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Lloyd-Jones DM, Allen NB, Anderson CAM, Black T, Brewer LC, Foraker RE, Grandner MA, Lavretsky H, Perak AM, Sharma G, Rosamond W. Life's Essential 8: Updating and Enhancing the American Heart Association's Construct of Cardiovascular Health: A Presidential Advisory From the American Heart Association. Circulation 2022; 146:e18-e43. [PMID: 35766027 PMCID: PMC10503546 DOI: 10.1161/cir.0000000000001078] [Citation(s) in RCA: 704] [Impact Index Per Article: 352.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In 2010, the American Heart Association defined a novel construct of cardiovascular health to promote a paradigm shift from a focus solely on disease treatment to one inclusive of positive health promotion and preservation across the life course in populations and individuals. Extensive subsequent evidence has provided insights into strengths and limitations of the original approach to defining and quantifying cardiovascular health. In response, the American Heart Association convened a writing group to recommend enhancements and updates. The definition and quantification of each of the original metrics (Life's Simple 7) were evaluated for responsiveness to interindividual variation and intraindividual change. New metrics were considered, and the age spectrum was expanded to include the entire life course. The foundational contexts of social determinants of health and psychological health were addressed as crucial factors in optimizing and preserving cardiovascular health. This presidential advisory introduces an enhanced approach to assessing cardiovascular health: Life's Essential 8. The components of Life's Essential 8 include diet (updated), physical activity, nicotine exposure (updated), sleep health (new), body mass index, blood lipids (updated), blood glucose (updated), and blood pressure. Each metric has a new scoring algorithm ranging from 0 to 100 points, allowing generation of a new composite cardiovascular health score (the unweighted average of all components) that also varies from 0 to 100 points. Methods for implementing cardiovascular health assessment and longitudinal monitoring are discussed, as are potential data sources and tools to promote widespread adoption in policy, public health, clinical, institutional, and community settings.
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Ballesio A, Zagaria A, Ottaviani C, Steptoe A, Lombardo C. Sleep disturbance, neuro-immune markers, and depressive symptoms in older age: Conditional process analysis from the English Longitudinal Study of Aging (ELSA). Psychoneuroendocrinology 2022; 142:105770. [PMID: 35490483 DOI: 10.1016/j.psyneuen.2022.105770] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/30/2022] [Accepted: 04/13/2022] [Indexed: 01/01/2023]
Abstract
This study aimed to investigate the long-term association between subjective sleep disturbance and depressive symptoms in older adults, and ascertain whether this association is partially mediated by neuro-immune markers, while testing the moderation of sex using conditional process analyses, i.e., combinations of mediation and moderation analyses. We analysed data of 2124 participants aged 50 and above from the English Longitudinal Study of Ageing (ELSA) across three waves of data collection. Sleep disturbance was assessed in 2008/9, serum levels of high sensitivity C-reactive protein (hs-CRP), insulin like growth factor-1 (IGF-1), white blood cell (WBC) count in 2012/2013, and self-reported depressive symptoms in 2016/2017. After accounting for health-related and psychosocial confounders, results showed that sleep disturbance significantly predicted depressive symptoms at follow-up in the whole sample and hs-CRP in women, but not in men. Hs-CRP also predicted depressive symptoms only in women. Moreover, hs-CRP significantly mediated the association between sleep disturbance and depressive symptoms in women, but not in men. The association between sleep disturbance and IFG-1was marginal, and the latter did not mediate the association between sleep and depressive symptoms neither in women nor in men. Results on WBC count were all non-significant. In conclusion, sleep disturbance resulted significantly associated with depressive symptoms in a long-term follow-up. Moreover, ELSA data provide preliminary evidence that increased inflammation may mediate this association in women. Future longitudinal studies may advance the knowledge in the field considering the mediating role of proinflammatory cytokines such as interleukin-6.
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Affiliation(s)
- Andrea Ballesio
- Department of Psychology, Sapienza University of Rome, Rome, Italy.
| | - Andrea Zagaria
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
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Palagini L, Bianchini C. Pharmacotherapeutic management of insomnia and effects on sleep processes, neural plasticity, and brain systems modulating stress: A narrative review. Front Neurosci 2022; 16:893015. [PMID: 35968380 PMCID: PMC9374363 DOI: 10.3389/fnins.2022.893015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionInsomnia is a stress-related sleep disorder, may favor a state of allostatic overload impairing brain neuroplasticity, stress immune and endocrine pathways, and may contribute to mental and physical disorders. In this framework, assessing and targeting insomnia is of importance.AimSince maladaptive neuroplasticity and allostatic overload are hypothesized to be related to GABAergic alterations, compounds targeting GABA may play a key role. Accordingly, the aim of this review was to discuss the effect of GABAA receptor agonists, short-medium acting hypnotic benzodiazepines and the so called Z-drugs, at a molecular level.MethodLiterature searches were done according to PRISMA guidelines. Several combinations of terms were used such as “hypnotic benzodiazepines” or “brotizolam,” or “lormetazepam” or “temazepam” or “triazolam” or “zolpidem” or “zopiclone” or “zaleplon” or “eszopiclone” and “insomnia” and “effects on sleep” and “effect on brain plasticity” and “effect on stress system”. Given the complexity and heterogeneity of existing literature, we ended up with a narrative review.ResultsAmong short-medium acting compounds, triazolam has been the most studied and may regulate the stress system at central and peripheral levels. Among Z-drugs eszopiclone may regulate the stress system. Some compounds may produce more “physiological” sleep such as brotizolam, triazolam, and eszopiclone and probably may not impair sleep processes and related neural plasticity. In particular, triazolam, eszopiclone, and zaleplon studied in vivo in animal models did not alter neuroplasticity.ConclusionCurrent models of insomnia may lead us to revise the way in which we use hypnotic compounds in clinical practice. Specifically, compounds should target sleep processes, the stress system, and sustain neural plasticity. In this framework, among the short/medium acting hypnotic benzodiazepines, triazolam has been the most studied compound while among the Z-drugs eszopiclone has demonstrated interesting effects. Both offer potential new insight for treating insomnia.
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Affiliation(s)
- Laura Palagini
- Psychiatry Division, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- *Correspondence: Laura Palagini,
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Associations between comorbid anxiety and sleep disturbance in people with bipolar disorder: Findings from actigraphy and subjective sleep measures. J Affect Disord 2022; 309:165-171. [PMID: 35427709 PMCID: PMC9225955 DOI: 10.1016/j.jad.2022.04.065] [Citation(s) in RCA: 2] [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: 09/09/2021] [Revised: 02/03/2022] [Accepted: 04/10/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Studies show that comorbid anxiety disorders are common in people with bipolar disorder. However, little is known about whether this anxiety is associated with sleep disturbance. We investigated, in individuals with bipolar disorder, whether comorbid anxiety disorder is associated with sleep disturbance. METHODS Participants were 101 (64% female) currently euthymic individuals with a history of bipolar disorder. Sleep disturbances were assessed using self-report measures of sleep quality (Pittsburgh Sleep Quality Index, PSQI) and six weeks of sleep monitoring using actigraphy. Bipolar disorder and comorbid anxiety diagnoses were assessed using the Mini International Neuropsychiatric Interview. Multiple regression analyses examined associations between comorbid anxiety and sleep disturbance, whilst controlling for confounding covariates known to impact on sleep. RESULTS A comorbid anxiety disorder was associated with increased sleep disturbance as measured using the PSQI global score (B = 3.58, 95% CI 1.85-5.32, P < 0.001) but was not associated with sleep metrics (total sleep time, sleep onset latency, sleep efficiency, and wake after sleep onset) derived using actigraphy. LIMITATIONS Objective measures of sleep were limited to actigraphy, therefore we were not able to examine differences in sleep neurophysiology. CONCLUSIONS Clinicians should be aware that comorbid anxiety may increase the risk of experiencing subjective sleep disturbance in people with bipolar disorder. Research should assess for evidence of comorbid anxiety when examining associations between sleep and bipolar disorder. Future research should explore the mechanisms by which comorbid anxiety may contribute to subjective sleep disturbances in bipolar disorder using neurophysiological measures of sleep (i.e., polysomnography).
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Draper CE, Cook CJ, Redinger S, Rochat T, Prioreschi A, Rae DE, Ware LJ, Lye SJ, Norris SA. Cross-sectional associations between mental health indicators and social vulnerability, with physical activity, sedentary behaviour and sleep in urban African young women. Int J Behav Nutr Phys Act 2022; 19:82. [PMID: 35818066 PMCID: PMC9272865 DOI: 10.1186/s12966-022-01325-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 06/23/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Relationships between mental health and multiple health behaviours have not been explored in young South African women experiencing social constraints. The aim of this study was to identify associations between mental health indicators and risk factors with physical activity, sedentary behaviour, and sleep, amongst young women living in Soweto, a predominantly low-income, urban South African setting. METHODS For this cross-sectional study, baseline measurements for participants (n = 1719, 18.0-25.9 years old) recruited for the Healthy Life Trajectories Initiative were used including: physical activity, sedentary behaviour (sitting, screen and television time), sleep (duration and quality), depression and anxiety indicators, emotional health, adverse childhood experiences, alcohol-use risk; social vulnerability, self-efficacy, and social support. RESULTS Multiple regression analyses showed that depression (β = 0.161, p < 0.001), anxiety (β = 0.126, p = 0.001), adverse childhood experiences (β = 0.076, p = 0.014), and alcohol-use risk (β = 0.089, p = 0.002) were associated with poor quality sleep. Alcohol-use risk was associated with more screen time (β = 0.105, p < 0.001) and television time (β = 0.075, p < 0.016). Social vulnerability was associated with lower sitting time (β = - 0.187, p < 0001) and screen time (β = - 0.014, p < 0.001). Higher self-efficacy was associated with more moderate- to vigorous-intensity physical activity (β = 0.07, p = 0.036), better-quality sleep (β = - 0.069, p = 0.020) and less television time (β = - 0.079, p = 0.012). Having no family support was associated with more sitting time (β = 0.075, p = 0.022). Binomial logistic regression analyses supported these findings regarding sleep quality, with anxiety and depression risk doubling the risk of poor-quality sleep (OR = 2.425, p < 0.001, OR = 2.036, p = 0.003 respectively). CONCLUSIONS These findings contribute to our understanding of how mental health indicators and risk factors can be barriers to health behaviours of young women in Soweto, and that self-efficacy and social support can be protective for certain of these behaviours for these women. Our results highlight the uniqueness of this setting regarding associations between mental health and behaviours associated with non-communicable diseases risk.
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Affiliation(s)
- Catherine E Draper
- SAMRC-Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa.
| | - Caylee J Cook
- SAMRC-Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Stephanie Redinger
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Tamsen Rochat
- SAMRC-Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Alessandra Prioreschi
- SAMRC-Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Dale E Rae
- Health through Physical Activity, Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Lisa J Ware
- SAMRC-Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Stephen J Lye
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada
- Departments of Obstetrics and Gynecology, Physiology and Medicine, University of Toronto, Toronto, Canada
| | - Shane A Norris
- SAMRC-Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
- Global Health Research Unit, School of Human Development and Health, University of Southampton, Southampton, UK
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Croghan IT, Hurt RT, Fokken SC, Fischer KM, Lindeen SA, Schroeder DR, Ganesh R, Ghosh K, Bausek N, Bauer BA. Stress Resilience Program for Health Care Professionals During a Pandemic: A Pilot Program. Workplace Health Saf 2022; 71:173-180. [PMID: 35787711 PMCID: PMC10079895 DOI: 10.1177/21650799221093775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The COVID-19 pandemic has led to increased burnout and staff turnover for health care providers (HCPs). The purpose of this pilot study was to evaluate the safety and acceptability of a Stress Resilience Program (SRP) for reducing perceived stress and improving resilience among HCPs during a pandemic. METHOD Of the 12 HCPs expressing interest in the study, 10 were enrolled in this study. Participants attended three in-person visits (consent/screen, baseline, and end-of-study). The SRP consisted of education related to resilience enhancement and a breathing device (BreatherFit®) for combined respiratory muscle training (cRMT). Participants completed 4 weeks of cRMT and applied situational breathing strategies as needed. Outcomes measured were changes in stress (PSS-10), resilience (BRS), depression (PRIME-MD), and sleep (PSQI and Ōura Ring®). FINDINGS The majority of participants were male (60%) and White (60%) with an average age of 39.7 years. Changes from baseline to end-of-treatment indicated a positive trend with significant stress reduction (-3.2 ± 3.9, p = .028) and nonsignificant depression reduction (-0.5 ± 0.7, p = .05). Resilience was high at baseline and continued to stay high during the study with a nonsignificant increase at end-of-study (+0.07 ± 0.7, p = .77). No changes in overall sleep scores were noted. All participants agreed the study was worthwhile, 80% indicated they would repeat the experience, while 90% indicated they would recommend the study to others. CONCLUSION/APPLICATION TO PRACTICE Because of its size and portability, SRP is an easily applicable and promising option for reducing stress among HCPs during a high-stress period, such as a pandemic. Larger studies are needed.
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Affiliation(s)
- Ivana T Croghan
- Department of Medicine, Division of General Internal Medicine.,Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery.,Department of Quantitative Health Sciences
| | - Ryan T Hurt
- Department of Medicine, Division of General Internal Medicine
| | - Shawn C Fokken
- Department of Medicine, Division of General Internal Medicine
| | | | | | | | - Ravindra Ganesh
- Department of Medicine, Division of General Internal Medicine
| | - Karthik Ghosh
- Department of Medicine, Division of General Internal Medicine
| | - Nina Bausek
- Department of Cardiovascular Disease, Mayo Clinic
| | - Brent A Bauer
- Department of Medicine, Division of General Internal Medicine
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McLaughlin KA, Rosen ML, Kasparek SW, Rodman AM. Stress-related psychopathology during the COVID-19 pandemic. Behav Res Ther 2022; 154:104121. [PMID: 35642991 PMCID: PMC9110305 DOI: 10.1016/j.brat.2022.104121] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/29/2022] [Accepted: 05/13/2022] [Indexed: 02/06/2023]
Abstract
The COVID-19 pandemic has introduced widespread societal changes that have required ongoing adaptation. Unsurprisingly, stress-related psychopathology has increased during the pandemic, in both children and adults. We review these patterns through the lens of several leading conceptual models of the link between stress and psychopathology. Some of these models focus on characteristics of environmental stressors-including cumulative risk, specific stressor types, and stress sensitization approaches. Understanding the specific aspects of environmental stressors that are most likely to lead to psychopathology can shed light on who may be in most need of clinical intervention. Other models center on factors that can buffer against the onset of psychopathology following stress and the mechanisms through which stressors contribute to emergent psychopathology. These models highlight specific psychosocial processes that may be most usefully targeted by interventions to reduce stress-related psychopathology. We review evidence for each of these stress models in the context of other widescale community-level disruptions, like natural disasters and terrorist attacks, alongside emerging evidence for these stress pathways from the COVID-19 pandemic. We discuss clinical implications for developing interventions to reduce stress-related psychopathology during the pandemic, with a focus on brief, digital interventions that may be more accessible than traditional clinical services.
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Affiliation(s)
| | - Maya L Rosen
- Department of Psychology, Harvard University, USA
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208
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Schäfer AA, Santos LP, Manosso LM, Quadra MR, Meller FO. Relationship between sleep duration and quality and mental health before and during COVID-19 pandemic: Results of population-based studies in Brazil. J Psychosom Res 2022; 158:110910. [PMID: 35427941 PMCID: PMC8993422 DOI: 10.1016/j.jpsychores.2022.110910] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 03/08/2022] [Accepted: 04/04/2022] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This study aimed to evaluate the association between sleep duration and quality and mental health before and amid the COVID-19 pandemic. METHODS Data from two population-based cross-sectional studies conducted in 2019 and 2020 with adults in Criciúma, Southern Brazil. The Patient Health Questionnaire-9 (PHQ-9) was used to screen major depressive episodes, while the perceived stress scale was used to assess perceived stress. Sleep was evaluated through self-reported duration and quality. Crude and adjusted Poisson regression models were used to assess the association between sleep and mental health disorders. RESULTS A total of 820 (in 2019) and 863 subjects (in 2020) were assessed. Sleep quality presented significant associations with depression and stress in both years, and the magnitude of the association with depression increased amid COVID-19 pandemic. In individuals with poor/very poor sleep quality, the risk of depression in 2019 was 2.14 (95%IC 1.48;3.09) higher when compared to those with good/very good sleep quality. This risk increased to 2.26 (95%IC 1.49;3.40) in 2020. The risk of stress was 1.90 (95%IC 1.42;2.55) in 2019 and 1.66 (95%IC1.34;2.07) in 2020. The sleep duration was not associated with mental health disorders in the adjusted analyses. CONCLUSION The results provide important evidence that sleep quality can influence mental health of adults. The COVID-19 pandemic seems to have had a considerable impact on this association.
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Affiliation(s)
- Antônio Augusto Schäfer
- Postgraduate Program in Public Health, University of Southern Santa Catarina, Criciúma, Santa Catarina, Brazil.
| | - Leonardo Pozza Santos
- Nutrition College, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil.
| | | | - Micaela Rabelo Quadra
- Postgraduate Program in Public Health, University of Southern Santa Catarina, Criciúma, Santa Catarina, Brazil.
| | - Fernanda Oliveira Meller
- Postgraduate Program in Public Health, University of Southern Santa Catarina, Criciúma, Santa Catarina, Brazil.
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209
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Joëls M, de Kloet ER. Sleeping off stress. Science 2022; 377:27-28. [PMID: 35771905 DOI: 10.1126/science.adc9782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Social defeat activates midbrain cells, promoting sleep and reducing anxiety in mice.
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Affiliation(s)
- Marian Joëls
- Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.,University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - E Ronald de Kloet
- Leiden Academic Center for Drug Research, Leiden University Medical Center, Leiden University, Leiden, Netherlands
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210
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Zheng C, Ge Y, Chen X, Shao W, Wang G, Zhang B, Zhang W. Association between sleep status and lower urinary tract symptoms among men aged 40 or older in Zhengzhou. Sleep Biol Rhythms 2022; 20:337-344. [PMID: 38469426 PMCID: PMC10900034 DOI: 10.1007/s41105-022-00373-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 01/03/2022] [Indexed: 11/30/2022]
Abstract
A cross-sectional study based on the community was conducted to explore the association between sleep status and LUTS among middle and old-aged men. Male residents in Zhengzhou aged 40 or older were recruited. Participants received the Pittsburgh Sleep Quality Index questionnaire and the International Prostate Symptom Score questionnaire to evaluate sleep status and the severity of lower urinary tract symptoms (LUTS), respectively. Logistic regression analyses and linear regression analyses were performed to evaluate the relationship between sleep quality and sleep duration and LUTS. A total of 5785 participants were enrolled. Multivariable analyses showed a positive relationship between sleep quality and LUTS (β 0.716, 95% CI 0.647-0.784), and poor sleepers were significantly associated with moderate or severe LUTS (OR 2.486, 95% CI 2.095-2.950). U-shaped dose-response relationship revealed that sleeping less than 5.8 h/day and more than 7.9 h/day was related to moderate or severe LUTS and more than 7.9 h/day of sleep duration was associated with poor voiding and storage symptoms (P for nonlinearity < 0.001). Similar relationship was observed between sleep status and nocturia. It showed a significantly positive relationship between sleep quality and LUTS. U-shaped dose-response relationships between sleep duration and LUTS were observed.
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Affiliation(s)
- Caifang Zheng
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, 450001 Henan China
| | - Yongchao Ge
- Department of Urology, The Third People’s Hospital of Zhengzhou, Zhengzhou, 450000 Henan China
| | - Xiaorui Chen
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, 450001 Henan China
| | - Weihao Shao
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, 450001 Henan China
| | - Gaili Wang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, 450001 Henan China
| | - Bowen Zhang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, 450001 Henan China
| | - Weidong Zhang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, 450001 Henan China
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Bayo Jimenez MT, Frenis K, Hahad O, Steven S, Cohen G, Cuadrado A, Münzel T, Daiber A. Protective actions of nuclear factor erythroid 2-related factor 2 (NRF2) and downstream pathways against environmental stressors. Free Radic Biol Med 2022; 187:72-91. [PMID: 35613665 DOI: 10.1016/j.freeradbiomed.2022.05.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/23/2022] [Accepted: 05/19/2022] [Indexed: 12/14/2022]
Abstract
Environmental risk factors, including noise, air pollution, chemical agents, ultraviolet radiation (UVR) and mental stress have a considerable impact on human health. Oxidative stress and inflammation are key players in molecular pathomechanisms of environmental pollution and risk factors. In this review, we delineate the impact of environmental risk factors and the protective actions of the nuclear factor erythroid 2-related factor 2 (NRF2) in connection to oxidative stress and inflammation. We focus on well-established studies that demonstrate the protective actions of NRF2 and its downstream pathways against different environmental stressors. State-of-the-art mechanistic considerations on NRF2 signaling are discussed in detail, e.g. classical concepts like KEAP1 oxidation/electrophilic modification, NRF2 ubiquitination and degradation. Specific focus is also laid on NRF2-dependent heme oxygenase-1 induction with detailed presentation of the protective down-stream pathways of heme oxygenase-1, including interaction with BACH1 system. The significant impact of all environmental stressors on the circadian rhythm and the interactions of NRF2 with the circadian clock will also be considered here. A broad range of NRF2 activators is discussed in relation to environmental stressor-induced health side effects, thereby suggesting promising new mitigation strategies (e.g. by nutraceuticals) to fight the negative effects of the environment on our health.
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Affiliation(s)
- Maria Teresa Bayo Jimenez
- Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Katie Frenis
- Department of Hematology and Oncology, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA, 02115, USA
| | - Omar Hahad
- Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University, Langenbeckstraße 1, 55131, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany; Leibniz Insitute for Resilience Research (LIR), Mainz, Germany
| | - Sebastian Steven
- Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Guy Cohen
- The Skin Research Institute, The Dead Sea and Arava Science Center, Masada, 86910, Israel; Ben Gurion University of the Negev, Eilat Campus, Eilat, 8855630, Israel
| | - Antonio Cuadrado
- Departamento de Bioquímica, Facultad de Medicina, Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Investigación Sanitaria La Paz (IdiPaz), Instituto de Investigaciones Biomédicas 'Alberto Sols' UAM-CSIC, Universidad Autónoma de Madrid, Madrid, Spain
| | - Thomas Münzel
- Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University, Langenbeckstraße 1, 55131, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany.
| | - Andreas Daiber
- Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University, Langenbeckstraße 1, 55131, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany.
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Gardner W, Fuchs F, Durieux L, Bourgin P, Coenen VA, Döbrössy M, Lecourtier L. Slow Wave Sleep Deficits in the Flinders Sensitive Line Rodent Model of Depression: Effects of Medial Forebrain Bundle Deep-Brain Stimulation. Neuroscience 2022; 498:31-49. [PMID: 35750113 DOI: 10.1016/j.neuroscience.2022.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 05/20/2022] [Accepted: 06/15/2022] [Indexed: 10/17/2022]
Abstract
Major Depressive Disorder (MDD) is an affective disorder typically accompanied by sleep disturbances. Deep brain stimulation (DBS) of the medial forebrain bundle (MFB) is an emerging intervention for treatment-resistant depression, but its effect on sleep has not been closely examined. Here we aimed to characterise sleep deficits in the Flinders sensitive line, an established rodent model of depression, and investigate the consequences of MFB stimulation on sleep-related phenotypes. Rats were implanted with bilateral stimulation electrodes in the MFB, surface electrodes to record electrocorticography and electromyography for sleep scoring and electrodes within the prelimbic cortex, nucleus accumbens (NAc) and dorsal hippocampus. Recordings of sleep and oscillatory activity were conducted prior to and following twenty-four hours of MFB stimulation. Behavioural anti-depressant effects were monitored using the forced swim test. Previously unreported abnormalities in the Flinders sensitive line rats were observed during slow wave sleep, including decreased circadian amplitude of its rhythm, a reduction in slow wave activity and elevated gamma band oscillations. Previously established rapid eye movement sleep deficits were replicated. MFB stimulation had anti-depressant effects on behavioural phenotype, but did not significantly impact sleep architecture; it suppressed elevated gamma activity during slow wave sleep in the electrocorticogram and prelimbic cortex signals. Diverse abnormalities in Flinders sensitive line rats emphasise slow wave sleep as a state of dysfunction in affective disorders. MFB stimulation is able to affect behaviour and sleep physiology without influencing sleep architecture. Gamma modulation may represent a component of antidepressant mechanism.
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Affiliation(s)
- Wilf Gardner
- Laboratory of Stereotaxy and Interventional Neurosciences, Department of Stereotactic and Functional Neurosurgery, University Hospital of Freiburg University and Medical Faculty of Freiburg University, Germany; Faculty of Biology, Albert-Ludwigs-Universität-Freiburg, Freiburg, Germany; Laboratoire de Neurosciences Cognitives et Adaptatives, University of Strasbourg, Strasbourg, France
| | - Fanny Fuchs
- Inovarion, Paris, France; Institut des Neurosciences Cellulaires et Intégratives, University of Strasbourg, Strasbourg France
| | - Laura Durieux
- Laboratoire de Neurosciences Cognitives et Adaptatives, University of Strasbourg, Strasbourg, France
| | - Patrice Bourgin
- Institut des Neurosciences Cellulaires et Intégratives, University of Strasbourg, Strasbourg France; Centre des troubles du sommeil - CIRCSom, Strasbourg University Hospitals, Strasbourg, France
| | - Volker A Coenen
- Laboratory of Stereotaxy and Interventional Neurosciences, Department of Stereotactic and Functional Neurosurgery, University Hospital of Freiburg University and Medical Faculty of Freiburg University, Germany; Center for Basics in Neuromodulation, Freiburg University, Freiburg, Germany; Center for Deep Brain Stimulation, Freiburg University, Freiburg, Germany
| | - Máté Döbrössy
- Laboratory of Stereotaxy and Interventional Neurosciences, Department of Stereotactic and Functional Neurosurgery, University Hospital of Freiburg University and Medical Faculty of Freiburg University, Germany; Faculty of Biology, Albert-Ludwigs-Universität-Freiburg, Freiburg, Germany; Dept of Stereotactic and Functional Neurosurgery, University Hospital Freiburg, Germany.
| | - Lucas Lecourtier
- Laboratoire de Neurosciences Cognitives et Adaptatives, University of Strasbourg, Strasbourg, France.
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213
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Wang Z, Chen M, Wei YZ, Zhuo CG, Xu HF, Li WD, Ma L. The causal relationship between sleep traits and the risk of schizophrenia: a two-sample bidirectional Mendelian randomization study. BMC Psychiatry 2022; 22:399. [PMID: 35705942 PMCID: PMC9202113 DOI: 10.1186/s12888-022-03946-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 04/19/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Observational studies suggest that sleep disturbances are commonly associated with schizophrenia. However, it is uncertain whether this relationship is causal. To investigate the bidirectional causal relation between sleep traits and schizophrenia, we performed a two-sample bidirectional Mendelian randomization (MR) study with the fixed effects inverse-variance weighted (IVW) method. METHODS As genetic variants for sleep traits, we selected variants from each meta-analysis of genome-wide association studies (GWASs) conducted using data from the UK Biobank (UKB). RESULTS We found that morning diurnal preference was associated with a lower risk of schizophrenia, while long sleep duration and daytime napping were associated with a higher risk of schizophrenia. Multivariable MR analysis also showed that sleep duration was associated with a higher risk of schizophrenia after adjusting for other sleep traits. Furthermore, genetically predicted schizophrenia was negatively associated with morning diurnal preference and short sleep duration and was positively associated with daytime napping and long sleep duration. CONCLUSIONS Therefore, sleep traits were identified as a potential treatment target for patients with schizophrenia.
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Affiliation(s)
- Zhen Wang
- Department of Cardiovascular Surgery, School of Medicine, the First Affiliated Hospital of Zhejiang University, Number 79 Qingchun Road, Hangzhou, China
| | - Miao Chen
- Department of Cardiovascular Surgery, School of Medicine, the First Affiliated Hospital of Zhejiang University, Number 79 Qingchun Road, Hangzhou, China
| | - Yin-Ze Wei
- Department of Cardiovascular Surgery, School of Medicine, the First Affiliated Hospital of Zhejiang University, Number 79 Qingchun Road, Hangzhou, China
| | - Chen-Gui Zhuo
- Department of Cardiology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China
| | - Hong-Fei Xu
- Department of Cardiovascular Surgery, School of Medicine, the First Affiliated Hospital of Zhejiang University, Number 79 Qingchun Road, Hangzhou, China
| | - Wei-Dong Li
- Department of Cardiovascular Surgery, School of Medicine, the First Affiliated Hospital of Zhejiang University, Number 79 Qingchun Road, Hangzhou, China.
| | - Liang Ma
- Department of Cardiovascular Surgery, School of Medicine, the First Affiliated Hospital of Zhejiang University, Number 79 Qingchun Road, Hangzhou, China.
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214
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Effect of internet-delivered cognitive behavioral therapy on insomnia in convalescent patients with COVID-19: Protocol for a systematic review and meta-analysis. PLoS One 2022; 17:e0269882. [PMID: 35700174 PMCID: PMC9197064 DOI: 10.1371/journal.pone.0269882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 05/17/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Coronavirus Disease 2019 (COVID-19) has made a serious public health threat worldwide. Recent evidence has indicated that COVID-19 patients in convalescence frequently experience insomnia, which reduces their quality of life and causes unknown risks. The positive effect of cognitive behavior on insomnia has been well addressed in previous studies. Given the high infectivity and epidemicity of COVID-19, Internet-delivered intervention may be safer than face-to-face treatment. However, whether Internet-delivered cognitive behavioral therapy can effectively improve the insomnia of COVID-19 patients in convalescence has not been completely determined yet. Therefore, we conducted a meta-analysis and systematic review to evaluate the effects of Internet-delivered cognitive behavioral therapy on insomnia in COVID-19 patients in convalescence, with the aim to confer some guidance for its clinical application. Methods and analysis This systematic review and meta-analysis has been registered in the International Prospective Register of Systematic Reviews (PROSPERO). Two researchers will retrieve the relevant literature on Internet-delivered cognitive behavioral therapy for insomnia in convalescent patients with COVID-19 in PubMed, Web of Science, Embase, MEDLINE, Cochrane Library, Clinical Trials gov, Chinese Biomedical Literature Database (CBM), and Chinese National Knowledge Infrastructure (CNKI) from inception to 11th of December. In addition, we will review the relevant trials and references of the included literature and manually searched the grey literature. The two researchers will independently extracted data and information and evaluated the quality of the included literature. The Review Manager software (version 5.3) and Stata software (version 14.0) will be used for data analysis. The mean difference or the standardized mean difference of 95% CI will be used to calculate continuous variables to synthesize the data. In addition, I2 and Cochrane will be used for heterogeneity assessment. Trial registration PROSPERO registration number CRD42021271278.
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215
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Weinhold SL, Lechinger J, Timm N, Hansen A, Ngo HVV, Göder R. Auditory stimulation in-phase with slow oscillations to enhance overnight memory consolidation in patients with schizophrenia? J Sleep Res 2022; 31:e13636. [PMID: 35686351 DOI: 10.1111/jsr.13636] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 03/24/2022] [Accepted: 04/27/2022] [Indexed: 11/27/2022]
Abstract
Sleep-dependent memory consolidation is disturbed in patients with schizophrenia, who furthermore show reductions in sleep spindles and probably also in delta power during sleep. The memory dysfunction in these patients is one of the strongest markers for worse long-term functional outcome. However, therapeutic interventions to normalise memory functions, e.g., with medication, still do not exist. Against this backdrop, we investigated to what extent a non-invasive approach enhancing sleep with real-time auditory stimulation in-phase with slow oscillations might affect overnight memory consolidation in patients with schizophrenia. To this end, we examined 18 patients with stably medicated schizophrenia in a double-blinded sham-controlled design. Memory performance was assessed by a verbal (word list) and a non-verbal (complex figure) declarative memory task. In comparison to a sham condition without auditory stimuli, we found that in patients with schizophrenia, auditory stimulation evokes an electrophysiological response similar to that in healthy participants leading to an increase in slow wave and temporally coupled sleep spindle activity during stimulation. Despite this finding, patients did not show any beneficial effect on the overnight change in memory performance by stimulation. Although the stimulation in our study did not improve the patient's memory, the electrophysiological response gives hope that auditory stimulation could enable us to provide better treatment for sleep-related detriments in these patients in the future.
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Affiliation(s)
- Sara Lena Weinhold
- Department of Psychiatry and Psychotherapy (ZIP), University Hospital Schleswig-Holstein (UKSH), Kiel, Germany
| | - Julia Lechinger
- Department of Psychiatry and Psychotherapy (ZIP), University Hospital Schleswig-Holstein (UKSH), Kiel, Germany
| | - Nele Timm
- Department of Psychiatry and Psychotherapy (ZIP), University Hospital Schleswig-Holstein (UKSH), Kiel, Germany
| | - Anja Hansen
- Department of Psychiatry and Psychotherapy (ZIP), University Hospital Schleswig-Holstein (UKSH), Kiel, Germany
| | - Hong-Viet V Ngo
- Department of Psychology, University of Lübeck, Lübeck, Germany
| | - Robert Göder
- Department of Psychiatry and Psychotherapy (ZIP), University Hospital Schleswig-Holstein (UKSH), Kiel, Germany
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216
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Thakre TP, Kulkarni H, Adams KS, Mischel R, Hayes R, Pandurangi A. Polysomnographic identification of anxiety and depression using deep learning. J Psychiatr Res 2022; 150:54-63. [PMID: 35358832 DOI: 10.1016/j.jpsychires.2022.03.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/10/2022] [Accepted: 03/21/2022] [Indexed: 10/18/2022]
Abstract
Anxiety and depression are common psychiatric conditions associated with significant morbidity and healthcare costs. Sleep is an evolutionarily conserved health state. Anxiety and depression have a bidirectional relationship with sleep. This study reports on the use of analysis of polysomnographic data using deep learning methods to detect the presence of anxiety and depression. Polysomnography data on 940 patients performed at an academic sleep center during the 3-year period from 01/01/2016 to 12/31/2018 were identified for analysis. The data were divided into 3 subgroups: 205 patients with Anxiety/Depression, 349 patients with no Anxiety/Depression, and 386 patients with likely Anxiety/Depression. The first two subgroups were used for training and testing of the deep learning algorithm, and the third subgroup was used for external validation of the resulting model. Hypnograms were constructed via automatic sleep staging, with the 12-channel PSG data being transformed into three-channel RGB (red, green, blue channels) images for analysis. Composite patient images were generated and utilized for training the Xception model, which provided a validation set accuracy of 0.9782 on the ninth training epoch. In the independent test set, the model achieved a high accuracy (0.9688), precision (0.9533), recall (0.9630), and F1-score (0.9581). Classification performance of most other mainstream deep learning models was comparable. These findings suggest that machine learning techniques have the potential to accurately detect the presence of anxiety and depression from analysis of sleep study data. Further studies are needed to explore the utility of these techniques in the field of psychiatry.
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Affiliation(s)
- Tushar P Thakre
- Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, USA; Center for Sleep Medicine, Virginia Commonwealth University Health, Richmond, VA, USA
| | | | - Katie S Adams
- Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, USA; Department of Pharmacy Services, Virginia Commonwealth University Health, Richmond, VA, USA
| | - Ryan Mischel
- Department of Psychiatry, Washington University at St. Louis School of Medicine, St. Louis, MO, USA
| | - Ronnie Hayes
- Center for Sleep Medicine, Virginia Commonwealth University Health, Richmond, VA, USA
| | - Ananda Pandurangi
- Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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217
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Melatonin Prescribing in Assisted Living. J Am Med Dir Assoc 2022; 23:1031-1037. [PMID: 34762846 PMCID: PMC9097337 DOI: 10.1016/j.jamda.2021.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/11/2021] [Accepted: 10/11/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Aging is associated with sleep problems, which are common among assisted living (AL) residents. More than 40% of residents have insomnia, and almost 70% have a sleep disturbance of some kind. Melatonin to treat sleep disorders has become common among older adults, but its use in AL is unknown, which is concerning because melatonin may have side effects and interfere with other medications. The purpose of this study was to determine the prevalence and correlates of melatonin prescribing in AL, to inform whether changes in care may be indicated. DESIGN Cross-sectional chart abstracts and interviews. SETTINGS AND PARTICIPANTS Data were collected in 250 randomly selected AL communities among 5777 residents across 7 states in the United States and weighted to an estimated 4043 communities and 152,719 residents. METHODS Charts of residents were abstracted, and AL administrators and health care supervisors were interviewed to obtain information related to case-mix, staffing, and attitudes regarding psychoactive medications. Weighted analyses primarily examined the association of melatonin prescribing with community- and resident-level characteristics. RESULTS Melatonin was prescribed in 82% of communities, more commonly in those that had a registered nurse or licensed practical nurse on site (+7%, P = .027), and whose health care supervisor was more favorable toward nonpharmacologic practices (+18%, P = .010). On average, 9% of residents were prescribed melatonin, with prescriptions being more common among those diagnosed with dementia (+24%, P = .004); a psychiatric disorder, especially an anxiety disorder (+43%, P = .007); having behavioral expressions; and taking other psychotropics. Coprescribing was common, especially with antidepressants (OR 2.64, 95% CI 1.99, 3.48; P < .001). CONCLUSIONS AND IMPLICATIONS This study is the first to examine melatonin prescribing in AL, and finds it to be common. Such use may be appropriate if it is as a more suitable replacement for hypnotics. The fact that use varies by organizational characteristics suggests practices may be modifiable. Research examining benefits and side effects of melatonin, overall and in relation to other medications, is indicated to promote better care for AL residents.
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218
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Nguyen AW, Taylor HO, Lincoln KD, Wang F, Hamler T, Mitchell UA. Religious Involvement and Sleep Among Older African Americans. J Aging Health 2022; 34:413-423. [PMID: 35416083 DOI: 10.1177/08982643221085408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Objective: This study sought to determine whether religious involvement is associated with sleep quality in a nationally representative sample of older African Americans. Methods: The analytic sample included African American respondents aged 55+ from the National Survey of American Life-Reinterview (N = 459). Religious involvement variables included service attendance, reading religious texts, watching religious television programs, listening to religious radio programs, prayer, and subjective religiosity. Sleep outcomes were restless sleep and sleep satisfaction. Multiple linear regression analysis was used. Results: Watching religious television programs was associated with more restless sleep. Respondents who attended religious services less than once a year, at least once a week, or nearly every day reported greater sleep satisfaction than respondents who never attended religious services. Subjective religiosity was associated with lower sleep satisfaction. Discussion: The findings demonstrate the importance of examining a variety of religious involvement domains, which could point to different explanatory pathways between religious involvement and sleep.
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Affiliation(s)
- Ann W Nguyen
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, 114588Case Western Reserve University, Cleveland, OH, USA
| | - Harry Owen Taylor
- Factor-Inwentash Faculty of Social Work, 7938University of Toronto, Toronto, ON, Canada
| | - Karen D Lincoln
- Suzanne Dworak-Peck School of Social Work, 5116University of Southern California, Los Angeles, CA, USA
| | - Fei Wang
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, 114588Case Western Reserve University, Cleveland, OH, USA
| | - Tyrone Hamler
- Graduate School of Social Work, University of Denver, Denver, CO, USA
| | - Uchechi A Mitchell
- School of Public Health, 14681University of Illinois Chicago, Chicago, USA
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219
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Kuula L, Halonen R, Lipsanen J, Pesonen AK. Adolescent circadian patterns link with psychiatric problems: A multimodal approach. J Psychiatr Res 2022; 150:219-226. [PMID: 35397335 DOI: 10.1016/j.jpsychires.2022.03.056] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/04/2022] [Accepted: 03/31/2022] [Indexed: 11/20/2022]
Abstract
Circadian rhythms orchestrate brain function and mental wellbeing. We compared circadian patterns derived from continuous measurements of body temperature, sleep actigraphy and self-reported circadian preference in relation to different psychiatric disorders. 342 adolescents (70% females) aged 17.4y underwent M.I.N.I. psychiatric interviews, wore Ibutton 1922L skin temperature loggers (n = 281; 3 days), completed one-week GeneActiv Original actigraphy measurements (n = 306) and responded to Morningness-Eveningness Questionnaire (MEQ; n = 330). We derived circadian period length and amplitude from the temperature loggers. Actigraphy measures included sleep duration, midpoint, efficiency, and irregularity as well as Delayed Sleep Phase (DSP) characteristics (bedtime after 1 a.m. 3 times/week). M.I.N.I. psychiatric interviews suggested that 36% of participants had one or more psychiatric problem, with 21% suffering from comorbidity. Severe depression was associated with longer circadian period (p = 0.002). Suicidality was associated with later midpoint (p = 0.007) and more irregular sleep (p = 0.007). Those with agoraphobia slept longer (p = 0.013). Manic episodes and psychotic disorders were associated with irregular sleep (p-values <0.02). DSP was related to suicidality (p = 0.026), panic disorder (p = 0.022), and greater comorbidity (p = 0.026). Preference for eveningness was similarly related to higher prevalence of Generalized Anxiety Disorder (p = 0.014), social anxiety (p = 0.03), agoraphobia (p = 0.026), panic disorder (p = 0.004), suicidality (p = 0.018), severe depression (p < 0.001), and comorbidity (p < 0.001). Deviations in circadian rhythms were widely associated with psychiatric problems, whereas sleep duration was not. Especially suicidality linked with several markers of circadian disruption: later sleep midpoint, irregular sleep, and DSP characteristics. Longer circadian period length was associated with severe depression.
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Affiliation(s)
- Liisa Kuula
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Finland.
| | - Risto Halonen
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Finland
| | - Jari Lipsanen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anu-Katriina Pesonen
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Finland
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220
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Wang J, Li W, Ding L, Chen S. The Relationship between Duration of Smartphone Uses and Anxiety in University Students during the COVID-19 Outbreak. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116620. [PMID: 35682205 PMCID: PMC9180890 DOI: 10.3390/ijerph19116620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 11/30/2022]
Abstract
Background: During the COVID-19 pandemic, China adopted a home isolation policy, which caused lifestyle changes for university students, including increased smartphone use. Several studies indicate that problematic smartphone use is associated with anxiety. However, this association has not been examined in the context of epidemics. The aim of this study was to investigate whether the duration of smartphone use was associated with anxiety in Chinese university students during the COVID-19 pandemic. Methods: Participants included 9716 university students (5458 men and 4258 women) from Liaoning, China. We assessed the duration of smartphone use with a self-reported questionnaire. Anxiety was assessed using the generalized anxiety disorder seven-item scale. A multivariate logistic regression analysis was performed to determine the adjusted association between smartphone use and anxiety. Results: After adjusting for confounding factors, we observed a positive association between smartphone use duration and the prevalence of anxiety in all participating students. Compared with short periods of smartphone usage, the odds ratios (95% confidence interval) for moderate and long smartphone usage duration were 1.17 (1.00, 1.36) and 1.58 (1.36, 1.83), respectively. This significant positive association did not change in the sex-stratified analysis (for both men and women). Conclusions: Our examination of the association between duration of smartphone uses and university students’ anxiety levels revealed that long smartphone use was associated with a high prevalence of anxiety during the COVID-19 pandemic.
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Affiliation(s)
- Jianmin Wang
- Department of Physical Education, Huaiyin Institute of Technology, Huaian 223003, China;
- Correspondence: or
| | - Wang Li
- Department of Physical Education, Huaiyin Institute of Technology, Huaian 223003, China;
| | - Liang Ding
- Department of Physical Education, Southeast University, Nanjing 211189, China;
| | - Shulei Chen
- Department of Physical Education, Dalian University of Science and Technology, Dalian 116052, China;
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221
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Werner GG, Cludius B, Sckopke P, Stefan A, Schönbrodt F, Zygar‐Hoffmann C. The predictive power of insomnia symptoms on other aspects of mental health during the COVID-19 pandemic: a longitudinal study. J Sleep Res 2022; 32:e13641. [PMID: 35623381 PMCID: PMC9347492 DOI: 10.1111/jsr.13641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 04/29/2022] [Accepted: 05/05/2022] [Indexed: 02/03/2023]
Abstract
Symptoms of insomnia are an important risk factor for the development of mental disorders, especially during stressful life periods such as the coronavirus disease 2019 (COVID-19) pandemic. However, up to now, most studies have used cross-sectional data, and the prolonged impact of insomnia symptoms during the pandemic on later mental health remains unclear. Therefore, we investigated insomnia symptoms as a predictor of other aspects of mental health across 6 months, with altogether seven assessments (every 30 days, t0-t6), in a community sample (N = 166-267). Results showed no mean-level increase of insomnia symptoms and/or deterioration of mental health between baseline assessment (t0) and the 6- month follow-up (t6). As preregistered, higher insomnia symptoms (between persons) across all time points predicted reduced mental health at the 6-month follow-up. Interestingly, contrary to our hypothesis, higher insomnia symptoms at 1 month, within each person (i.e., compared to that person's symptoms at other time points), predicted improved rather than reduced aspects of mental health 1 month later. Hence, we replicated the predictive effect of averagely increased insomnia symptoms on impaired later mental health during the COVID-19 pandemic. However, we were surprised that increased insomnia symptoms at 1 month predicted aspects of improved mental health 1 month later. This unexpected effect might be specific for our study population and a consequence of our study design. Overall, increased insomnia symptoms may have served as a signal to engage in, and successfully implement, targeted countermeasures, which led to better short-term mental health in this healthy sample.
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Affiliation(s)
- Gabriela G. Werner
- Department of Psychology, Clinical Psychology and PsychotherapyLMU MunichMunichGermany
| | - Barbara Cludius
- Department of Psychology, Clinical Psychology and PsychotherapyLMU MunichMunichGermany
| | - Philipp Sckopke
- Department of Psychology, Psychological Methods and DiagnosticsLMU MunichMunichGermany
| | - Angelika Stefan
- Faculty of Social and Behavioural Sciences, Programme group Psychological MethodsUniversity of AmsterdamAmsterdamthe Netherlands
| | - Felix Schönbrodt
- Department of Psychology, Psychological Methods and DiagnosticsLMU MunichMunichGermany
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222
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Evening light environments can be designed to consolidate and increase the duration of REM-sleep. Sci Rep 2022; 12:8719. [PMID: 35610265 PMCID: PMC9130237 DOI: 10.1038/s41598-022-12408-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 05/04/2022] [Indexed: 01/15/2023] Open
Abstract
Evening exposure to short-wavelength light has disruptive effects on circadian rhythms and sleep. These effects can be mitigated by blocking short-wavelength (blue) frequencies, which has led to the development of evening blue-depleted light environments (BDLEs). We have previously reported that residing 5 days in an evening BDLE, compared with residing in a normal indoor light environment of similar photopic lux, advances circadian rhythms and increases the duration of rapid eye movement (REM) sleep in a randomized cross-over trial with twelve healthy participants. The current study extends these findings by testing whether residing in the evening BDLE affects the consolidation and microstructure of REM sleep in the same sample. Evening BDLE significantly reduces the fragmentation of REM sleep (p = 0.0003), and REM sleep microarousals in (p = 0.0493) without significantly changing REM density or the latency to first REM sleep episode. Moreover, the increased accumulation of REM sleep is not at the expense of NREM stage 3 sleep. BDLE further has a unique effect on REM sleep fragmentation (p = 0.0479) over and above that of circadian rhythms phase-shift, indicating a non-circadian effect of BDLE. If these effects can be replicated in clinical populations, this may have a therapeutic potential in disorders characterized by fragmented REM sleep.
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223
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Pallanti S, Di Ponzio M, Grassi E, Vannini G, Cauli G. Transcranial Photobiomodulation for the Treatment of Children with Autism Spectrum Disorder (ASD): A Retrospective Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9050755. [PMID: 35626932 PMCID: PMC9139753 DOI: 10.3390/children9050755] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/06/2022] [Accepted: 05/19/2022] [Indexed: 12/27/2022]
Abstract
Children with Autism Spectrum Disorder (ASD) face several challenges due to deficits in social function and communication along with restricted patterns of behaviors. Often, they also have difficult-to-manage and disruptive behaviors. At the moment, there are no pharmacological treatments for ASD core features. Recently, there has been a growing interest in non-pharmacological interventions for ASD, such as neuromodulation. In this retrospective study, data are reported and analyzed from 21 patients (13 males, 8 females) with ASD, with an average age of 9.1 (range 5−15), who received six months of transcranial photobiomodulation (tPBM) at home using two protocols (alpha and gamma), which, respectively, modulates the alpha and gamma bands. They were evaluated at baseline, after three and six months of treatment using the Childhood Autism Rating Scale (CARS), the Home Situation Questionnaire-ASD (HSQ-ASD), the Autism Parenting Stress Index (APSI), the Montefiore Einstein Rigidity Scale−Revised (MERS−R), the Pittsburgh Sleep Quality Index (PSQI) and the SDAG, to evaluate attention. Findings show that tPBM was associated with a reduction in ASD severity, as shown by a decrease in CARS scores during the intervention (p < 0.001). A relevant reduction in noncompliant behavior and in parental stress have been found. Moreover, a reduction in behavioral and cognitive rigidity was reported as well as an improvement in attentional functions and in sleep quality. Limitations were discussed as well as future directions for research.
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Affiliation(s)
- Stefano Pallanti
- Neurodevelopment Division, Istituto di Neuroscienze, 50121 Florence, Italy; (M.D.P.); (E.G.); (G.V.)
- Department of Psychiatry, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Correspondence:
| | - Michele Di Ponzio
- Neurodevelopment Division, Istituto di Neuroscienze, 50121 Florence, Italy; (M.D.P.); (E.G.); (G.V.)
| | - Eleonora Grassi
- Neurodevelopment Division, Istituto di Neuroscienze, 50121 Florence, Italy; (M.D.P.); (E.G.); (G.V.)
| | - Gloria Vannini
- Neurodevelopment Division, Istituto di Neuroscienze, 50121 Florence, Italy; (M.D.P.); (E.G.); (G.V.)
| | - Gilla Cauli
- Asst Fatebenefratelli Sacco, 20154 Milan, Italy;
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224
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Lu Y, Zhang J, Su H, Xiao Y, Guo B, Li H. Improvement of associated symptoms using combined therapy in 44 patients with sleep-related painful erection during 1-year follow up. Andrologia 2022; 54:e14472. [PMID: 35593076 DOI: 10.1111/and.14472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 04/06/2022] [Accepted: 05/03/2022] [Indexed: 11/27/2022] Open
Abstract
The current study was aimed at analysing the clinical features and efficacy of combined treatments in patients with sleep-related painful erection (SRPE). Patients who presented with SRPE were continuously enrolled from the outpatient clinic of Peking Union Medical College Hospital from 2015 to 2021. Demographic data, medical history, diagnostics, treatment options and their effectiveness on SRPE in the short and long therapeutic term were recorded. Individually designed combined therapy aimed at controlling SRPE-related symptoms and comorbidities (general health, pain, psychological and sleeping disorders, late-onset hypogonadism, and lower urinary tract symptoms) was used, and the effectiveness was evaluated. In total, 44 patients with an average age of 44.66 ± 7.96 years were enrolled. The median length of the delay in diagnosis was 1.5 years (range, 1 month to 27 years). Combined treatment aimed at controlling symptoms was used, the mean GAD-7, PHQ-9, PSQI and VAS scores were significantly decreased to 4.25 ± 3.44, 4.55 ± 2.86, 7.65 ± 3.06, and 2.90 ± 1.89 after treatment for 3 months. Moreover, the VAS ratings were significantly decreased at 1 year of follow-up (p < 0.001). SRPE mainly occurred in middle aged males, 79.55% (35/44) patients were more than 40 years old. The prevalence of anxiety, depression, poor sleep and nocturia is high in patients with SRPE. Combined treatments aimed at controlling these symptoms can be more effective.
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Affiliation(s)
- Yi Lu
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jianzhong Zhang
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hao Su
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yi Xiao
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Bin Guo
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University, Beijing, China
| | - Hongjun Li
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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225
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Orouji F, Abdi R, Chalabianloo G. Mediating Role of Psychological Inflexibility as Transdiagnostic Factor in the Relationship Between Emotional Dysregulation and Sleep Problems With Symptoms of Emotional Disorders. Front Psychol 2022; 13:800041. [PMID: 35548493 PMCID: PMC9082666 DOI: 10.3389/fpsyg.2022.800041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 03/23/2022] [Indexed: 11/19/2022] Open
Abstract
This study aims to investigate the mediating role of psychological inflexibility as a transdiagnostic factor in the relationship between emotional dysregulation and sleep problems with symptoms of emotional disorders. A total of 500 subjects from three universities were selected by random multistage clustering, and they completed the Pittsburgh Sleep Quality Index, Difficulties in Emotional Regulation Scale, and Acceptance and Action Questionnaire–II, Inventory of Depression and Anxiety Symptoms. The results of correlation coefficients revealed that there is a positive and significant correlation among emotional dysregulation, sleep problems, and psychological inflexibility with emotional disorders. In addition, the results showed that psychological inflexibility acts as a transdiagnostic factor that mediates the relationship between emotional dysregulation and sleep problems with symptoms of emotional disorders. These findings illustrate how emotional dysregulation and sleep problems affect emotional disorders through psychological inflexibility.
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Affiliation(s)
- Farrin Orouji
- Department of Psychology, Azarbaijan Shahid Madani University, Tabriz, Iran
| | - Reza Abdi
- Department of Psychology, Faculty of Education and Psychology, Azarbaijan Shahid Madani University, Tabriz, Iran
| | - Gholamreza Chalabianloo
- Department of Psychology, Faculty of Education and Psychology, Azarbaijan Shahid Madani University, Tabriz, Iran
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226
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Høier NK, Madsen T, Spira AP, Hawton K, Benros ME, Nordentoft M, Erlangsen A. Association between hospital-diagnosed sleep disorders and suicide: a nationwide cohort study. Sleep 2022; 45:zsac069. [PMID: 35554572 DOI: 10.1093/sleep/zsac069] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 02/22/2022] [Indexed: 01/10/2023] Open
Abstract
STUDY OBJECTIVES Sleep disorders are related to mental disorders. Yet few studies have examined their association with suicide. We examined whether males and females diagnosed with sleep disorders had higher rates of suicide than individuals not diagnosed with sleep disorders. METHODS In a cohort study, nationwide data on all males and females aged over 15 years living in Denmark during 1980-2016 were analyzed. Sleep disorders were identified through diagnoses recorded during contacts to somatic hospitals. Incidence rate ratios (IRR) were estimated using Poisson regression models and adjusted for covariates. RESULTS In all, 3 674 563 males and 3 688 164 females were included, of whom 82 223 (2.2%, mean age: 50.2 years, SD: 17.5) males and 40 003 (1.1%, mean age: 50.6 years, SD: 19.9) females had sleep disorder diagnoses. Compared with those with no sleep disorders, the adjusted IRR for suicide were 1.6 (95% CI, 1.4 to 1.7) and 2.2 (95% CI, 1.8 to 2.6) for males and females with sleep disorders, respectively. Excess rates for narcolepsy were found for males (IRR: 1.2, 95% CI, 1.0 to 1.5) and females (IRR: 3.3, 95% CI, 3.0 to 4.1), and for sleep apnea in males (IRR: 1.8, 95% CI, 1.5 to 2.2). A difference with respect to age and sex was observed (p < 0.001) between males and females. Males and females had IRR of 4.1 (95% CI, 3.1 to 5.5) and 7.0 (95% CI, 4.8 to 10.1), during the first 6 months after being diagnosed with a sleep disorder. CONCLUSIONS Sleep disorders were associated with higher suicide rates even after adjusting for preexisting mental disorders. Our findings suggest attention toward suicidality in patients with sleep disorders is warranted.
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Affiliation(s)
- Nikolaj Kjær Høier
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Denmark
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, UK
| | - Trine Madsen
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Denmark
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Public Health, Faculty of Health, University of Copenhagen, Denmark
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
| | - Keith Hawton
- Centre for Suicide Research, University of Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Michael Eriksen Benros
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Merete Nordentoft
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Denmark
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Annette Erlangsen
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Denmark
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
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227
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Translational Approaches to Influence Sleep and Arousal. Brain Res Bull 2022; 185:140-161. [PMID: 35550156 PMCID: PMC9554922 DOI: 10.1016/j.brainresbull.2022.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/27/2022] [Accepted: 05/03/2022] [Indexed: 12/16/2022]
Abstract
Sleep disorders are widespread in society and are prevalent in military personnel and in Veterans. Disturbances of sleep and arousal mechanisms are common in neuropsychiatric disorders such as schizophrenia, post-traumatic stress disorder, anxiety and affective disorders, traumatic brain injury, dementia, and substance use disorders. Sleep disturbances exacerbate suicidal ideation, a major concern for Veterans and in the general population. These disturbances impair quality of life, affect interpersonal relationships, reduce work productivity, exacerbate clinical features of other disorders, and impair recovery. Thus, approaches to improve sleep and modulate arousal are needed. Basic science research on the brain circuitry controlling sleep and arousal led to the recent approval of new drugs targeting the orexin/hypocretin and histamine systems, complementing existing drugs which affect GABAA receptors and monoaminergic systems. Non-invasive brain stimulation techniques to modulate sleep and arousal are safe and show potential but require further development to be widely applicable. Invasive viral vector and deep brain stimulation approaches are also in their infancy but may be used to modulate sleep and arousal in severe neurological and psychiatric conditions. Behavioral, pharmacological, non-invasive brain stimulation and cell-specific invasive approaches covered here suggest the potential to selectively influence arousal, sleep initiation, sleep maintenance or sleep-stage specific phenomena such as sleep spindles or slow wave activity. These manipulations can positively impact the treatment of a wide range of neurological and psychiatric disorders by promoting the restorative effects of sleep on memory consolidation, clearance of toxic metabolites, metabolism, and immune function and by decreasing hyperarousal.
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228
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Palagini L, Hertenstein E, Riemann D, Nissen C. Sleep, insomnia and mental health. J Sleep Res 2022; 31:e13628. [PMID: 35506356 DOI: 10.1111/jsr.13628] [Citation(s) in RCA: 62] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 01/23/2023]
Abstract
While sleep serves important regulatory functions for mental health, sleep disturbances, in particular insomnia, may favour a state of allostatic overload impairing brain neuroplasticity and stress immune pathways, hence contributing to mental disorders. In this framework, the aim of this work was to link current understanding about insomnia mechanisms with current knowledge about mental health dysregulatory mechanisms. The focus of the present work was on mood, anxiety, and psychotic disorders, which represent important challenges in clinical practice. Literature searches were conducted on clinical, neurobiological, and therapeutic implications for insomnia comorbid with these mental disorders. Given the complexity and heterogeneity of the existing literature, we ended up with a narrative review. Insomnia may play an important role as a risk factor, a comorbid condition and transdiagnostic symptom for many mental disorders including mood/anxiety disorders and schizophrenia. Insomnia may also play a role as a marker of disrupted neuroplasticity contributing to dysregulation of different neurobiological mechanisms involved in these different mental conditions. In this framework, insomnia treatment may not only foster normal sleep processes but also the stress system, neuroinflammation and brain plasticity. Insomnia treatment may play an important preventive and neuroprotective role with cognitive behavioural therapy for insomnia being the treatment with important new evidence of efficacy for insomnia, psychopathology, and indices of disrupted neuroplasticity. On the other hand, pharmacological pathways for insomnia treatment in these mental conditions are still not well defined. Therapeutic options acting on melatonergic systems and new therapeutic options acting on orexinergic systems may represents interesting pathways of interventions that may open new windows on insomnia treatment in mental disorders.
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Affiliation(s)
- Laura Palagini
- Psychiatry Division, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Elisabeth Hertenstein
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Hauptstraße, Germany.,Center for Basics in NeuroModulation (NeuroModulBasics), Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph Nissen
- Department of Psychiatry, Psychiatric Specialties Division, Geneva University Hospitals (HUG), Geneva, Switzerland
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229
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Riemann D, Benz F, Dressle RJ, Espie CA, Johann AF, Blanken TF, Leerssen J, Wassing R, Henry AL, Kyle SD, Spiegelhalder K, Van Someren EJW. Insomnia disorder: State of the science and challenges for the future. J Sleep Res 2022; 31:e13604. [PMID: 35460140 DOI: 10.1111/jsr.13604] [Citation(s) in RCA: 77] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 03/23/2022] [Accepted: 03/23/2022] [Indexed: 12/25/2022]
Abstract
Insomnia disorder comprises symptoms during night and day that strongly affect quality of life and wellbeing. Prolonged sleep latency, difficulties to maintain sleep and early morning wakening characterize sleep complaints, whereas fatigue, reduced attention, impaired cognitive functioning, irritability, anxiety and low mood are key daytime impairments. Insomnia disorder is well acknowledged in all relevant diagnostic systems: Diagnostic and Statistical Manual of the American Psychiatric Association, 5th revision, International Classification of Sleep Disorders, 3rd version, and International Classification of Diseases, 11th revision. Insomnia disorder as a chronic condition is frequent (up to 10% of the adult population, with a preponderance of females), and signifies an important and independent risk factor for physical and, especially, mental health. Insomnia disorder diagnosis primarily rests on self-report. Objective measures like actigraphy or polysomnography are not (yet) part of the routine diagnostic canon, but play an important role in research. Disease concepts of insomnia range from cognitive-behavioural models to (epi-) genetics and psychoneurobiological approaches. The latter is derived from knowledge about basic sleep-wake regulation and encompass theories like rapid eye movement sleep instability/restless rapid eye movement sleep. Cognitive-behavioural models of insomnia led to the conceptualization of cognitive-behavioural therapy for insomnia, which is now considered as first-line treatment for insomnia worldwide. Future research strategies will include the combination of experimental paradigms with neuroimaging and may benefit from more attention to dysfunctional overnight alleviation of distress in insomnia. With respect to therapy, cognitive-behavioural therapy for insomnia merits widespread implementation, and digital cognitive-behavioural therapy may assist delivery along treatment guidelines. However, given the still considerable proportion of patients responding insufficiently to cognitive-behavioural therapy for insomnia, fundamental studies are highly necessary to better understand the brain and behavioural mechanisms underlying insomnia. Mediators and moderators of treatment response/non-response and the associated development of tailored and novel interventions also require investigation. Recent studies suggest that treatment of insomnia may prove to add significantly as a preventive strategy to combat the global burden of mental disorders.
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Affiliation(s)
- Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany.,Center for Basics in NeuroModulation (NeuroModulBasics), Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Fee Benz
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Raphael J Dressle
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Colin A Espie
- Sir Jules Thorn Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.,Big Health Ltd, London, UK.,Big Health Ltd, San Francisco, California, USA
| | - Anna F Johann
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany.,Institute of Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tessa F Blanken
- Department of Psychological Methods, University of Amsterdam, Amsterdam, The Netherlands
| | - Jeanne Leerssen
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Rick Wassing
- Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, The Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Alasdair L Henry
- Sir Jules Thorn Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.,Big Health Ltd, London, UK.,Big Health Ltd, San Francisco, California, USA
| | - Simon D Kyle
- Sir Jules Thorn Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Eus J W Van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
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230
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Harvey AG. Treating sleep and circadian problems to promote mental health: perspectives on comorbidity, implementation science and behavior change. Sleep 2022; 45:zsac026. [PMID: 35079830 PMCID: PMC8996031 DOI: 10.1093/sleep/zsac026] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 01/14/2022] [Indexed: 01/27/2023] Open
Abstract
Insufficient sleep and mistimed sleep are prominent, yet under-appreciated and understudied, contributors to poor mental health and to mental disorders. The evidence that improving sleep and circadian functioning is an important pathway to mental health continues to mount. The goal of this paper is to highlight three major challenges ahead. Challenge 1 points to the possibility that comorbidity is the norm not the exception for the sleep and circadian disorders that are associated with mental disorders. Hence, the sleep and circadian problems experienced by people diagnosed with a mental disorder may not fit into the neat diagnostic categories of existing nosologies nor be adequately treated with single disorder approaches. The Sleep Health Framework and the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) are discussed as alternative approaches. Challenge 2 points to the large time lag between the development of a treatment and the availability of that treatment in routine clinical practice. This is a key reason for the emergence of implementation science, which is a flourishing, well-developed, and quickly moving field. There is an urgent need for more applications of implementation science within sleep and circadian science. Challenge 3 describes one of the greatest puzzles of our time-the need to unlock the fundamental elements of behavior change. There is potential to harness the science of behavior change to encourage widespread engagement in sleep health behavior and thereby reduce the staggering burden of sleep and circadian problems and the associated mental health problems.
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Affiliation(s)
- Allison G Harvey
- Department of Psychology, University of California, Berkeley, CA, USA
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231
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Miyashita M, Obara T, Ishikuro M, Kikuya M, Kuriyama S. Association between Recurrence or Exacerbation at Time of Disaster and Allergic Symptoms Several Years Later in Schoolchildren with Asthma or Atopic Dermatitis: The ToMMo Child Health Study. TOHOKU J EXP MED 2022; 257:23-32. [PMID: 35387905 DOI: 10.1620/tjem.2022.j018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University.,Tohoku University Hospital
| | - Mami Ishikuro
- Tohoku Medical Megabank Organization, Tohoku University
| | - Masahiro Kikuya
- Tohoku Medical Megabank Organization, Tohoku University.,Teikyo University School of Medicine
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University.,Tohoku University International Research Institute of Disaster Science
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232
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Liang Y, Zhao X, Zhang C, Liu G, Lu B, Han L, Tong F, Luo X, Hu C, Liu H. Sleep Misperception and Associated Factors in Patients With Anxiety-Related Disorders and Complaint of Insomnia: A Retrospective Study. Front Neurol 2022; 13:836949. [PMID: 35463154 PMCID: PMC9021819 DOI: 10.3389/fneur.2022.836949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose Data on sleep parameters by polysomnography (PSG) in patients with anxiety-related disorders are limited. Although the disturbance and risk factors of sleep misperception have been implicated in psychopathology, its role in anxiety-related disorders remains unclear. This retrospective study aimed to explore the characteristics and sleep parameters in patients with anxiety-related disorders and different sleep perception types, and to explore the associated factors for sleep misperception. Methods Patients with anxiety-related disorders who had complaint of insomnia for more than 3 months were collected at Wuhan Mental Health Center between December 2019 and July 2021. Patients underwent a two-night PSG monitoring and completed a self-reported sleep questionnaire. Behaviors were assessed using 30-item Nurses' Observation Scale for Inpatient Evaluation (NOSIE-30). Patients were divided into normal sleep perception (NSP), positive sleep perception abnormality [PSPA; overestimation of total sleep time (TST) >60 min], and negative sleep perception abnormality (NSPA; underestimation of TST >60 min) groups. PSG indicators and NOSIE-30 scores were compared among groups using the one-way analysis of variance and the Kruskal-Wallis test. Multiple linear regression analysis was performed to determine the associated factors for misperception index. Results The subjective and objective TST were 5.5 ± 1.9 h and 6.4 ± 1.7 h in 305 patients, respectively. Sixty-nine (22.6%) had PSPA, 80 (26.2%) had NSP, and 156 (51.1%) had NSPA. Subjective TST and objective sleep parameters were significantly different among groups. No statistical differences in NOSIE-30 subscale and total scores were observed among groups. Sex, rapid eye movement (REM)/TST (%), sleep efficiency, number of awakenings, Non-rapid eye movement of stage 2 sleep (NREM)/TST (%), REM spontaneous arousal times, sleep latency, diagnosis, social competence, and manifest psychosis were associated with sleep misperception. Conclusion Sleep misperception is common in patients with anxiety-related disorders. Various sleep perception types have different PSG profiles, but similar personal and social behaviors. These data may be helpful to conduct personalized treatment.
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Affiliation(s)
- Yingjie Liang
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Sleep Disorder, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Xu Zhao
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Sleep Disorder, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Changyong Zhang
- Department of Psychiatry, Wuhan Wudong Hospital (Wuhan Second Mental Hospital), Wuhan, China
- *Correspondence: Changyong Zhang
| | - Guangya Liu
- Outpatient Office, Wuhan Jinyintan Hospital, Wuhan, China
- Guangya Liu
| | - Baili Lu
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
| | - Li Han
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
| | - Fang Tong
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Sleep Disorder, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Xinyu Luo
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Sleep Disorder, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Chuang Hu
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Sleep Disorder, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Hui Liu
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Sleep Disorder, Wuhan Hospital for Psychotherapy, Wuhan, China
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233
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Armstrong CC, Dong L, Harvey AG. Mediators and moderators of outcome from the Transdiagnostic Sleep and Circadian Intervention for adults with severe mental illness in a community setting. Behav Res Ther 2022; 151:104053. [DOI: 10.1016/j.brat.2022.104053] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 10/11/2021] [Accepted: 02/04/2022] [Indexed: 01/04/2023]
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234
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Sarfan LD, Hilmoe HE, Gumport NB, Harvey AG. The Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) in Community Mental Health: Comorbidity and Use of Modules Under the Microscope. COGNITIVE AND BEHAVIORAL PRACTICE 2022. [DOI: 10.1016/j.cbpra.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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235
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Weinberger AH, Steinberg ML, Mills SD, Dermody SS, Heffner JL, Kong AY, Pang RD, Rosen RL. Assessing Sex, Gender Identity, Sexual Orientation, Race, Ethnicity, Socioeconomic Status, and Mental Health Concerns in Tobacco Use Disorder Treatment Research: Measurement Challenges and Recommendations From a Society for Research on Nicotine and Tobacco Pre-conference Workshop. Nicotine Tob Res 2022; 24:643-653. [PMID: 34622932 PMCID: PMC8962699 DOI: 10.1093/ntr/ntab201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 10/04/2021] [Indexed: 11/15/2022]
Abstract
This paper reports on topics discussed at a Society for Research on Nicotine and Tobacco pre-conference workshop at the 2019 annual Society for Research on Nicotine and Tobacco meeting. The goal of the pre-conference workshop was to help develop a shared understanding of the importance of several tobacco-related priority groups in tobacco use disorder (TUD) treatment research and to highlight challenges in measurement related to these groups. The workshop focused on persons with minoritized sex, gender identity, and sexual orientation identities; persons with minoritized racial and ethnic backgrounds; persons with lower socioeconomic status (SES); and persons with mental health concerns. In addition to experiencing commercial tobacco-related health disparities, these groups are also underrepresented in tobacco research, including TUD treatment studies. Importantly, there is wide variation in how and whether researchers are identifying variation within these priority groups. Best practices for measuring and reporting sex, gender identity, sexual orientation, race, ethnicity, SES, and mental health concerns in TUD treatment research are needed. This paper provides information about measurement challenges when including these groups in TUD treatment research and specific recommendations about how to measure these groups and assess potential disparities in outcomes. The goal of this paper is to encourage TUD treatment researchers to use measurement best practices in these priority groups in an effort to conduct meaningful and equity-promoting research. Increasing the inclusion and visibility of these groups in TUD treatment research will help to move the field forward in decreasing tobacco-related health disparities. Implications: Tobacco-related disparities exist for a number of priority groups including, among others, women, individuals with minoritized sexual and gender identities, individuals with minoritized racial and ethnic backgrounds, individuals with lower SES, and individuals with mental health concerns. Research on TUD treatments for many of these subgroups is lacking. Accurate assessment and consideration of these subgroups will provide needed information about efficacious and effective TUD treatments, about potential mediators and moderators, and for accurately describing study samples, all critical elements for reducing tobacco-related disparities, and improving diversity, equity, and inclusion in TUD treatment research.
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Affiliation(s)
- Andrea H Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Marc L Steinberg
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Sarah D Mills
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sarah S Dermody
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada
| | - Jaimee L Heffner
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA,USA
| | - Amanda Y Kong
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Raina D Pang
- Department of Preventive Medicine, Keck School of Medicine at University of Southern California, Los Angeles, CA, USA
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Rachel L Rosen
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
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236
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Sleep's role in updating aversive autobiographical memories. Transl Psychiatry 2022; 12:117. [PMID: 35332136 PMCID: PMC8948270 DOI: 10.1038/s41398-022-01878-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 02/24/2022] [Accepted: 02/24/2022] [Indexed: 01/15/2023] Open
Abstract
Aversive autobiographical memories play a key role in the development and maintenance of many mental disorders. Imagery rescripting is a well-established psychotherapeutic intervention aiming to create a more adaptive version of an aversive memory by modifying its interpretation. Sleep has been shown to support reconsolidation of updated neutral memories. Here, we investigated in healthy participants whether a 90-min nap compared to wake supports the adaptive reconsolidation of autobiographical memories. Forty-four university students received a single 50-min imagery rescripting session. Thereafter, half of the participants took a 90-min nap, whereas the other half stayed awake. Subjective (arousal ratings, reports of emotions and dysfunctional cognitions) and heart rate (HR) responses to individual memory scripts were measured before the intervention (pre), after the 90-min retention interval (post 1) and 7 days later (post 2). Results demonstrate a significant decrease in distress of aversive memories pre to post imagery rescripting. The nap group showed less distressing dysfunctional cognitions along with a lower HR in response to the negative memory script as compared to the wake group at post 1. These differences were no longer evident 1 week later (post 2). Central sleep spindle density during the nap was correlated with the reduction in HR in response to the negative memory script from pre to post 1. Our results provide first evidence for sleep benefitting adaptive reconsolidation of aversive autobiographical memories. Future research should expand this approach to clinical populations and investigate precise conditions under which sleep may benefit psychotherapeutic interventions utilizing reconsolidation mechanisms.
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Neculicioiu VS, Colosi IA, Costache C, Sevastre-Berghian A, Clichici S. Time to Sleep?-A Review of the Impact of the COVID-19 Pandemic on Sleep and Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063497. [PMID: 35329184 PMCID: PMC8954484 DOI: 10.3390/ijerph19063497] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 02/06/2023]
Abstract
Sleep is intrinsically tied to mental and overall health. Short sleep duration accompanies the modern lifestyle, possibly reaching epidemic proportions. The pandemic and subsequent lockdowns determined a fundamental shift in the modern lifestyle and had profound effects on sleep and mental health. This paper aims to provide an overview of the relationship between sleep, mental health and COVID-19. Contrasting outcomes on sleep health have been highlighted by most reports during the pandemic in the general population. Consequently, while longer sleep durations have been reported, this change was accompanied by decreases in sleep quality and altered sleep timing. Furthermore, an increased impact of sleep deficiencies and mental health burden was generally reported in health care workers as compared with the adult general population. Although not among the most frequent symptoms during the acute or persistent phase, an increased prevalence of sleep deficiencies has been reported in patients with acute and long COVID. The importance of sleep in immune regulation is well known. Consequently, sleep deficiencies may influence multiple aspects of COVID-19, such as the risk, severity, and prognosis of the infection and even vaccine response.
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Affiliation(s)
- Vlad Sever Neculicioiu
- Department of Microbiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (I.A.C.); (C.C.)
- Correspondence:
| | - Ioana Alina Colosi
- Department of Microbiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (I.A.C.); (C.C.)
| | - Carmen Costache
- Department of Microbiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (I.A.C.); (C.C.)
| | - Alexandra Sevastre-Berghian
- Department of Physiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (A.S.-B.); (S.C.)
| | - Simona Clichici
- Department of Physiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (A.S.-B.); (S.C.)
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238
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Seo J, Oliver KI, Daffre C, Moore KN, Gazecki S, Lasko NB, Milad MR, Pace-Schott EF. Associations of sleep measures with neural activations accompanying fear conditioning and extinction learning and memory in trauma-exposed individuals. Sleep 2022; 45:zsab261. [PMID: 34718807 PMCID: PMC8919204 DOI: 10.1093/sleep/zsab261] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 10/26/2021] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES Sleep disturbances increase risk of posttraumatic stress disorder (PTSD). Sleep effects on extinction may contribute to such risk. Neural activations to fear extinction were examined in trauma-exposed participants and associated with sleep variables. METHODS Individuals trauma-exposed within the past 2 years (N = 126, 63 PTSD) completed 2 weeks actigraphy and sleep diaries, three nights ambulatory polysomnography and a 2-day fMRI protocol with Fear-Conditioning, Extinction-Learning and, 24 h later, Extinction-Recall phases. Activations within the anterior cerebrum and regions of interest (ROI) were examined within the total, PTSD-diagnosed and trauma-exposed control (TEC) groups. Sleep variables were used to predict activations within groups and among total participants. Family wise error was controlled at p < 0.05 using nonparametric analysis with 5,000 permutations. RESULTS Initially, Fear Conditioning activated broad subcortical and cortical anterior-cerebral regions. Within-group analyses showed: (1) by end of Fear Conditioning activations decreased in TEC but not PTSD; (2) across Extinction Learning, TEC activated medial prefrontal areas associated with emotion regulation whereas PTSD did not; (3) beginning Extinction Recall, PTSD activated this emotion-regulatory region whereas TEC did not. However, the only between-group contrast reaching significance was greater activation of a hippocampal ROI in TEC at Extinction Recall. A greater number of sleep variables were associated with cortical activations in separate groups versus the entire sample and in PTSD versus TEC. CONCLUSIONS PTSD nonsignificantly delayed extinction learning relative to TEC possibly increasing vulnerability to pathological anxiety. The influence of sleep integrity on brain responses to threat and extinction may be greater in more symptomatic individuals.
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Affiliation(s)
- Jeehye Seo
- Department of Psychiatry, Massachusetts General Hospital, Charlestown MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA
- Department of Psychiatry, Harvard Medical School, Charlestown, MA, USA
- Department of Brain & Cognitive Engineering, Korea University, Seongbuk-gu, Seoul, South Korea
| | - Katelyn I Oliver
- Department of Psychiatry, Massachusetts General Hospital, Charlestown MA, USA
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Carolina Daffre
- Department of Psychiatry, Massachusetts General Hospital, Charlestown MA, USA
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Kylie N Moore
- Department of Psychiatry, Massachusetts General Hospital, Charlestown MA, USA
- Graduate Program in Neuroscience, Boston University, Boston, MA, USA
| | - Samuel Gazecki
- Department of Psychiatry, Massachusetts General Hospital, Charlestown MA, USA
- Rush Medical College, Chicago, IL, USA
| | - Natasha B Lasko
- Department of Psychiatry, Massachusetts General Hospital, Charlestown MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA
- Department of Psychiatry, Harvard Medical School, Charlestown, MA, USA
| | - Mohammed R Milad
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
- Nathan Kline Institute for Psychiatric Research, Rockland, NY, USA
| | - Edward F Pace-Schott
- Department of Psychiatry, Massachusetts General Hospital, Charlestown MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA
- Department of Psychiatry, Harvard Medical School, Charlestown, MA, USA
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239
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Krempel R, Schleicher D, Jarvers I, Ecker A, Brunner R, Kandsperger S. Sleep quality and neurohormonal and psychophysiological accompanying factors in adolescents with depressive disorders: study protocol. BJPsych Open 2022; 8:e57. [PMID: 35236539 PMCID: PMC8935910 DOI: 10.1192/bjo.2022.29] [Citation(s) in RCA: 2] [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] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Depressive disorders are common mental health problems during adolescence. Many adolescents with depression describe difficulties with sleeping. Findings of previous studies regarding changes in objective sleep quality in adolescents with depressive disorders are heterogeneous. AIMS This study aims to investigate differences in objective and subjective sleep quality between adolescents with depressive disorders and healthy peers, and to evaluate if potential changes in sleep occur concurrently with changes in the release of cortisol and alpha-amylase after awakening. METHOD This non-interventional parallel study examines correlations between depressive disorders, sleep quality and release of stress hormones. Sleep quality in the past 2 weeks, severity of depressive symptoms, psychiatric comorbidities and stress response of 30 adolescents with depressive disorders and 30 healthy controls (N = 60) are assessed via questionnaires. In participants' home environments, the objective sleep quality of seven consecutive nights is measured by sleep accelerometry. After awakening, participants answer sleep questionnaires to examine the subjective sleep quality of those nights. Furthermore, salivary cortisol and alpha-amylase are measured three times after awakening (+0 min, +30 min and +45 min after awakening). CONCLUSIONS Sleep is an important factor for prognosis and well-being in adolescents with depression. The results of this study can be highly valuable to integrate a more detailed examination of sleep quality and sleeping impairments in the treatment of adolescent depressive disorders.
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Affiliation(s)
- Rebekka Krempel
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
| | - Daniel Schleicher
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
| | - Irina Jarvers
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
| | - Angelika Ecker
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
| | - Romuald Brunner
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
| | - Stephanie Kandsperger
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
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240
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Assessment of Sleep and Sleepiness in Patients With Mental Disorders: Applicability of the German Version of the SCOPA-Sleep Questionnaire. J Psychiatr Pract 2022; 28:156-165. [PMID: 35238827 DOI: 10.1097/pra.0000000000000617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Sleep problems affect the majority of patients with mental disorders and are very clinically relevant. However, they are often not assessed and treated appropriately and, to date, there is no established screening routine for sleep disturbances in this specific patient group. For patients with Parkinson disease, the Scales for Outcomes in Parkinson's Disease-Sleep (SCOPA-Sleep) questionnaire is widely used. This questionnaire has excellent psychometric properties. It consists of 2 scales for assessing nighttime sleep problems (NS) and daytime sleepiness (DS). As the items in the scales are not disease-specific, the goal of this study was to validate the SCOPA-Sleep for use in patients with mental disorders. A total of 370 German patients with mental disorders completed the SCOPA-Sleep as well as a multitude of other instruments for assessment of validity [eg, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS)]. For validity estimation, 627 healthy subjects were also included in this study. Internal consistency was good with coefficients of 0.806 and 0.772 for the SCOPA-NS and the SCOPA-DS. Factor analysis revealed 2 factors which could each be assigned to one of the subscales. Convergent validity was high with correlations of 0.672 between the SCOPA-NS and the PSQI and 0.644 between the SCOPA-DS and the ESS. The German version of the SCOPA-Sleep showed good diagnostic accuracy, resulting in an area under the receiver operating curve of 0.959 for the SCOPA-NS and 0.728 for the SCOPA-DS. For patients with mental disorders, the SCOPA-Sleep proved to be an economical, reliable, and valid instrument for assessing NS and DS which is well accepted by patients. It can be recommended for routine assessment of both NS and DS.
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241
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Ho GW, Yang Z, Xing L, Tsang KKT, Ruan HD, Li Y. Nighttime Sleep Awakening Frequency and Its Consistency Predict Future Academic Performance in College Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052933. [PMID: 35270625 PMCID: PMC8910766 DOI: 10.3390/ijerph19052933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/01/2022] [Accepted: 02/07/2022] [Indexed: 02/04/2023]
Abstract
Although the relationship between sleep and academic performance has been extensively examined, how sleep predicts future academic performance (e.g., 2-3 years) remains to be further investigated. Using wearable smartwatches and a self-report questionnaire, we tracked sleep activities of 45 college students over a period of approximately half a month to see whether their sleep activities predicted their academic performance, which was estimated by grade point average (GPA). Results showed that both nighttime sleep awakening frequency and its consistency in the tracking period were not significantly correlated with the GPA for the courses taken in the sleep tracking semester (current GPA). However, both nighttime sleep awakening frequency and its consistency inversely predicted the GPA for the rest of the courses taken after that semester (future GPA). Moreover, students with more difficulty staying awake throughout the day obtained lower current and future GPAs, and students with higher inconsistency of sleep quality obtained lower future GPA. Together, these findings highlight the importance of nighttime sleep awakening frequency and consistency in predicting future academic performance, and emphasize the necessity of assessing the consistency of sleep measures in future studies.
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Affiliation(s)
- Ghee Wee Ho
- Applied Psychology Programme, Division of Science and Technology, BNU-HKBU United International College, 2000 Jintong Rd, Tangjiawan, Zhuhai 519087, China; (Z.Y.); (L.X.)
- Correspondence: (G.W.H.); (Y.L.)
| | - Zhenzhi Yang
- Applied Psychology Programme, Division of Science and Technology, BNU-HKBU United International College, 2000 Jintong Rd, Tangjiawan, Zhuhai 519087, China; (Z.Y.); (L.X.)
| | - Linna Xing
- Applied Psychology Programme, Division of Science and Technology, BNU-HKBU United International College, 2000 Jintong Rd, Tangjiawan, Zhuhai 519087, China; (Z.Y.); (L.X.)
| | - Ken Kang-Too Tsang
- Statistics Programme, Division of Science and Technology, BNU-HKBU United International College, Zhuhai 519087, China;
| | - Huada Daniel Ruan
- Environmental Science Programme, Division of Science and Technology, BNU-HKBU United International College, Zhuhai 519087, China;
| | - Yu Li
- Applied Psychology Programme, Division of Science and Technology, BNU-HKBU United International College, 2000 Jintong Rd, Tangjiawan, Zhuhai 519087, China; (Z.Y.); (L.X.)
- Correspondence: (G.W.H.); (Y.L.)
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242
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Sumaya I, Dubocovich M. Melatonin-Mediated Attenuation of Fluphenazine-Induced Hypokinesia in C57BL/6 Mice is Dependent on the Light/Dark Phase. Behav Brain Res 2022; 425:113827. [DOI: 10.1016/j.bbr.2022.113827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 02/11/2022] [Accepted: 03/02/2022] [Indexed: 11/28/2022]
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243
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Lee CT, Ting GK, Bellissimo N, Khalesi S. The associations between lifestyle factors and mental well-being in baccalaureate nursing students: An observational study. Nurs Health Sci 2022; 24:255-264. [PMID: 35080779 DOI: 10.1111/nhs.12923] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/01/2022] [Accepted: 01/10/2022] [Indexed: 01/08/2023]
Abstract
Lifestyle factors are modifiable habits that shape the way in which individuals live their lives and can influence mental health. This study examined the associations between lifestyle factors and mental well-being among baccalaureate nursing students at one Canadian university. A cross-sectional, observational online survey was distributed at one urban university campus in Ontario, Canada. Baccalaureate nursing students (n = 147) completed the survey containing questions for demographic variables, sleep quality, dietary pattern, alcohol use, physical activity, sitting time, cigarette smoking, depression, anxiety and stress. Linear regression analysis revealed that more sitting time, poor sleep quality, and low dairy consumption were associated with higher scores in depression, anxiety, and psychological stress. In conclusion, poor lifestyle behaviors such as sedentary lifestyle, poor sleep, and low dairy consumption may reduce the mental well-being of baccalaureate nursing students. Future efforts should aim to establish a causal relationship between lifestyle and mental well-being, which would contribute to the development of lifestyle interventions to promote mental health.
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Affiliation(s)
| | | | | | - Saman Khalesi
- Central Queensland University, Brisbane, Queensland, Australia
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244
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Baker AL, Forbes E, Pohlman S, McCarter K. Behavioral Interventions to Reduce Cardiovascular Risk Among People with Severe Mental Disorder. Annu Rev Clin Psychol 2022; 18:99-124. [PMID: 35175861 DOI: 10.1146/annurev-clinpsy-072720-012042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Cardiovascular disease (CVD) is the leading cause of death among people with severe mental disorder (SMD). CVD risk factors occur at the individual, health system, and socio-environmental levels and contribute not only to high rates of CVD but also to worsening mental health. While acknowledging this wider context, this review focuses on behavioral interventions for seven CVD risk behaviors-smoking, physical inactivity, excessive alcohol consumption, low fruit and vegetable intake, inadequate sleep, poor social participation, and poor medication adherence-that are common among people with SMD. We survey recent meta-reviews of the literature and then review additional key studies to provide clinical recommendations for behavioral interventions to reduce CVD risk among people with SMD. A transdiagnostic psychological approach from the start of mental health treatment, drawing upon multidisciplinary expertise to address multiple risk behaviors, is recommended. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 18 is May 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Amanda L Baker
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia;
| | - Erin Forbes
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia;
| | - Sonja Pohlman
- School of Psychology, College of Engineering, Science and Environment, University of Newcastle, Callaghan, New South Wales, Australia
| | - Kristen McCarter
- School of Psychology, College of Engineering, Science and Environment, University of Newcastle, Callaghan, New South Wales, Australia
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245
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Healthy Dwelling: Design of Biophilic Interior Environments Fostering Self-Care Practices for People Living with Migraines, Chronic Pain, and Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042248. [PMID: 35206441 PMCID: PMC8871637 DOI: 10.3390/ijerph19042248] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 12/22/2022]
Abstract
The benefits of biophilic interior design have been recognized by healthcare facilities, but residential environments receive relatively less attention with respect to improving the health of people living with chronic diseases. Recent “stay-at-home” restrictions due to the COVID-19 pandemic further emphasized the importance of creating interior spaces that directly and indirectly support physical and mental health. In this viewpoint article, we discuss opportunities for combining biophilic interventions with interior design, fostering disease-specific self-care. We provide examples of designing residential spaces integrating biophilic interventions, light therapy, relaxation opportunities, mindfulness meditation, listening to music, physical activities, aromatherapy, and quality sleep. These modalities can provide the clinical benefits of reducing migraine headaches and chronic pain, as well as improving depressive symptoms. The disease-specific interior environment can be incorporated into residential homes, workplaces, assisted-living residences, hospitals and hospital at home programs. This work aims to promote a cross-disciplinary dialogue towards combining biophilic design and advances in lifestyle medicine to create therapeutic interior environments and to improve healthcare outcomes.
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246
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Leclair-Visonneau L. Orientation diagnostique devant une plainte d’hypersomnolence. Rev Med Interne 2022; 43:429-435. [DOI: 10.1016/j.revmed.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/12/2022] [Accepted: 01/22/2022] [Indexed: 11/17/2022]
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247
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Gumport NB, Harvey AG. Memory and learning for sleep and circadian treatment in serious mental illness treated in a community mental health setting. Behav Res Ther 2022; 149:104029. [PMID: 34995953 PMCID: PMC10883147 DOI: 10.1016/j.brat.2021.104029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 11/30/2021] [Accepted: 12/28/2021] [Indexed: 11/02/2022]
Abstract
OBJECTIVE Existing research has demonstrated that patient memory and learning of treatment contents are poor and poorer learning is associated with worse treatment outcome. Most prior studies have included individuals from only a single diagnostic group, offer limited data on possible contributors to poor memory and learning, and have included small samples recruited in university settings. This study sought to describe patient recall of treatment contents, describe patient learning of treatment contents, examine contributors to patient recall and learning of treatment contents, and examine the association of patient recall and learning of treatment contents with treatment outcome. METHODS Adults with serious mental illness and sleep and circadian dysfunction (N = 99) received the Transdiagnostic Intervention for Sleep and Circadian Dysfunction in a community mental health setting. Measures of recall, learning, age, years of education, symptom severity, and treatment outcome were collected at post-treatment and 6-month follow-up. RESULTS Recall and learning were poor, fewer years of education was associated with worse recall and learning, and recall and learning were not associated with treatment outcome. CONCLUSIONS The findings offer evidence that poor patient memory for, and learning of, treatment contents extends to community settings and are transdiagnostic concerns.
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248
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López-Gil JF, Roman-Viñas B, Aznar S, Tremblay MS. Meeting 24-h movement guidelines: prevalence, correlates and associations with socioemotional behavior in Spanish minors. Scand J Med Sci Sports 2022; 32:881-891. [PMID: 35090196 PMCID: PMC9303223 DOI: 10.1111/sms.14132] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/21/2021] [Accepted: 01/25/2022] [Indexed: 11/29/2022]
Abstract
The aims of this study were to determine for the first time the prevalence of a national sample of Spanish minors meeting the 24‐h movement guidelines; to determine their correlates; and to examine their associations with socioemotional behavioral problems. Cross‐sectional data from the Spanish National Health Survey (2017) were analyzed for this study. A total of 3772 Spanish minors were included. Physical activity was parent‐reported by a modified short version of the International Physical Activity Questionnaire, which included a single question related to the participation in physical activity in free time. Recreational screen time was parent‐reported by asking respondents for weekdays and weekends independently: “How much time does your child typically spend in front of a screen, including a computer, tablet, television, video, video game, or cell phone screen?”. Sleep duration was parent‐reported by the following question: “Can you tell me approximately how many hours your child usually sleeps daily?”. The Strengths and Difficulties Questionnaire was applied for the evaluation of socioemotional behavioral problems. The prevalence of meeting of all the three guidelines was 13.5%. Compared to meeting all guidelines, higher odds of socioemotional behavioral problems were found in participants meeting two guidelines (OR = 1.42; CI95%, 1.10–1.83), one guideline (OR = 1.50; 95%CI,1.14–1.96), or none of the guidelines (OR = 1.92; 95%CI,1.30–2.83). Our study demonstrated that the proportion of Spanish minors who meet with all the 24‐h movement guidelines is low. Furthermore, it could be relevant to the promotion of the 24‐h movement guidelines to prevent the risk of socioemotional behavioral problems.
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Affiliation(s)
| | - Blanca Roman-Viñas
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,School of Health and Sport Sciences (EUSES), Universitat de Girona, Salt, Spain.,Department of Physical Activity and Sport Sciences, Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Susana Aznar
- PAFS Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa, Canada
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249
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Zhang H, Liu L, Cheng S, Jia Y, Wen Y, Yang X, Meng P, Li C, Pan C, Chen Y, Zhang Z, Zhang J, Zhang F. Assessing the joint effects of brain aging and gut microbiota on the risks of psychiatric disorders. Brain Imaging Behav 2022; 16:1504-1515. [PMID: 35076893 DOI: 10.1007/s11682-022-00630-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2021] [Indexed: 12/20/2022]
Abstract
We aim to explore the potential interaction effects of brain aging and gut microbiota on the risks of sleep, anxiety and depression disorders. The genome-wide association study (GWAS) datasets of brain aging (N = 21,407) and gut microbiota (N = 3,890) were obtained from published studies. Individual level genotype and phenotype data of psychiatric traits (including sleep, anxiety and depression) were all from the UK Biobank (N = 107,947-374,505). We first calculated the polygenic risk scores (PRS) of 62 brain aging modes and 114 gut microbiota taxa as the instrumental variables, and then constructed linear and logistic regression analyses to systematically explore the potential interaction effects of brain aging and gut microbiota on psychiatric disorders. We observed the interaction effects of brain aging and gut microbiota on sleep, anxiety and depression disorders, such as Putamen/caudate T2* vs. Rhodospirillales (β = -0.012, P = 8.4 × 10-4) was negatively associated with chronotype, Fornix MD vs. Holdemanella (β = -0.007, P = 1.76 × 10-2) was negatively related to general anxiety disorder (GAD) scores, and White matter lesions vs. Acidaminococcaceae (β = 0.019, P = 1.29 × 10-3) was positively correlated with self-reported depression. Interestingly, Putamen volume vs. Intestinibacter was associated with all three psychiatric disorders, including chronotype (negative correlation), GAD scores (positive correlation) and self-reported depression (positive correlation). Our study results suggest the significant impacts of brain aging and gut microbiota on the development of sleep, anxiety and depression disorders, providing new clues for clarifying the pathogenesis of these disorders.
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Affiliation(s)
- Huijie Zhang
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, 710061, Xi'an, People's Republic of China
| | - Li Liu
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, 710061, Xi'an, People's Republic of China
| | - Shiqiang Cheng
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, 710061, Xi'an, People's Republic of China
| | - Yumeng Jia
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, 710061, Xi'an, People's Republic of China
| | - Yan Wen
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, 710061, Xi'an, People's Republic of China
| | - Xuena Yang
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, 710061, Xi'an, People's Republic of China
| | - Peilin Meng
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, 710061, Xi'an, People's Republic of China
| | - Chun'e Li
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, 710061, Xi'an, People's Republic of China
| | - Chuyu Pan
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, 710061, Xi'an, People's Republic of China
| | - Yujing Chen
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, 710061, Xi'an, People's Republic of China
| | - Zhen Zhang
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, 710061, Xi'an, People's Republic of China
| | - Jingxi Zhang
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, 710061, Xi'an, People's Republic of China
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, 710061, Xi'an, People's Republic of China.
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Raja R, Na X, Badger TM, Ou X. Neural correlates of sleep quality in children: Sex-specific associations shown by brain diffusion tractography. J Neuroimaging 2022; 32:530-543. [PMID: 35041231 PMCID: PMC9173651 DOI: 10.1111/jon.12964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/08/2021] [Accepted: 12/25/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND AND PURPOSE Sleep quality is important for healthy growth and development of children. We aimed to identify associations between sleep disturbances in healthy children without clinical diagnosis of sleep disorders and brain white matter (WM) microstructure using an advanced diffusion-weighted magnetic resonance imaging (DW-MRI) based tractography analysis, and to explore whether there are sex differences in these associations. METHODS Brain DW-MRI data were collected from sixty-two 8-year-old children (28 boys, 34 girls) whose parents also completed Children's Sleep Habits Questionnaire (CSHQ). Track-weighted imaging (TWI) measures were computed from the DW-MRI data for 37 WM tracts in each subject. Sex-specific partial correlation analyses were performed to evaluate correlations between TWI measures and a set of sleep disturbance scores derived from the CSHQ. RESULTS Significant correlations (P < .05, FDR-corrected; r: .48-.67) were identified in 13 WM tracts between TWI and sleep disturbance scores. Sexually dimorphic differences in correlations between sleep disturbance scores and WM microstructure measurements were observed. Specifically, in boys, daytime sleepiness positively correlated with track-weighted mean or radial diffusivity in 10 WM tracts (bilateral arcuate fasciculus, left cingulum, right middle longitudinal fasciculus, and three bilateral segments of superior longitudinal fasciculus). In girls, total CSHQ score, night walking, or sleep onset delay negatively correlated with track-weighted fractional anisotropy or axial diffusivity in 4 WM tracts (bilateral inferior longitudinal fasciculus and uncinate fasciculus). CONCLUSIONS The findings suggest that sleep disturbances without clinical diagnosis of sleep disorders are associated with lower WM microstructural integrity in children. Additionally, the associations possess unique patterns in boys and girls.
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Affiliation(s)
- Rajikha Raja
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Xiaoxu Na
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Thomas M Badger
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.,Arkansas Children's Nutrition Center, Little Rock, Arkansas, USA
| | - Xiawei Ou
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.,Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.,Arkansas Children's Nutrition Center, Little Rock, Arkansas, USA.,Arkansas Children's Research Institute, Little Rock, Arkansas, USA
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