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Metlaine A, Sauvet F, Gomez-Merino D, Boucher T, Elbaz M, Delafosse JY, Leger D, Chennaoui M. Sleep and biological parameters in professional burnout: A psychophysiological characterization. PLoS One 2018; 13:e0190607. [PMID: 29385150 PMCID: PMC5791983 DOI: 10.1371/journal.pone.0190607] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 12/18/2017] [Indexed: 12/12/2022] Open
Abstract
Professional burnout syndrome has been described in association with insomnia and metabolic, inflammatory and immune correlates. We investigated the interest of exploring biological parameters and sleep disturbances in relation to burnout symptoms among white-collar workers. Fifty-four participants with burnout were compared to 86 healthy control participants in terms of professional rank level, sleep, job strain (Karasek questionnaire), social support, anxiety and depression (HAD scale). Fasting concentrations of glycaemia, glycosylated hemoglobin (HbA1C), total-cholesterol, triglycerides, C-reactive protein (CRP), thyroid stimulating hormone (TSH), 25-hydroxyvitamin D (25[OH]D), and white blood cell (WBC) counts were assessed. Analysis of variance and a forward Stepwise Multiple Logistic Regression were made to identify predictive factors of burnout. Besides reporting more job strain (in particular job control p = 0.02), higher levels of anxiety (p<0.001), and sleep disorders related to insomnia (OR = 21.5, 95%CI = 8.8–52.3), participants with burnout presented higher levels of HbA1C, glycaemia, CRP, lower levels of 25(OH)D, higher number of leukocytes, neutrophils and monocytes (P<0.001 for all) and higher total-cholesterol (P = 0.01). In particular, when HbA1c is > 3.5%, the prevalence of burnout increases from 16.6% to 60.0% (OR = 4.3, 95%CI = 2.8–6.9). Strong significant positive correlation existed between HbA1C and the two dimensions (emotional exhaustion and depersonalization (r = 0.79 and r = 0.71, p<0.01)) of burnout. Models including job strain, job satisfaction, anxiety and insomnia did not predict burnout (p = 0.30 and p = 0.50). However, when HbA1C levels is included, the prediction of burnout became significant (P = 0.03). Our findings demonstrated the interest of sleep and biological parameters, in particular HbA1C levels, in the characterization of professional burnout.
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Affiliation(s)
- Arnaud Metlaine
- Université Paris Descartes, Sorbonne Paris Cité, Hôtel Dieu, Paris, France
- APHP, Hôtel Dieu, Centre du sommeil et de la vigilance, Paris, France
- * E-mail:
| | - Fabien Sauvet
- Université Paris Descartes, Sorbonne Paris Cité, Hôtel Dieu, Paris, France
- Unité Fatigue et Vigilance, Institut de recherche biomédicale des armées (IRBA), Brétigny sur Orge, France
| | - Danielle Gomez-Merino
- Université Paris Descartes, Sorbonne Paris Cité, Hôtel Dieu, Paris, France
- Unité Fatigue et Vigilance, Institut de recherche biomédicale des armées (IRBA), Brétigny sur Orge, France
| | | | - Maxime Elbaz
- Université Paris Descartes, Sorbonne Paris Cité, Hôtel Dieu, Paris, France
- APHP, Hôtel Dieu, Centre du sommeil et de la vigilance, Paris, France
| | | | - Damien Leger
- Université Paris Descartes, Sorbonne Paris Cité, Hôtel Dieu, Paris, France
- APHP, Hôtel Dieu, Centre du sommeil et de la vigilance, Paris, France
| | - Mounir Chennaoui
- Université Paris Descartes, Sorbonne Paris Cité, Hôtel Dieu, Paris, France
- Unité Fatigue et Vigilance, Institut de recherche biomédicale des armées (IRBA), Brétigny sur Orge, France
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202
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Buysse DJ. Evidence-Based Guidelines for Fatigue Risk Management in Emergency Medical Services: A Step in the Right Direction Toward Better Sleep Health. PREHOSP EMERG CARE 2018; 22:3-5. [DOI: 10.1080/10903127.2017.1380099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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203
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Whitesell PL, Obi J, Tamanna NS, Sumner AE. A Review of the Literature Regarding Sleep and Cardiometabolic Disease in African Descent Populations. Front Endocrinol (Lausanne) 2018; 9:140. [PMID: 29695999 PMCID: PMC5904363 DOI: 10.3389/fendo.2018.00140] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 03/16/2018] [Indexed: 12/22/2022] Open
Abstract
UNLABELLED In the twenty-first century, African descent populations on both the continent of Africa and throughout the world are experiencing a high rate of both sleep disturbances and cardiometabolic diseases. The most common sleep disturbances are reduced sleep duration, insomnia, disordered circadian rhythm, and obstructive sleep apnea. Cardiometabolic diseases include hypertension, coronary artery disease, diabetes, hyperlipidemia, and the metabolic syndrome. This review seeks to call attention to new insights regarding the impact of sleep disturbance on cardiometabolic risk factors and outcomes and then apply these concepts to African descent populations, a relatively understudied population. Initial data suggest disparities in sleep quality may have an important role in current and emerging patterns of cardiometabolic disease for African descent populations both in the United States and abroad. CLINICALTRIALSGOV IDENTIFIER Not applicable.
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Affiliation(s)
- Peter L. Whitesell
- Howard University Hospital Sleep Disorders Center, Washington, DC, United States
| | - Jennifer Obi
- Department of Internal Medicine, Howard University Hospital, Washington, DC, United States
| | - Nuri S. Tamanna
- Howard University Hospital Sleep Disorders Center, Washington, DC, United States
| | - Anne E. Sumner
- Section on Ethnicity and Health, Diabetes, Endocrinology and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases and National Institute of Minority Health and Health Disparities, National Institutes of Health (NIH), Bethesda, MD, United States
- *Correspondence: Anne E. Sumner,
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204
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McHill AW, Hull JT, McMullan CJ, Klerman EB. Chronic Insufficient Sleep Has a Limited Impact on Circadian Rhythmicity of Subjective Hunger and Awakening Fasted Metabolic Hormones. Front Endocrinol (Lausanne) 2018; 9:319. [PMID: 29946297 PMCID: PMC6005823 DOI: 10.3389/fendo.2018.00319] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 05/28/2018] [Indexed: 01/04/2023] Open
Abstract
UNLABELLED Weight gain and obesity have reached epidemic proportions in modern society. Insufficient sleep-which is also prevalent in modern society-and eating at inappropriate circadian times have been identified as risk factors for weight gain, yet the impact of chronic insufficient sleep on the circadian timing of subjective hunger and physiologic metabolic outcomes are not well understood. We investigated how chronic insufficient sleep impacts the circadian timing of subjective hunger and fasting metabolic hormones in a 32-day in-laboratory randomized single-blind control study, with healthy younger participants (range, 20-34 years) randomized to either Control (1:2 sleep:wake ratio, 6.67 h sleep:13.33 h wake, n = 7, equivalent to 8 h of sleep per 24 h) or chronic sleep restriction (CSR, 1:3.3 sleep:wake ratio, 4.67 h sleep:15.33 h wake, n = 8, equivalent to 5.6 h of sleep per 24 h) conditions. Participants lived on a "20 h day" designed to distribute all behaviors and food intake equally across all phases of the circadian cycle over every six consecutive 20 h protocol days. During each 20 h day, participants were provided a nutritionist-designed, isocaloric diet consisting of 45-50% carbohydrate, 30-35% fat, and 15-20% protein adjusted for sex, weight, and age. Subjective non-numeric ratings of hunger were recorded before and after meals and fasting blood samples were taken within 5 min of awakening. Subjective levels of hunger and fasting concentrations of leptin, ghrelin, insulin, glucose, adiponectin, and cortisol all demonstrated circadian patterns; there were no differences, however, between CSR and Control conditions in subjective hunger ratings or any fasting hormone concentrations. These findings suggest that chronic insufficient sleep may have a limited role in altering the robust circadian profile of subjective hunger and fasted metabolic hormones. CLINICAL TRIAL REGISTRATION The study was registered as clinical trial #NCT01581125.
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Affiliation(s)
- Andrew W. McHill
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, United States
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, United States
- *Correspondence: Andrew W. McHill,
| | - Joseph T. Hull
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, United States
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
| | - Ciaran J. McMullan
- Renal Division, Brigham and Women’s Hospital, Boston, MA, United States
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA, United States
| | - Elizabeth B. Klerman
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, United States
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
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205
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Joyce T, Chirino YI, Natalia MT, Jose PC. Renal damage in the metabolic syndrome (MetSx): Disorders implicated. Eur J Pharmacol 2018; 818:554-568. [DOI: 10.1016/j.ejphar.2017.11.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 11/14/2017] [Accepted: 11/16/2017] [Indexed: 02/08/2023]
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206
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Roomkham S, Lovell D, Cheung J, Perrin D. Promises and Challenges in the Use of Consumer-Grade Devices for Sleep Monitoring. IEEE Rev Biomed Eng 2018; 11:53-67. [DOI: 10.1109/rbme.2018.2811735] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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207
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Lin CL, Chien WC, Chung CH, Wu FL. Risk of type 2 diabetes in patients with insomnia: A population-based historical cohort study. Diabetes Metab Res Rev 2018; 34. [PMID: 28834008 DOI: 10.1002/dmrr.2930] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 04/14/2017] [Accepted: 08/07/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND We investigated the risk of type 2 diabetes mellitus (T2DM) in patients with and without insomnia. METHODS In this historical cohort study, we performed a secondary analysis of data from 2001 to 2010, which was obtained from Taiwan's National Health Insurance Database. We developed a Cox proportional hazard regression model to estimate the effects of insomnia on T2DM risk. Kaplan-Meier survival analysis was applied to compare the differences in the cumulative incidence of T2DM between the groups with and without insomnia. RESULTS During the follow-up period, the T2DM incidence rate of patients with insomnia was significantly higher than that of patients without insomnia (34.7 vs 24.3 per 1000 person-years). Overall, patients with insomnia had a higher risk of T2DM than did patients without insomnia (adjusted hazard ratio, 1.16; 95% confidence interval [CI], 1.10-1.19). Among patients aged younger than 40 years, those with insomnia had a higher risk of T2DM than did the comparison cohort (adjusted hazard ratio, 1.31; 95% CI, 1.14-1.55). Compared with patients without insomnia, the risk tended to increase with the duration of follow-up in patients with insomnia; when the insomnia duration was <4 years, 4 to 8 years, and >8 years, the risk of T2DM increased by 1.14, 1.38, and 1.51 times (95% CI, 1.03-1.17, 1.15-1.49, and 1.20-1.86), respectively. Patients with insomnia had a higher risk of T2DM, and this risk was particularly pronounced among the younger (≤40 years) population. CONCLUSION Chronic insomnia could be an important risk factor for T2DM.
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Affiliation(s)
- Chia-Ling Lin
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hsiang Chung
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Fei-Ling Wu
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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208
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Tarasiuk A, Segev Y. Abnormal Growth and Feeding Behavior in Upper Airway Obstruction in Rats. Front Endocrinol (Lausanne) 2018; 9:298. [PMID: 29915561 PMCID: PMC5994397 DOI: 10.3389/fendo.2018.00298] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 05/18/2018] [Indexed: 12/18/2022] Open
Abstract
Pediatric obstructive sleep apnea (OSA) is a syndrome manifesting with snoring and increased respiratory effort due to increased upper airway resistance. In addition to cause the abnormal sleep, this syndrome has been shown to elicit either growth retardation or metabolic syndrome and obesity. Treating OSA by adenotonsillectomy is usually associated with increased risk for obesity, despite near complete restoration of breathing and sleep. However, the underlying mechanism linking upper airways obstruction (AO) to persistent change in food intake, metabolism, and growth remains unclear. Rodent models have examined the impact of intermittent hypoxia on metabolism. However, an additional defining feature of OSA that is not related to intermittent hypoxia is enhanced respiratory loading leading to increased respiratory effort and abnormal sleep. The focus of this mini review is on recent evidence indicating the persistent abnormalities in endocrine regulation of feeding and growth that are not fully restored by the chronic upper AO removal in rats. Here, we highlight important aspects related to abnormal regulation of metabolism that are not related to intermittent hypoxia per se, in an animal model that mimics many of the clinical features of pediatric OSA. Our evidence from the AO model indicates that obstruction removal may not be sufficient to prevent the post-removal tendency for abnormal growth.
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Affiliation(s)
- Ariel Tarasiuk
- Sleep-Wake Disorders Unit, Soroka University Medical Center, Beer-Sheva, Israel
- Department of Physiology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- *Correspondence: Ariel Tarasiuk,
| | - Yael Segev
- Shraga Segal Department of Microbiology and Immunology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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209
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Klein L, Gao T, Barzilai N, Milman S. Association between Sleep Patterns and Health in Families with Exceptional Longevity. Front Med (Lausanne) 2017; 4:214. [PMID: 29276708 PMCID: PMC5727046 DOI: 10.3389/fmed.2017.00214] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 11/15/2017] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Sleep patterns such as longer sleep duration or napping are associated with poor health outcomes. Although centenarians and their offspring demonstrate a delayed onset of age-related diseases, it is not known whether they have healthier sleep patterns or are protected against the negative effects of sleep disturbances. METHODS Data on sleep patterns and health history were collected from Ashkenazi Jewish subjects of the Longevity Genes Project using standardized questionnaires. Participants included individuals with exceptional longevity (centenarians) with preserved cognition (n = 348, median age 97 years), their offspring (n = 513, median age 69 years), and controls (n = 199) age-matched to the offspring. Centenarians reported on their sleep patterns at age 70, while the offspring and controls on their current sleep patterns. Biochemical parameters were measured at baseline. Models were adjusted for age, sex, BMI, and use of sleep medication. RESULTS The offspring and controls reported similar sleep patterns, with 33% sleeping ≥8 h and 17% napping in each group. At age 70, centenarians were more likely to have slept ≥8 h (55%) and to have napped (28%) compared with offspring and controls, p < 0.01. Among centenarians, no association was noted between sleep patterns and health outcomes. Sleeping for ≥8 h was associated with lower high-density lipoprotein cholesterol levels in the offspring and controls, and with insulin resistance in the offspring, but not with diabetes. Napping was associated with insulin resistance among the controls (p < 0.01), but not the offspring. Controls, but not offspring, who napped were 2.79 times more likely to have one or more of the following diseases: hypertension, myocardial infarction, stroke, or diabetes (OR 2.79, 95% CI 1.08-7.21, p = 0.04). CONCLUSION Despite being more likely to exhibit risky sleep patterns at age 70 compared with the offspring and controls, the centenarians were protected from age-related morbidities. The offspring of centenarians did exhibit metabolic disturbances in association with less healthy sleep patterns; however, unlike the controls, they were much less likely to manifest age-related diseases. This suggests that offspring may have inherited resilience genotypes from their centenarian parents that protect them against the harmful effects of sleep disturbances.
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Affiliation(s)
- Lavy Klein
- Department of Geriatrics, Shoham Medical Center, Pardes-Hanna, The Technion-Israel Institute of Technology, Haifa, Israel
| | - Tina Gao
- Institute for Aging Research, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Nir Barzilai
- Institute for Aging Research, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Genetics, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Sofiya Milman
- Institute for Aging Research, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
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210
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Krittanawong C, Tunhasiriwet A, Wang Z, Zhang H, Farrell AM, Chirapongsathorn S, Sun T, Kitai T, Argulian E. Association between short and long sleep durations and cardiovascular outcomes: a systematic review and meta-analysis. EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE 2017; 8:762-770. [PMID: 29206050 DOI: 10.1177/2048872617741733] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND A shorter sleep duration has been identified as a risk factor for cardiovascular diseases and increased mortality. It has been hypothesized that a short sleep duration may be linked to changes in ghrelin and leptin production, leading to an alteration of stress hormone production. Here, we conducted a systematic review and meta-analysis to investigate the potential relationship between a sleep duration and cardiovascular disease mortality. METHODS We conducted a comprehensive search of Ovid Medline In-Process and other non-indexed citations, Ovid MEDLINE, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, and Scopus from database inception to March 2017. Observational studies were included if the studies reported hazard ratios or odds ratios of the associations between sleep durations (short and long) and cardiovascular disease mortality. Data were extracted by a reviewer and then reviewed by two separate reviewers. Conflicts were resolved through consensus. Using the DerSimonian and Laird random effects models, we calculated pooled hazard ratios and pooled odds ratios with 95% confidence intervals (CI). Subgroup analyses were performed to explore potential sources of heterogeneity. The quality of the included studies and publication bias were assessed. RESULTS In total, our meta-analysis included 19 studies (31 cohorts) with a total of 816,995 individuals with 42,870 cardiovascular disease mortality cases. In pooled analyses, both short (risk ratio 1.19; 95% CI 1.13 to 1.26, P<0.001, I2=30.7, Pheterogeneity=0.034), and long (risk ratio 1.37; 95% CI 1.23 to 1.52, P<0.001, I2=79.75, Pheterogeneity<0.001) sleep durations were associated with a greater risk of cardiovascular disease mortality. CONCLUSIONS Both short (<7 hours) and long sleep durations (>9 hours) can increase the risk of overall cardiovascular disease mortality, particularly in Asian populations and elderly individuals. Future epidemiological studies would ideally include objective sleep measurements, rather than self-report measures, and all potential confounders, such as genetic variants.
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Affiliation(s)
- Chayakrit Krittanawong
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, USA.,Department of Cardiovascular Diseases, Icahn School of Medicine at Mount Sinai St' Luke, Mount Sinai Heart, USA
| | | | - Zhen Wang
- Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, USA.,Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic. USA
| | - HongJu Zhang
- Division of Cardiovascular Diseases, Mayo Clinic, USA
| | | | - Sakkarin Chirapongsathorn
- Division of Gastroenterology and Hepatology, Mayo Clinic, USA.,Division of Gastroenterology, Phramongkutklao Hospital and College of Medicine, Royal Thai Army, Bangkok, Thailand
| | - Tao Sun
- Division of Cardiovascular Diseases, Mayo Clinic, USA
| | - Takeshi Kitai
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Japan.,Department of Cardiovascular Medicine, Cleveland Clinic, USA
| | - Edgar Argulian
- Department of Cardiovascular Diseases, Icahn School of Medicine at Mount Sinai St' Luke, Mount Sinai Heart, USA
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211
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Zohal M, Ghorbani A, Esmailzadehha N, Ziaee A, Mohammadi Z. Association of sleep quality components and wake time with metabolic syndrome: The Qazvin Metabolic Diseases Study (QMDS), Iran. Diabetes Metab Syndr 2017; 11 Suppl 1:S377-S380. [PMID: 28284911 DOI: 10.1016/j.dsx.2017.03.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 03/03/2017] [Indexed: 12/31/2022]
Abstract
PURPOSE The aim of this study was to determine the association of sleep quality and sleep quantity with metabolic syndrome in Qazvin, Iran. METHODS this cross sectional study was conducted in 1079 residents of Qazvin selected by multistage cluster random sampling method in 2011. Metabolic syndrome was defined according to the criteria proposed by the national cholesterol education program third Adult treatment panel. Sleep was assessed using the Pittsburgh sleep quality index (PSQI). A logistic regression analysis was used to examine the association of sleep status and metabolic syndrome. RESULTS Mean age was 40.08±10.33years. Of 1079, 578 (52.2%) were female, and 30.6% had metabolic syndrome. The total global PSQI score in the subjects with metabolic syndrome was significantly higher than subjects without metabolic syndrome (6.30±3.20 vs. 5.83±2.76, P=0.013). In logistic regression analysis, sleep disturbances was associated with 1.388 fold increased risk of metabolic syndrome after adjustment for age, gender, and body mass index. CONCLUSION Sleep disturbances component was a predictor of metabolic syndrome in the present study. More longitudinal studies are necessary to understand the association of sleep quality and its components with metabolic syndrome.
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Affiliation(s)
- Mohammadali Zohal
- Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Azam Ghorbani
- Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran; School of Nursing & Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran.
| | - Neda Esmailzadehha
- Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Amir Ziaee
- Growth and Development Research Center, Iran University of Medical Sciences, Tehran, Iran; Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Zahrasadat Mohammadi
- Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
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212
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Farr OM, Rifas-Shiman SL, Oken E, Taveras EM, Mantzoros CS. Current child, but not maternal, snoring is bi-directionally related to adiposity and cardiometabolic risk markers: A cross-sectional and a prospective cohort analysis. Metabolism 2017; 76:70-80. [PMID: 28774733 PMCID: PMC5733777 DOI: 10.1016/j.metabol.2017.06.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 06/23/2017] [Accepted: 06/23/2017] [Indexed: 01/09/2023]
Abstract
PURPOSE Obstructive sleep apnea (OSA), typically manifested as snoring, is closely associated with obesity. However, the directionality of associations of OSA with cardiometabolic risk markers is unclear, as obesity increases risk for OSA, and OSA results in excess weight gain and its metabolic consequences. Less is known about how obesity and OSA may relate in children and adolescents and whether maternal OSA may influence the development of obesity and cardiometabolic dysfunction in offspring. BASIC PROCEDURES Among 1078 children from the Project Viva cohort, we examined cross-sectionally and prospectively associations of parent-reported child or maternal snoring with cardiometabolic outcomes, including adiposity, adipokines, and insulin resistance. MAIN FINDINGS Cross-sectionally, child snoring was related to adiposity and metabolic risk, particularly body mass index (BMI; β 0.61kg/m2, 95% CI 0.33, 0.89; p<0.001), trunk fat mass index (β 0.23kg/m2, CI 0.12, 0.34; p<0.001), high-density lipoprotein cholesterol (β -1.47mg/dL, CI -2.69, -0.25; p=0.02), and metabolic risk z-score (β 0.08, CI 0.02, 0.14; p=0.01) after correction for covariates. Prospectively, adiposity (BMI, trunk fat, fat mass, and waist circumference) and cardiometabolic (leptin, HOMA-IR, CRP, and global metabolic risk) measures at mid-childhood (~7y) were associated with child snoring at the early teen visit (~12y) after correction for covariates. Child snoring at ~9y was related to changes in adiposity between mid-childhood and early teen visits. CONCLUSIONS Child but not maternal snoring, was related to child adiposity and cardiometabolic outcomes. Adiposity and child snoring are associated with each other cross-sectionally and are each predictive of the other among children/adolescents prospectively. These results suggest similar mechanisms in pediatric/adolescent populations as in adults for the development of sleep-disordered breathing and sleep apnea that will need to be confirmed in randomized clinical trials. Importantly, this research points to the need to target both sleep and obesity in order to break this vicious cycle.
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Affiliation(s)
- Olivia M Farr
- Division of Endocrinology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, United States.
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA, United States
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA, United States; Department of Nutrition, Harvard School of Public Health, Boston, MA, United States
| | - Elsie M Taveras
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States
| | - Christos S Mantzoros
- Division of Endocrinology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, United States; Section of Endocrinology, VA Boston Healthcare System, Boston, MA, United States
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Demos KE, Sweet LH, Hart CN, McCaffery JM, Williams SE, Mailloux KA, Trautvetter J, Owens MM, Wing RR. The Effects of Experimental Manipulation of Sleep Duration on Neural Response to Food Cues. Sleep 2017; 40:3980278. [PMID: 28977574 PMCID: PMC5806554 DOI: 10.1093/sleep/zsx125] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Despite growing literature on neural food cue responsivity in obesity, little is known about how the brain processes food cues following partial sleep deprivation and whether short sleep leads to changes similar to those observed in obesity. We used functional magnetic resonance imaging (fMRI) to test the hypothesis that short sleep leads to increased reward-related and decreased inhibitory control-related processing of food cues.In a within-subject design, 30 participants (22 female, mean age = 36.7 standard deviation = 10.8 years, body mass index range 20.4-40.7) completed four nights of 6 hours/night time-in-bed (TIB; short sleep) and four nights of 9 hours/night TIB (long sleep) in random counterbalanced order in their home environments. Following each sleep condition, participants completed an fMRI scan while viewing food and nonfood images.A priori region of interest analyses revealed increased activity to food in short versus long sleep in regions of reward processing (eg, nucleus accumbens/putamen) and sensory/motor signaling (ie, right paracentral lobule, an effect that was most pronounced in obese individuals). Contrary to the hypothesis, whole brain analyses indicated greater food cue responsivity during short sleep in an inhibitory control region (right inferior frontal gyrus) and ventral medial prefrontal cortex, which has been implicated in reward coding and decision-making (false discovery rate corrected q = 0.05).These findings suggest that sleep restriction leads to both greater reward and control processing in response to food cues. Future research is needed to understand the dynamic functional connectivity between these regions during short sleep and whether the interplay between these neural processes determines if one succumbs to food temptation.
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Affiliation(s)
- Kathryn E Demos
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Miriam Hospital, Weight Control and Diabetes Research Center, Providence, RI
| | | | - Chantelle N Hart
- Center for Obesity Research and Education, Department of Public Health, Temple University
| | - Jeanne M McCaffery
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Miriam Hospital, Weight Control and Diabetes Research Center, Providence, RI
| | - Samantha E Williams
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Miriam Hospital, Weight Control and Diabetes Research Center, Providence, RI
| | - Kimberly A Mailloux
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Miriam Hospital, Weight Control and Diabetes Research Center, Providence, RI
| | - Jennifer Trautvetter
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Miriam Hospital, Weight Control and Diabetes Research Center, Providence, RI
| | - Max M Owens
- Center for Obesity Research and Education, Department of Public Health, Temple University
| | - Rena R Wing
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Miriam Hospital, Weight Control and Diabetes Research Center, Providence, RI
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214
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Stankiewicz AJ, McGowan EM, Yu L, Zhdanova IV. Impaired Sleep, Circadian Rhythms and Neurogenesis in Diet-Induced Premature Aging. Int J Mol Sci 2017; 18:E2243. [PMID: 29072584 PMCID: PMC5713213 DOI: 10.3390/ijms18112243] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 10/13/2017] [Accepted: 10/22/2017] [Indexed: 01/02/2023] Open
Abstract
Chronic high caloric intake (HCI) is a risk factor for multiple major human disorders, from diabetes to neurodegeneration. Mounting evidence suggests a significant contribution of circadian misalignment and sleep alterations to this phenomenon. An inverse temporal relationship between sleep, activity, food intake, and clock mechanisms in nocturnal and diurnal animals suggests that a search for effective therapeutic approaches can benefit from the use of diurnal animal models. Here, we show that, similar to normal aging, HCI leads to the reduction in daily amplitude of expression for core clock genes, a decline in sleep duration, an increase in scoliosis, and anxiety-like behavior. A remarkable decline in adult neurogenesis in 1-year old HCI animals, amounting to only 21% of that in age-matched Control, exceeds age-dependent decline observed in normal 3-year old zebrafish. This is associated with misalignment or reduced amplitude of daily patterns for principal cell cycle regulators, cyclins A and B, and p20, in brain tissue. Together, these data establish HCI in zebrafish as a model for metabolically induced premature aging of sleep, circadian functions, and adult neurogenesis, allowing for a high throughput approach to mechanistic studies and drug trials in a diurnal vertebrate.
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Affiliation(s)
- Alexander J Stankiewicz
- Department of Preclinical Research and Development, BioChron LLC, Worcester, MA 01605, USA.
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA 02118, USA.
| | - Erin M McGowan
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA 02118, USA.
| | - Lili Yu
- Department of Preclinical Research and Development, BioChron LLC, Worcester, MA 01605, USA.
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA 02118, USA.
| | - Irina V Zhdanova
- Department of Preclinical Research and Development, BioChron LLC, Worcester, MA 01605, USA.
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA 02118, USA.
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215
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Salwen JK, Smith MT, Finan PH. Mid-Treatment Sleep Duration Predicts Clinically Significant Knee Osteoarthritis Pain reduction at 6 months: Effects From a Behavioral Sleep Medicine Clinical Trial. Sleep 2017; 40:2740597. [PMID: 28364511 DOI: 10.1093/sleep/zsw064] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Study Objectives To determine the relative influence of sleep continuity (sleep efficiency, sleep onset latency, total sleep time [TST], and wake after sleep onset) on clinical pain outcomes within a trial of cognitive behavioral therapy for insomnia (CBT-I) for patients with comorbid knee osteoarthritis and insomnia. Methods Secondary analyses were performed on data from 74 patients with comorbid insomnia and knee osteoarthritis who completed a randomized clinical trial of 8-session multicomponent CBT-I versus an active behavioral desensitization control condition (BD), including a 6-month follow-up assessment. Data used herein include daily diaries of sleep parameters, actigraphy data, and self-report questionnaires administered at specific time points. Results Patients who reported at least 30% improvement in self-reported pain from baseline to 6-month follow-up were considered responders (N = 31). Pain responders and nonresponders did not differ significantly at baseline across any sleep continuity measures. At mid-treatment, only TST predicted pain response via t tests and logistic regression, whereas other measures of sleep continuity were nonsignificant. Recursive partitioning analyses identified a minimum cut-point of 382 min of TST achieved at mid-treatment in order to best predict pain improvements 6-month posttreatment. Actigraphy results followed the same pattern as daily diary-based results. Conclusions Clinically significant pain reductions in response to both CBT-I and BD were optimally predicted by achieving approximately 6.5 hr sleep duration by mid-treatment. Thus, tailoring interventions to increase TST early in treatment may be an effective strategy to promote long-term pain reductions. More comprehensive research on components of behavioral sleep medicine treatments that contribute to pain response is warranted.
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Affiliation(s)
- Jessica K Salwen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine,Baltimore, MD
| | - Michael T Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine,Baltimore, MD
| | - Patrick H Finan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine,Baltimore, MD
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216
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Effect of Jiaotai Pill (交泰丸) on intestinal damage in partially sleep deprived rats. Chin J Integr Med 2017; 23:901-907. [DOI: 10.1007/s11655-017-2969-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Indexed: 12/29/2022]
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217
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Affiliation(s)
- David R Hillman
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Centre for Sleep Science, University of Western Australia, Perth, Australia.
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218
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Lin CL, Liu TC, Chung CH, Chien WC. Risk of pneumonia in patients with insomnia: A nationwide population-based retrospective cohort study. J Infect Public Health 2017; 11:270-274. [PMID: 28916233 DOI: 10.1016/j.jiph.2017.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 08/05/2017] [Indexed: 02/06/2023] Open
Abstract
Evidence is lacking regarding whether insomnia increases the risk of infectious disease. Accordingly, the present study examined the risk of pneumonia in patients with insomnia. This study was a population-based retrospective cohort study on a cohort of 8061 patients with insomnia and a control cohort of 16,112 patients (matched by age, sex, and year of diagnosis) from the Taiwan National Health Insurance Research Database for the 2000-2010 period. Overall incidence of pneumonia was 50.6 per 1000 person-years in the insomnia cohort, which was significantly higher than that in the control cohort (30.9 per 1000 person-years). Overall, the insomnia cohort exhibited a higher risk of pneumonia (HR=2.43; CI, 2.24-2.62). By age group, the risk of pneumonia was significantly higher in the insomnia cohort for those aged ≤40 years (HR=3.23, CI: 1.38-7.57), 41-65 years (HR=2.62, CI: 2.07-3.32), and >65years (CI: 2.21-2.61). Compared with the controls, the insomnia cohort exhibited a higher risk of pneumonia, particularly in young adults.
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Affiliation(s)
- Chia-Ling Lin
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Ta-Chun Liu
- Department of Stem Cell Biology and Regenerative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Chi-Hsiang Chung
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan.
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219
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Itani O, Kaneita Y, Tokiya M, Jike M, Murata A, Nakagome S, Otsuka Y, Ohida T. Short sleep duration, shift work, and actual days taken off work are predictive life-style risk factors for new-onset metabolic syndrome: a seven-year cohort study of 40,000 male workers. Sleep Med 2017; 39:87-94. [PMID: 29157594 DOI: 10.1016/j.sleep.2017.07.027] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 07/13/2017] [Accepted: 07/14/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND This longitudinal study investigated the effects of various lifestyle-related factors - including sleep duration, shift work, and actual days taken off work - on new-onset metabolic syndrome (MetS). METHODS AND RESULTS A total of 39,182 male employees (mean age 42.4 ± 9.8 years) of a local government organization in Japan were followed up for a maximum of seven years, between 1999 and 2006. Multivariate analysis (Cox proportional hazard method) identified seven high-risk lifestyle factors that were significantly associated with new-onset MetS or a range of metabolic factors (obesity, hypertension, hyperglycemia, dyslipidemia): (1) short sleep duration (<5 h/day), (2) shift work, (3) insufficient number of days off work, (4) always eating until satiety, (5) not trying to take every opportunity to walk, (6) alcohol intake ≥60 g/day, and (7) smoking. In addition, a higher number of these high-risk lifestyle factors significantly promoted the onset of MetS. The hazard ratio for MetS associated with 0-1 high-risk lifestyle parameters per subject at the baseline was set at 1.00. Hazard ratios associated with the following numbers of high-risk lifestyle parameters were: 1.22 (95% CI 1.15-1.29) for 2-3 of these parameters; and 1.43 (1.33-1.54) for 4-7. CONCLUSION An increase in the number of high-risk lifestyle factors - such as short sleep duration, shift work, and an insufficient number of days off work - increased the risk of MetS onset. Comprehensive strategies to improve a range of lifestyle factors for workers, such as sleep duration and days off work, could reduce the risk of MetS onset.
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Affiliation(s)
- Osamu Itani
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University, Oita, Japan
| | - Yoshitaka Kaneita
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan.
| | - Mikiko Tokiya
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University, Oita, Japan
| | - Maki Jike
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Atsushi Murata
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Sachi Nakagome
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Yuichiro Otsuka
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Takashi Ohida
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
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220
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Ao KH, Ho CH, Wang CC, Wang JJ, Chio CC, Kuo JR. The increased risk of stroke in early insomnia following traumatic brain injury: a population-based cohort study. Sleep Med 2017; 37:187-192. [DOI: 10.1016/j.sleep.2017.02.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 01/06/2017] [Accepted: 02/09/2017] [Indexed: 12/12/2022]
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221
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Affiliation(s)
- Scott Kahan
- Johns Hopkins Bloomberg School of Public Health; George Washington University School of Medicine, 1020 19th Street NW, Suite 450, Washington, DC, 20036.
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222
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Full KM, Schmied EA, Parada H, Cherrington A, Horton LA, Ayala GX. The Relationship Between Sleep Duration and Glycemic Control Among Hispanic Adults With Uncontrolled Type 2 Diabetes. DIABETES EDUCATOR 2017; 43:519-529. [DOI: 10.1177/0145721717724564] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Purpose The purpose of this study was to examine the relationship between sleep duration and glycemic control in adult Hispanic patients with uncontrolled type 2 diabetes. Methods This cross-sectional study used baseline data from 317 Hispanic adults with uncontrolled type 2 diabetes who participated in a randomized controlled trial testing a peer support intervention to improve diabetes control. To be eligible, participants had to be 18 years or older and have A1C >7% in the 3 months prior to randomization. Glycemic control was assessed by A1C ascertained through medical chart review; higher A1C levels reflected poorer glycemic control. Sleep duration (hours/night), diabetes control behaviors, and demographics were obtained by interviewer-administered questionnaire. We used multivariable generalized linear models to estimate the association between sleep duration and glycemic control. Results Forty-three percent of participants reported sleeping fewer than 7 hours per night. Sleep duration (hours/night) was inversely associated with A1C levels; however, the relationship was no longer statistically significant after adjusting for insulin status. Conclusions Sleep duration was not significantly associated with glycemic control in this sample of Hispanic adults with uncontrolled type 2 diabetes when adjusting for insulin. Future research should continue to explore this relationship among Hispanic adults with diabetes using an objective measure of sleep duration and a larger sample of Hispanic adults with both controlled and uncontrolled type 2 diabetes to determine if these results hold true.
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Affiliation(s)
- Kelsie M. Full
- San Diego State University/University of California, San Diego Joint Doctoral Program in Public Health (Health Behavior), San Diego, California (Miss Full)
- Institute for Behavioral and Community Health, San Diego State University Research Foundation, San Diego, California (Miss Full, Dr Schmied, Miss Horton, Dr Ayala)
- University of North Carolina at Chapel Hill, Department of Epidemiology, Chapel Hill, North Carolina (Dr Parada)
- Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (Dr Cherrington)
- College of Health and Human Services, San Diego State University, San Diego, California (Dr Ayala)
| | - Emily A. Schmied
- San Diego State University/University of California, San Diego Joint Doctoral Program in Public Health (Health Behavior), San Diego, California (Miss Full)
- Institute for Behavioral and Community Health, San Diego State University Research Foundation, San Diego, California (Miss Full, Dr Schmied, Miss Horton, Dr Ayala)
- University of North Carolina at Chapel Hill, Department of Epidemiology, Chapel Hill, North Carolina (Dr Parada)
- Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (Dr Cherrington)
- College of Health and Human Services, San Diego State University, San Diego, California (Dr Ayala)
| | - Humberto Parada
- San Diego State University/University of California, San Diego Joint Doctoral Program in Public Health (Health Behavior), San Diego, California (Miss Full)
- Institute for Behavioral and Community Health, San Diego State University Research Foundation, San Diego, California (Miss Full, Dr Schmied, Miss Horton, Dr Ayala)
- University of North Carolina at Chapel Hill, Department of Epidemiology, Chapel Hill, North Carolina (Dr Parada)
- Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (Dr Cherrington)
- College of Health and Human Services, San Diego State University, San Diego, California (Dr Ayala)
| | - Andrea Cherrington
- San Diego State University/University of California, San Diego Joint Doctoral Program in Public Health (Health Behavior), San Diego, California (Miss Full)
- Institute for Behavioral and Community Health, San Diego State University Research Foundation, San Diego, California (Miss Full, Dr Schmied, Miss Horton, Dr Ayala)
- University of North Carolina at Chapel Hill, Department of Epidemiology, Chapel Hill, North Carolina (Dr Parada)
- Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (Dr Cherrington)
- College of Health and Human Services, San Diego State University, San Diego, California (Dr Ayala)
| | - Lucy A. Horton
- San Diego State University/University of California, San Diego Joint Doctoral Program in Public Health (Health Behavior), San Diego, California (Miss Full)
- Institute for Behavioral and Community Health, San Diego State University Research Foundation, San Diego, California (Miss Full, Dr Schmied, Miss Horton, Dr Ayala)
- University of North Carolina at Chapel Hill, Department of Epidemiology, Chapel Hill, North Carolina (Dr Parada)
- Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (Dr Cherrington)
- College of Health and Human Services, San Diego State University, San Diego, California (Dr Ayala)
| | - Guadalupe X. Ayala
- San Diego State University/University of California, San Diego Joint Doctoral Program in Public Health (Health Behavior), San Diego, California (Miss Full)
- Institute for Behavioral and Community Health, San Diego State University Research Foundation, San Diego, California (Miss Full, Dr Schmied, Miss Horton, Dr Ayala)
- University of North Carolina at Chapel Hill, Department of Epidemiology, Chapel Hill, North Carolina (Dr Parada)
- Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (Dr Cherrington)
- College of Health and Human Services, San Diego State University, San Diego, California (Dr Ayala)
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223
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De Nobrega AK, Mellers AP, Lyons LC. Aging and circadian dysfunction increase alcohol sensitivity and exacerbate mortality in Drosophila melanogaster. Exp Gerontol 2017; 97:49-59. [PMID: 28750752 DOI: 10.1016/j.exger.2017.07.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 07/12/2017] [Accepted: 07/24/2017] [Indexed: 11/29/2022]
Abstract
Alcohol abuse is a rising problem in middle-aged and older individuals resulting in serious health, family and economic consequences. Effective treatment necessitates the identification of factors influencing alcohol toxicity with aging. We investigated the interaction between aging, alcohol toxicity and circadian function using Drosophila as a model system. We found as wild type flies age, sensitivity to alcohol increases and circadian regulation of alcohol-induced behaviors weakens. Decreased circadian modulation is correlated with significantly greater alcohol sensitivity during the subjective day. The circadian clock modulates alcohol-induced mortality in younger flies with increased mortality following alcohol exposure at night. Older flies exhibit significantly longer recovery times following alcohol-induced sedation and increased mortality following binge-like or chronic alcohol exposure. Flies rendered arrhythmic either genetically or environmentally exhibit significantly increased alcohol sensitivity, longer recovery times and increased mortality. We hypothesize that the circadian clock phase specifically buffers behavioral and cellular alcohol sensitivity with this protection diminishing as the circadian clock weakens with age.
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Affiliation(s)
- Aliza K De Nobrega
- Department of Biological Science, Program in Neuroscience, Florida State University, Tallahassee, FL 32306, United States
| | - Alana P Mellers
- Department of Biological Science, Program in Neuroscience, Florida State University, Tallahassee, FL 32306, United States
| | - Lisa C Lyons
- Department of Biological Science, Program in Neuroscience, Florida State University, Tallahassee, FL 32306, United States.
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224
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Abstract
The objective of this review is to provide an overview of intermittent fasting regimens, summarize the evidence on the health benefits of intermittent fasting, and discuss physiological mechanisms by which intermittent fasting might lead to improved health outcomes. A MEDLINE search was performed using PubMed and the terms "intermittent fasting," "fasting," "time-restricted feeding," and "food timing." Modified fasting regimens appear to promote weight loss and may improve metabolic health. Several lines of evidence also support the hypothesis that eating patterns that reduce or eliminate nighttime eating and prolong nightly fasting intervals may result in sustained improvements in human health. Intermittent fasting regimens are hypothesized to influence metabolic regulation via effects on (a) circadian biology, (b) the gut microbiome, and (c) modifiable lifestyle behaviors, such as sleep. If proven to be efficacious, these eating regimens offer promising nonpharmacological approaches to improving health at the population level, with multiple public health benefits.
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Affiliation(s)
- Ruth E Patterson
- Moores Cancer Center, University of California, San Diego, La Jolla, California 92093; .,Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California 92093
| | - Dorothy D Sears
- Moores Cancer Center, University of California, San Diego, La Jolla, California 92093; .,Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California 92093.,Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Diego, La Jolla, California 92093
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225
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Shamshirgaran SM, Ataei J, Malek A, Iranparvar-Alamdari M, Aminisani N. Quality of sleep and its determinants among people with type 2 diabetes mellitus in Northwest of Iran. World J Diabetes 2017; 8:358-364. [PMID: 28751959 PMCID: PMC5507833 DOI: 10.4239/wjd.v8.i7.358] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 01/31/2017] [Accepted: 06/08/2017] [Indexed: 02/05/2023] Open
Abstract
AIM To examine sleep quality and its determinants among people with type 2 diabetes mellitus (T2DM).
METHODS This is a cross-sectional study conducted among diabetic patients referring to Ardabil diabetes clinic in Northwest of Iran. Information on sleep quality was collected using Pittsburg Sleep Quality Index (PSQI). A questionnaire was used to collect data on sociodemographic lifestyle factors and psychological distress. This questionnaire was completed through an interview, and clinical information was extracted from patient’s record. Data analysis was done using SPSS software version 23 and univariate and multivariate analyses.
RESULTS Study participants consist of 256 people with T2DM the majority of whom were women (70%), and mean age of participants was 54.06 ± 9.09. The mean of total score of PSQI was 5.56 ± 3.34. Relative to younger age group, the middle-aged people with T2DM were twice more likely to be poor sleeper; the adjusted OR was 2.03 (95%CI: 1.01-4.08); and those with longer duration of diabetes were about 1.8 times more likely to report poor quality of sleep (ORadj = 1.77, 95%CI: 0.98-3.13). Participants with cholesterol level ≥ 240 mg/dL were about twice more likely to be poor sleeper (ORadj = 1.99, 95%CI: 1.01-3.94). The odds of being poor sleeper increased as the level of distress increased (1.84-4.09).
CONCLUSION As indicated by the results of the present study, some factors including age, duration of disease, psychological distress and high level of cholesterol were independently associated with poor sleep quality.
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226
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Dunietz GL, Matos-Moreno A, Singer DC, Davis MM, O'Brien LM, Chervin RD. Later School Start Times: What Informs Parent Support or Opposition? J Clin Sleep Med 2017; 13:889-897. [PMID: 28558863 DOI: 10.5664/jcsm.6660] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 05/05/2017] [Indexed: 12/12/2022]
Abstract
STUDY OBJECTIVES To investigate parental knowledge about adolescent sleep needs, and other beliefs that may inform their support for or objection to later school start times. METHODS In 2014, we conducted a cross-sectional, Internet-based survey of a nationally representative sample of parents as part of the C.S. Mott Children's Hospital National Poll on Children's Health. Parents with teens aged 13-17 years reported their children's sleep patterns and school schedules, and whether the parents supported later school start times (8:30 am or later). Responses associated with parental support of later school start times were examined with logistic regression analysis. RESULTS Overall, 88% of parents reported school start times before 8:30 am, and served as the analysis sample (n = 554). In this group, 51% expressed support for later school start times. Support was associated with current school start times before 7:30 am (odds ratio [OR] = 3.1 [95% confidence interval (CI) 1.2, 8.4]); parental opinion that their teen's current school start time was "too early" (OR = 3.8 [1.8, 7.8]); and agreement with American Academy of Pediatrics recommendations about school start times (OR = 4.7 [2.2, 10.1]). Support also was associated with anticipation of improved school performance (OR = 3.0 [1.5, 5.9]) or increased sleep duration (OR = 4.0 [1.8, 8.9]) with later school start times. Conversely, parents who anticipated too little time for after-school activities (OR = 0.5 [0.3, 0.9]) and need for different transportation plans (OR = 0.5 [0.2, 0.9]) were often less supportive. CONCLUSIONS Parental education about healthy sleep needs and anticipated health benefits may increase their support for later school start times. Educational efforts should also publicize the positive experiences of communities that have made this transition, with regard to limited adverse effect on after-school activity schedules and transportation.
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Affiliation(s)
- Galit Levi Dunietz
- Department of Neurology and Sleep Disorders Center, University of Michigan, Ann Arbor, Michigan
| | - Amilcar Matos-Moreno
- Child Health Evaluation and Research (CHEAR) Unit, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan
| | - Dianne C Singer
- Child Health Evaluation and Research (CHEAR) Unit, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan
| | - Matthew M Davis
- Child Health Evaluation and Research (CHEAR) Unit, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan.,Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.,Institute for Healthcare Policy and Innovation University of Michigan, Ann Arbor, Michigan
| | - Louise M O'Brien
- Department of Neurology and Sleep Disorders Center, University of Michigan, Ann Arbor, Michigan
| | - Ronald D Chervin
- Department of Neurology and Sleep Disorders Center, University of Michigan, Ann Arbor, Michigan
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227
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Henry AL, Kyle SD, Chisholm A, Griffiths CEM, Bundy C. A cross-sectional survey of the nature and correlates of sleep disturbance in people with psoriasis. Br J Dermatol 2017; 177:1052-1059. [PMID: 28314054 DOI: 10.1111/bjd.15469] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Research suggests that sleep disturbance is common in psoriasis. While several sleep investigations have been conducted in psoriasis populations, many have methodological shortcomings, and no study has examined multiple dimensions of sleep-wake functioning. Moreover, research has yet to be performed comprehensively examining the range of physical and psychological factors that may affect sleep in people with psoriasis. OBJECTIVES To characterize sleep disturbance using validated measures and to identify physical and psychological predictors of sleep quality in people with psoriasis. METHODS An online survey was conducted (186 respondents; mean age 39·2 years) comprising validated measures assessing sleep [Pittsburgh Sleep; Quality Index (PSQI), Berlin Questionnaire, Pre-Sleep Arousal Scale]; chronotype (Morningness-Eveningness Questionnaire); mood (Hospital Anxiety and Depression Scale); itch (5-D Itch Scale); and psoriasis severity (Simplified Psoriasis Index). Group comparisons and regression analyses were used to examine predictors of poor sleep. RESULTS The mean PSQI score was 9·2 ± 4·3, with 76·3% scoring above the threshold for poor sleep (≥ 6 on the PSQI) and 32·5% scoring 'positive' for probable obstructive sleep apnoea (OSA). Poor sleep and high likelihood of OSA were associated with more severe psoriasis (P < 0·05; η = 0·07; η2 = 0·005). Cognitive arousal (β = 0·26, P = 0·001), itch (β = 0·26, P < 0·001) and depression (β = 0·24, P = 0·001) were the most robust predictors of poor sleep quality, which, together with somatic arousal (β = 0·17, P = 0·022), accounted for 43% of variance in PSQI scores. CONCLUSIONS Poor sleep is common in psoriasis and associated with psychological and physical factors. Rates of probable OSA are also high. Given the importance of restorative sleep for health, sleep complaints should receive greater clinical attention in the management of psoriasis.
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Affiliation(s)
- A L Henry
- Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester, U.K.,Manchester Centre for Health Psychology, University of Manchester, Manchester, U.K.,Manchester Academic Health Science Centre, University of Manchester, Manchester, U.K
| | - S D Kyle
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, U.K
| | - A Chisholm
- Department of Psychological Sciences, University of Liverpool, Liverpool, U.K
| | - C E M Griffiths
- Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester, U.K.,Manchester Academic Health Science Centre, University of Manchester, Manchester, U.K.,Salford Royal NHS Foundation Trust, Manchester, U.K
| | - C Bundy
- Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester, U.K.,Manchester Centre for Health Psychology, University of Manchester, Manchester, U.K.,Manchester Academic Health Science Centre, University of Manchester, Manchester, U.K
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Abstract
BACKGROUND Health care involves taking care of other peoples' lives. Professionals in the field of health care are expected to be at their best all the time because mistakes or errors could be costly and sometimes irreversible. AIM This study assessed the quality of sleep and well-being of health workers in Najran city, Saudi Arabia. MATERIALS AND METHODS It was a cross-sectional study done among health workers from different hospitals within the kingdom of Najran, Saudi Arabia. The subjects were administered questionnaire that contained sections on demographic and clinical characteristics, sleep quality, and section relating to well-being. RESULTS One hundred and twenty-three health workers comprising 29 (23.6%) males and 94 (76.4%) females participated in this study. The majority of the workers 74 (60.2%) were nurses; a quarter were doctors while the remaining 13.6% accounted for other categories of health workers such as the pharmacist and laboratory technicians. Fifty-two (42.3%) of the workers were poor sleepers. Significantly (χ2 = 23.98, P = 0.000), majority of the subjects that were poor sleepers (84.6%) compared with the 42.3% of the good sleepers rated the last 12 months of their profession as a bit stressful or quite a bit stressful. Similarly, 46.2% of the workers that were poor sleepers significantly (χ2 = 24.69, P = 0.000) rated their ability to handle unexpected and difficult problems in their life as fair or poor compared with 14.1% of the good sleepers. CONCLUSION Health workers expressed some level of stress in their professional life, and a good proportion of the subjects were poor sleepers. There is, therefore, the need to establish a program within the health-care organization to address social, physical, and psychological well-being at work.
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Affiliation(s)
- O Ogunsemi Olawale
- Department of Medicine, Faculty of Clinical Sciences, Olabisi Onabanjo University, Sagamu, Ogun State, Nigeria
| | - O Afe Taiwo
- Department of Medicine, Faculty of Clinical Sciences, Olabisi Onabanjo University, Sagamu, Ogun State, Nigeria
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229
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Kim S, Cho MR, Kim T, Lim HJ, Lee JW, Kang HT. Factors Positively Influencing Health Are Associated with a Lower Risk of Development of Metabolic Syndrome in Korean Men: The 2007-2009 Korean National Health and Nutrition Examination Survey. Korean J Fam Med 2017; 38:148-155. [PMID: 28572891 PMCID: PMC5451449 DOI: 10.4082/kjfm.2017.38.3.148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Revised: 06/08/2016] [Accepted: 07/19/2016] [Indexed: 12/20/2022] Open
Abstract
Background The prevalence of metabolic syndrome (MetS) has risen rapidly worldwide, including in South Korea. Factors related to lifestyle are closely associated with the development of MetS. The aim of this study was to investigate the association between MetS and a number of factors positively influencing health, namely non-smoking, low-risk drinking, sufficient sleep, regular exercise, and the habit of reading food labels, among Korean men. Methods This cross-sectional study included 3,869 men from the 2007–2009 Korean National Health and Nutrition Examination Survey. Information on five factors positively influencing their health was obtained using a self-reported questionnaire. We categorized subjects into four groups, depending on the number of positive factors reported (group I, 0–1 factor; group II, 2 factors; group III, 3 factors; group IV, 4–5 factors). Results Men who reported a greater number of positive health factors had better laboratory and anthropometric values than men who reported fewer positive health factors. The prevalence of MetS was 29.1, 27.2, 20.7, and 14.6% in groups I to IV, respectively. Compared to group I, odds ratios (95% confidence intervals) for MetS were 0.96 (0.78–1.19) in group II, 0.67 (0.52–0.87) in group III, and 0.52 (0.35–0.76) in group IV, after adjusting for confounding factors. Odds ratios for abdominal obesity, glucose intolerance, and hypertriglyceridemia were statistically significant. Conclusion A greater number of positive lifestyle factors influencing health were associated with a lower risk of developing MetS, in a nationally representative sample of Korean men.
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Affiliation(s)
- Shinhye Kim
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Mi-Ra Cho
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Taejong Kim
- Department of Family Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Hyoung-Ji Lim
- Department of Family Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Jae Woo Lee
- Department of Family Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Hee-Taik Kang
- Department of Family Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
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230
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Saravani R, Esmaeilzaei E, Noorzehi N, Galavi HR. Melatonin Receptor 1B Gene Polymorphisms, Haplotypes and Susceptibility to Schizophrenia. REV ROMANA MED LAB 2017. [DOI: 10.1515/rrlm-2017-0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Melatonin has an important role in the regulation of human sleep circadian rhythms. Sleep disturbances commonly exist in schizophrenia (SCZ) patients. To begin its performance, melatonin must interact to its receptor. In the present study, Single Nucleotide Polymorphisms (SNPs) of melatonin receptor gene 1 B (MTN1B) with SCZ development in Iranian population were investigated. The current case-control study was performed on 92 SCZ patients and 92 healthy control (HC) subjects. NESTED-PCR and ARMS-PCR modified methods (combination) and ARMSPCR method were used on the genotype. The impact of MTN1B rs3781637 (T/C) and rs10830963(C/G) polymorphism variants on the risk SCZ in the sample of Iranian population was investigated. The findings showed significant association between MTN1B rs10830963(C/G) variant and SCZ (OR=2.78, 95%CI=1.25-6.25, P=0.012, GG vs. CC, OR=1.66, 95%CI=1.09-2.51, P=0.021 G vs. C, OR=3.85 95%CI=.89-8.33, P<0.0001, GG vs. CC+CG). There was no association between MTN1B rs3781637 (T/C) and SCZ risk. In addition, haplotype analysis revealed that TG and CC haplotype of rs3781637 (T/C) and rs10830963 (C/G) polymorphisms were associated with SCZ risk (P=0.039) and protective (P<0.0001) effects, respectively. The findings revealed that MTN1B rs10830963 (C/G) polymorphism was associated with the risk of SCZ; while another SNP rs3781637 (T/C) MTN1B gene did not show any risk/protection association with SCZ. Further studies with larger sample sizes and different ethnicities are required to approve the results.
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Affiliation(s)
- Ramin Saravani
- Cellular and Molecular Research Center and Department of Clinical Biochemistry, School of Medicine, Zahedan University of Medical Sciences , Zahedan , Iran (Islamic Republic of)
| | - Elahe Esmaeilzaei
- Department of Genetics, School of Medicine, Zahedan University of Medical Sciences , Zahedan , Iran (Islamic Republic of)
| | - Nafiseh Noorzehi
- Department of Biology, Zabol University , Zabol , Iran (Islamic Republic of)
| | - Hamid Reza Galavi
- Cellular and Molecular Research Center and Department of Clinical Biochemistry, School of Medicine, Zahedan University of Medical Sciences , Zahedan , Iran (Islamic Republic of)
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231
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Innate immunity modulation in the duodenal mucosa induced by REM sleep deprivation during infection with Trichinella spirallis. Sci Rep 2017; 7:45528. [PMID: 28374797 PMCID: PMC5379483 DOI: 10.1038/srep45528] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 02/28/2017] [Indexed: 02/07/2023] Open
Abstract
Sleep is considered to be an important predictor of the immunity, since the absence of sleep can affect the development of the immune response, and consequently increase the susceptibility to contract an infection. The aim of the present study was to investigate if sleep deprivation and stress induce dysregulation of the duodenal mucous membrane during the acute infection with Trichinella spiralis. Our results shows that, in the intestinal mucous membrane, stress and sleep deprivation, produces different effect in the cells, and this effect depends on the studied duodenal compartment, glands or villi. The sleep deprivation affect mast cells mainly, and the stress response is more heterogeneous. Interestingly, in the duodenal mucous membrane, none population of cells in the infected groups responded equally to both conditions. These findings suggest that the response of the intestinal mucous membrane during the infection caused for T. spiralis turns out to be affected in the sleep-deprived rats, therefore, the results of the present study sustain the theory that sleep is a fundamental process that is capable of modulating the immune response of mucous membranes, particularly the one generated against the parasite Trichinella spiralis.
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232
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Farr OM, Mantzoros CS. Sleep apnea in relation to metabolism: An urgent need to study underlying mechanisms and to develop novel treatments for this unmet clinical need. Metabolism 2017; 69:207-210. [PMID: 28190524 PMCID: PMC5865071 DOI: 10.1016/j.metabol.2017.01.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 01/24/2017] [Indexed: 01/07/2023]
Affiliation(s)
- Olivia M Farr
- Division of Endocrinology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA.
| | - Christos S Mantzoros
- Division of Endocrinology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA
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233
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Affiliation(s)
- JungHwan Kim
- Department of Family Medicine, Eulji Hospital, Eulji University, College of Medicine, Seoul, Korea
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234
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Porto F, Sakamoto YS, Salles C. Association between Obstructive Sleep Apnea and Myocardial Infarction: A Systematic Review. Arq Bras Cardiol 2017; 108:361-369. [PMID: 28380133 PMCID: PMC5421476 DOI: 10.5935/abc.20170031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 08/31/2016] [Indexed: 12/27/2022] Open
Abstract
Obstructive sleep apnea (OSA) has been associated to cardiovascular risk factors.
However, the association between OSA and cardiovascular disease is still
controversial. The objective of the present study was to verify the association
between OSA and myocardial infarction (MI). This is a systematic review of the
literature performed through electronic data sources MEDLINE/PubMed, PubMed
Central, Web of Science and BVS -Biblioteca Virtual em
Saúde (Virtual Health Library). The descriptors used were:
'obstructive sleep apnea' AND 'polysomnography' AND 'myocardial infarction' AND
'adults NOT 'treatment.' The present work analysed three prospective studies,
selected from 142 articles. The studies followed a total sample of 5,067 OSA
patients, mostly composed by male participants. All patients underwent night
polysomnography, and all studies found an association between OSA and fatal and
non-fatal cardiovascular outcomes. Thus, we were able to observe that 644
(12.7%) of the 5,067 patients suffered MI or stroke, or required a
revascularization procedure, and 25.6% of these cardiovascular events were
fatal. MI was responsible for 29.5% of all 644 analysed outcomes. There is an
association between OSA and MI, in male patients, and apnea and hypopnea index
(AHI) are the most reliable markers.
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Affiliation(s)
- Fernanda Porto
- Escola Bahiana de Medicina e Saúde Pública, Salvador, BA - Brazil
| | | | - Cristina Salles
- Escola Bahiana de Medicina e Saúde Pública, Salvador, BA - Brazil
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235
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Mehta R, Singh A, Mallick BN. Disciplined sleep for healthy living: Role of noradrenaline. World J Neurol 2017; 7:6-23. [DOI: 10.5316/wjn.v7.i1.6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 11/10/2016] [Accepted: 11/29/2016] [Indexed: 02/06/2023] Open
Abstract
Sleep is essential for maintaining normal physiological processes. It has been broadly divided into rapid eye movement sleep (REMS) and non-REMS (NREMS); one spends the least amount of time in REMS. Sleep (both NREMS and REMS) disturbance is associated with most altered states, disorders and pathological conditions. It is affected by factors within the body as well as the environment, which ultimately modulate lifestyle. Noradrenaline (NA) is one of the key molecules whose level increases upon sleep-loss, REMS-loss in particular and it induces several REMS-loss associated effects and symptoms. The locus coeruleus (LC)-NAergic neurons are primarily responsible for providing NA throughout the brain. As those neurons project to and receive inputs from across the brain, they are modulated by lifestyle changes, which include changes within the body as well as in the environment. We have reviewed the literature showing how various inputs from outside and within the body integrate at the LC neuronal level to modulate sleep (NREMS and REMS) and vice versa. We propose that these changes modulate NA levels in the brain, which in turn is responsible for acute as well as chronic psycho-somatic disorders and pathological conditions.
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236
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Al-Hariri MT, Al-Enazi AS, Alshammari DM, Bahamdan AS, Al-Khtani SM, Al-Abdulwahab AA. Descriptive study on the knowledge, attitudes and practices regarding the diabetic foot. J Taibah Univ Med Sci 2017; 12:492-496. [PMID: 31435284 PMCID: PMC6695035 DOI: 10.1016/j.jtumed.2017.02.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Revised: 01/31/2017] [Accepted: 02/06/2017] [Indexed: 01/03/2023] Open
Abstract
Objectives The aim of this study is to assess the knowledge, attitudes, practices and risk factors influencing diabetic foot ulcers among diabetes patients attending a diabetic clinic in a Saudi hospital. Methods In this cross-sectional study, a random sample of 229 participants was selected from the diabetic clinic of the outpatient department of King Fahd Hospital of the University of Dammam during January to March 2015. A pre-tested structured questionnaire was administered to the diabetes patients to obtain information regarding the outcome variables. Results The results showed that diabetic foot ulcers were observed among 26% of diabetic patients. Concerning knowledge of the diabetic foot, the majority of participants had good education and favourable attitudes towards diabetic foot care. Interestingly, the results demonstrated that despite these characteristics, a high percentage of the participants ignored very important information and instructions before buying new shoes. Conclusion All diabetic patients with diabetes mellitus should be educated regarding diabetic foot complications and the characteristic specifications of diabetic shoes. However, levels of knowledge, attitudes and practices should be improved. This improvement could be achieved by an awareness programme for the early detection and care of diabetic foot problems in KSA.
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Affiliation(s)
- Mohammed T Al-Hariri
- Department of Physiology, College of Medicine, University of Dammam, Al Khobar, KSA
| | - Abdulaziz S Al-Enazi
- ENT Department, King Fahd University of the Hospital, University of Dammam, Al Khobar, KSA
| | | | - Ahmed S Bahamdan
- King Fahd University of the Hospital, University of Dammam, Al Khobar, KSA
| | | | - Abdullah A Al-Abdulwahab
- Internal Medicine Department, King Fahd University of the Hospital, University of Dammam, Al Khobar, KSA
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237
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Zhang Y, Yatsuya H, Li Y, Chiang C, Hirakawa Y, Kawazoe N, Tamakoshi K, Toyoshima H, Aoyama A. Long-term weight-change slope, weight fluctuation and risk of type 2 diabetes mellitus in middle-aged Japanese men and women: findings of Aichi Workers' Cohort Study. Nutr Diabetes 2017; 7:e252. [PMID: 28319107 PMCID: PMC5380898 DOI: 10.1038/nutd.2017.5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Revised: 12/19/2016] [Accepted: 01/17/2017] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE This study aims to investigate the association of long-term weight-change slopes, weight fluctuation and the risk of type 2 diabetes mellitus (T2DM) in middle-aged Japanese men and women. METHODS A total of 4234 participants of Aichi Workers' Cohort Study who were aged 35-66 years and free of diabetes in 2002 were followed through 2014. Past body weights at the ages of 20, 25, 30, 40 years, and 5 years before baseline as well as measured body weight at baseline were regressed on the ages. Slope and root-mean-square-error of the regression line were obtained and used to represent the weight changes and the weight fluctuation, respectively. The associations of the weight-change slopes and the weight fluctuation with incident T2DM were estimated by Cox proportional hazards models. RESULTS During the median follow-up of 12.2 years, 400 incident cases of T2DM were documented. After adjustment for baseline overweight and other lifestyle covariates, the weight-change slopes were significantly associated with higher incidence of T2DM (hazard ratio (HR): 1.80, 95% confident interval (CI): 1.17-2.77 for men; and HR: 2.78, 95% CI: 1.07-7.23 for women), while the weight fluctuation was not (HR: 1.08, 95% CI: 1.00-1.18 for men and HR: 1.02, 95% CI: 0.84-1.25 for women). CONCLUSIONS Regardless of the presence of overweight, the long-term weight-change slopes were significantly associated with the increased risk of T2DM; however, the weight fluctuation was not associated with the risk of T2DM in middle-aged Japanese men and women.
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Affiliation(s)
- Y Zhang
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - H Yatsuya
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Public Health, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Y Li
- Department of Public Health, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - C Chiang
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Y Hirakawa
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - N Kawazoe
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - K Tamakoshi
- Department of Nursing, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - H Toyoshima
- Education and Clinical Research Training Centre, Anjo Kosei Hospital, Anjo, Aichi, Japan
| | - A Aoyama
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan
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238
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Adabimohazab R, Garfinkel A, Milam EC, Frosch O, Mangone A, Convit A. Does Inflammation Mediate the Association Between Obesity and Insulin Resistance? Inflammation 2017; 39:994-1003. [PMID: 26956471 DOI: 10.1007/s10753-016-0329-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
In adult obesity, low-grade systemic inflammation is considered an important step in the pathogenesis of insulin resistance (IR). The association between obesity and inflammation is less well established in adolescents. Here, we ascertain the importance of inflammation in IR among obese adolescents by utilizing either random forest (RF) classification or mediation analysis approaches. The inflammation balance score, composed of eight pro- and anti-inflammatory makers, as well as most of the individual inflammatory markers differed significantly between lean and overweight/obese. In contrast, adiponectin was the only individual marker selected as a predictor of IR by RF, and the balance score only revealed a medium-to-low importance score. Neither adiponectin nor the inflammation balance score was found to mediate the relationship between obesity and IR. These findings do not support the premise that low-grade systemic inflammation is a key for the expression of IR in the human. Prospective longitudinal studies should confirm these findings.
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Affiliation(s)
- Razieh Adabimohazab
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
| | - Amanda Garfinkel
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
| | - Emily C Milam
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
| | - Olivia Frosch
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
| | - Alexander Mangone
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
| | - Antonio Convit
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA. .,Department of Medicine, New York University School of Medicine, New York, NY, USA. .,Department of Radiology, New York University School of Medicine, New York, NY, USA. .,Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA. .,Brain, Obesity, and Diabetes Laboratory (BODyLab), New York University School of Medicine, 145 East 32nd Street, 8th Floor, New York, NY, 10016, USA.
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239
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The effects of kiwi fruit consumption in students with chronic insomnia symptoms: a randomized controlled trial. Sleep Biol Rhythms 2017. [DOI: 10.1007/s41105-017-0095-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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240
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Hu X, Jiang J, Wang H, Zhang L, Dong B, Yang M. Association between sleep duration and sarcopenia among community-dwelling older adults: A cross-sectional study. Medicine (Baltimore) 2017; 96:e6268. [PMID: 28272238 PMCID: PMC5348186 DOI: 10.1097/md.0000000000006268] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Both sleep disorders and sarcopenia are common among older adults. However, little is known about the relationship between these 2 conditions.This study aimed to investigate the possible association between sleep duration and sarcopenia in a population of Chinese community-dwelling older adults.Community-dwelling older adults aged 60 years or older were recruited. Self-reported sleep duration, anthropometric data, gait speed, and handgrip strength were collected by face-to-face interviews. Sarcopenia was defined according to the recommended algorithm of the Asian Working Group for Sarcopenia (AWGS).We included 607 participants aged 70.6 ± 6.6 years (range, 60-90 years) in the analyses. The prevalence of sarcopenia in the whole study population was 18.5%. In women, the prevalence of sarcopenia was significantly higher in the short sleep duration group (< 6 hours) and long sleep duration group (>8 hours) compared with women in the normal sleep duration group (6-8 hours; 27.5%, 22.2% and 13.9%, respectively; P = .014). Similar results were found in men; however, the differences between groups were not statistically significant (18.5%, 20.6%, and 13.0%, respectively; P = .356). After adjustments for the potential confounding factors, older women having short sleep duration (OR: 4.34; 95% CI: 1.74-10.85) or having long sleep duration (OR: 2.50; 95% CI: 1.05-6.99) had greater risk of sarcopenia compared with women having normal sleep duration. With comparison to men with normal sleep duration, the adjusted OR for sarcopenia was 2.12 (0.96-8.39) in the short sleep duration group and 2.25 (0.88-6.87) in the long sleep duration group, respectively.A U-shape relationship between self-reported sleep duration and sarcopenia was identified in a population of Chinese community-dwelling older adults, especially in women.
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Affiliation(s)
- Xiaoyi Hu
- The Center of Gerontology and Geriatrics
| | | | - Haozhong Wang
- The Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lei Zhang
- The Center of Gerontology and Geriatrics
| | | | - Ming Yang
- The Center of Gerontology and Geriatrics
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241
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Abstract
Biological needs for sleep are met by engaging in behaviors that are largely influenced by the environment, social norms and demands, and societal influences and pressures. Insufficient sleep duration and sleep disorders such as insomnia and sleep apnea are highly prevalent in the US population. This article outlines some of these downstream factors, including cardiovascular and metabolic disease risk, neurocognitive dysfunction, and mortality, as well as societal factors such as age, sex, race/ethnicity, and socioeconomics. This review also discusses societal factors related to sleep, such as globalization, health disparities, public policy, public safety, and changing patterns of use of technology.
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Affiliation(s)
- Michael A Grandner
- Department of Psychiatry, College of Medicine, University of Arizona, 1501 North Campbell Avenue, PO Box 245002, BUMC Suite 7326, Tucson, AZ 85724-5002, USA.
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242
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Um YH, Hong SC, Jeong JH. Sleep Problems as Predictors in Attention-Deficit Hyperactivity Disorder: Causal Mechanisms, Consequences and Treatment. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2017; 15:9-18. [PMID: 28138105 PMCID: PMC5290714 DOI: 10.9758/cpn.2017.15.1.9] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 09/06/2016] [Accepted: 09/11/2016] [Indexed: 01/11/2023]
Abstract
Attention-deficit hyperactivity disorder (ADHD) is notorious for its debilitating consequences and early age of onset. The need for early diagnosis and intervention has frequently been underscored. Previous studies have attempted to clarify the bidirectional relationship between ADHD and sleep problems, proposing a potential role for sleep problems as early predictors of ADHD. Sleep deprivation, sleep-disordered breathing, and circadian rhythm disturbances have been extensively studied, yielding evidence with regard to their induction of ADHD-like symptoms. Genetic-phenotypic differences across individuals regarding the aforementioned sleep problems have been elucidated along with the possible use of these characteristics for early prediction of ADHD. The long-term consequences of sleep problems in individuals with ADHD include obesity, poor academic performance, and disrupted parent-child interactions. Early intervention has been proposed as an approach to preventing these debilitating outcomes of ADHD, with novel treatment approaches ranging from melatonin and light therapy to myofunctional therapy and adjustments of the time point at which school starts.
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Affiliation(s)
- Yoo Hyun Um
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung-Chul Hong
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong-Hyun Jeong
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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243
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Wang C, Hao G, Bo J, Li W. Correlations between sleep patterns and cardiovascular diseases in a Chinese middle-aged population. Chronobiol Int 2017; 34:601-608. [PMID: 28276852 DOI: 10.1080/07420528.2017.1285785] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Chuangshi Wang
- Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Guang Hao
- Georgia Prevention Institute, Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Jian Bo
- Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Wei Li
- Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
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244
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Komada Y, Narisawa H, Ueda F, Saito H, Sakaguchi H, Mitarai M, Suzuki R, Tamura N, Inoue S, Inoue Y. Relationship between Self-Reported Dietary Nutrient Intake and Self-Reported Sleep Duration among Japanese Adults. Nutrients 2017; 9:nu9020134. [PMID: 28208812 PMCID: PMC5331565 DOI: 10.3390/nu9020134] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 01/19/2017] [Accepted: 02/08/2017] [Indexed: 11/16/2022] Open
Abstract
Several studies have reported that short sleep duration is a risk factor for obesity and metabolic disease. Moreover, both sleep duration and sleep timing might independently be associated with dietary nutrient intake. In this study, we investigated the associations between self-reported sleep duration and dietary nutrient intake, with and without adjustments for variations in sleep timing (i.e., the midpoint of sleep). We conducted a questionnaire survey, comprising a validated brief self-administered diet history questionnaire (BDHQ) and the Japanese version of the Pittsburgh Sleep Quality Index (PSQI) among 1902 healthy Japanese adults and found that the dietary intakes of several nutrients correlated with sleep duration among men regardless of adjustment for the midpoint of sleep. Particularly, (1) small but significant correlations were observed between sleep duration and the percentage of energy from protein, regardless of adjustment for the midpoint of sleep; (2) energy-adjusted intakes of sodium, vitamin D, and vitamin B12 also significantly correlated with sleep duration; and (3) intakes of bread, pulses, and fish and shellfish correlated with sleep duration. In contrast, no significant correlations were observed between sleep duration and dietary intakes among women. This study revealed that after controlling for the midpoint of sleep, sleep duration correlated significantly with the dietary intake of specific nutrients and foods in a population of Japanese men.
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Affiliation(s)
- Yoko Komada
- Department of Somnology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan.
- Japan Somnology Center, Neuropsychiatric Research Institute, 1-24-10 Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan.
| | - Hajime Narisawa
- Department of Somnology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan.
- Japan Somnology Center, Neuropsychiatric Research Institute, 1-24-10 Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan.
| | - Fumitaka Ueda
- Pharmaceutical and Healthcare Research Laboratories, FUJIFILM Corporation, 2-5-1 Suwa, Tama, Tokyo 206-0024, Japan.
| | - Hitomi Saito
- Pharmaceutical and Healthcare Research Laboratories, FUJIFILM Corporation, 2-5-1 Suwa, Tama, Tokyo 206-0024, Japan.
| | - Hiroyuki Sakaguchi
- Pharmaceutical and Healthcare Research Laboratories, FUJIFILM Corporation, 2-5-1 Suwa, Tama, Tokyo 206-0024, Japan.
| | - Makoto Mitarai
- Marketing Department, Maruha Nichiro Corporation, 3-2-20 Toyosu, Koto-ku, Tokyo 135-8608, Japan.
| | - Rina Suzuki
- Marketing Department, Maruha Nichiro Corporation, 3-2-20 Toyosu, Koto-ku, Tokyo 135-8608, Japan.
| | - Norihisa Tamura
- Department of Somnology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan.
- Japan Somnology Center, Neuropsychiatric Research Institute, 1-24-10 Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan.
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan.
| | - Yuichi Inoue
- Department of Somnology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan.
- Japan Somnology Center, Neuropsychiatric Research Institute, 1-24-10 Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan.
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245
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Saslow LR, Mason AE, Kim S, Goldman V, Ploutz-Snyder R, Bayandorian H, Daubenmier J, Hecht FM, Moskowitz JT. An Online Intervention Comparing a Very Low-Carbohydrate Ketogenic Diet and Lifestyle Recommendations Versus a Plate Method Diet in Overweight Individuals With Type 2 Diabetes: A Randomized Controlled Trial. J Med Internet Res 2017; 19:e36. [PMID: 28193599 PMCID: PMC5329646 DOI: 10.2196/jmir.5806] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Revised: 12/01/2016] [Accepted: 01/05/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Type 2 diabetes is a prevalent, chronic disease for which diet is an integral aspect of treatment. In our previous trial, we found that recommendations to follow a very low-carbohydrate ketogenic diet and to change lifestyle factors (physical activity, sleep, positive affect, mindfulness) helped overweight people with type 2 diabetes or prediabetes improve glycemic control and lose weight. This was an in-person intervention, which could be a barrier for people without the time, flexibility, transportation, social support, and/or financial resources to attend. OBJECTIVE The aim was to determine whether an online intervention based on our previous recommendations (an ad libitum very low-carbohydrate ketogenic diet with lifestyle factors; "intervention") or an online diet program based on the American Diabetes Associations' "Create Your Plate" diet ("control") would improve glycemic control and other health outcomes among overweight individuals with type 2 diabetes. METHODS In this pilot feasibility study, we randomized overweight adults (body mass index ≥25) with type 2 diabetes (glycated hemoglobin [HbA1c] 6.5%-9.0%) to a 32-week online intervention based on our previous recommendations (n=12) or an online diet program based around a plate method diet (n=13) to assess the impact of each intervention on glycemic control and other health outcomes. Primary and secondary outcomes were analyzed by mixed-effects linear regression to compare outcomes by group. RESULTS At 32 weeks, participants in the intervention group reduced their HbA1c levels more (estimated marginal mean [EMM] -0.8%, 95% CI -1.1% to -0.6%) than participants in the control group (EMM -0.3%, 95% CI -0.6% to 0.0%; P=.002). More than half of the participants in the intervention group (6/11, 55%) lowered their HbA1c to less than 6.5% versus 0% (0/8) in the control group (P=.02). Participants in the intervention group lost more weight (EMM -12.7 kg, 95% CI -16.1 to -9.2 kg) than participants in the control group (EMM -3.0 kg, 95% CI -7.3 to 1.3 kg; P<.001). A greater percentage of participants lost at least 5% of their body weight in the intervention (10/11, 90%) versus the control group (2/8, 29%; P=.01). Participants in the intervention group lowered their triglyceride levels (EMM -60.1 mg/dL, 95% CI -91.3 to -28.9 mg/dL) more than participants in the control group (EMM -6.2 mg/dL, 95% CI -46.0 to 33.6 mg/dL; P=.01). Dropout was 8% (1/12) and 46% (6/13) for the intervention and control groups, respectively (P=.07). CONCLUSIONS Individuals with type 2 diabetes improved their glycemic control and lost more weight after being randomized to a very low-carbohydrate ketogenic diet and lifestyle online program rather than a conventional, low-fat diabetes diet online program. Thus, the online delivery of these very low-carbohydrate ketogenic diet and lifestyle recommendations may allow them to have a wider reach in the successful self-management of type 2 diabetes. TRIAL REGISTRATION ClinicalTrials.gov NCT01967992; https://clinicaltrials.gov/ct2/show/NCT01967992 (Archived by WebCite at http://www.webcitation.org/6o0fI9Mkq).
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Affiliation(s)
- Laura R Saslow
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Ashley E Mason
- Osher Center for Integrative Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Sarah Kim
- School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Veronica Goldman
- Osher Center for Integrative Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Robert Ploutz-Snyder
- Applied Biostatistics Laboratory, School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | | | - Jennifer Daubenmier
- Institute of Holistic Health, Department of Health Education, San Francisco State University, San Francisco, CA, United States
| | - Frederick M Hecht
- Osher Center for Integrative Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Judith T Moskowitz
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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246
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Samson DR, Manus MB, Krystal AD, Fakir E, Yu JJ, Nunn CL. Segmented sleep in a nonelectric, small-scale agricultural society in Madagascar. Am J Hum Biol 2017; 29. [DOI: 10.1002/ajhb.22979] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 10/25/2016] [Accepted: 01/16/2017] [Indexed: 11/06/2022] Open
Affiliation(s)
- David R. Samson
- Department of Evolutionary Anthropology; Duke University; Durham North Carolina 27708
| | - Melissa B. Manus
- Duke Global Health Institute, Duke University; Durham North Carolina 27708
| | - Andrew D. Krystal
- Psychiatry and Behavioral Sciences; Duke University; Durham North Carolina 27708
| | - Efe Fakir
- Bahcesehir University, School of Medicine; Istanbul Turkey
| | - James J. Yu
- Department of Evolutionary Anthropology; Duke University; Durham North Carolina 27708
| | - Charles L. Nunn
- Department of Evolutionary Anthropology; Duke University; Durham North Carolina 27708
- Duke Global Health Institute, Duke University; Durham North Carolina 27708
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247
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Abstract
Sleep disorders and neurologic illness are common and burdensome in their own right; when combined, they can have tremendous negative impact at an individual level as well as societally. The socioeconomic burden of sleep disorders and neurologic illness can be identified, but the real cost of these conditions lies far beyond the financial realm. There is an urgent need for comprehensive care and support systems to help with the burden of disease. Further research in improving patient outcomes in those who suffer with these conditions will help patients and their families, and society in general.
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248
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Khambaty T, Callahan CM, Perkins AJ, Stewart JC. Depression and Anxiety Screens as Simultaneous Predictors of 10-Year Incidence of Diabetes Mellitus in Older Adults in Primary Care. J Am Geriatr Soc 2017; 65:294-300. [PMID: 27641686 PMCID: PMC5311025 DOI: 10.1111/jgs.14454] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To examine depression and anxiety screens and their individual items as simultaneous predictors of incident diabetes mellitus. DESIGN Ten-year follow-up study of individuals screened for the Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) trial. SETTING Two large urban primary care clinics in Indianapolis, Indiana. PARTICIPANTS Diverse sample (53% African American, 80% of lower socioeconomic status) of 2,156 older adults initially free of diabetes mellitus. MEASUREMENTS Depression and anxiety screens were completed during routine primary care visits between 1999 and 2001. Incident diabetes mellitus data were obtained from an electronic medical record system and the Centers for Medicare and Medicaid Services analytical files though 2009. RESULTS Over the 10-year period, 558 (25.9%) participants had diabetes mellitus onset. Cox proportional hazards models adjusted for demographic and diabetes mellitus risk factors revealed that a positive screen for anxiety, but not for depression, predicted incident diabetes mellitus when entered into separate models (anxiety: hazard ratio (HR) = 1.36, 95% confidence interval (CI) = 1.15-1.61, P < .001; depression: HR = 1.18, 95% CI = 0.95-1.46, P = .13) and when entered simultaneously into one model (anxiety: HR = 1.35, 95% CI = 1.12-1.61, P < .001; depression: HR = 1.04, 95% CI = 0.83-1.31, P = .73). The feeling anxious (P = .03) and the worry (P = .02) items predicted incident diabetes mellitus independent of the depression screen. CONCLUSION These findings suggest that screening positive for anxiety is a risk factor for diabetes mellitus in older adults independent of depression and traditional diabetes mellitus risk factors. Anxiety requires greater consideration and awareness in the context of diabetes mellitus risk assessment and primary prevention.
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Affiliation(s)
| | - Christopher M. Callahan
- Indiana University Center for Aging Research, Indiana University School of Medicine, Indianapolis, IN
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
- Regenstrief Institute, Inc., Indianapolis, IN
| | - Anthony J. Perkins
- Indiana University Center for Aging Research, Indiana University School of Medicine, Indianapolis, IN
- Regenstrief Institute, Inc., Indianapolis, IN
| | - Jesse C. Stewart
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, IN
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249
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Lin F, Zhuang Y, Song C, Wang A, Li Y, Gu C, Li C, Xu W. SleepSense: A Noncontact and Cost-Effective Sleep Monitoring System. IEEE TRANSACTIONS ON BIOMEDICAL CIRCUITS AND SYSTEMS 2017; 11:189-202. [PMID: 27483474 DOI: 10.1109/tbcas.2016.2541680] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Quality of sleep is an important indicator of health and well being. Recent developments in the field of in-home sleep monitoring have the potential to enhance a person's sleeping experience and contribute to an overall sense of well being. Existing in-home sleep monitoring devices either fail to provide adequate sleep information or are obtrusive to use. To overcome these obstacles, a noncontact and cost-effective sleep monitoring system, named SleepSense, is proposed for continuous recognition of the sleep status, including on-bed movement, bed exit, and breathing section. SleepSense consists of three parts: a Doppler radar-based sensor, a robust automated radar demodulation module, and a sleep status recognition framework. Herein, several time-domain and frequency-domain features are extracted for the sleep recognition framework. A prototype of SleepSense is presented and evaluated using two sets of experiments. In the short-term controlled experiment, the SleepSense achieves an overall 95.1% accuracy rate in identifying various sleep status. In the 75-minute sleep study, SleepSense demonstrates wide usability in real life. The error rate for breathing rate extraction in this study is only 6.65%. These experimental results indicate that SleepSense is an effective and promising solution for in-home sleep monitoring.
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250
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McHill AW, Wright KP. Role of sleep and circadian disruption on energy expenditure and in metabolic predisposition to human obesity and metabolic disease. Obes Rev 2017; 18 Suppl 1:15-24. [PMID: 28164449 DOI: 10.1111/obr.12503] [Citation(s) in RCA: 194] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 12/02/2016] [Indexed: 12/12/2022]
Abstract
Weight gain, obesity and diabetes have reached alarming levels in the developed world. Traditional risk factors such as over-eating, poor nutritional choices and lack of exercise cannot fully account for the high prevalence of metabolic disease. This review paper examines the scientific evidence on two novel risk factors that contribute to dys-regulated metabolic physiology: sleep disruption and circadian misalignment. Specifically, fundamental relationships between energy metabolism and sleep and circadian rhythms and the impact of sleep and circadian disruption on metabolic physiology are examined. Millions of individuals worldwide do not obtain sufficient sleep for healthy metabolic function, and many participate in shift work and social activities at times when the internal physiological clock is promoting sleep. These behaviours predispose an individual for poor metabolic health by promoting excess caloric intake in response to reduced sleep, food intake at internal biological times when metabolic physiology is not prepared, decreased energy expenditure when wakefulness and sleep are initiated at incorrect internal biological times, and disrupted glucose metabolism during short sleep and circadian misalignment. In addition to the traditional risk factors of poor diet and exercise, disturbed sleep and circadian rhythms represent modifiable risk factors for prevention and treatment of metabolic disease and for promotion of healthy metabolism.
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Affiliation(s)
- A W McHill
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital and Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - K P Wright
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
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