of variance (ANOVA) was used to determine the interactions between sleep duration and variables, and multivariate logistic regression analysis was used to analyze the effect of independent variables on longer virus shedding duration. Results The two-way ANOVA revealed a significant sleep duration × snoring interaction effect for virus shedding duration, and a sleep duration × sex interaction effect for virus shedding duration. Multivariate logistic regression model illustrated that patients sleeping <6 h were at greater risk of prolonged virus shedding duration compared to those sleeping ≥6 hours (OR = 1.80, 95% CI = 1.01-3.26), independent of age, sex, co-existing diseases, vaccination condition, and antiviral treatment. Conclusion Short sleep duration (<6 h) was associated with increased virus shedding in SARS-CoV-2 Omicron-infected patients.
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Affiliation(s)
- Ying Ni Lin
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 20025, People’s Republic of China
- Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of China
| | - Li Na Zhou
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 20025, People’s Republic of China
- Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of China
| | - Zhuo Ran Liu
- Department of Thyroid and Vascular Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of China
| | - Yi Wang
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 20025, People’s Republic of China
- Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of China
| | - Shi Qi Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 20025, People’s Republic of China
- Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of China
| | - Fang Ying Lu
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 20025, People’s Republic of China
- Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of China
| | - Liu Zhang
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 20025, People’s Republic of China
- Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of China
| | - Qing Yun Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 20025, People’s Republic of China
- Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of China
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249
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Valle VID, Mafla-España MA, Silva J, Cauli O. Actigraphy Analysis of Sleep Associates with Salivary IL-6 Concentration in Institutionalized Older Individuals. Diseases 2023; 11:93. [PMID: 37489445 PMCID: PMC10366774 DOI: 10.3390/diseases11030093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/25/2023] [Accepted: 07/02/2023] [Indexed: 07/26/2023] Open
Abstract
Sleep disorders are common in older individuals and are most prevalent in those who are institutionalized. Sleep complaints are often comorbid with medical and neuro-psychiatric illness and associated with polypharmacy. Various studies show an association between sleep disorders and altered levels of inflammatory cytokines, especially IL-6. In this study, an objective sleep analysis was performed using actigraphy, and IL-6 measurements in saliva in 61 older people residing in long-term nursing homes (72.1% women). Almost half (49.2%) of the people had no or mild cognitive impairment, and the rest suffered from moderate to severe dementia, mainly due to Alzheimer's disease (25 out of 31 individuals). A significant correlation was found between salivary IL6 and sleep parameters; e.g., less salivary IL-6 had significantly (p < 0.05) worse sleep efficiency and more night awakenings. In turn, actigraphy detected alterations in people with dementia in average sleep time, daily bedtime, and average daily time out of bed. There was no significant correlation between these sleep patterns and the total number of psychotropic drugs. No significant differences were found in salivary IL-6 between individuals with or without dementia. These results should be considered in future research with institutionalized people to detect sleep disturbances and to establish interventions aimed to improve sleep quality.
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Affiliation(s)
- Vanessa Ibáñez-Del Valle
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, c/de Méndez y Pelayo, 19, 46010 Valencia, Spain
- Frailty and Cognitive Impairment Organized Group (FROG), University of Valencia, 46010 Valencia, Spain
- Chair of Active Ageing, University of Valencia, 46010 Valencia, Spain
| | - Mayra Alejandra Mafla-España
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, c/de Méndez y Pelayo, 19, 46010 Valencia, Spain
- Frailty and Cognitive Impairment Organized Group (FROG), University of Valencia, 46010 Valencia, Spain
| | - Josep Silva
- Valencian Research Institute for Artificial Intelligence, Universitat Politècnica de València, 46010 Valencia, Spain
| | - Omar Cauli
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, c/de Méndez y Pelayo, 19, 46010 Valencia, Spain
- Frailty and Cognitive Impairment Organized Group (FROG), University of Valencia, 46010 Valencia, Spain
- Chair of Active Ageing, University of Valencia, 46010 Valencia, Spain
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250
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Han L, Wang Q. Association between hemoglobin adducts of ethylene oxide levels and the risk of short sleep duration in the general population: an analysis based on the National Health and Nutrition Examination Survey. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:76761-76768. [PMID: 37247137 DOI: 10.1007/s11356-023-27734-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 05/13/2023] [Indexed: 05/30/2023]
Abstract
This study aimed to evaluate the association between blood ethylene oxide (HbEtO) levels and short sleep duration (SSD). Data of 3438 participants aged 20 years or older in this study were collected from the National Health and Nutrition Examination Survey (NHANES). The ethylene oxide (EtO) biomarker (HbEtO) was quantified in blood using a high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method. SSD was defined as sleep time equal to or less than 6 h. The analyses utilized weighted logistic regression models and restricted cubic spline. There was a significant non-linear relationship between HbEtO levels and the risk of SSD (P for-nonlinearity = 0.035). After the full adjustment for confounders, compared with the lowest quantile, the odds ratios (ORs) with 95% confidence intervals (CIs) of SSD across the quantiles of ethylene oxide levels were 1.54(1.09-2.18), 1.15(0.87-1.53), and 1.80(1.11-2.92), respectively (P for trend < 0.05). In subgroup analysis, people who were female, who were non-Hispanic Black, who never engaged in physical activity, who consumed alcohol ≤ 14 g/day, who were normal weight or obese had a significantly higher risk of SSD when they had highest quartiles of HbEtO levels than those had lowest (p < 0.05). Our study indicated that HbEtO levels, an indicator for EtO exposure, were associated with SSD in general adult populations.
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Affiliation(s)
- Lu Han
- Department of Gynecologic Oncology, Shaanxi Provincial Cancer Hospital, 710061, Xi'an, China
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, 710061, Xi'an, China
| | - Qi Wang
- Department of Gynecologic Oncology, Shaanxi Provincial Cancer Hospital, 710061, Xi'an, China.
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, 710061, Xi'an, China.
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