201
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Ackland GL, Brudney CS, Cecconi M, Ince C, Irwin MG, Lacey J, Pinsky MR, Grocott MPW, Mythen MG, Edwards MR, Miller TE, Miller TE, Mythen MG, Grocott MPW, Edwards MR, Ackland GL, Brudney CS, Cecconi M, Ince C, Irwin MG, Lacey J, Pinsky MR, Sanders R, Hughes F, Bader A, Thompson A, Hoeft A, Williams D, Shaw AD, Sessler DI, Aronson S, Berry C, Gan TJ, Kellum J, Plumb J, Bloomstone J, McEvoy MD, Thacker JK, Gupta R, Koepke E, Feldheiser A, Levett D, Michard F, Hamilton M. Perioperative Quality Initiative consensus statement on the physiology of arterial blood pressure control in perioperative medicine. Br J Anaesth 2019; 122:542-551. [DOI: 10.1016/j.bja.2019.01.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 12/10/2018] [Accepted: 01/02/2019] [Indexed: 01/19/2023] Open
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202
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Grzegrzolka J, McEvoy P, Mansell W. Use of the Method of Levels Therapy as a Low-Intensity Intervention to Work With People Experiencing Sleep Difficulties. J Cogn Psychother 2019; 33:140-156. [PMID: 32746389 DOI: 10.1891/0889-8391.33.2.140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Sleep problems are common with nearly one in three people reporting disturbed sleep. In line with guidelines, most people experiencing poor sleep in the United Kingdom are referred for cognitive and behavioral treatment approaches. A large proportion of these clients are seen by Psychological Well-being Practitioners (PWPs) delivering low-intensity therapy within Improving Access to Psychological Therapies (IAPT) services. The training of PWPs in the treatment of sleep problems is limited to sleep hygiene psychoeducation. The role that sleep hygiene psychoeducation plays in improving sleep quality is unclear, especially if used as a stand-alone intervention. The article introduces method of levels (MOL) as an alternative approach explaining sleep problems by transdiagnostic mechanisms. Two clinical cases are presented to demonstrate how MOL was implemented to support clients with the perceived sleep issue. This article adds to growing evidence that a transdiagnostic approach to helping people experiencing psychological distress is needed.
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Affiliation(s)
- Jakub Grzegrzolka
- Six Degrees Social Enterprise, Southwood House, Greenwood Business Centre, Salford, UK.,Northpoint Wellbeing Limited, Leeds Bridge House, Leeds, UK.,University of Manchester, Manchester, UK
| | - Phil McEvoy
- Six Degrees Social Enterprise, Southwood House, Greenwood Business Centre, Salford, UK
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203
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Holbein JB, Schafer JP, Dickinson DL. Insufficient sleep reduces voting and other prosocial behaviours. Nat Hum Behav 2019; 3:492-500. [PMID: 31089294 DOI: 10.1038/s41562-019-0543-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 01/25/2019] [Indexed: 11/09/2022]
Abstract
Insufficient sleep is a growing public health concern in industrial societies. Although a lack of sleep is known to negatively affect private behaviours-such as working or going to school-comparatively little is known about its consequences for the social behaviours that hold society and democracy together. Using three complementary methods, we show how insufficient sleep affects various measures of civic participation. With survey data from two countries, we show that insufficient sleep predicts lower voter turnout. Next, with a geographical regression discontinuity design, we demonstrate that individuals from the United States who tend to sleep less due to circadian impacts of time-zone boundaries are also less likely to vote. Finally, we experimentally manipulate short-term sleep over a two-stage study. We observe that the treatment decreases the levels of civic engagement, as shown by their willingness to vote, sign petitions and donate to charities. These results highlight the strong negative consequences that current levels of insufficient sleep have on vitally important measures of social capital.
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Affiliation(s)
- John B Holbein
- Department of Political Science, Brigham Young University, Provo, UT, USA.
| | - Jerome P Schafer
- Department of Political Science, Ludwig-Maximilians-University, Munich, Germany
| | - David L Dickinson
- Department of Economics, Appalachian State University, Boone, NC, USA.,IZA, Bonn, Germany.,Economic Science Institute, Chapman University, Orange, CA, USA
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204
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Fuller PM, Eikermann M. Genomic consequences of sleep restriction: the devil is in the details. Anaesthesia 2019; 74:417-419. [PMID: 30383307 DOI: 10.1111/anae.14479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2018] [Indexed: 11/28/2022]
Affiliation(s)
- P M Fuller
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - M Eikermann
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
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205
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Henry AL, Bundy C, Kyle SD, Griffiths CEM, Chisholm A. Understanding the experience of sleep disturbance in psoriasis: a qualitative exploration using the Common-Sense Model of Self-Regulation. Br J Dermatol 2019; 180:1397-1404. [PMID: 30671939 DOI: 10.1111/bjd.17685] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Psoriasis is associated with significant morbidity, which negatively impacts upon quality of life. Sleep disturbance is reported to be common in patients with psoriasis and is associated with physical and psychological variables, although there is little published work in this area. Understanding sleep and the factors involved in its disturbance in psoriasis is a potentially important clinical area given the role of sleep in health and disease processes. OBJECTIVES To explore the experience of sleep and sleep disturbance in psoriasis using the Common-Sense Model of Self-Regulation (CS-SRM). METHODS Semistructured interviews were conducted with adults diagnosed with psoriasis. Interview questions were informed by the CS-SRM and previous research. Framework analysis was applied, including coding data into the CS-SRM dimensions and allowing additional inductive themes to emerge. RESULTS Seventeen people with psoriasis (nine women, eight men; aged 19-86 years) were interviewed about sleep and sleep disturbance. Seven themes emerged, with six accounted for by the CS-SRM: characteristics of sleep disturbance, change in sleep patterns, thoughts about and symptoms of disease disturbing sleep, impact of poor sleep on daily life, attempts to improve sleep, a daily battle for control and a seventh relating to metacognitive processes. A reciprocal relationship between sleep and psoriasis was evident across themes with interactions between key sleep-related thoughts, emotions and behaviours. CONCLUSIONS This study showed that sleep disturbance is a persistent concern for people with psoriasis; it has a 24-h impact, and interacts with the psychological and physical aspects of psoriasis. The distress and frustration felt when managing sleep disturbance perpetuated problematic sleep. Addressing this with currently available sleep treatments may therefore confer sleep and psoriasis-related benefits for people living with this condition.
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Affiliation(s)
- A L Henry
- Centre for Dermatology, Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester, U.K.,Manchester Centre for Health Psychology, University of Manchester, Manchester, U.K
| | - C Bundy
- School of Healthcare Sciences, University of Cardiff, Cardiff, U.K
| | - S D Kyle
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, U.K
| | - C E M Griffiths
- Centre for Dermatology, Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester, U.K.,Salford Royal NHS Foundation Trust, Manchester, U.K
| | - A Chisholm
- Department of Psychological Sciences, University of Liverpool, Liverpool, U.K
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206
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Liu H, Chen A. Roles of sleep deprivation in cardiovascular dysfunctions. Life Sci 2019; 219:231-237. [PMID: 30630005 DOI: 10.1016/j.lfs.2019.01.006] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 12/14/2018] [Accepted: 01/06/2019] [Indexed: 01/09/2023]
Abstract
It is widely recognized that inadequate sleep is associated with multiple acute and chronic diseases and results in increased mortality and morbidity for cardiovascular diseases. In recent years, there has been increasing interest in sleep related investigations. Emerging evidence indicates that sleep deprivation changes the biological phenotypes of DNA, RNA and protein levels, but the underlying mechanisms are not clear. We summarized the current research on the detrimental roles of sleep deprivation on the heart and elucidated the underlying mechanisms of sleep deficiency to improve our understanding of sleep deprivation and the emerging strategies to target this process for therapeutic benefit.
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Affiliation(s)
- Haiqiong Liu
- Department of Cardiology, Heart Center, Zhujiang Hospital, Southern Medical University, NO. 253, Gongye Avenue, 510282 Guangzhou, China; Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Disease, NO. 253, Gongye Avenue, 510282 Guangzhou, China; Sino-Japanese Cooperation Platform for Translational Research in Heart Failure, China; Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, NO. 253, Gongye Avenue, 510282 Guangzhou, China
| | - Aihua Chen
- Department of Cardiology, Heart Center, Zhujiang Hospital, Southern Medical University, NO. 253, Gongye Avenue, 510282 Guangzhou, China; Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Disease, NO. 253, Gongye Avenue, 510282 Guangzhou, China; Sino-Japanese Cooperation Platform for Translational Research in Heart Failure, China; Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, NO. 253, Gongye Avenue, 510282 Guangzhou, China.
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207
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Cooper LN, Mishra I, Ashley NT. Short-Term Sleep Loss Alters Cytokine Gene Expression in Brain and Peripheral Tissues and Increases Plasma Corticosterone of Zebra Finch (Taeniopygia guttata). Physiol Biochem Zool 2019; 92:80-91. [DOI: 10.1086/701170] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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208
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Agorastos A, Pervanidou P, Chrousos GP, Baker DG. Developmental Trajectories of Early Life Stress and Trauma: A Narrative Review on Neurobiological Aspects Beyond Stress System Dysregulation. Front Psychiatry 2019; 10:118. [PMID: 30914979 PMCID: PMC6421311 DOI: 10.3389/fpsyt.2019.00118] [Citation(s) in RCA: 185] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 02/15/2019] [Indexed: 12/21/2022] Open
Abstract
Early life stressors display a high universal prevalence and constitute a major public health problem. Prolonged psychoneurobiological alterations as sequelae of early life stress (ELS) could represent a developmental risk factor and mediate risk for disease, leading to higher physical and mental morbidity rates in later life. ELS could exert a programming effect on sensitive neuronal brain networks related to the stress response during critical periods of development and thus lead to enduring hyper- or hypo-activation of the stress system and altered glucocorticoid signaling. In addition, alterations in emotional and autonomic reactivity, circadian rhythm disruption, functional and structural changes in the brain, as well as immune and metabolic dysregulation have been lately identified as important risk factors for a chronically impaired homeostatic balance after ELS. Furthermore, human genetic background and epigenetic modifications through stress-related gene expression could interact with these alterations and explain inter-individual variation in vulnerability or resilience to stress. This narrative review presents relevant evidence from mainly human research on the ten most acknowledged neurobiological allostatic pathways exerting enduring adverse effects of ELS even decades later (hypothalamic-pituitary-adrenal axis, autonomic nervous system, immune system and inflammation, oxidative stress, cardiovascular system, gut microbiome, sleep and circadian system, genetics, epigenetics, structural, and functional brain correlates). Although most findings back a causal relation between ELS and psychobiological maladjustment in later life, the precise developmental trajectories and their temporal coincidence has not been elucidated as yet. Future studies should prospectively investigate putative mediators and their temporal sequence, while considering the potentially delayed time-frame for their phenotypical expression. Better screening strategies for ELS are needed for a better individual prevention and treatment.
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Affiliation(s)
- Agorastos Agorastos
- II. Department of Psychiatry, Division of Neurosciences, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Panagiota Pervanidou
- Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, School of Medicine, Aghia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George P Chrousos
- Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, School of Medicine, Aghia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dewleen G Baker
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States.,VA Center of Excellence for Stress and Mental Health, San Diego, La Jolla, CA, United States
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209
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Paine SJ, Harris R, Cormack D, Stanley J. Self-reported sleep complaints are associated with adverse health outcomes: cross-sectional analysis of the 2002/03 New Zealand Health Survey. ETHNICITY & HEALTH 2019; 24:44-56. [PMID: 28412838 DOI: 10.1080/13557858.2017.1315368] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The aim was to investigate the prevalence of self-reported sleep complaints in New Zealand adults and determine the independent association of sleep complaints with adverse health outcomes. DESIGN We used 2002/03 New Zealand Health Survey data (n = 12,500 adults, ≥15 years). The prevalence of self-reported sleep complaints was estimated by ethnicity. The relationship between sleep complaints and mental health, physical health and health risk behaviors were investigated using multivariable logistic regression models. RESULTS The prevalence of each sleep complaint measure was highest for the indigenous Māori population (23.6% reported 'any' sleep complaint; 10.3% reported multiple sleep complaints). Reporting 'any' sleep complaint was associated with higher odds of poorer mental health, diagnosed high blood pressure, diagnosed diabetes, diagnosed heart disease, poor/fair self-rated health, obesity, current smoking, and hazardous drinking. CONCLUSION The higher prevalence of sleep complaints among Māori and the consistent association with poor health suggests a potential role for suboptimal sleep in ethnic health inequities.
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Affiliation(s)
- Sarah-Jane Paine
- a Sleep/Wake Research Centre , College of Health, Massey University , Wellington , New Zealand
| | - Ricci Harris
- b Eru Pōmare Māori Health Research Centre, Department of Public Health, University of Otago , Wellington South , New Zealand
| | - Donna Cormack
- b Eru Pōmare Māori Health Research Centre, Department of Public Health, University of Otago , Wellington South , New Zealand
| | - James Stanley
- c Deans Department , University of Otago , Wellington South , New Zealand
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210
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Agorastos A, Nicolaides NC, Bozikas VP, Chrousos GP, Pervanidou P. Multilevel Interactions of Stress and Circadian System: Implications for Traumatic Stress. Front Psychiatry 2019; 10:1003. [PMID: 32047446 PMCID: PMC6997541 DOI: 10.3389/fpsyt.2019.01003] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 12/19/2019] [Indexed: 12/11/2022] Open
Abstract
The dramatic fluctuations in energy demands by the rhythmic succession of night and day on our planet has prompted a geophysical evolutionary need for biological temporal organization across phylogeny. The intrinsic circadian timing system (CS) represents a highly conserved and sophisticated internal "clock," adjusted to the 24-h rotation period of the earth, enabling a nyctohemeral coordination of numerous physiologic processes, from gene expression to behavior. The human CS is tightly and bidirectionally interconnected to the stress system (SS). Both systems are fundamental for survival and regulate each other's activity in order to prepare the organism for the anticipated cyclic challenges. Thereby, the understanding of the temporal relationship between stressors and stress responses is critical for the comprehension of the molecular basis of physiology and pathogenesis of disease. A critical loss of the harmonious timed order at different organizational levels may affect the fundamental properties of neuroendocrine, immune, and autonomic systems, leading to a breakdown of biobehavioral adaptative mechanisms with increased stress sensitivity and vulnerability. In this review, following an overview of the functional components of the SS and CS, we present their multilevel interactions and discuss how traumatic stress can alter the interplay between the two systems. Circadian dysregulation after traumatic stress exposure may represent a core feature of trauma-related disorders mediating enduring neurobiological correlates of trauma through maladaptive stress regulation. Understanding the mechanisms susceptible to circadian dysregulation and their role in stress-related disorders could provide new insights into disease mechanisms, advancing psychochronobiological treatment possibilities and preventive strategies in stress-exposed populations.
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Affiliation(s)
- Agorastos Agorastos
- Department of Psychiatry, Division of Neurosciences, Faculty of Medical Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.,VA Center of Excellence for Stress and Mental Health (CESAMH), VA San Diego Healthcare System, San Diego, CA, United States
| | - Nicolas C Nicolaides
- First Department of Pediatrics, Division of Endocrinology, Metabolism and Diabetes, School of Medicine, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Vasilios P Bozikas
- Department of Psychiatry, Division of Neurosciences, Faculty of Medical Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George P Chrousos
- First Department of Pediatrics, Division of Endocrinology, Metabolism and Diabetes, School of Medicine, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece.,Unit of Developmental & Behavioral Pediatrics, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Panagiota Pervanidou
- Unit of Developmental & Behavioral Pediatrics, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
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211
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Oyola MG, Shupe EA, Soltis AR, Sukumar G, Paez-Pereda M, Larco DO, Wilkerson MD, Rothwell S, Dalgard CL, Wu TJ. Sleep Deprivation Alters the Pituitary Stress Transcriptome in Male and Female Mice. Front Endocrinol (Lausanne) 2019; 10:676. [PMID: 31649619 PMCID: PMC6794367 DOI: 10.3389/fendo.2019.00676] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 09/18/2019] [Indexed: 01/02/2023] Open
Abstract
Poor sleep hygiene is a growing problem, with detrimental effects on many biological systems. The pituitary gland plays a crucial role in the regulation of sleep and the stress response, and its dysfunction leads to sleep-related disorders. However, the interaction between these critical functions remains unclear. Thus, we performed a comparative, whole-transcriptome, analysis to identify stress-induced genes and relevant pathways that may be affected by sleep deprivation. One day following 12 h of Paradoxical Sleep Deprivation (PSD), mice were restrained for 20 min. Gene expression changes in the pituitary were assessed via RNA-Seq and Gene Ontology in PSD and/or restrained groups compared to controls. We show that restraint triggers transcriptional responses involved in hormone secretion, the glucocorticoid response, and apoptosis in both sexes, with 285 differentially expressed genes in females and 93 in males. When PSD preceded restraint stress, the numbers of differentially expressed genes increased to 613 in females and 580 in males. The pituitary transcriptome of restraint+PSD animals was enriched for microglia and macrophage proliferation, cellular response to corticosteroids, and apoptosis, among others. Finally, we identify sex-specific differences in restraint-induced genes following PSD. These findings provide genetic targets to consider when studying sleep and the response to stress.
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Affiliation(s)
- Mario G. Oyola
- Department of Obstetrics and Gynecology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- Center for Neuroscience and Regenerative Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, United States
| | - Elizabeth A. Shupe
- Department of Obstetrics and Gynecology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Anthony R. Soltis
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, United States
- Collaborative Health Initiative Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Gauthaman Sukumar
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, United States
- Collaborative Health Initiative Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Marcelo Paez-Pereda
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Darwin O. Larco
- Department of Obstetrics and Gynecology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Matthew D. Wilkerson
- Collaborative Health Initiative Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- Department of Anatomy, Physiology and Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Stephen Rothwell
- Department of Anatomy, Physiology and Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Clifton L. Dalgard
- Collaborative Health Initiative Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- Department of Anatomy, Physiology and Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - T. John Wu
- Department of Obstetrics and Gynecology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- Center for Neuroscience and Regenerative Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- *Correspondence: T. John Wu
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212
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Facco FL, Parker CB, Hunter S, Reid KJ, Zee PC, Silver RM, Haas DM, Chung JH, Pien GW, Nhan-Chang CL, Simhan HN, Parry S, Wapner RJ, Saade GR, Mercer BM, Torres C, Knight J, Reddy UM, Grobman WA. Association of Adverse Pregnancy Outcomes With Self-Reported Measures of Sleep Duration and Timing in Women Who Are Nulliparous. J Clin Sleep Med 2018; 14:2047-2056. [PMID: 30518449 DOI: 10.5664/jcsm.7534] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 08/31/2018] [Indexed: 12/21/2022]
Abstract
STUDY OBJECTIVES To examine the relationship of self-reported sleep during pregnancy with adverse pregnancy outcomes. A secondary objective was to describe the concordance between self-reported and objectively assessed sleep during pregnancy. METHODS In this prospective cohort, women completed a survey of sleep patterns at 6 to 13 weeks' gestation (visit 1) and again at 22 to 29 weeks' gestation (visit 3). Additionally, at 16 to 21 weeks (visit 2), a subgroup completed a week-long sleep diary coincident with an actigraphy recording. Weekly averages of self-reported sleep duration and sleep midpoint were calculated. A priori, sleep duration < 7 hours was defined as "short," and sleep midpoint after 5:00 AM was defined as "late." The relationship of these sleep abnormalities with hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) was determined. RESULTS Of the 10,038 women enrolled, sleep survey data were available for 7,524 women at visit 1 and 7,668 women at visit 3. A total of 752 women also provided ≥ 5 days of sleep diary data coincident with actigraphy at visit 2. We did not observe any consistent relationship between self-reported short sleep and HDP or GDM. There was an association between self-reported late sleep midpoint and GDM (visit 1 adjusted odds ratio 1.67, 95% confidence interval 1.17, 2.38; visit 2 adjusted odds ratio 1.73, 95% confidence interval 1.23, 2.43). At visit 2, 77.1% of participants had concordance between their diary and actigraphy for short sleep duration, whereas 94.3% were concordant for sleep midpoint. CONCLUSIONS Self-reported sleep midpoint, which is more accurate than self-reported sleep duration, is associated with the risk of GDM. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov, Title: Pregnancy as a Window to Future Cardiovascular Health: Adverse Pregnancy Outcomes as Predictors of Increased Risk Factors for Cardiovascular Disease, Identifier: NCT02231398, URL: https://clinicaltrials.gov/ct2/show/NCT02231398.
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Affiliation(s)
- Francesca L Facco
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | | - Shannon Hunter
- RTI International, Research Triangle Park, North Carolina
| | - Kathryn J Reid
- Department of Neurology, Northwestern University, Chicago, Illinois
| | - Phyllis C Zee
- Department of Neurology, Northwestern University, Chicago, Illinois
| | - Robert M Silver
- Department of Obstetrics and Gynecology, University of Utah and Intermountain Healthcare, Salt Lake City, Utah
| | - David M Haas
- Department of Obstetrics and Gynecology, School of Medicine, Indiana University, Indianapolis, Indiana
| | - Judith H Chung
- Department of Obstetrics and Gynecology, University of California, Irvine, Orange, California
| | - Grace W Pien
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Chia-Ling Nhan-Chang
- Department of Obstetrics and Gynecology, Columbia University, New York, New York
| | - Hyagriv N Simhan
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Samuel Parry
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ronald J Wapner
- Department of Obstetrics and Gynecology, Columbia University, New York, New York
| | - George R Saade
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, University of Texas, Galveston, Texas
| | - Brian M Mercer
- Department of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, Ohio
| | - Caroline Torres
- Department of Obstetrics and Gynecology, Columbia University, New York, New York
| | - Jordan Knight
- Department of Obstetrics and Gynecology, School of Medicine, Indiana University, Indianapolis, Indiana
| | - Uma M Reddy
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - William A Grobman
- Department of Obstetrics and Gynecology Medicine, Northwestern University, Chicago, Illinois
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213
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Peters JL, Zevitas CD, Redline S, Hastings A, Sizov N, Hart JE, Levy JI, Roof CJ, Wellenius GA. Aviation Noise and Cardiovascular Health in the United States: a Review of the Evidence and Recommendations for Research Direction. CURR EPIDEMIOL REP 2018. [PMID: 30505645 DOI: 10.1007/s40471-018-0151-2.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
Purpose of the Review In the USA, there is mounting pressure on aviation operators and regulators to address concerns about community impacts of aircraft noise given increasing evidence of adverse health impacts, continuing community complaints, availability of cost-effective programs to reduce exposures to aircraft noise, and more stringent international policies. In the USA, regulation of civil aviation noise is the responsibility of the Federal Aviation Administration (FAA), which requires a "significant body of scientific support," particularly applicable to the USA, to inform health-based policy and regulatory decisions. However, there have been very few studies investigating the relationship between noise and health in the USA and limited studies across the globe characterizing the effects of aviation noise specifically on cardiovascular health. This review focuses on recent findings on the relationship between aircraft noise and cardiovascular outcomes and directions for future research. Recent Findings Epidemiological studies generally report statistically significant associations between aircraft noise and adverse cardiovascular outcomes, although with limited evidence within the USA. Sleep disturbance, associated with nighttime noise, has been shown to be a risk factor for cardiovascular disease given associations with inflammatory markers and metabolic changes. Given numerous cardiovascular markers, the most appropriate choices depend on the ultimate objectives of the individual studies. Summary Given the state of the literature, future research should leverage emerging tools to estimate aviation, railway, and road traffic noise and apply noise estimates to a range of epidemiological study designs and endpoints to inform causal interpretation and help determine potential intervention strategies.
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Affiliation(s)
- Junenette L Peters
- Department of Environmental Health, Boston University School of Public Health, 710 Albany Street, Boston, MA 02118, USA
| | - Christopher D Zevitas
- Volpe National Transportation System Center, US Department of Transportation, Cambridge, MA, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Aaron Hastings
- Volpe National Transportation System Center, US Department of Transportation, Cambridge, MA, USA
| | - Natalia Sizov
- Office of Environment and Energy, Federal Aviation Administration, US Department of Transportation, Washington, DC, USA
| | - Jaime E Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jonathan I Levy
- Department of Environmental Health, Boston University School of Public Health, 710 Albany Street, Boston, MA 02118, USA
| | - Christopher J Roof
- Volpe National Transportation System Center, US Department of Transportation, Cambridge, MA, USA
| | - Gregory A Wellenius
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
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214
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Kervezee L, Kosmadopoulos A, Boivin DB. Metabolic and cardiovascular consequences of shift work: The role of circadian disruption and sleep disturbances. Eur J Neurosci 2018; 51:396-412. [PMID: 30357975 DOI: 10.1111/ejn.14216] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 09/25/2018] [Accepted: 10/11/2018] [Indexed: 12/26/2022]
Abstract
Shift work, defined as work occurring outside typical daytime working hours, is associated with an increased risk of various non-communicable diseases, including diabetes and cardiovascular disease. Disruption of the internal circadian timing system and concomitant sleep disturbances is thought to play a critical role in the development of these health problems. Indeed, controlled laboratory studies have shown that short-term circadian misalignment and sleep restriction independently impair physiological processes, including insulin sensitivity, energy expenditure, immune function, blood pressure and cardiac modulation by the autonomous nervous system. If allowed to persist, these acute effects may lead to the development of cardiometabolic diseases in the long term. Here, we discuss the evidence for the contributions of circadian disruption and associated sleep disturbances to the risk of metabolic and cardiovascular health problems in shift workers. Improving the understanding of the physiological mechanisms affected by circadian misalignment and sleep disturbance will contribute to the development and implementation of strategies that prevent or mitigate the cardiometabolic impact of shift work.
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Affiliation(s)
- Laura Kervezee
- Centre for Study and Treatment of Circadian Rhythms, Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Anastasi Kosmadopoulos
- Centre for Study and Treatment of Circadian Rhythms, Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Diane B Boivin
- Centre for Study and Treatment of Circadian Rhythms, Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
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215
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Flatt AA, Howells D, Williams S. Effects of consecutive domestic and international tournaments on heart rate variability in an elite rugby sevens team. J Sci Med Sport 2018; 22:616-621. [PMID: 30527686 DOI: 10.1016/j.jsams.2018.11.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 11/04/2018] [Accepted: 11/19/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate heart rate variability and athlete self-report measures of recovery status (ASRM) in response to consecutive domestic and international tournaments among an elite rugby sevens team. DESIGN Retrospective. METHODS Olympic-level rugby sevens players (n=10) recorded post-waking natural logarithm of the root mean square of successive differences (LnRMSSD) and ASRM (sleep quality, energy, soreness, recovery and mood) throughout a 1-week baseline period and daily thereafter throughout a domestic and subsequent international tournament, separated by five days. Linear mixed models and Hedge's effect sizes ±95% confidence interval (ES±95% CI) were used to evaluate variation in LnRMSSD and ASRM relative to baseline. RESULTS Decrements in various ASRM were observed in response to both tournaments (ES=-0.80±0.91 to -1.73±1.03, p<0.05) and international travel (ES=-1.03±0.93 to -1.70±1.02, p<0.05) whereas decrements in LnRMSSD were only observed in response to the international tournament (ES=-0.89±0.92 to -1.21±0.96, p=0.02-0.07). No clear differences in internal or external match-load parameters were observed between tournaments (ES=-0.35±0.88 to 0.13±0.88, p>0.05). CONCLUSIONS Greater decrements in cardiac-autonomic activity were observed in response to an international tournament relative to a domestic tournament, despite no difference in match-physical demands. Thus, factors separate from competition alone may impact players' cardiac-autonomic response to an international tournament.
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Affiliation(s)
- Andrew A Flatt
- Georgia Southern University, Department of Health Sciences and Kinesiology, Biodynamics and Human Performance Center, USA.
| | | | - Sean Williams
- Department for Health, University of Bath, United Kingdom
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216
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Prolonged Waking and Recovery Sleep Affect the Serum MicroRNA Expression Profile in Humans. Clocks Sleep 2018; 1:75-86. [PMID: 33089155 PMCID: PMC7509676 DOI: 10.3390/clockssleep1010008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 11/20/2018] [Indexed: 01/28/2023] Open
Abstract
MicroRNAs (miRNAs) are small, abundant, non-coding RNA fragments that regulate gene expression and silencing at the post-transcriptional level. The miRNAs each control various downstream targets and play established roles in different biological processes. Given that miRNAs were recently proposed to contribute to the molecular control of sleep-wake regulation in animal models and narcoleptic patients, we investigated the impact of acute sleep deprivation on blood miRNA expression in healthy adult men of two different age groups. Twenty-two young (mean age: 24 ± 3 years) and nine older (65 ± 1 years) volunteers completed a controlled in-lab study, consisting of 8 h baseline sleep, followed by 40 h of extended wakefulness, and a 10-h recovery sleep opportunity. At the same circadian time in all three conditions (at 4:23 p.m. ± 23 min), qPCR expression profiling of 86 miRNAs was performed in blood serum. Thirteen different miRNAs could be reliably quantified and were analyzed using mixed-model ANOVAs. It was found that miR-30c and miR-127 were reliably affected by previous sleep and wakefulness, such that expression of these miRNAs was upregulated after extended wakefulness and normalized after recovery sleep. Together with previous findings in narcolepsy patients, our preliminary data indicate that miR-30c and its target proteins may provide a biomarker of elevated sleep debt in humans.
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217
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Shaver JL, Iacovides S. Sleep in Women with Chronic Pain and Autoimmune Conditions: A Narrative Review. Sleep Med Clin 2018; 13:375-394. [PMID: 30098754 DOI: 10.1016/j.jsmc.2018.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Chronic pain and sleep disturbances are intricately intertwined. This narrative review provides comments on observations related to pain, stress-immunity, and sleep. Sleep evidence is reviewed from studies of select conditions involving pain (ie, functional somatic syndromes and autoimmune) that are predominant in women. Chronic pain and poor sleep encompass persistent stress-immune activation with systemic inflammation, cellular oxidative stress, and sick behavior indicators that increase morbidity and threaten quality of life. In painful conditions, sleep impairments are nearly ubiquitous, and exaggerated combined effects should not be underestimated or ignored, nor should crucial implications for clinical practice and research.
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Affiliation(s)
- Joan L Shaver
- Biobehavioral Health Science Division, University of Arizona College of Nursing, 1305 North Martin Avenue, Tucson, AZ 85721, USA.
| | - Stella Iacovides
- Faculty of Health Sciences, Brain Function Research Group, School of Physiology, University of the Witwatersrand, 7 York Road, Parktown 2193, Johannesburg, South Africa
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218
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Słomko J, Zawadka-Kunikowska M, Kozakiewicz M, Klawe JJ, Tafil-Klawe M, Newton JL, Zalewski P. Hemodynamic, Autonomic, and Vascular Function Changes after Sleep Deprivation for 24, 28, and 32 Hours in Healthy Men. Yonsei Med J 2018; 59:1138-1142. [PMID: 30328330 PMCID: PMC6192892 DOI: 10.3349/ymj.2018.59.9.1138] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/02/2018] [Accepted: 09/11/2018] [Indexed: 11/27/2022] Open
Abstract
This study aimed to analyze the impact of sleep deprivation (SD) on cardiac, hemodynamic, and endothelial parameters and to determine whether these are sustained with increased periods of SD. The study included 60 healthy men (mean: age 31.2±6.3 years; body mass index 24.6±2.6 kg/m²). Hemodynamic parameters, parameters of myocardial contractility, spectral analysis of heart rate (HR) and blood pressure (BP) variability, and the sensitivity of arterial baroreflex function were evaluated. Biochemical tests were performed to assess L-arginine (L-Arg) and asymmetric dimethylarginine (ADMA) levels in reflection of endothelial nitric oxide synthase ability. Measurements of cardiovascular system parameters were obtained at 9 a.m. (baseline) on the first day of the study and 9 a.m. (24-h SD), 1 p.m. (28-h SD), and 5 p.m. (32-h SD) on the second day. Blood samples for evaluating biochemical parameters were obtained at baseline and after 24-h SD. ANOVA Friedman's test revealed a significant effect for time in relation to HR (χ²=26.04, df=5, p=0.000), systolic BP (χ²=35.98, df=5, p=0.000), diastolic BP (χ²=18.01, df=5, p=0.003), and mean BP (χ²=28.32, df=5, p=0.000). L-Arg and ADMA levels changed from 78.2±12.9 and 0.3±0.1 at baseline to 68.8±10.2 and 0.4±0.1 after 24-hr SD, respectively (p=0.001, p=0.004). SD in healthy men is associated with increases in BP, which appear to occur after 24 hours of SD and are maintained over increasing periods of SD. The observed hemodynamic changes may have resulted due to disordered vascular endothelial function, as reflected in alterations in L-Arg and ADMA levels.
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Affiliation(s)
- Joanna Słomko
- Department of Hygiene, Epidemiology and Ergonomics, Faculty of Health Sciences, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland.
| | - Monika Zawadka-Kunikowska
- Department of Hygiene, Epidemiology and Ergonomics, Faculty of Health Sciences, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Mariusz Kozakiewicz
- Department of Food Chemistry, Faculty of Health Sciences, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Jacek J Klawe
- Department of Hygiene, Epidemiology and Ergonomics, Faculty of Health Sciences, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Małgorzata Tafil-Klawe
- Department of Human Physiology, Faculty of Medicine, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Julia L Newton
- Institute for Cellular Medicine, The Medical School, Newcastle University, Newcastle-upon-Tyne, UK
| | - Paweł Zalewski
- Department of Hygiene, Epidemiology and Ergonomics, Faculty of Health Sciences, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
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219
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Lattanzi S, Brigo F, Silvestrini M. Sleep and blood pressure. J Clin Hypertens (Greenwich) 2018; 20:1721-1723. [PMID: 30375713 DOI: 10.1111/jch.13423] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Simona Lattanzi
- Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
| | - Francesco Brigo
- Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Verona, Italy.,Division of Neurology, "Franz Tappeiner" Hospital, Merano, Italy
| | - Mauro Silvestrini
- Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
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220
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Ma B, Chen J, Mu Y, Xue B, Zhao A, Wang D, Chang D, Pan Y, Liu J. Proteomic analysis of rat serum revealed the effects of chronic sleep deprivation on metabolic, cardiovascular and nervous system. PLoS One 2018; 13:e0199237. [PMID: 30235220 PMCID: PMC6147403 DOI: 10.1371/journal.pone.0199237] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 08/28/2018] [Indexed: 12/11/2022] Open
Abstract
Sleep is an essential and fundamental physiological process that plays crucial roles in the balance of psychological and physical health. Sleep disorder may lead to adverse health outcomes. The effects of sleep deprivation were extensively studied, but its mechanism is still not fully understood. The present study aimed to identify the alterations of serum proteins associated with chronic sleep deprivation, and to seek for potential biomarkers of sleep disorder mediated diseases. A label-free quantitative proteomics technology was used to survey the global changes of serum proteins between normal rats and chronic sleep deprivation rats. A total of 309 proteins were detected in the serum samples and among them, 117 proteins showed more than 1.8-folds abundance alterations between the two groups. Functional enrichment and network analyses of the differential proteins revealed a close relationship between chronic sleep deprivation and several biological processes including energy metabolism, cardiovascular function and nervous function. And four proteins including pyruvate kinase M1, clusterin, kininogen1 and profilin-1were identified as potential biomarkers for chronic sleep deprivation. The four candidates were validated via parallel reaction monitoring (PRM) based targeted proteomics. In addition, protein expression alteration of the four proteins was confirmed in myocardium and brain of rat model. In summary, the comprehensive proteomic study revealed the biological impacts of chronic sleep deprivation and discovered several potential biomarkers. This study provides further insight into the pathological and molecular mechanisms underlying sleep disorders at protein level.
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Affiliation(s)
- Bo Ma
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jincheng Chen
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yongying Mu
- Institute of Crop Science, Chinese Academy of Agricultural Science, Beijing, China
| | - Bingjie Xue
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Aimei Zhao
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Daoping Wang
- Institute of Crop Science, Chinese Academy of Agricultural Science, Beijing, China
| | - Dennis Chang
- National Institute of Complementary Medicine, Western Sydney University, Penrith, Australia
| | - Yinghong Pan
- Institute of Crop Science, Chinese Academy of Agricultural Science, Beijing, China
- The National Key Facility for Crop Gene Resources and Genetic Improvement, Chinese Academy of Agricultural Science, Beijing, China
- * E-mail: (JL); (YP)
| | - Jianxun Liu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Institute of Complementary Medicine, Western Sydney University, Penrith, Australia
- * E-mail: (JL); (YP)
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221
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Garg H. Role of optimum diagnosis and treatment of insomnia in patients with hypertension and diabetes: A review. J Family Med Prim Care 2018; 7:876-883. [PMID: 30598926 PMCID: PMC6259555 DOI: 10.4103/jfmpc.jfmpc_337_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Sleep plays a pivotal role in regulation and function of the central nervous system (CNS) and other physiological functions of the body such as regulation of body temperature, metabolism, catabolism, learning, and memory consolidation. Therefore, sleep is not a mere passive state, but it is a highly organized interaction of neural networks and neurotransmitters of the CNS which maintain active neurobehavioral state. However, in insomnia normal physiological function is disturbed which results in several comorbidities such as depression, cardiovascular disorders, hypertension, diabetes mellitus, breathing difficulties, chronic pain, and gastrointestinal problems which affect the quality of life. Diagnosis of insomnia requires a comprehensive assessment of patient's medical history, physical examination, and sleeping pattern using various screen tools. There are several options available for the treatment of insomnia such as non-pharmacological and pharmacological that increase our understanding of the involvement of neurophysiological, neurobehavioral, neurochemical, neurocognitive, and neuroendocrine factors associated with insomnia. The pharmacological agents that are currently in use for the treatment of insomnia include benzodiazepines (BZDs), non-BZD hypnotics, and ramelteon as well as antidepressants such as doxepin. However, due to adverse events and addiction potential, use of BZDs is obsolete. Among non-BZD, zolpidem is the highly prescribed drug for the treatment of insomnia, globally. This review article focuses on prevalence, pathophysiology, diagnosis, and treatment of insomnia in patients with hypertension and diabetes. In addition, it also discusses the role of zolpidem in comparison to BZDs in the management of insomnia.
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Affiliation(s)
- Himanshu Garg
- Respiratory Critical Care and Sleep Medicine, Artemis Hospital, Gurugram, Haryana, India
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222
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Caponecchia C, Williamson A. Drowsiness and driving performance on commuter trips. JOURNAL OF SAFETY RESEARCH 2018; 66:179-186. [PMID: 30121104 DOI: 10.1016/j.jsr.2018.07.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 06/13/2018] [Accepted: 07/11/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Driver fatigue is a major road safety problem. While much is known about the effects of fatigue and the factors that contribute to it, fatigue on commuter trips has received comparatively little attention in road safety. Most interventions have focused on longer trips, while investigations of commuting have typically examined particular groups, such as shift workers. METHOD This study examined the effects of mild sleep deprivation on driving performance in simulated driving tasks in the morning and evening. Three groups of participants with different levels of sleep deprivation (Group 1: no deprivation; Group 2: two-hour deprivation; Group 3: four-hour deprivation) drove in a simulator for 45 min in the morning and evening, following a practice session the previous day. RESULTS Results showed that participants reported feeling more drowsy in the afternoon, and performance impairments (increased lane deviations) were most evident in the morning for those with sleep deprivation. Measurements of eye closure did not reflect drowsiness in participants, despite performance impairments. PRACTICAL APPLICATIONS These results suggest that mild levels of sleep deprivation (2 h), which many people regularly experience, can result in poor on-road performance, and that these effects are present in the morning, and on relatively short trips. These results warrant follow-up in naturalistic and on-road studies.
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Affiliation(s)
| | - Ann Williamson
- School of Aviation, UNSW; Transport and Road Safety Research (TARS), UNSW
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223
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Lõhmus M. Possible Biological Mechanisms Linking Mental Health and Heat-A Contemplative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071515. [PMID: 30021956 PMCID: PMC6068666 DOI: 10.3390/ijerph15071515] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 07/09/2018] [Accepted: 07/17/2018] [Indexed: 12/15/2022]
Abstract
This review provides examples of possible biological mechanisms that could, at least partly, explain the existing epidemiological evidence of heatwave-related exacerbation of mental disease morbidity. The author reviews the complicated central processes involved in the challenge of maintaining a stable body temperature in hot environments, and the maladaptive effects of certain psychiatric medicines on thermoregulation. In addition, the author discusses some alternative mechanisms, such as interrupted functional brain connectivity and the effect of disrupted sleep, which may further increase the vulnerability of mental health patients during heatwaves.
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Affiliation(s)
- Mare Lõhmus
- Centre for Occupational and Environmental Medicine, Stockholm County Council, Solnavägen 4, 113 65 Stockholm, Sweden.
- Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, 17177 Solna, Sweden.
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224
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225
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Delaney LJ, Currie MJ, Huang HCC, Lopez V, Van Haren F. "They can rest at home": an observational study of patients' quality of sleep in an Australian hospital. BMC Health Serv Res 2018; 18:524. [PMID: 29976191 PMCID: PMC6034217 DOI: 10.1186/s12913-018-3201-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Accepted: 05/10/2018] [Indexed: 02/02/2023] Open
Abstract
Background Poor sleep is known to adversely affect hospital patients’ recovery and rehabilitation. The aim of the study was to investigate the perceived duration and quality of patient sleep and identify any environmental factors associated with patient-reported poor sleep in hospital. Method A cross-sectional study was conducted involving 15 clinical units within a 672-bed tertiary-referral hospital in Australia. Semi-structured interviews to determine perceptions of sleep quantity and quality and factors that disturb nocturnal sleep were conducted with patients and nursing staff. Environmental noise, light and temperature were monitored overnight, with concurrent logging of noise sources by observers. Results Patients reported a mean reduction in hospital sleep duration, compared to home, of 1.8 h (5.3 vs. 7.1 h; p < 0.001). The proportions of patients reporting their sleep quality to be poor/very poor, fair and of good quality were 41.6, 34.2 and 24.2% respectively. Patients reported poorer sleep quality than nurses (p < 0.05). Patients, nurses and observers all reported the main factors associated with poor sleep as clinical care interventions (34.3%) and environmental noise (32.1%). Noise levels in all 15 clinical areas exceeded WHO recommended levels of < 30 dB [A] by 36.7 to 82.6%, with peak noise levels of 51.3 to 103.3 dB (A). Conclusion Hospital in-patients are exposed to factors which reduce the duration and quality of their sleep. These extrinsic factors are potentially modifiable through behaviour change and reconfiguration of the clinical environment. The findings from this study provided the foundation for a quality improvement project currently underway to improve patients’ sleep.
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Affiliation(s)
- Lori J Delaney
- Faculty of Nursing, University of Canberra, Canberra, Australia. .,College of Health and Medicine, Australian National University, Canberra, Australia. .,Faculty of Health, Discipline of Nursing and Midwifery, University of Canberra, Canberra, ACT, 2601, Australia.
| | - Marian J Currie
- Faculty of Nursing, University of Canberra, Canberra, Australia.,College of Health and Medicine, Australian National University, Canberra, Australia
| | | | - Violeta Lopez
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, Singapore, Singapore
| | - Frank Van Haren
- College of Health and Medicine, Australian National University, Canberra, Australia.,Intensive Care Unit, Canberra Hospital, Garran, Australia
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226
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Teye-Kau M, Tenkorang EY, Adjei PB. Revisiting the Housing-Health Relationship for HIV-Positive Persons: Qualitative Evidence From the Lower Manya Krobo District, Ghana. QUALITATIVE HEALTH RESEARCH 2018; 28:1217-1228. [PMID: 29598769 DOI: 10.1177/1049732318764646] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The relationship between housing and HIV infection is complex. On one hand, poor housing arrangements may affect the health of persons living with HIV/AIDS (PLWHAs). On the other hand, PLWHAs may be more likely to live in substandard homes because of their health. We used qualitative in-depth individual interviews of 38 PLWHAs attending voluntary counseling services at two government hospitals in the Lower Manya Krobo District (LMKD) in the Eastern region of Ghana to examine their housing and health outcomes. Results show that the majority of PLWHAs lived in homes that lacked basic amenities, were overcrowded, had structural deficiencies, and were noisy and dirty. They suffered from poor housing conditions mainly because of their HIV serostatus, as this affected their ability to finance adequate homes, while HIV-related stigmatization led to eviction from either family homes or rented facilities.
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Affiliation(s)
- Mabel Teye-Kau
- 1 Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Eric Y Tenkorang
- 1 Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Paul B Adjei
- 1 Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
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227
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Peters JL, Zevitas CD, Redline S, Hastings A, Sizov N, Hart JE, Levy JI, Roof CJ, Wellenius GA. Aviation Noise and Cardiovascular Health in the United States: a Review of the Evidence and Recommendations for Research Direction. CURR EPIDEMIOL REP 2018; 5:140-152. [PMID: 30505645 PMCID: PMC6261366 DOI: 10.1007/s40471-018-0151-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF THE REVIEW In the USA, there is mounting pressure on aviation operators and regulators to address concerns about community impacts of aircraft noise given increasing evidence of adverse health impacts, continuing community complaints, availability of cost-effective programs to reduce exposures to aircraft noise, and more stringent international policies. In the USA, regulation of civil aviation noise is the responsibility of the Federal Aviation Administration (FAA), which requires a "significant body of scientific support," particularly applicable to the USA, to inform health-based policy and regulatory decisions. However, there have been very few studies investigating the relationship between noise and health in the USA and limited studies across the globe characterizing the effects of aviation noise specifically on cardiovascular health. This review focuses on recent findings on the relationship between aircraft noise and cardiovascular outcomes and directions for future research. RECENT FINDINGS Epidemiological studies generally report statistically significant associations between aircraft noise and adverse cardiovascular outcomes, although with limited evidence within the USA. Sleep disturbance, associated with nighttime noise, has been shown to be a risk factor for cardiovascular disease given associations with inflammatory markers and metabolic changes. Given numerous cardiovascular markers, the most appropriate choices depend on the ultimate objectives of the individual studies. SUMMARY Given the state of the literature, future research should leverage emerging tools to estimate aviation, railway, and road traffic noise and apply noise estimates to a range of epidemiological study designs and endpoints to inform causal interpretation and help determine potential intervention strategies.
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Affiliation(s)
- Junenette L. Peters
- Department of Environmental Health, Boston University School of Public Health, 710 Albany Street, Boston, MA 02118, USA
| | - Christopher D. Zevitas
- Volpe National Transportation System Center, US Department of Transportation, Cambridge, MA, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Aaron Hastings
- Volpe National Transportation System Center, US Department of Transportation, Cambridge, MA, USA
| | - Natalia Sizov
- Office of Environment and Energy, Federal Aviation Administration, US Department of Transportation, Washington, DC, USA
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jonathan I. Levy
- Department of Environmental Health, Boston University School of Public Health, 710 Albany Street, Boston, MA 02118, USA
| | - Christopher J. Roof
- Volpe National Transportation System Center, US Department of Transportation, Cambridge, MA, USA
| | - Gregory A. Wellenius
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
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228
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Li L, Zhao K, Hua J, Li S. Association between Sleep-Disordered Breathing during Pregnancy and Maternal and Fetal Outcomes: An Updated Systematic Review and Meta-Analysis. Front Neurol 2018; 9:91. [PMID: 29892255 PMCID: PMC5985400 DOI: 10.3389/fneur.2018.00091] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 02/08/2018] [Indexed: 01/05/2023] Open
Abstract
Background Due to the high prevalence in pregnant women and potential association with pregnancy complications or perinatal outcomes, sleep-disordered breathing (SDB) has become an increasing concern. Methods Pubmed and Embase were retrieved from inception until 2017 to conduct a meta-analysis to explore the association of SDB and several outcomes during gestation. A stratified analysis differentiated by the type of SDB [snoring alone/obstructive sleep apnea (OSA)] was also performed. Pooled odds ratios were produced for binary outcomes. Weighted mean differences were also produced for continuous outcomes. Sensitivity analysis was performed to identify the impact of individual studies on summary results and estimation of publication bias was performed by funnel plot. Results 35 studies with a total of 56,751,837 subjects were included. SDB during pregnancy was associated with a significantly increased risk of gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH), and preeclampsia (PEC), but not significantly associated with fetal maternal outcomes, namely APGAR score and birth weight. Moreover, OSA was linked with an increasing risk of GDM, PIH, PEC and preterm birth while snoring appeared to increase the risk of GDM, PIH, and PEC. Conclusion The finding provided potential evidence for association between SDB and adverse perinatal outcomes. SDB increased the risk of some pregnancy complications while its influence to fetal outcomes was not clear.
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Affiliation(s)
- Liwen Li
- MOE - Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, Shanghai, China.,School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kena Zhao
- MOE - Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, Shanghai, China.,School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jin Hua
- Shanghai First Maternity and Infant Hospital Corporation, Tongji University, Shanghai, China
| | - Shenghui Li
- MOE - Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, Shanghai, China.,School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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229
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Holingue C, Owusu JT, Feder KA, Spira AP. Sleep duration and C-reactive protein: Associations among pregnant and non-pregnant women. J Reprod Immunol 2018; 128:9-15. [PMID: 29803192 DOI: 10.1016/j.jri.2018.05.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 04/27/2018] [Accepted: 05/09/2018] [Indexed: 12/30/2022]
Abstract
Pregnant women experience more sleep disturbances and greater systemic inflammation than non-pregnant women. However, the few studies that have examined the links between sleep and inflammation in pregnant women have been in clinical samples. We examined whether sleep duration is associated with C-reactive protein (CRP) levels, a marker of inflammation, in pregnant and non-pregnant women in a population-based sample of US women. Participants were 2865 women of reproductive age (aged 20-44 years) in the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of Americans. Sleeping <5 h on weeknights or workdays was significantly associated with increased CRP levels among both pregnant and non-pregnant women in unadjusted analyses; however, after adjustment for demographic, and health-related variables (depressive symptoms, self-rated health status, body mass index (BMI), diabetes), sleeping <5 h was no longer significantly related to CRP levels. Pregnant women had significantly higher CRP levels, after adjusting for sleep duration, demographic, and health-related variables. Our findings suggest that pregnancy is associated with increased peripheral CRP, after adjustment for sleep duration, demographic, and health factors. Further, in both pregnant and non-pregnant U.S. women of reproductive age, short sleep duration is associated with higher CRP levels, but this link is explained by self-rated health, BMI, and diabetes. Further studies are needed to investigate links of other sleep parameters (e.g., sleep fragmentation) with CRP in these populations.
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Affiliation(s)
- Calliope Holingue
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
| | - Jocelynn T Owusu
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
| | - Kenneth A Feder
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States; Center on Aging and Health, Johns Hopkins University, Baltimore, MD, United States.
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230
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Abstract
Investigating sleep disturbances among intensive care unit (ICU) patients and its serious consequences is considered a crucial issue for nurses. The need of sleep increases during hospitalization time to preserve energy for the healing process. Previous studies have demonstrated that sleep disturbance is one of the most common complaints of patients in the ICUs, with a prevalence of more than 50%. Although the total sleep time might be normal, the patients' sleep is fragmented and light in the intensive care settings. The main purpose of this review is to generate a clear view of what is known about sleep disturbances among ICU patients as well as to identify the gap in knowledge regarding this issue. This was done by describing, summarizing, clarifying, and evaluating well-selected previous studies about this topic. In addition, this concise review has focused on the prevalence of sleep disturbances in the ICU, factors contributing to poor quality of sleep among ICU patients, and the physiological effects of poor sleep on the patients' prognosis.
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231
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Skein M, Wingfield G, Gale R, Washington TL, Minett GM. Sleep quantity and quality during consecutive day heat training with the inclusion of cold-water immersion recovery. J Therm Biol 2018; 74:63-70. [DOI: 10.1016/j.jtherbio.2018.03.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 03/12/2018] [Accepted: 03/13/2018] [Indexed: 10/17/2022]
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232
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Gupta N, Maranda L, Gupta R. Differences in self-reported weekend catch up sleep between children and adolescents with and without primary hypertension. Clin Hypertens 2018; 24:7. [PMID: 29636986 PMCID: PMC5887206 DOI: 10.1186/s40885-018-0092-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 03/28/2018] [Indexed: 01/14/2023] Open
Abstract
Background The data on the association of sleep duration and blood pressure in the pediatric age group have been mixed and most studies have focused on weekday sleep duration. The purpose of this study was to compare the weekday and weekend sleep patterns between children and adolescents with newly diagnosed primary hypertension and a normotensive control group. Methods Children and adolescents from a pediatric nephrology clinic, aged 6-18 years with newly diagnosed primary hypertension were compared to an age and sex matched normotensive control group from a general pediatric clinic. The questions about bed time and getting out of bed times from the Pediatric Sleep Questionnaire (PSQ) were used to obtain weekday and weekend bed time, getting out of bed time and sleep duration. The Pediatric Daytime Sleepiness Scale (PDSS) was used to assess subjective sleepiness. Results In both groups of 60 subjects each, weekday total sleep time was similar. Subjects in both groups went to bed later and woke up later on the weekends. However, in the hypertensive group, weekend getting out of the bed time was earlier (8:52 AM ±93 min vs. 9:36 AM ±88 min, p = 0.013) and weekend catchup sleep was about 40 min less (62.8 ± 85.5 vs. 102.7 ± 84.9, p = 0.035). Hypertensive children perceived less subjective sleepiness (PDSS scores 8.28 ± 4.88 vs. 10.63 ± 5.41, p = 0.007). The p values were calculated after adjusting for body mass index (BMI), race, daytime nap, caffeine use, sleep related breathing disorder (SRBD) scale and periodic limb movement of sleep (PLMS) scale subcomponents of the PSQ. Conclusions Hypertensive children obtained less weekend catch up sleep and reported less subjective sleepiness compared to the control group. More weekend sleep may potentially mitigate the effect of weekday sleep deprivation on blood pressure.
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Affiliation(s)
- Neena Gupta
- 1University of Massachusetts Children's Medical Center, Division of Pediatric Nephrology, 55 Lake Avenue North, Benedict Bldg, A2 210, Worcester, MA 01655 USA
| | - Louise Maranda
- 2University of Massachusetts Memorial Medical Center, Quantitative Health Sciences, Worcester, MA 01655 USA
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233
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Li JWS, Au CT, Chan KCC, Chook P, Wing YK, Li AM. Short Sleep Duration Is Weakly Associated with Carotid Intima-Media Thickness in Adolescents. J Pediatr 2018; 195:80-84. [PMID: 29415800 DOI: 10.1016/j.jpeds.2017.12.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 11/29/2017] [Accepted: 12/14/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate the relationship between sleep duration and carotid intima-media thickness (CIMT) in adolescents. We hypothesized that short sleep duration was associated with an increased CIMT. STUDY DESIGN This was a cross-sectional study. Healthy participants aged 10-18 years were recruited from a school-based cohort established to examine the prevalence of obstructive sleep apnea in Hong Kong. All participants completed a prospective 7-day sleep diary, underwent anthropometric measurements, overnight polysomnography, and CIMT assessment. Overweight participants or those with an obstructive apnea hypopnea index of ≥5 were excluded from analysis. Regression analysis was used to assess the association between CIMT and sleep duration and other possible correlates. RESULTS One hundred forty-two participants completed the assessments. Male participants tended to have shorter sleep duration than females (P = .012). There were no differences in age, body mass index, Tanner developmental stage, or parental history of hypertension between groups of different sleep durations. There was a weak but significant association between short sleep duration and CIMT (r = -0.273; P < .001). CONCLUSION Sleep duration was found to have a weakly negative association with CIMT. Further research is needed to determine whether adult adverse cardiovascular events may originate in childhood owing to short sleep duration.
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Affiliation(s)
- Jade Wing Sum Li
- Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Chun Ting Au
- Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Kate Ching Ching Chan
- Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Ping Chook
- Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Yun Kwok Wing
- Department of Psychiatry, Shatin Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Albert Martin Li
- Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
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234
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Güzel Özdemir P, Ökmen AC, Yılmaz O. Vardiyalı Çalışma Bozukluğu ve Vardiyalı Çalışmanın Ruhsal ve Bedensel Etkileri. PSIKIYATRIDE GUNCEL YAKLASIMLAR 2018. [DOI: 10.18863/pgy.336513] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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235
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Ding C, Lim LL, Xu L, Kong APS. Sleep and Obesity. J Obes Metab Syndr 2018; 27:4-24. [PMID: 31089536 PMCID: PMC6489488 DOI: 10.7570/jomes.2018.27.1.4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 03/08/2018] [Accepted: 03/09/2018] [Indexed: 12/30/2022] Open
Abstract
Rising global prevalence and incidence of obesity lead to increased cardiovascular-renal complications and cancers. Epidemiological studies reported a worldwide trend towards suboptimal sleep duration and poor sleep quality in parallel with this obesity epidemic. From rodents and human models, it is highly plausible that abnormalities in sleep, both quantity and quality, impact negatively on energy metabolism. While excess dietary intake and physical inactivity are the known drivers of the obesity epidemic, promotion of healthy sleep habits has emerged as a new target to combat obesity. In this light, present review focuses on the existing literature examining the relationship between sleep physiology and energy homeostasis. Notably, sleep dysregulation perturbs the metabolic milieu via alterations in hormones such as leptin and ghrelin, eating behavior, neuroendocrine and autonomic nervous systems. In addition, shift work and trans-meridian air travel may exert a negative influence on the hypothalamic-pituitary-adrenal axis and trigger circadian misalignment, leading to impaired glucose tolerance and increased fat accumulation. Amassing evidence has also suggested that uncoupling of the circadian clock can increase the risk of adverse metabolic health. Given the importance of sleep in maintaining energy homeostasis and that it is potentially modifiable, promoting good sleep hygiene may create new avenues for obesity prevention and treatment.
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Affiliation(s)
- Chenzhao Ding
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Lee Ling Lim
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.,Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Li Xu
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Alice Pik Shan Kong
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
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236
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Danielson SJ, Rappaport CA, Loher MK, Gehlbach BK. Looking for light in the din: An examination of the circadian-disrupting properties of a medical intensive care unit. Intensive Crit Care Nurs 2018; 46:57-63. [PMID: 29605239 DOI: 10.1016/j.iccn.2017.12.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 12/03/2017] [Accepted: 12/18/2017] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Critically ill patients exhibit profound disturbances of circadian rhythmicity, most commonly in the form of a phase delay. We investigated the specific zeitgeber properties of a medical intensive care unit to develop a model that explained these abnormalities. RESEARCH METHODOLOGY Prospective, observational study conducted during 2013-2014. Twenty-four-hour ambient light (lux, 672 hours) and sound pressure levels (dBA, 504 hours) were measured in patient rooms. Patients and families were surveyed regarding their perceptions of the environment. SETTING University-based adult medical intensive care unit. MAIN OUTCOME MEASURES The timing and intensity of the ambient light-dark cycle and sound environment and the relationship of these measurements to patient/family perceptions. RESULTS Twenty-four-hour light-dark cycles were extremely weak and phase delayed relative to the solar cycle. Morning light averaged 12.1 (4.8, 37.2) lux, when only 24.9% ± 10.9% of available light was utilised; yet patients and families did not identify low daytime light levels as problematic. Median noise levels were invariably excessive (nighttime 47.9 [45.0, 51.3] dBA) with minimal variation, consistent with the absence of a defined rest period. CONCLUSION The intensive care unit functions as a near-constant routine protocol disconnected from solar time. Behavioural interventions to promote entrainment should be supported by objective measurements of light and sound.
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Affiliation(s)
- Samantha J Danielson
- University of Iowa, Department of Internal Medicine, Division of Pulmonary, Critical Care, and Occupational Medicine, 200 Hawkins Drive, Iowa City, IA 52242, USA.
| | - Charles A Rappaport
- University of Iowa, Department of Internal Medicine, Division of Pulmonary, Critical Care, and Occupational Medicine, 200 Hawkins Drive, Iowa City, IA 52242, USA.
| | - Michael K Loher
- University of Iowa, Department of Internal Medicine, Division of Pulmonary, Critical Care, and Occupational Medicine, 200 Hawkins Drive, Iowa City, IA 52242, USA.
| | - Brian K Gehlbach
- University of Iowa, Department of Internal Medicine, Division of Pulmonary, Critical Care, and Occupational Medicine, 200 Hawkins Drive, Iowa City, IA 52242, USA; University of Iowa, Department of Neurology, 200 Hawkins Drive, Iowa City, IA 52242, USA.
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237
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Moreno-Villanueva M, von Scheven G, Feiveson A, Bürkle A, Wu H, Goel N. The degree of radiation-induced DNA strand breaks is altered by acute sleep deprivation and psychological stress and is associated with cognitive performance in humans. Sleep 2018; 41:4954606. [DOI: 10.1093/sleep/zsy067] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Indexed: 11/14/2022] Open
Affiliation(s)
- Maria Moreno-Villanueva
- National Aeronautics and Space Administration, Johnson Space Center, Houston, TX
- Department of Biology, Molecular Toxicology Group, University of Konstanz, Konstanz, Germany
| | - Gudrun von Scheven
- Department of Biology, Molecular Toxicology Group, University of Konstanz, Konstanz, Germany
| | - Alan Feiveson
- National Aeronautics and Space Administration, Johnson Space Center, Houston, TX
| | - Alexander Bürkle
- Department of Biology, Molecular Toxicology Group, University of Konstanz, Konstanz, Germany
| | - Honglu Wu
- National Aeronautics and Space Administration, Johnson Space Center, Houston, TX
| | - Namni Goel
- Department of Psychiatry, Division of Sleep and Chronobiology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
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238
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Grant CL, Coates AM, Dorrian J, Paech GM, Pajcin M, Della Vedova C, Johnson K, Kamimori GH, Fidock J, Aidman E, Banks S. The impact of caffeine consumption during 50 hr of extended wakefulness on glucose metabolism, self-reported hunger and mood state. J Sleep Res 2018; 27:e12681. [DOI: 10.1111/jsr.12681] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 01/18/2018] [Accepted: 01/24/2018] [Indexed: 12/29/2022]
Affiliation(s)
- Crystal L. Grant
- Sleep and Chronobiology Laboratory; School of Psychology, Social Work and Social Policy; University of South Australia; Adelaide SA Australia
| | - Alison M. Coates
- Alliance for Research in Exercise, Nutrition and Activity; University of South Australia; Adelaide SA Australia
| | - Jillian Dorrian
- Sleep and Chronobiology Laboratory; School of Psychology, Social Work and Social Policy; University of South Australia; Adelaide SA Australia
| | - Gemma M. Paech
- Sleep and Chronobiology Laboratory; School of Psychology, Social Work and Social Policy; University of South Australia; Adelaide SA Australia
| | - Maja Pajcin
- School of Pharmacy and Medical Sciences; University of South Australia; Adelaide SA Australia
| | - Chris Della Vedova
- School of Pharmacy and Medical Sciences; University of South Australia; Adelaide SA Australia
| | - Kayla Johnson
- Defence Science and Technology (DST) Group; Adelaide SA Australia
| | - Gary H. Kamimori
- Behavioral Biology Branch; Walter Reed Army Institute for Research; Silver Spring MD USA
| | - Justin Fidock
- Defence Science and Technology (DST) Group; Adelaide SA Australia
| | - Eugene Aidman
- Defence Science and Technology (DST) Group; Adelaide SA Australia
| | - Siobhan Banks
- Sleep and Chronobiology Laboratory; School of Psychology, Social Work and Social Policy; University of South Australia; Adelaide SA Australia
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239
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Association of Sleep Quality With Cardiovascular Disease Risk and Mental Health in Law Enforcement Officers. J Occup Environ Med 2018; 58:e281-6. [PMID: 27414012 DOI: 10.1097/jom.0000000000000814] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVES The aim of the study was to determine whether sleep quality is associated with an increased risk for cardiovascular disease (CVD) or worsened mental health. METHODS Self-reported sleep quality, 35 inflammatory factors, CVD risk factors, personal stress, police operational and organizational stress, social support, depressive symptoms, and health-related quality of life were compared among a cohort of officers. RESULTS Of 379 officers, 39% and 27% had poor and borderline sleep quality. Sleep quality was not associated with either an altered inflammatory profile or worsened CVD risk factors. Compared with good sleepers, borderline and poor sleepers reported increased personal stress, police organizational and operational stress, and depressive symptoms, but decreased health-related quality of life. CONCLUSIONS Poor sleep quality is prevalent in the law enforcement profession and is associated with worsened mental health but not with an increased risk for CVD.
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240
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Johnson DA, Thorpe RJ, McGrath JA, Jackson WB, Jackson CL. Black-White Differences in Housing Type and Sleep Duration as Well as Sleep Difficulties in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E564. [PMID: 29561769 PMCID: PMC5923606 DOI: 10.3390/ijerph15040564] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 03/10/2018] [Accepted: 03/16/2018] [Indexed: 11/16/2022]
Abstract
Housing environments can directly and indirectly affect sleep, and blacks are more likely than whites to live in suboptimal housing conditions, which may independently contribute to sleep disparities. However, few large-scale epidemiological studies consider the potential influence of housing type on sleep health. Using data from the 2004-2015 National Health Interview Survey, we investigated overall and Black-White differences in the association between housing type (house/apartment versus mobile home/trailer) and sleep duration as well as sleep difficulties among 226,208 adults in the U.S. Poisson regression with robust variance was used to estimate sex-specific prevalence ratios (PR) for sleep categories, first comparing houses/apartments to mobile homes/trailers and then blacks to whites within housing types. All models were adjusted for age, educational attainment, income, occupational class, self-reported general health status, and region of residence. Compared to participants living in houses/apartments, the prevalence of short sleep was higher for men (PR = 1.05 (95% confidence interval (CI): 1.02-1.08)) and women (PR = 1.07 (95% CI: 1.04-1.09)) in mobile homes/trailers. Black men (PR = 1.26 (95% CI: 1.21-1.30)) and women (PR = 1.24 (95% CI: 1.20-1.27)) in a house/apartment were more likely to be short sleepers than their white counterparts. There was generally no significant difference in sleep characteristics (except long sleep) between black and white men in mobile homes/trailers after adjustments, and black men in houses/apartments as well as black women in both housing types were less likely to report sleep difficulties although being more likely to report short sleep. Overall, individuals in mobile homes/trailers, which may represent suboptimal housing, had worse sleep than those in houses/apartments; and racial differences in the quality of houses and apartments are likely to greatly vary in ways that still contribute to sleep disparities. Race-sex group differences in sleep duration among residents in a house/apartment and even a lack of racial difference among individuals living in mobile homes/trailers support the need for more research on residential environments and eventually multi-level interventions designed to reduce sleep disparities.
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Affiliation(s)
- Dayna A Johnson
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02131, USA.
| | - Roland J Thorpe
- Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
| | - John A McGrath
- Social & Scientific Systems, Inc., Research Triangle Park, NC 27709, USA.
| | - W Braxton Jackson
- Social & Scientific Systems, Inc., Research Triangle Park, NC 27709, USA.
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, 111 TW Alexander Drive, Research Triangle Park, NC 27709, USA.
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241
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Redman KN, Karstaedt AS, Scheuermaier K. Increased CD4 counts, pain and depression are correlates of lower sleep quality in treated HIV positive patients with low baseline CD4 counts. Brain Behav Immun 2018; 69:548-555. [PMID: 29452219 DOI: 10.1016/j.bbi.2018.02.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 01/12/2018] [Accepted: 02/12/2018] [Indexed: 12/17/2022] Open
Abstract
Poor sleep quality leads to increased immune activation and immune activation leads to worse sleep quality. South African HIV positive patients typically have delayed start of treatment, which has been associated with CD4+ effector T cells being more spontaneously activated in chronically treated patients. This cross-sectional study investigated whether subjective sleep quality was associated with CD4+ T lymphocyte reconstitution in treated South African HIV+ patients. One hundred and thirty-nine treated HIV+ patients (109 F, age average (SD) = 43 (9)) were recruited from Chris Hani Baragwanath Academic Hospital in Soweto, Johannesburg, South Africa. Participants completed questionnaires evaluating their subjective sleep quality (Pittsburgh Sleep Quality Index), daytime sleepiness (Epworth sleepiness scale), pain, and depression severity (Beck Depression Inventory). Univariate and multivariate analyses were run to determine the correlates of sleep quality in this population. Patients had been on antiretroviral treatment for about 4 years and had increased their CD4 counts from a median at baseline of 82 to 467 cells/µL. They had overall poor sleep quality (average (SD) PSQI = 7.7 (±5), 61% reporting PSQI > 5, a marker of lower sleep quality), 41% had clinical depression (average (SD) BDI = 17 (±12)) and 55% reported pain. In two separate multivariate analyses, both the overall CD4 count increase from baseline (p = 0.0006) and higher current CD4 counts (p = 0.0007) were associated with worse sleep quality, when adjusting for depression severity (p < 0.001), daytime sleepiness (p = 0.01) and the presence of pain (p < 0.01). In this cohort of treated South African HIV positive patients, poor sleep quality was associated with higher current CD4 counts, when adjusting for depression severity, daytime sleepiness and pain. Further studies should investigate the temporal relationship between HIV-related poor sleep quality and underlying immune activation.
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Affiliation(s)
- K N Redman
- Wits Sleep Laboratory, Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - A S Karstaedt
- Division of Infectious Diseases, Department of Medicine, Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - K Scheuermaier
- Wits Sleep Laboratory, Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa.
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242
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Kuetting DLR, Feisst A, Sprinkart AM, Homsi R, Luetkens J, Thomas D, Schild HH, Dabir D. Effects of a 24‐hr‐shift‐related short‐term sleep deprivation on cardiac function: A cardiac magnetic resonance‐based study. J Sleep Res 2018; 28:e12665. [DOI: 10.1111/jsr.12665] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 12/21/2017] [Accepted: 12/24/2017] [Indexed: 01/20/2023]
Affiliation(s)
| | | | | | - Rami Homsi
- Department of Radiology University of Bonn Bonn Germany
| | | | - Daniel Thomas
- Department of Radiology University of Bonn Bonn Germany
| | | | - Darius Dabir
- Department of Radiology University of Bonn Bonn Germany
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243
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Xie J, Sert Kuniyoshi FH, Covassin N, Singh P, Gami AS, Chahal CAA, Somers VK. Excessive Daytime Sleepiness Independently Predicts Increased Cardiovascular Risk After Myocardial Infarction. J Am Heart Assoc 2018; 7:JAHA.117.007221. [PMID: 29352093 PMCID: PMC5850153 DOI: 10.1161/jaha.117.007221] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Excessive daytime sleepiness (EDS), a common symptom among patients with sleep-disordered breathing, is closely associated with the development of cardiovascular diseases, but its long-term prognostic value is not completely understood. The aim of this study was to investigate whether EDS would be an independent prognostic factor after myocardial infarction. METHODS AND RESULTS We prospectively recruited 112 post-myocardial infarction patients. The Epworth Sleepiness Scale was completed before polysomnography, and EDS was defined as a score ≥11. After exclusion of 8 patients who accepted treatment with continuous positive airway pressure, 104 patients were followed up for 48 months. The primary composite end point was major adverse cardiac events. Patients with EDS had higher rates of major adverse cardiac events (48.4% versus 27.4%, χ2=5.27, P=0.022) and reinfarction (29.0% versus 5.5%, χ2=13.51, P=0.0002) compared with those without EDS. In the Cox proportional hazards model, patients with EDS had 2.15 times (95% confidence interval, 1.08-4.18; P=0.030) higher crude risk of major adverse cardiac events, with prognostic significance persisting after adjusting for age, diabetes mellitus, depression, left ventricular ejection fraction, apnea-hypopnea index, and nocturnal nadir oxygen saturation (hazard ratio: 2.13, 95% confidence interval, 1.04-4.26, P=0.039). Furthermore, among participants with moderate to severe sleep-disordered breathing, the presence of EDS was associated with higher risk of major adverse cardiac events than those without EDS, after adjusting for age and nadir oxygen saturation (hazard ratio: 3.17, 95% confidence interval, 1.22-7.76, P=0.019). CONCLUSIONS EDS may be an independent prognostic factor of adverse outcome in post-myocardial infarction patients with moderate to severe sleep-disordered breathing. Evaluation of EDS may shed new light on risk stratification and identify treatment responders for this patient population.
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Affiliation(s)
- Jiang Xie
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.,Department of Respiratory and Critical Medicine of Beijing An Zhen Hospital, Capital Medical University, Beijing, China
| | | | - Naima Covassin
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - Prachi Singh
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - Apoor S Gami
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - C Anwar A Chahal
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - Virend K Somers
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
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244
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Kauhl B, Maier W, Schweikart J, Keste A, Moskwyn M. Exploring the small-scale spatial distribution of hypertension and its association to area deprivation based on health insurance claims in Northeastern Germany. BMC Public Health 2018; 18:121. [PMID: 29321032 PMCID: PMC5761146 DOI: 10.1186/s12889-017-5017-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 12/21/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Hypertension is one of the most frequently diagnosed chronic conditions in Germany. Targeted prevention strategies and allocation of general practitioners where they are needed most are necessary to prevent severe complications arising from high blood pressure. However, data on chronic diseases in Germany are mostly available through survey data, which do not only underestimate the actual prevalence but are also only available on coarse spatial scales. The discussion of including area deprivation for planning of healthcare is still relatively young in Germany, although previous studies have shown that area deprivation is associated with adverse health outcomes, irrespective of individual characteristics. The aim of this study is therefore to analyze the spatial distribution of hypertension at very fine geographic scales and to assess location-specific associations between hypertension, socio-demographic population characteristics and area deprivation based on health insurance claims of the AOK Nordost. METHODS To visualize the spatial distribution of hypertension prevalence at very fine geographic scales, we used the conditional autoregressive Besag-York-Mollié (BYM) model. Geographically weighted regression modelling (GWR) was applied to analyze the location-specific association of hypertension to area deprivation and further socio-demographic population characteristics. RESULTS The sex- and age-adjusted prevalence of hypertension was 33.1% in 2012 and varied widely across northeastern Germany. The main risk factors for hypertension were proportions of insurants aged 45-64, 65 and older, area deprivation and proportion of persons commuting to work outside their residential municipality. The GWR model revealed important regional variations in the strength of the examined associations. CONCLUSION Area deprivation has only a significant and therefore direct influence in large parts of Mecklenburg-West Pomerania. However, the spatially varying strength of the association between demographic variables and hypertension indicates that there also exists an indirect effect of area deprivation on the prevalence of hypertension. It can therefore be expected that persons ageing in deprived areas will be at greater risk of hypertension, irrespective of their individual characteristics. The future planning and allocation of primary healthcare in northeastern Germany would therefore greatly benefit from considering the effect of area deprivation.
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Affiliation(s)
- B. Kauhl
- AOK Nordost – Die Gesundheitskasse, Department of Medical Care, Berlin, Germany
- Beuth University of Applied Sciences, Department III, Civil Engineering and Geoinformatics, Berlin, Germany
| | - W. Maier
- Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Health Economics and Health Care Management, Neuherberg, Germany
| | - J. Schweikart
- Beuth University of Applied Sciences, Department III, Civil Engineering and Geoinformatics, Berlin, Germany
| | - A. Keste
- AOK Nordost – Die Gesundheitskasse, Department of Medical Care, Berlin, Germany
| | - M. Moskwyn
- AOK Nordost – Die Gesundheitskasse, Department of Medical Care, Berlin, Germany
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245
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White MP, Yeo NL, Vassiljev P, Lundstedt R, Wallergård M, Albin M, Lõhmus M. A prescription for "nature" - the potential of using virtual nature in therapeutics. Neuropsychiatr Dis Treat 2018; 14:3001-3013. [PMID: 30510422 PMCID: PMC6231506 DOI: 10.2147/ndt.s179038] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Many studies suggest that increased exposure to urban greenness is associated with better population health. Accessing nature can in some circumstances, however, be difficult, especially for individuals with mobility constraints. Therefore, a growing body of work is investigating the ways to replace the in vivo experience with forms of "virtual" contact, in order to provide these individuals with at least some benefits of the natural environment. The aim of this paper is to provide a review of previous use of virtual reality (VR) nature in health and care settings and contemplate the potential use of this technology in future. Our central question is whether engaging with virtual nature can contribute to enhanced physical and emotional well-being in housebound or mobility-constrained individuals. We conclude that while contact with real-world nature is preferred, VR use can be an alternative in cases when in vivo contact with nature is not possible. There are many possibilities for the use of VR technology in psychiatric and medical care; however, the risks, benefits, and cost efficiency of these attempts should be carefully assessed and the outcomes should be measured in a scientifically valid manner. The current review has nonetheless demonstrated that VR nature could play a role in each of the proposed mediating mechanisms linking natural environments and health.
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Affiliation(s)
- Matthew P White
- The European Centre for Environment & Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital Treliske, Truro, Cornwall TR1 3HD, UK
| | - Nicola L Yeo
- The European Centre for Environment & Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital Treliske, Truro, Cornwall TR1 3HD, UK
| | - Peeter Vassiljev
- Institute of Agricultural and Environmental Sciences, Estonian University of Life Sciences, 51014 Tartu, Estonia
| | - Rikard Lundstedt
- Department of Design Science, Division of Ergonomics and Aerosol Technology, Lund University, 22100 Lund, Sweden
| | - Mattias Wallergård
- Department of Design Science, Division of Ergonomics and Aerosol Technology, Lund University, 22100 Lund, Sweden
| | - Maria Albin
- Faculty of Medicine, Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University, 22363 Lund, Sweden, .,Institute of Environmental Medicine, Karolinska Institute, 17177 Stockholm, Sweden, .,Centre for Occupational and Environmental Medicine, Stockholm County Council, 11365 Stockholm, Sweden,
| | - Mare Lõhmus
- Faculty of Medicine, Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University, 22363 Lund, Sweden, .,Institute of Environmental Medicine, Karolinska Institute, 17177 Stockholm, Sweden, .,Centre for Occupational and Environmental Medicine, Stockholm County Council, 11365 Stockholm, Sweden,
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Reis C, Dias S, Rodrigues AM, Sousa RD, Gregório MJ, Branco J, Canhão H, Paiva T. Sleep duration, lifestyles and chronic diseases: a cross-sectional population-based study. ACTA ACUST UNITED AC 2018; 11:217-230. [PMID: 30746039 PMCID: PMC6361301 DOI: 10.5935/1984-0063.20180036] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background Adequate sleep is essential for health. Both, short and long sleep durations
are associated to worse quality of life and poor health outcomes. Portugal
represents a specific population model, since according to European
statistics it has high rates of chronic diseases like depression,
hypertension, diabetes and stroke; and low quality of life as well as low
index of physical activity, while in parallel it has some other good health
indicators such as: low age-standardized mortality for both genders,
nutrition in terms of energy and fruit consumption, smoking and alcohol,
obesity and overweight prevalence. The aim of this study was to characterize
health and chronic diseases, lifestyles and quality of life in subjects with
short and long sleep duration. Methods A population-based cross-sectional evaluation of the third wave of follow-up
of the EpiDoC Cohort was carried between 2015-2016. A sample of 5,436 adults
≥18 years, representative of the national population, self-reported
their daily total sleep time. Associations between short sleep duration (SSD
≤5h), long sleep duration (LSD≥9h) and independent variables
were determined. Results The prevalence for SSD was high (20.7%) and the LSD (5.9%) was low. Being
older, with lower education, retired and unemployed were associated to SSD
and LSD (p<0.01). Being obese was associated to SSD as
well as hypertension, gastrointestinal disease and hypercholesterolemia
(p<0.01). SSD and LSD, were associated with diabetes
(p<0.01 and p=0.03) and depression
(p<0.01 and p=0.02) respectively.
Cardiovascular disease (p<0.01) was associated to LSD.
Multimorbidity (p<0.01) was associated to SSD. Worse
quality of life and bad physical function were associated to SSD and LSD, as
well as being hospitalized in the previous 12 months
(p<0.01). Conclusions Socio-demographic, physical activity and chronic diseases were associated to
reduction and extension of sleep duration. There was no association between
rheumatic diseases and cancer with sleep duration, as found in other
studies. This study emphasizes the burden of self-reported SSD for Portugal,
its consequences to health and the need to increase sleep awareness
campaigns enhancing the importance of sleep in health. Furthermore, it
emphasizes that chronic diseases risks are dependent on multiple parameters
which varying in different countries or regions, imply the need of regional
studies and interventions.
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Affiliation(s)
- Cátia Reis
- Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal, Instituto de Saúde Ambiental (ISAMB) - Lisboa - Lisboa - Portugal.,CENC - Sleep Medicine Center, Sleep and circadian rhythms - Lisboa - Lisboa - Portugal
| | - Sara Dias
- EpiDoC Unit, NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), Centro de Estudos de Doenças Crónicas (CEDOC) - Lisboa - Lisboa - Portugal.,EpiSaúde, Associação Científica - Évora - Évora - Portugal.,Escola Superior de Saúde do Instituto Politécnico de Leiria, CiTechCare, Center for innovative care and health technology - Leiria - Leiria - Portugal
| | - Ana Maria Rodrigues
- EpiDoC Unit, NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), Centro de Estudos de Doenças Crónicas (CEDOC) - Lisboa - Lisboa - Portugal.,Sociedade Portuguesa de Reumatologia, Sociedade Portuguesa de Reumatologia - Lisboa - Lisboa - Portugal.,Instituto de Medicina Molecular, Rheumatology Research Unit - Lisboa - Lisboa - Portugal.,EpiSaúde, Associação Científica - Évora - Évora - Portugal
| | - Rute Dinis Sousa
- EpiDoC Unit, NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), Centro de Estudos de Doenças Crónicas (CEDOC) - Lisboa - Lisboa - Portugal.,EpiSaúde, Associação Científica - Évora - Évora - Portugal
| | - Maria João Gregório
- EpiDoC Unit, NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), Centro de Estudos de Doenças Crónicas (CEDOC) - Lisboa - Lisboa - Portugal.,Direção-Geral da Saúde, Programa Nacional para a Promoção da Alimentação Saudável - Lisboa - Lisboa - Portugal.,Universidade do Porto, Faculdade de Ciências da Nutrição e Alimentação - Porto - Porto - Portugal
| | - Jaime Branco
- EpiDoC Unit, NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), Centro de Estudos de Doenças Crónicas (CEDOC) - Lisboa - Lisboa - Portugal.,Sociedade Portuguesa de Reumatologia, Sociedade Portuguesa de Reumatologia - Lisboa - Lisboa - Portugal.,Centro Hospitalar Lisboa Ocidental (CHLO- E.P.E.), Serviço de Reumatologia do Hospital Egas Moniz - Lisboa - Lisboa - Portugal
| | - Helena Canhão
- EpiDoC Unit, NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), Centro de Estudos de Doenças Crónicas (CEDOC) - Lisboa - Lisboa - Portugal.,Sociedade Portuguesa de Reumatologia, Sociedade Portuguesa de Reumatologia - Lisboa - Lisboa - Portugal.,EpiSaúde, Associação Científica - Évora - Évora - Portugal
| | - Teresa Paiva
- CENC - Sleep Medicine Center, Sleep and circadian rhythms - Lisboa - Lisboa - Portugal
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Tarasiuk A, Segev Y. Abnormal Growth and Feeding Behavior in Upper Airway Obstruction in Rats. Front Endocrinol (Lausanne) 2018; 9:298. [PMID: 29915561 PMCID: PMC5994397 DOI: 10.3389/fendo.2018.00298] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 05/18/2018] [Indexed: 12/18/2022] Open
Abstract
Pediatric obstructive sleep apnea (OSA) is a syndrome manifesting with snoring and increased respiratory effort due to increased upper airway resistance. In addition to cause the abnormal sleep, this syndrome has been shown to elicit either growth retardation or metabolic syndrome and obesity. Treating OSA by adenotonsillectomy is usually associated with increased risk for obesity, despite near complete restoration of breathing and sleep. However, the underlying mechanism linking upper airways obstruction (AO) to persistent change in food intake, metabolism, and growth remains unclear. Rodent models have examined the impact of intermittent hypoxia on metabolism. However, an additional defining feature of OSA that is not related to intermittent hypoxia is enhanced respiratory loading leading to increased respiratory effort and abnormal sleep. The focus of this mini review is on recent evidence indicating the persistent abnormalities in endocrine regulation of feeding and growth that are not fully restored by the chronic upper AO removal in rats. Here, we highlight important aspects related to abnormal regulation of metabolism that are not related to intermittent hypoxia per se, in an animal model that mimics many of the clinical features of pediatric OSA. Our evidence from the AO model indicates that obstruction removal may not be sufficient to prevent the post-removal tendency for abnormal growth.
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Affiliation(s)
- Ariel Tarasiuk
- Sleep-Wake Disorders Unit, Soroka University Medical Center, Beer-Sheva, Israel
- Department of Physiology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- *Correspondence: Ariel Tarasiuk,
| | - Yael Segev
- Shraga Segal Department of Microbiology and Immunology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Associations among Neighborhood, Race, and Sleep Apnea Severity in Children. A Six-City Analysis. Ann Am Thorac Soc 2017; 14:76-84. [PMID: 27768852 DOI: 10.1513/annalsats.201609-662oc] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
RATIONALE Prior researchers found that individual-level environmental and social indicators did not explain the racial disparity in obstructive sleep apnea syndrome. Neighborhood socioeconomic variables, as well as risk factors for a range of adverse behavioral and health outcomes, may better explain this racial disparity and help identify modifiable intervention targets. OBJECTIVES To evaluate the associations of neighborhood socioeconomic variables with obstructive sleep apnea severity and to assess whether the neighborhood variables explain the association between race and obstructive sleep apnea severity. METHODS We performed a cross-sectional analysis of data of 774 children in six cities who participated in the Childhood Adenotonsillectomy Trial. The outcome variable was the apnea-hypopnea index (AHI). Neighborhood socioeconomic variables were obtained on the basis of the children's residential addresses and information in the American Community Survey. Regression models were used to assess the associations among neighborhood conditions, race, and AHI. MEASUREMENTS AND MAIN RESULTS Higher poverty rate and percentage of single-female-headed households were associated with higher AHI (P = 0.008 and 0.002, respectively). African American race was associated with a 1.33 (1.08-1.64 95% confidence interval)-fold increase in AHI, adjusting for age and sex. After controlling for poverty rate or percentage of single-female-headed households with children, the association between race and AHI levels was no longer significant (P = 0.15 and 0.26, respectively), and the magnitude of race association decreased 34 or 55%, suggesting that the association between race and AHI levels was largely explained by poverty rate or percentage of single-female-headed households with children. CONCLUSIONS Neighborhood socioeconomic variables in comparison with individual-level socioeconomic indicators provides better explanations for the racial disparity in pediatric obstructive sleep apnea syndrome. Further research aimed at identifying factors that aggregate in disadvantaged neighborhoods and increase sleep apnea risk may suggest modifiable intervention targets. Clinical trial registered with clinicaltrials.gov (NCT00560859).
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249
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Maillane-Vanegas S, Turi-Lynch BC, Lira FSD, Codogno JS, Fernandes RA, Lima MCSD, Machado-Rodrigues A, Kemper HCG. Relationship between carotid intima-media thickness, physical activity, sleep quality, metabolic/inflamatory profile, body fatness, smoking and alcohol consumption in young adults. MOTRIZ: REVISTA DE EDUCACAO FISICA 2017. [DOI: 10.1590/s1980-6574201700030020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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250
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Knutson KL, Wu D, Patel SR, Loredo JS, Redline S, Cai J, Gallo LC, Mossavar-Rahmani Y, Ramos AR, Teng Y, Daviglus ML, Zee PC. Association Between Sleep Timing, Obesity, Diabetes: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Cohort Study. Sleep 2017; 40:2962431. [PMID: 28329091 DOI: 10.1093/sleep/zsx014] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Study Objectives Recent studies implicate inadequate sleep duration and quality in metabolic disease. Fewer studies have examined the timing of sleep, which may be important because of its potential impact on circadian rhythms of metabolic function. We examined the association between sleep timing and metabolic risk among Hispanic/Latino adults. Methods Cross-sectional data from community-based study of 13429 participants aged 18-74 years. People taking diabetic medications were excluded. Sleep timing was determined from self-reported bedtimes and wake times. Chronotype was defined as the midpoint of sleep on weekends adjusted for sleep duration on weekdays. Other measurements included body mass index (BMI), fasting glucose levels, estimated insulin resistance (HOMA-IR), glucose levels 2 hours post oral glucose ingestion, and hemoglobin A1c. Survey linear regression models tested associations between sleep timing and metabolic measures. Analyses were stratified by diabetes status and age-group when significant interactions were observed. Results Among participants with diabetes, fasting glucose levels were positively associated with bedtime (approximately +3%/hour later, p < .01) and midpoint of sleep (approximately +2%/hour later, p < .05). In participants with and without diabetes combined, HOMA-IR was positively associated with midpoint of sleep (+1.5%/hr later, p < .05), and chronotype (+1.2%/hour later, p < .05). Associations differed by age-group. Among those < 36 years, later sleep timing was associated with lower BMI, lower fasting glucose, and lower HbA1c, but the opposite association was observed among older participants. Conclusions Later sleep timing was associated with higher estimated insulin resistance across all groups. Some associations between sleep timing and metabolic measures may be age-dependent.
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Affiliation(s)
- Kristen L Knutson
- Center for Circadian and Sleep Medicine, Department of Neurology, Northwestern University
| | - Donghong Wu
- Institute for Minority Health Research, University of Illinois at Chicago
| | - Sanjay R Patel
- Division of Pulmonary Allergy and Critical Care Medicine, University of Pittsburgh
| | - Jose S Loredo
- Department of Medicine, University of California San Diego
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital; Division of Pulmonary, Critical Care and Sleep, Beth Israel Deaconess Medical Center; Harvard Medical School
| | - Jianwen Cai
- Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina at Chapel Hill
| | - Linda C Gallo
- Department of Psychology, San Diego State University
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Alberto R Ramos
- Department of Neurology, University of Miami, Miller School of Medicine
| | - Yanping Teng
- Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina at Chapel Hill
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago
| | - Phyllis C Zee
- Center for Circadian and Sleep Medicine, Department of Neurology, Northwestern University
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