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Facco FL, Grobman WA, Reid KJ, Parker CB, Hunter SM, Silver RM, Basner RC, Saade GR, Pien GW, Manchanda S, Louis JM, Nhan-Chang CL, Chung JH, Wing DA, Simhan HN, Haas DM, Iams J, Parry S, Zee PC. Objectively measured short sleep duration and later sleep midpoint in pregnancy are associated with a higher risk of gestational diabetes. Am J Obstet Gynecol 2017; 217:447.e1-447.e13. [PMID: 28599896 DOI: 10.1016/j.ajog.2017.05.066] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/24/2017] [Accepted: 05/31/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Experimental and epidemiologic data suggest that among nonpregnant adults, sleep duration may be an important risk factor for chronic disease. Although pregnant women commonly report poor sleep, few studies objectively evaluated the quality of sleep in pregnancy or explored the relationship between sleep disturbances and maternal and perinatal outcomes. OBJECTIVE Our objective was to examine the relationship between objectively assessed sleep duration, timing, and continuity (measured via wrist actigraphy) and maternal cardiovascular and metabolic morbidity specific to pregnancy. STUDY DESIGN This was a prospective cohort study of nulliparous women. Women were recruited between 16 0/7 and 21 6/7 weeks' gestation. They were asked to wear a wrist actigraphy monitor and complete a daily sleep log for a period of 7 consecutive days. The primary sleep exposure variables were the averages of the following over the total valid nights (minimum 5, maximum 7 nights): short sleep duration during the primary sleep period (<7 h/night), late sleep midpoint (midpoint between sleep onset and sleep offset >5 am), and top quartile of minutes of wake time after sleep onset and sleep fragmentation index. The primary outcomes of interest were a composite of hypertensive disorders of pregnancy (mild, severe, or superimposed preeclampsia; eclampsia; or antepartum gestational hypertension) and gestational diabetes mellitus. We used χ2 tests to assess associations between sleep variables and categorical baseline characteristics. Crude odds ratios and 95% confidence intervals were estimated from univariate logistic regression models to characterize the magnitude of the relationship between sleep characteristics and hypertensive disorders of pregnancy and gestational diabetes. For associations significant in univariate analysis, multiple logistic regression was used to explore further the association of sleep characteristics with pregnancy outcomes. RESULTS In all, 901 eligible women consented to participate; 782 submitted valid actigraphy studies. Short sleep duration and a later sleep midpoint were associated with an increased risk of gestational diabetes (odds ratio, 2.24; 95% confidence interval, 1.11-4.53; and odds ratio, 2.58; 95% confidence interval, 1.24-5.36, respectively) but not of hypertensive disorders. A model with both sleep duration and sleep midpoint as well as their interaction term revealed that while there was no significant interaction between these exposures, the main effects of both short sleep duration and later sleep midpoint with gestational diabetes remained significant (adjusted odds ratio, 2.06; 95% confidence interval, 1.01-4.19; and adjusted odds ratio, 2.37; 95% confidence interval, 1.13-4.97, respectively). Additionally, after adjusting separately for age, body mass index, and race/ethnicity, both short sleep duration and later sleep midpoint remained associated with gestational diabetes. No associations were demonstrated between the sleep quality measures (wake after sleep onset, sleep fragmentation) and hypertensive disorders or gestational diabetes. CONCLUSION Our results demonstrate a relationship between short sleep duration and later sleep midpoint with gestational diabetes. Our data suggest independent contributions of these 2 sleep characteristics to the risk for gestational diabetes in nulliparous women.
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202
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Bianchi MT, Thomas RJ, Westover MB. Response. Sleep Med 2017; 38:160-161. [PMID: 28843388 PMCID: PMC9847345 DOI: 10.1016/j.sleep.2017.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 07/24/2017] [Indexed: 01/21/2023]
Affiliation(s)
- Matt T. Bianchi
- Corresponding author. Neurology Department, Massachusetts General Hospital, Wang 7, 55 Fruit Street, Boston, MA 02114, USA. Fax: +1 617 724 6513. (M.T. Bianchi)
| | - Robert J. Thomas
- Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA; Division of Pulmonary, Critical Care & Sleep, Department of Medicine, Beth, Israel; Deaconess Medical Center, Boston, MA 02215, USA
| | - M. Brandon Westover
- Neurology Department, Massachusetts General Hospital, Wang 7, 55 Fruit Street, Boston, MA 02114, USA
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203
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Palinkas M, Semprini M, Filho JE, de Luca Canto G, Regalo IH, Bataglion C, Rodrigues LAM, Siéssere S, Regalo SCH. Nocturnal sleep architecture is altered by sleep bruxism. Arch Oral Biol 2017; 81:56-60. [DOI: 10.1016/j.archoralbio.2017.04.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 03/09/2017] [Accepted: 04/20/2017] [Indexed: 01/18/2023]
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204
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Grandner MA. Sleep and obesity risk in adults: possible mechanisms; contextual factors; and implications for research, intervention, and policy. Sleep Health 2017; 3:393-400. [PMID: 28923200 DOI: 10.1016/j.sleh.2017.07.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 07/29/2017] [Indexed: 12/21/2022]
Abstract
Obesity is a major public health problem among US adults. Insufficient sleep and sleep disorders are prevalent and may contribute to the public health problem of obesity. This review addresses several key questions regarding sleep and obesity in adults, including the following: (1) What constitutes adequate sleep in adults? (2) What are the consequences of inadequate sleep in adults? (3) What factors influence sleep in adults? (4) How can adults improve their sleep? (5) How can we implement these in adults? (6) How can these issues be addressed in future research and policy decisions? Although a comprehensive review of all of these is beyond the scope of this article, this review brings these concepts together toward a discussion of the role of sleep in the health of US adults.
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Affiliation(s)
- Michael A Grandner
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona, 1501 N Campbell Ave, PO Box 245002, Tucson, AZ 85724-5002.
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205
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Curtis DS, Fuller-Rowell TE, El-Sheikh M, Carnethon MR, Ryff CD. Habitual sleep as a contributor to racial differences in cardiometabolic risk. Proc Natl Acad Sci U S A 2017; 114:8889-8894. [PMID: 28760970 PMCID: PMC5565403 DOI: 10.1073/pnas.1618167114] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Insufficient and disrupted sleep is linked with cardiovascular and metabolic dysregulation and morbidity. The current study examines the degree to which differences in sleep between black/African American (AA) and white/European American (EA) adults explain racial differences in cardiometabolic (CMB) disease risk. Total sleep time and sleep efficiency (percent of time in bed asleep) were assessed via seven nights of wrist actigraphy among 426 participants in the Midlife in the United States Study (31% AA; 69% EA; 61% female; mean age = 56.8 y). CMB risk was indexed as a composite of seven biomarkers [blood pressure, waist circumference, hemoglobin A1c (HbA1c), insulin resistance, triglycerides, HDL cholesterol (HDL-C), and C-reactive protein]. Covariates included sociodemographic characteristics and relevant health behaviors. Results indicated that AAs relative to EAs obtained less sleep (341 vs. 381 min) and had lower sleep efficiency (72.3 vs. 82.2%) (P values < 0.001). Further, 41% and 58% of the racial difference in CMB risk was explained by sleep time and sleep efficiency, respectively. In models stratified by sex, race was indirectly associated with CMB risk via sleep time and efficiency only among females (explaining 33% and 65% of the race difference, respectively). Indirect effects were robust to alternative model specifications that excluded participants with diabetes or heart disease. Consideration of sleep determinants and sleep health is therefore needed in efforts to reduce racial differences in CMB disease.
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Affiliation(s)
- David S Curtis
- Department of Human Development and Family Studies, Auburn University, Auburn, AL 36849;
| | | | - Mona El-Sheikh
- Department of Human Development and Family Studies, Auburn University, Auburn, AL 36849
| | | | - Carol D Ryff
- Department of Psychology, University of Wisconsin-Madison, Madison, WI 53706
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206
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Pacek LR, Herrmann ES, Smith MT, Vandrey R. Sleep continuity, architecture and quality among treatment-seeking cannabis users: An in-home, unattended polysomnographic study. Exp Clin Psychopharmacol 2017; 25:295-302. [PMID: 28782982 PMCID: PMC6309181 DOI: 10.1037/pha0000126] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The objective of the study was to describe self-report and objectively measured sleep characteristics of adult treatment-seeking cannabis users. Study participants (n = 87) were adults who were screened for a 12-week outpatient cannabis treatment research program in Baltimore, MD. Participants completed objective and self-report measures of sleep quality. Data were analyzed for the sample overall and after stratifying by sex (54 men, 33 women). Participants were primarily urban, socioeconomically disadvantaged African Americans. Participants were frequent, heavy cannabis users; among a subset of participants assessed, 76.7% used cannabis on the day/night of the assessment. Participants had low rates of other substance abuse and of psychiatric comorbidities. Polysomnography indicated 19.5% of participants received the recommended 7 to 9 hr of sleep, with women averaging more sleep than men. One third (31.0%) had sleep latencies >30 min, one half spent >30 min awake after sleep onset, and more than one half of the sample (55.2%) had sleep efficiency scores of <85%. Most participants met criteria for subthreshold (36.8%) or clinical insomnia (25.3%) on the Insomnia Severity Index, 77.0% had scores of >5 on the Pittsburgh Sleep Quality Index. Most had average scores on the Dysfunctional Beliefs and Attitudes About Sleep (DBAS) questionnaire (M = 51.1, SD = 18.8) that were higher than average among clinical insomnia patients. Women had higher DBAS scores than men. Most participants exhibited characteristics of disordered sleep, and sex differences were observed on polysomnography and self-report measures. Findings extend prior research concerning the association between cannabis use and disordered sleep. Data presented in this article come from Clinical Trial NCT01685073. (PsycINFO Database Record
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Affiliation(s)
- Lauren R. Pacek
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, NC, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, MD, USA
| | - Evan S. Herrmann
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, MD, USA
- Division on Substance Abuse, New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons, Columbia University, NY, USA
| | - Michael T. Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, MD, USA
| | - Ryan Vandrey
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, MD, USA
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207
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Lee SH, Kang Y, Cho SJ. Subjective cognitive decline in patients with migraine and its relationship with depression, anxiety, and sleep quality. J Headache Pain 2017; 18:77. [PMID: 28744704 PMCID: PMC5526827 DOI: 10.1186/s10194-017-0779-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 07/04/2017] [Indexed: 01/03/2023] Open
Abstract
Background Cognitive decline is a major concern in patients with migraine. Depression, anxiety, and/or poor sleep quality are well-known comorbidities of migraine, but available evidence on the subjective cognitive decline (SCD) is limited. This study aimed to investigate the presence and frequency of SCD and its relationship with anxiety, depression and sleep quality in patients with migraine. Methods We enrolled patients with migraine who scored within the normal range of the Korean-Mini Mental State Examination and the Korean-Montreal Cognitive Assessment. Using the Subjective Cognitive Decline Questionnaire (SCD-Q), participants with ≥7 were assigned to the SCD group. The Headache Impact Test-6, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Pittsburgh Sleep Quality Index were used and analyzed between the two groups. Results A total of 188 patients with migraine, aged 38.1 ± 9.9 years, were enrolled. The mean SCD-Q score was 6.5 ± 5.5, and 44.7% of participants were identified as SCD. Migraineurs with SCD reported higher headache pain intensity and headache impact, as well as greater prevalence of anxiety, depression, reduced quality of sleep, and shorter sleep duration during weekdays compared to migraineurs without SCD. There were no significant differences in terms of age, sex, migraine type (chronic/episodic), medication, or sleep duration during weekends between the two groups. Upon multivariate logistic analysis adjusted for age, sex, headache characteristics, and psychological variables, depression was associated with increased risk of SCD (Odds ratio 1.31, 95% confidence interval 1.16–1.49) and sleep duration during weekdays was associated with decreased risk of SCD (Odds ratio 0.66, 95% confidence interval 0.44–0.97). Conclusions A non-negligible number of patients with migraine complained of SCD. Depression and short sleep duration during weekdays were related to SCD among adult migraineurs.
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Affiliation(s)
- Sun Hwa Lee
- Department of Neurology, Hallym University Dongtan Sacred Heart Hospital, 7, Keunjaebong-gil, Hwaseong-si, Gyeonggi-do, 445-907, South Korea
| | - Yeonwook Kang
- Department of Psychology, Hallym University, Chuncheon, Korea
| | - Soo-Jin Cho
- Department of Neurology, Hallym University Dongtan Sacred Heart Hospital, 7, Keunjaebong-gil, Hwaseong-si, Gyeonggi-do, 445-907, South Korea.
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208
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Xu X, Liu D, Zhang Z, Sharma M, Zhao Y. Sleep Duration and Quality in Pregnant Women: A Cross-Sectional Survey in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14070817. [PMID: 28726747 PMCID: PMC5551255 DOI: 10.3390/ijerph14070817] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 07/14/2017] [Accepted: 07/18/2017] [Indexed: 12/04/2022]
Abstract
Objectives: Good maternal health and fetal development require sufficient and good quality of sleep during pregnancy. This study investigated sleep duration and quality in pregnant women, assessing factors with possibly influence on sleep. Method: A cross-sectional survey was conducted on pregnant women between June and August in 2015 in 16 hospitals in five provinces in China. A total of 2345 pregnant women aged 18 years and older were surveyed. Insufficient sleeping duration was defined as sleeping of less than 7 h per day. Excessive sleep duration was defined as sleeping of more than 9 h per day. Results: A total of 561 (23.9%) participants reported insufficient sleeping duration, whereas 485 (20.9%) claimed excessive sleep duration. A total of 358 (15.2%) of pregnant women reported problems regarding sleep quality. Compared to pregnant women with sufficient sleeping duration, those with insufficient sleeping duration were prone to have poor sleep quality, whereas those with excessive sleeping duration featured low possibility of poor sleep quality. High-risk groups of insufficient sleep duration include women of Han nationality, with siblings, in their first trimester of pregnancy, receiving care in low-capacity/quality hospital settings, and with daily or 1-3 days of secondhand smoke exposure. High-risk groups of excessive sleep duration include women living in rural areas, unemployed, in their third trimester of pregnancy, and receiving care in medium-capacity/quality hospital settings. High-risk groups of poor sleep quality include women of non-Han nationality, low income level, in their third trimester of pregnancy, and with insufficient sleep duration. Conclusions: Insufficient/excessive sleep duration and poor sleep quality commonly occur during pregnancy in China. Findings provide a better understanding of the influencing factors of insufficient/excessive sleep duration and poor quality of sleep. These findings have some implications for future interventions on sleep among pregnant women.
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Affiliation(s)
- Xianglong Xu
- School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China.
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China.
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China.
| | - Dengyuan Liu
- School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China.
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China.
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China.
| | - Zhangyi Zhang
- School of the Second Clinical, Chongqing Medical University, Chongqing 400016, China.
| | - Manoj Sharma
- Department of Behavioral and Environmental Health, Jackson State University, Jackson, MS 39213, USA.
| | - Yong Zhao
- School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China.
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China.
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China.
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209
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Sandoval Y, Lobo AS, Somers VK, Rosenfield K, Bradley SM, Sorajja P, Tajti P, Brilakis ES. Sleep deprivation in interventional cardiology: Implications for patient care and physician-health. Catheter Cardiovasc Interv 2017; 91:905-910. [PMID: 28707310 DOI: 10.1002/ccd.27185] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 05/04/2017] [Accepted: 06/08/2017] [Indexed: 11/09/2022]
Abstract
The burden and impact of sleep deprivation on both patient care and on the health of interventional cardiologists is not well understood. Due to the nature of emergent procedures occurring in the cardiac catheterization laboratory, interventionalists are prone to suffer from acute and/or chronic sleep deprivation. Sleep deprivation has been associated with numerous adverse effects, such as impaired performance, cognitive deficits, reduced psychomotor vigilance, and workplace errors and injuries, among many others. Although sleep deprivation has been linked to more errors in trainees, there is paucity of data addressing outcomes in interventional cardiology. The purpose of this overview is to explore the possible impact of sleep deprivation on interventional cardiology in relation to patient care and physician health, and examine potential approaches to this issue.
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Affiliation(s)
- Yader Sandoval
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota.,Division of Cardiology, Hennepin County Medical Center, Minneapolis, Minnesota
| | - Angie S Lobo
- Department of Medical Education, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Virend K Somers
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | - Kenneth Rosenfield
- Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Steven M Bradley
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Paul Sorajja
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Peter Tajti
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Emmanouil S Brilakis
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
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210
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Sletten TL, Ftouni S, Nicholas CL, Magee M, Grunstein RR, Ferguson S, Kennaway DJ, O'Brien D, Lockley SW, Rajaratnam SMW. Randomised controlled trial of the efficacy of a blue-enriched light intervention to improve alertness and performance in night shift workers. Occup Environ Med 2017. [PMID: 28630378 DOI: 10.1136/oemed-2016-103818] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Night workers often experience high levels of sleepiness due to misalignment of the sleep-wake cycle from the circadian pacemaker, in addition to acute and chronic sleep loss. Exposure to light, in particular short wavelength light, can improve alertness and neurobehavioural performance. This randomised controlled trial examined the efficacy of blue-enriched polychromatic light to improve alertness and neurobehavioural performance in night workers. DESIGN Participants were 71 night shift workers (42 males; 32.8±10.5 years) who worked at least 6 hours between 22:00 and 08:00 hours. Sleep-wake logs and wrist actigraphy were collected for 1-3 weeks, followed by 48-hour urine collection to measure the circadian 6-sulphatoxymelatonin (aMT6s) rhythm. On the night following at least two consecutive night shifts, workers attended a simulated night shift in the laboratory which included subjective and objective assessments of sleepiness and performance. Workers were randomly assigned for exposure to one of two treatment conditions from 23:00 hours to 07:00 hours: blue-enriched white light (17 000 K, 89 lux; n=36) or standard white light (4000 K, 84 lux; n=35). RESULTS Subjective and objective sleepiness increased during the night shift in both light conditions (p<0.05, ηp2=0.06-0.31), but no significant effects of light condition were observed. The 17 000 K light, however, did improve subjective sleepiness relative to the 4000 K condition when light exposure coincided with the time of the aMT6s peak (p<0.05, d=0.41-0.60). CONCLUSION This study suggests that, while blue-enriched light has potential to improve subjective sleepiness in night shift workers, further research is needed in the selection of light properties to maximise the benefits. TRIAL REGISTRATION NUMBER The Australian New Zealand Clinical Trials Registry ACTRN12610000097044 (https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=320845&isReview=true).
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Affiliation(s)
- Tracey L Sletten
- Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia.,CRC for Alertness, Safety and Productivity, Clayton, Victoria, Australia
| | - Suzanne Ftouni
- Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia.,CRC for Alertness, Safety and Productivity, Clayton, Victoria, Australia
| | - Christian L Nicholas
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Michelle Magee
- Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia.,CRC for Alertness, Safety and Productivity, Clayton, Victoria, Australia
| | - Ronald R Grunstein
- CRC for Alertness, Safety and Productivity, Clayton, Victoria, Australia.,Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia.,Department of Respiratory & Sleep Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Sally Ferguson
- Appleton Institute, Central Queensland University, Wayville, South Australia, Australia
| | - David J Kennaway
- Robinson Research Institute, School of Medicine, Discipline of Obstetrics and Gynaecology, University of Adelaide, Adelaide, South Australia, Australia
| | - Darren O'Brien
- Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia.,Sydney Nursing School, University of Sydney, Sydney, New South Wales, Australia
| | - Steven W Lockley
- Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia.,CRC for Alertness, Safety and Productivity, Clayton, Victoria, Australia.,Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Shantha M W Rajaratnam
- Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia.,CRC for Alertness, Safety and Productivity, Clayton, Victoria, Australia.,Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
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211
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Kaar JL, Luberto CM, Campbell KA, Huffman JC. Sleep, health behaviors, and behavioral interventions: Reducing the risk of cardiovascular disease in adults. World J Cardiol 2017; 9:396-406. [PMID: 28603586 PMCID: PMC5442407 DOI: 10.4330/wjc.v9.i5.396] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 03/04/2017] [Accepted: 04/10/2017] [Indexed: 02/06/2023] Open
Abstract
Numerous health behaviors, including physical activity, diet, smoking, and sleep, play a major role in preventing the development and progression of cardiovascular disease (CVD). Among these behaviors, sleep may play a pivotal role, yet it has been studied somewhat less than other behaviors and there have been few well-designed sleep intervention studies targeting CVD. Furthermore, despite the fact that these behaviors are often interrelated, interventions tend to focus on changing one health behavior rather than concurrently intervening on multiple behaviors. Psychological constructs from depression to positive affect may also have a major effect on these health behaviors and ultimately on CVD. In this review, we summarize the existing literature on the impact of sleep and other cardiac health behaviors on CVD onset and prognosis. We also describe interventions that may promote these behaviors, from established interventions such as motivational interviewing and cognitive behavioral therapy, to more novel approaches focused on mindfulness and other positive psychological constructs. Finally, we outline population-health-level care management approaches for patients with psychiatric conditions (e.g., depression) that may impact cardiac health, and discuss their potential utility in improving mental health, promoting health behaviors, and reducing CVD-related risk. Much work is still needed to better understand how sleep and other health behaviors may uniquely contribute to CVD risk, and additional high-quality studies of interventions designed to modify cardiac health behaviors are required to improve cardiovascular health in individuals and the population at large.
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212
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Abstract
This review highlights recent advances in research addressing intimate partner relationships and health. Consideration of the strong mutual influences that the members of a couple have on each other's mental and physical health trajectories provides a new way to view the health implications of couples' convergence or interdependence; marital closeness can have a clear downside when one partner has mental or physical health problems. Couples' interconnectedness can also be leveraged to promote better treatment outcomes. Major themes include the pivotal role of depression and the importance of gender differences in the pathways from the marital relationship to physiological functioning and health. The health risks and benefits of support are weighed. Additionally, two prominent emerging paths from marital distress to poor health are emphasized: sleep problems and metabolic alterations that promote obesity and its comorbidities.
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Affiliation(s)
- Janice K Kiecolt-Glaser
- Institute for Behavioral Medicine Research, College of Medicine, The Ohio State University, Columbus, Ohio; ,
- Department of Psychiatry and Behavioral Health, College of Medicine, The Ohio State University, Columbus, Ohio
| | - Stephanie J Wilson
- Institute for Behavioral Medicine Research, College of Medicine, The Ohio State University, Columbus, Ohio; ,
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213
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Kiecolt-Glaser JK, Wilson SJ. Lovesick: How Couples' Relationships Influence Health. Annu Rev Clin Psychol 2017. [PMID: 28301763 DOI: 10.1146/annurevclinpsy-032816-045111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
This review highlights recent advances in research addressing intimate partner relationships and health. Consideration of the strong mutual influences that the members of a couple have on each other's mental and physical health trajectories provides a new way to view the health implications of couples' convergence or interdependence; marital closeness can have a clear downside when one partner has mental or physical health problems. Couples' interconnectedness can also be leveraged to promote better treatment outcomes. Major themes include the pivotal role of depression and the importance of gender differences in the pathways from the marital relationship to physiological functioning and health. The health risks and benefits of support are weighed. Additionally, two prominent emerging paths from marital distress to poor health are emphasized: sleep problems and metabolic alterations that promote obesity and its comorbidities.
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Affiliation(s)
- Janice K Kiecolt-Glaser
- Institute for Behavioral Medicine Research, College of Medicine, The Ohio State University, Columbus, Ohio; ,
- Department of Psychiatry and Behavioral Health, College of Medicine, The Ohio State University, Columbus, Ohio
| | - Stephanie J Wilson
- Institute for Behavioral Medicine Research, College of Medicine, The Ohio State University, Columbus, Ohio; ,
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214
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Fogelberg DJ, Leland NE, Blanchard J, Rich TJ, Clark FA. Qualitative Experience of Sleep in Individuals With Spinal Cord Injury. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2017; 37:89-97. [PMID: 28196449 PMCID: PMC5447661 DOI: 10.1177/1539449217691978] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Poor sleep contributes to adverse health outcomes making it important to understand sleep in medically vulnerable populations, including those with spinal cord injury (SCI). However, little attention has been paid to circumstances specific to SCI that may negatively affect sleep, or to consequences of poor sleep in this population. The objective of this study was to examine the experience of sleep among individuals with SCI. Secondary analysis using thematic coding of qualitative data from an ethnographic study of community-dwelling adults with SCI was conducted. Sleep-related data were found in transcripts for 90% of the sample. Participants described diminished sleep duration and irregular sleep patterns. Several factors contributing to poor sleep were identified, including SCI-related circumstances and sleep environment. Participants also discussed how poor sleep affected occupational engagement. This study highlights the extent of sleep disturbance experienced after SCI and the subsequent impact on occupational performance, and provides direction for clinical practice.
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Juel A, Kristiansen CB, Madsen NJ, Munk-Jørgensen P, Hjorth P. Interventions to improve lifestyle and quality-of-life in patients with concurrent mental illness and substance use. Nord J Psychiatry 2017; 71:197-204. [PMID: 27834103 DOI: 10.1080/08039488.2016.1251610] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Patients with co-existence of psychiatric disorders and substance use have an increased risk of premature death. This is attributable to a higher prevalence of physical comorbidities and a lifestyle related to substance use. Furthermore, they experience low quality-of-life (QoL). Studies addressing lifestyle interventions for these patients are warranted. AIMS To investigate the physical health and QoL in patients with co-existence of psychiatric disorders and substance use, and to analyse for changes in their (a) health, (b) substance use, and (c) QoL after a 24-month health-promotion programme. Further aims were to investigate associations between (a) QoL and number of interventions, (b) QoL and patient characteristics, and (c) QoL and length of participation in the intervention. METHODS In this naturalistic cohort study, 64 non-selected patients were engaged in health-promoting interventions added to contemporary treatments. QoL and clinical variables were measured at the beginning of and continuously during the programme by means of the WHOQoL-Bref questionnaire. RESULTS At enrolment, the patients' intake of cannabis and alcohol was high. During follow-up, patients consumed significantly fewer caffeinated beverages (p = .038) and fast-food meals (p = .018), and slept significantly less (p = .032). The average dose of antipsychotic medication increased significantly (p = .015). QoL was low at enrolment, but improved significantly overall (p = .009) and in the psychological (p = .020) and environmental domains (p = .012) at follow-up. The difference in total QoL was positively associated with the number of interventions attended. CONCLUSION This programme shows promise in addressing health promotion for these patients and can easily be integrated into contemporary treatments.
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Affiliation(s)
- Anette Juel
- a Department of Affective Disorders, Aarhus University Hospital , Risskov , Denmark
| | | | | | - Povl Munk-Jørgensen
- d Department of Psychiatry Odense , University Function, Southern University of Denmark , Odense , Denmark
| | - Peter Hjorth
- e Mental health Center, Psychiatric Hospital , Randers , Denmark
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Shockey TM, Wheaton AG. Short Sleep Duration by Occupation Group - 29 States, 2013-2014. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2017; 66:207-213. [PMID: 28253230 PMCID: PMC5657897 DOI: 10.15585/mmwr.mm6608a2] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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218
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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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Mansour HA, Wood J, Chowdari KV, Tumuluru D, Bamne M, Monk TH, Hall MH, Buysse DJ, Nimgaonkar VL. Associations between period 3 gene polymorphisms and sleep- /chronotype-related variables in patients with late-life insomnia. Chronobiol Int 2017; 34:624-631. [PMID: 28276850 PMCID: PMC5403599 DOI: 10.1080/07420528.2017.1287083] [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] [Received: 07/11/2016] [Revised: 01/20/2017] [Accepted: 01/23/2017] [Indexed: 10/20/2022]
Abstract
A variable number tandem repeat polymorphism (VNTR) in the period 3 (PER3) gene has been associated with heritable sleep and circadian variables, including self-rated chronotypes, polysomnographic (PSG) variables, insomnia and circadian sleep-wake disorders. This report describes novel molecular and clinical analyses of PER3 VNTR polymorphisms to better define their functional consequences. As the PER3 VNTR is located in the exonic (protein coding) region of PER3, we initially investigated whether both alleles (variants) are transcribed into messenger RNA in human fibroblasts. The VNTR showed bi-allelic gene expression. We next investigated genetic associations in relation to clinical variables in 274 older adult Caucasian individuals. Independent variables included genotypes for the PER3 VNTR as well as a representative set of single nucleotide polymorphisms (SNPs) that tag common variants at the PER3 locus (linkage disequilibrium (LD) between genetic variants < 0.5). In order to comprehensively evaluate variables analyzed individually in prior analyses, dependent measures included PSG total sleep time and sleep latency, self-rated chronotype, estimated with the Composite Scale (CS), and lifestyle regularity, estimated using the social rhythm metric (SRM). Initially, genetic polymorphisms were individually analyzed in relation to each outcome variable using analysis of variance (ANOVA). Nominally significant associations were further tested using regression analyses that incorporated individual ANOVA-associated DNA variants as potential predictors and each of the selected sleep/circadian variables as outcomes. The covariates included age, gender, body mass index and an index of medical co-morbidity. Significant genetic associations with the VNTR were not detected with the sleep or circadian variables. Nominally significant associations were detected between SNP rs1012477 and CS scores (p = 0.003) and between rs10462021 and SRM (p = 0.047); rs11579477 and average delta power (p = 0.043) (analyses uncorrected for multiple comparisons). In conclusion, alleles of the VNTR are expressed at the transcript level and may have a functional effect in cells expressing the PER3 gene. PER3 polymorphisms had a modest impact on selected sleep/circadian variables in our sample, suggesting that PER3 is associated with sleep and circadian function beyond VNTR polymorphisms. Further replicate analyses in larger, independent samples are recommended.
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Affiliation(s)
- Hader A Mansour
- a Department of Psychiatry , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA
| | - Joel Wood
- a Department of Psychiatry , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA
| | - Kodavali V Chowdari
- a Department of Psychiatry , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA
| | - Divya Tumuluru
- a Department of Psychiatry , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA
| | - Mikhil Bamne
- a Department of Psychiatry , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA
| | - Timothy H Monk
- a Department of Psychiatry , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA
| | - Martica H Hall
- a Department of Psychiatry , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA
| | - Daniel J Buysse
- a Department of Psychiatry , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA
| | - Vishwajit L Nimgaonkar
- a Department of Psychiatry , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA
- b Department of Human Genetics, Graduate School of Public Health , University of Pittsburgh , Pittsburgh , PA , USA
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Suri P, Boyko EJ, Smith NL, Jarvik JG, Williams FMK, Jarvik GP, Goldberg J. Modifiable risk factors for chronic back pain: insights using the co-twin control design. Spine J 2017; 17:4-14. [PMID: 27794503 PMCID: PMC6126929 DOI: 10.1016/j.spinee.2016.07.533] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 07/29/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND Inconsistent associations between modifiable risk factors and chronic back pain (CBP) may be due to the inability of traditional epidemiologic study designs to properly account for an array of potential genetic and environmental confounding factors. The co-twin control research design, comparing modifiable risk factors in twins discordant for CBP, offers a unique way to remove numerous confounding factors. PURPOSE The study aimed to examine the association of modifiable lifestyle and psychological factors with lifetime CBP. STUDY DESIGN/SETTING This is a cross-sectional co-twin control study in a nationwide sample of male twin members of the Vietnam Era Twin Registry. PATIENT SAMPLE The sample is composed of 7,108 participants, including 1,308 monozygotic (MZ) pairs and 793 dizygotic pairs. OUTCOME MEASURE The outcome measure is the self-reported lifetime history of CBP. METHODS Lifestyle factors included body mass index (BMI), smoking history, alcohol consumption, habitual physical activity, and typical sleep duration. Psychological factors included depression (Patient Health Questionnaire-9) and posttraumatic stress disorder (PTSD) symptoms (PTSD Checklist). Covariates included age, race, education, and income. Odds ratios (ORs) and 95% confidence intervals (CI) were estimated for the association of risk factors with lifetime CBP when considering twins as individuals, and a within-pair co-twin control analysis that accounted for familial and genetic factors. Funding was through VA Grant 5IK2RX001515; there were no study-specific conflicts of interest. RESULTS The mean age of respondents was 62 years and the prevalence of lifetime CBP was 28%. All lifestyle factors were associated with CBP in the individual level analysis. However, none of these persisted in the within-pair analyses, except for severe obesity (BMI ≥35.0), which was associated with lifetime CBP in both individual-level (OR=1.6, 95% CI: 1.3-1.9) and within-pair analyses (MZ analysis: OR=3.7, 95% CI: 1.2-11.4). Symptoms of PTSD and depression were strongly associated with lifetime CBP in both the individual-level (moderate or severe depression: OR=4.2, 95% CI: 3.6-4.9, and severe PTSD: OR=4.8, 95% CI: 4.0-5.7) and within-pair (MZ) analyses (moderate or severe depression: OR=4.6, 95% CI: 2.4-8.7, and severe PTSD: OR=3.2, 95% CI: 1.6-6.5). CONCLUSIONS Many associations between modifiable lifestyle risk factors and CBP are due to confounding by familial and genetic factors. Severe obesity, depression, and PTSD should be considered in the development of intervention strategies to reduce the prevalence of CBP.
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Affiliation(s)
- Pradeep Suri
- Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, S-152-ERIC, 1660 S. Columbian Way, Seattle, WA 98108, USA; Division of Rehabilitation Care Services, 1660 S. Columbian Way, Seattle, WA 98108, USA; Department of Rehabilitation Medicine, University of Washington, 325 Ninth Ave, Box 359612, Seattle, WA 98104, USA.
| | - Edward J Boyko
- Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, S-152-ERIC, 1660 S. Columbian Way, Seattle, WA 98108, USA; General Medicine Service, VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USA
| | - Nicholas L Smith
- Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, S-152-ERIC, 1660 S. Columbian Way, Seattle, WA 98108, USA; Department of Epidemiology, University of Washington, 1959 NE Pacific St Health Sciences Bldg, Box 357236, Seattle, WA 98195, USA
| | - Jeffrey G Jarvik
- Comparative Effectiveness, Cost and Outcomes Research Center, University of Washington, 4333 Brooklyn Ave NE, Box #359455, Seattle, WA 98195, USA; Department of Radiology, University of Washington, 325 9th Ave, Seattle, WA 98104, USA; Department of Neurological Surgery, University of Washington, 325 9th Ave, Seattle, WA 98104, USA; Department of Health Services, University of Washington, 325 9th Ave, Seattle, WA 98104, USA
| | - Frances M K Williams
- Department of Twin Research and Genetic Epidemiology, Kings College London, Strand, London WC2R 2LS, UK
| | - Gail P Jarvik
- Department of Medicine (Medical Genetics), 3720 15th Ave NE, Seattle, WA 98105, USA; Department of Genome Sciences, University of Washington, 3720 15th Ave NE, Seattle, WA 98105, USA
| | - Jack Goldberg
- Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, S-152-ERIC, 1660 S. Columbian Way, Seattle, WA 98108, USA; Department of Epidemiology, University of Washington, 1959 NE Pacific St Health Sciences Bldg, Box 357236, Seattle, WA 98195, USA
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Marino M, Killerby M, Lee S, Klein LC, Moen P, Olson R, Kossek EE, King R, Erickson L, Berkman LF, Buxton OM. The Effects of a Cluster Randomized Controlled Workplace Intervention on Sleep and Work-Family Conflict Outcomes in an Extended Care Setting. Sleep Health 2016; 2:297-308. [PMID: 28239635 PMCID: PMC5323265 DOI: 10.1016/j.sleh.2016.09.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To evaluate the effects of a workplace-based intervention on actigraphic and self-reported sleep outcomes in an extended care setting. DESIGN Cluster randomized trial. SETTING Extended-care (nursing) facilities. PARTICIPANTS US employees and managers at nursing homes. Nursing homes were randomly selected to intervention or control settings. INTERVENTION The Work, Family and Health Study developed an intervention aimed at reducing work-family conflict within a 4-month work-family organizational change process. Employees participated in interactive sessions with facilitated discussions, role-playing, and games designed to increase control over work processes and work time. Managers completed training in family-supportive supervision. MEASUREMENTS Primary actigraphic outcomes included: total sleep duration, wake after sleep onset, nighttime sleep, variation in nighttime sleep, nap duration, and number of naps. Secondary survey outcomes included work-to-family conflict, sleep insufficiency, insomnia symptoms and sleep quality. Measures were obtained at baseline, 6-months and 12-months post-intervention. RESULTS A total of 1,522 employees and 184 managers provided survey data at baseline. Managers and employees in the intervention arm showed no significant difference in sleep outcomes over time compared to control participants. Sleep outcomes were not moderated by work-to-family conflict or presence of children in the household for managers or employees. Age significantly moderated an intervention effect on nighttime sleep among employees (p=0.040), where younger employees benefited more from the intervention. CONCLUSION In the context of an extended-care nursing home workplace, the intervention did not significantly alter sleep outcomes in either managers or employees. Moderating effects of age were identified where younger employees' sleep outcomes benefited more from the intervention.
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Affiliation(s)
- Miguel Marino
- Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA; School of Public Health, Oregon Health & Science University, Portland, OR, USA.
| | - Marie Killerby
- Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Soomi Lee
- Department of Biobehavioral Health and Penn State Institute of the Neurosciences, Pennsylvania State University, University Park, PA, USA
| | - Laura Cousino Klein
- Department of Biobehavioral Health and Penn State Institute of the Neurosciences, Pennsylvania State University, University Park, PA, USA
| | - Phyllis Moen
- Department of Sociology and Minnesota Population Center, University of Minnesota, Minneapolis, MN, USA
| | - Ryan Olson
- Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA; School of Public Health, Oregon Health & Science University, Portland, OR, USA; Department of Psychology, Portland State University, Portland, OR, USA
| | - Ellen Ernst Kossek
- Krannert School of Management, Purdue University, West Lafayette, IN, USA
| | - Rosalind King
- Population Dynamics Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | | | - Lisa F Berkman
- Harvard Center for Population and Development Studies, Harvard University, Cambridge, MA, USA; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Orfeu M Buxton
- Department of Biobehavioral Health and Penn State Institute of the Neurosciences, Pennsylvania State University, University Park, PA, USA; Harvard Center for Population and Development Studies, Harvard University, Cambridge, MA, USA; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
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Fuller-Rowell TE, Curtis DS, El-Sheikh M, Chae DH, Boylan JM, Ryff CD. Racial disparities in sleep: the role of neighborhood disadvantage. Sleep Med 2016; 27-28:1-8. [PMID: 27938909 PMCID: PMC5171231 DOI: 10.1016/j.sleep.2016.10.008] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 10/04/2016] [Accepted: 10/06/2016] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Disparities in sleep duration and efficiency between Black/African American (AA) and White/European American (EA) adults are well-documented. The objective of this study was to examine neighborhood disadvantage as an explanation for race differences in objectively measured sleep. METHODS Data were from 133 AA and 293 EA adults who participated in the sleep assessment protocol of the Midlife in the United States (MIDUS) study (57% female; Mean Age = 56.8 years, SD = 11.4). Sleep minutes, onset latency, and waking after sleep onset (WASO) were assessed over seven nights using wrist actigraphy. Neighborhood characteristics were assessed by linking home addresses to tract-level socioeconomic data from the 2000 US Census. Multilevel models estimated associations between neighborhood disadvantage and sleep, and the degree to which neighborhood disadvantage mediated race differences in sleep controlling for family socioeconomic position and demographic variables. RESULTS AAs had shorter sleep duration, greater onset latency, and higher WASO than EAs (ps < 0.001). Neighborhood disadvantage was significantly associated with WASO (B = 3.54, p = 0.028), but not sleep minutes (B = -2.21, p = 0.60) or latency (B = 1.55, p = 0.38). Furthermore, race was indirectly associated with WASO via neighborhood disadvantage (B = 4.63, p = 0.035), which explained 24% of the race difference. When measures of depression, health behaviors, and obesity were added to the model, the association between neighborhood disadvantage and WASO was attenuated by 11% but remained significant. CONCLUSION Findings suggest that neighborhood disadvantage mediates a portion of race differences in WASO, an important indicator of sleep efficiency.
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Affiliation(s)
| | - David S Curtis
- Department of Human Development and Family Studies, Auburn University, AL, USA
| | - Mona El-Sheikh
- Department of Human Development and Family Studies, Auburn University, AL, USA
| | - David H Chae
- Department of Human Development and Family Studies, Auburn University, AL, USA
| | | | - Carol D Ryff
- Department of Psychology, University of Wisconsin - Madison, WI, USA
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Abstract
Sleep is important for regulating many physiologic functions that relate to metabolism. Because of this, there is substantial evidence to suggest that sleep habits and sleep disorders are related to diabetes risk. In specific, insufficient sleep duration and/or sleep restriction in the laboratory, poor sleep quality, and sleep disorders such as insomnia and sleep apnea have all been associated with diabetes risk. This research spans epidemiologic and laboratory studies. Both physiologic mechanisms such as insulin resistance, decreased leptin, and increased ghrelin and inflammation and behavioral mechanisms such as increased food intake, impaired decision-making, and increased likelihood of other behavioral risk factors such as smoking, sedentary behavior, and alcohol use predispose to both diabetes and obesity, which itself is an important diabetes risk factor. This review describes the evidence linking sleep and diabetes risk at the population and laboratory levels.
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Affiliation(s)
- Michael A Grandner
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine, 1501 N Campbell Ave, PO Box 245002, Tucson, AZ, 85724-5002, USA.
- Sarver Heart Center, University of Arizona College of Medicine, Tucson, AZ, USA.
- Department of Medicine, University of Arizona College of Medicine, Tucson, AZ, USA.
| | - Azizi Seixas
- Center for Healthful Behavior Change, Department of Population Health, New York University Langone Medical Center, New York, NY, USA
| | - Safal Shetty
- Department of Medicine, University of Arizona College of Medicine, Tucson, AZ, USA
| | - Sundeep Shenoy
- Department of Medicine, University of Arizona College of Medicine, Tucson, AZ, USA
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Chakravorty S, Chaudhary NS, Brower KJ. Alcohol Dependence and Its Relationship With Insomnia and Other Sleep Disorders. Alcohol Clin Exp Res 2016; 40:2271-2282. [PMID: 27706838 DOI: 10.1111/acer.13217] [Citation(s) in RCA: 124] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 08/09/2016] [Indexed: 12/12/2022]
Abstract
Sleep-related complaints are widely prevalent in those with alcohol dependence (AD). AD is associated not only with insomnia, but also with multiple sleep-related disorders as a growing body of literature has demonstrated. This article will review the various aspects of insomnia associated with AD. In addition, the association of AD with other sleep-related disorders will be briefly reviewed. The association of AD with insomnia is bidirectional in nature. The etiopathogenesis of insomnia has demonstrated multiple associations and is an active focus of research. Treatment with cognitive behavioral therapy for insomnia is showing promise as an optimal intervention. In addition, AD may be associated with circadian abnormalities, short sleep duration, obstructive sleep apnea, and sleep-related movement disorder. The burgeoning knowledge on insomnia associated with moderate-to-severe alcohol use disorder has expanded our understanding of its underlying neurobiology, clinical features, and treatment options.
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Affiliation(s)
- Subhajit Chakravorty
- Corporal Michael J. Crescenz VA Medical Center , Philadelphia, Pennsylvania. .,Perelman School of Medicine , Philadelphia, Pennsylvania.
| | | | - Kirk J Brower
- University of Michigan Medical School , Ann Arbor, Michigan
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Stewart S, Wiley JF, McDermott CJ, Thompson DR. Is the last "man" standing in comedy the least funny? A retrospective cohort study of elite stand-up comedians versus other entertainers. Int J Cardiol 2016; 220:789-93. [PMID: 27394976 DOI: 10.1016/j.ijcard.2016.06.284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 06/27/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND This study aimed to confirm, in a large, diverse cohort of elite Stand-up Comedians and other entertainers, that there is an inverse association between comedic ability and longevity. METHODS This retrospective cohort study included 200 Stand-up Comedians (13% women), 113 Comedy Actors (17.5% women), and 184 Dramatic Actors (29.3% women) listed in the top 200 in each category in a popular online ranking website. Longevity within each group was examined adjusting for life expectancy by year of birth and within-group ranking score. RESULTS Stand-up Comedians were younger than Comedy Actors (median birth year 1962 versus 1947: p<0.001) and Dramatic Actors (1962 versus 1946: p<0.001). Overall, 36/200 (18.0%), 33/114 (29.0%) and 56/184 (30.9%) of Stand-up Comedians, Comedy Actors and Dramatic Actors, respectively, had died (p=0.011). There was a significant gradient (p=0.011) in the age of death, with Stand-up Comedians dying at a younger age (67.1±21.3years) than their Comedy Actor (68.9±15.4years) and Dramatic Actor (70.7±16.6years) counterparts. Stand-up Comedians (38.9% versus 19.6%) were more likely to die prematurely compared to Dramatic Actors; p=0.043, OR 1.98; 95% CI 1.01 to 3.87). Independent of year of birth, for Stand-up Comedians alone, higher comedy rank was associated with shorter longevity (hazard ratio 0.938, 95% CI 0.880 to 0.999 for a 10-rank difference; p=0.045). CONCLUSIONS These data reaffirm an adverse relationship between comedic ability and longevity, with elite Stand-up Comedians more highly rated by the public more likely to die prematurely.
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Affiliation(s)
- Simon Stewart
- Mary MacKillop Institute for Health Research, Centre of Research Excellence in Health Service Research to Reduce Inequality in Heart Disease, Australian Catholic University, Level 5, 215 Spring Street, Melbourne, Victoria 3000, Australia.
| | - Joshua F Wiley
- Mary MacKillop Institute for Health Research, Centre for Primary Care and Prevention, Australian Catholic University, Level 5, 215 Spring Street, Melbourne, Victoria 3000, Australia.
| | - Cressida J McDermott
- Mary MacKillop Institute for Health Research, Centre of Research Excellence in Health Service Research to Reduce Inequality in Heart Disease, Australian Catholic University, Level 5, 215 Spring Street, Melbourne, Victoria 3000, Australia.
| | - David R Thompson
- Mary MacKillop Institute for Health Research, Centre for the Heart and Mind, Australian Catholic University, Level 5, 215 Spring Street, Melbourne, Victoria 3000, Australia.
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Lee WJ, Peng LN, Liang CK, Chiou ST, Chen LK. Long sleep duration, independent of frailty and chronic Inflammation, was associated with higher mortality: A national population-based study. Geriatr Gerontol Int 2016; 17:1481-1487. [PMID: 27679974 DOI: 10.1111/ggi.12899] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 07/08/2016] [Accepted: 07/19/2016] [Indexed: 01/17/2023]
Abstract
AIM There is a complex interrelationship between long sleep duration, frailty, chronic inflammation and mortality among the community-dwelling middle-aged and elderly population, which remains unclear and deserves to be investigated. The current study intended to explore these associations by using a prospective population-based cohort study. METHODS A total of 937 community-dwelling middle-aged and elderly people were enrolled. Sleep patterns of the study participants were categorized as short (<6 h), average or long (≥8 h). Sleep disturbance was defined by daytime dysfunction defined by the Pittsburg Sleep Quality Index. Frailty was defined as three or more phenotypes of Fried's Frailty. RESULTS During an average of 4.7 years follow up, 72 (7.7%) study participants died. The adjusted hazard ratio (HR) for death of long sleepers was 2.42 (95% confidence interval [CI] 1.38-4.27), HR of long sleepers plus frailty was 2.37 (95% CI 1.35-4.19) and HR of long sleepers plus log interleukin-6 was 2.11 (95% CI 1.19-3.76). Adjusted HR of daytime dysfunction was 1.79 (95% CI 1.09-2.94). The association between daytime dysfunction and mortality became statistical insignificant after further adjustment for frailty. CONCLUSIONS Long sleep duration, independent of frailty and interleukin-6, was associated with 5-year mortality in older adults. The relationship between daytime dysfunction and death diminished after adjusting for frailty. Geriatr Gerontol Int 2017; 17: 1481-1487.
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Affiliation(s)
- Wei-Ju Lee
- Aging and Health Research Center, National Yang Ming University, Taiwan.,Institute of Public Health, National Yang Ming University, Taiwan.,Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Taiwan
| | - Li-Ning Peng
- Aging and Health Research Center, National Yang Ming University, Taiwan.,Institute of Public Health, National Yang Ming University, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taiwan
| | - Chih-Kuang Liang
- Aging and Health Research Center, National Yang Ming University, Taiwan.,Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Taiwan
| | - Shu-Ti Chiou
- Institute of Public Health, National Yang Ming University, Taiwan.,Health Promotion Administration, Ministry of Health and Welfare, Taiwan
| | - Liang-Kung Chen
- Aging and Health Research Center, National Yang Ming University, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taiwan
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Jehan S, Auguste E, Hussain M, Pandi-Perumal SR, Brzezinski A, Gupta R, Attarian H, Jean-Louis G, McFarlane SI. Sleep and Premenstrual Syndrome. JOURNAL OF SLEEP MEDICINE AND DISORDERS 2016; 3:1061. [PMID: 28239684 PMCID: PMC5323065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The etiology of premenstrual syndrome (PMS) is unknown; it may be due to the normal effect of hormones during the menstrual cycle as it occurs in the late luteal phase of the menstrual cycle.PMS affects women of childbearing age and remits with the onset of menstruation. The menstrual phase is known to influence stage 2 and REM sleep in women, irrespective of premenstrual dysphoric disorder (PMDD). Women with PMDD showed a decreased response to melatonin in their luteal phase as compared to the follicular phase of the menstrual cycle. However, melatonin duration or timing of offset in the morning has not been reported to correlate with the mood. Rather, improvement in mood-related symptoms of PMDD has been found to be influenced by sleep deprivation, be it sleep restrictions in early or late night. Sleep disturbance and decreased melatonin secretions due to hormonal fluctuations during the luteal phase of the menstrual cycle could explain the sleep complaints of PMDD.
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Affiliation(s)
- Shazia Jehan
- Department of Population Health, Center for Healthful Behavior Change, Division of Health and Behavior, New York University School of Medicine, USA
| | - Evan Auguste
- Department of Population Health, Center for Healthful Behavior Change, Division of Health and Behavior, New York University School of Medicine, USA
| | - Mahjabeen Hussain
- Department of Population Health, Center for Healthful Behavior Change, Division of Health and Behavior, New York University School of Medicine, USA
| | | | - Amon Brzezinski
- Department of Obstetrics and Gynecology, Hebrew University Hadassah Medical School, Israel
| | - Ravi Gupta
- Department of Psychiatry, Sleep Clinic, Himalayan Institute of Medical Sciences, India
| | - Hrayr Attarian
- Department of Neurology, Northwestern University Feinberg School of Medicine, USA
| | - Giradin Jean-Louis
- Department of Population Health, Center for Healthful Behavior Change, Division of Health and Behavior, New York University School of Medicine, USA
| | - Samy I. McFarlane
- Division of Endocrinology and Medicine, SUNY Downstate Medical Center, USA
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228
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DeMartino T, Ghoul RE, Wang L, Bena J, Hazen SL, Tracy R, Patel SR, Auckley D, Mehra R. Oxidative Stress and Inflammation Differentially Elevated in Objective Versus Habitual Subjective Reduced Sleep Duration in Obstructive Sleep Apnea. Sleep 2016; 39:1361-9. [PMID: 27091532 DOI: 10.5665/sleep.5964] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 03/19/2016] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES Data have demonstrated adverse health effects of sleep deprivation. We postulate that oxidative stress and systemic inflammation biomarkers will be elevated in relation to short-term and long-term sleep duration reduction. METHODS We analyzed data from the baseline examination of a randomized controlled trial involving participants with moderate to severe obstructive sleep apnea (OSA). Baseline polysomnography provided the total sleep time (PSG-TST, primary predictor); self-reported habitual sleep duration (SR-HSD) data was collected. Morning measures of oxidative stress and systemic inflammation included: myeloperoxidase (MPO, pmol/L), oxidized low-density lipoprotein (ox-LDL, U/L), F2-isoprostane (ng/mg), paraoxonase 1 (PON1, nmol·min(-1)·mL(-1)), and aryl esterase (μmol·min(-1)·mL(-1)). Linear models adjusted for age, sex, race, body mass index (BMI), cardiovascular disease (CVD), smoking, statin/anti-inflammatory medications, and apnea-hypopnea index were utilized (beta estimates and 95% confidence intervals). RESULTS One hundred forty-seven participants comprised the final analytic sample; they were overall middle-aged (51.0 ± 11.7 y), obese (BMI = 37.3 ± 8.1 kg/m(2)), and 17% had CVD. Multivariable models demonstrated a significant inverse association of PSG-TST and MPO (β [95% CI] = -20.28 [-37.48, -3.08], P = 0.021), i.e., 20.3 pmol/L MPO reduction per hour increase PSG-TST. Alternatively, a significant inverse association with ox-LDL and SR-HSD was observed (β [95% CI] = 0.98 [0.96, 0.99], P = 0.027), i.e., 2% ox-LDL reduction per hour increase SR-HSD. CONCLUSIONS Even after consideration of obesity and OSA severity, inverse significant findings were observed such that reduced PSG-TST was associated with elevated MPO levels and SR-HSD with ox-LDL, suggesting differential up-regulation of oxidative stress and pathways of inflammation in acute versus chronic sleep curtailment. CLINICAL TRIAL REGISTRATION NIH clinical trials registry number NCT00607893.
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Affiliation(s)
| | - Rawad El Ghoul
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University Hospitals Case Medical Center, Cleveland, OH
| | - Lu Wang
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | - James Bena
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | - Stanley L Hazen
- Department of Molecular Cardiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | - Russel Tracy
- Departments of Biochemistry and Pathology, University of Vermont, Burlington, VT
| | - Sanjay R Patel
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Dennis Auckley
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, MetroHealth Medical Center, Cleveland, OH
| | - Reena Mehra
- Department of Molecular Cardiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH.,Sleep Center, Neurologic Institute, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
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229
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Hinds A, Jungquist CR, Leddy JJ, Seemant F, Baker JG, Willer B. Sleep disturbance in patients with chronic concussive effects. Concussion 2016; 1:CNC15. [PMID: 30202557 PMCID: PMC6093943 DOI: 10.2217/cnc-2016-0002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 04/27/2016] [Indexed: 12/02/2022] Open
Abstract
Aim: Sleep disturbance is relatively overlooked in concussion treatment although sleep disorders may prolong or exacerbate symptoms after a concussion. We looked at the incidence of both sleep disturbance and postconcussion symptoms in a sample of recently concussed individuals. Methods & results: We evaluated scores on the insomnia severity index (ISI) and postconcussion symptom scale (PCSS) in 96 participants with persistent symptoms. Sleep disturbance significantly contributed to the severity of postconcussive symptoms and length of recovery; this effect was less pronounced in athletes. Conclusion: These results suggest a relationship between sleep problems and the time course of recovery from concussive injury. Clinicians who regularly treat concussion would benefit from a more thorough consideration of sleep function in the assessment of postconcussive symptoms.
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Affiliation(s)
- Andrea Hinds
- Department of Psychiatry, University at Buffalo, Buffalo, NY, USA.,Department of Psychiatry, University at Buffalo, Buffalo, NY, USA
| | - Carla R Jungquist
- School of Nursing, University at Buffalo, Buffalo, NY, USA.,School of Nursing, University at Buffalo, Buffalo, NY, USA
| | - John J Leddy
- Department of Orthopaedics, University at Buffalo, Buffalo, NY, USA.,Department of Orthopaedics, University at Buffalo, Buffalo, NY, USA
| | - Fnu Seemant
- Department of Orthopaedics, University at Buffalo, Buffalo, NY, USA.,Department of Orthopaedics, University at Buffalo, Buffalo, NY, USA
| | - John G Baker
- Department of Orthopaedics, University at Buffalo, Buffalo, NY, USA.,Department of Orthopaedics, University at Buffalo, Buffalo, NY, USA
| | - Barry Willer
- Department of Psychiatry, University at Buffalo, Buffalo, NY, USA.,Department of Psychiatry, University at Buffalo, Buffalo, NY, USA
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Hossin MZ. From habitual sleep hours to morbidity and mortality: existing evidence, potential mechanisms, and future agenda. Sleep Health 2016; 2:146-153. [PMID: 28923258 DOI: 10.1016/j.sleh.2016.01.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 01/23/2016] [Accepted: 01/26/2016] [Indexed: 11/16/2022]
Abstract
Epidemiological studies consistently show a strong U-shaped association between sleep duration and health outcomes. That is, both short and long sleepers are exposed to greater risks of death and diseases than normal length sleepers. Moreover, long sleep is often demonstrated as a stronger predictor of mortality than short sleep. While there is some experimental evidence in favor of a causal connection between short sleep and health, no such evidence exists to explain why excessive sleep might be associated with poor health. One possible explanation is that long duration sleep, instead of being a real cause of illness, is merely a marker of poor sleep quality or some unmeasured risk factor that confounds the association of long habitual sleep with mortality and other health outcomes. As for short sleep, the effect is said to be mediated via the hormones that alters glucose metabolism and appetite regulation as well as via an overactivity of the stress systems that causes increased heart rate and blood pressure. The mechanisms, however, are still poorly understood and future investigations should take into account sleep quality, objective and longitudinal sleep measures, more confounding biases, and the broad social context that influences the length and quality of sleep.
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