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Rodriguez-Besteiro S, Beltran-Velasco AI, Tornero-Aguilera JF, Martínez-González MB, Navarro-Jiménez E, Yáñez-Sepúlveda R, Clemente-Suárez VJ. Social Media, Anxiety and COVID-19 Lockdown Measurement Compliance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20054416. [PMID: 36901425 PMCID: PMC10001599 DOI: 10.3390/ijerph20054416] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/27/2023] [Accepted: 02/28/2023] [Indexed: 06/03/2023]
Abstract
The aim of the present research was to analyze the effect of anxiety levels during the COVID-19 pandemic in the use of social media and compliance with lockdown measures during the confinement. A total of 1723 participants (32.1% males and 77.9% females; 32.6 ± 9.2 years) were interviewed by a Spanish version of the Spielberger State-Trait Anxiety Inventory. From the results obtained, the sample was divided into two 50th percentile groups, a high anxiety group (HAG) and a low anxiety group (LAG). We found how the LAG had lower use of social networks such as Facebook and Twitter during confinement. Also, this group presented a higher rate of leaving home during the confinement and higher values in people with whom they had lived with during confinement than high anxiety group. Regardless of the lack of results in the remaining variables, the present study nuances the high levels of anxiety experienced during COVID-19 confinement. The multifactorial analysis of factors related to the perception of anxiety during COVID-19 confinement may be a useful tool to measure multiple social behaviors when examining mental health factors. Thus, explaining and preventing the psychological consequences of the COVID-19 pandemic. The present knowledge could be used to determine key intervention factors for reducing the perception of fear and anxiety.
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Affiliation(s)
| | | | | | | | - Eduardo Navarro-Jiménez
- Facultad de Ciencias de la Salud, Grupo de Investigación en Medicina y Biotecnología—IMB, Universidad Libre seccional Barranquilla, Barranquilla 080001, Colombia
| | - Rodrigo Yáñez-Sepúlveda
- Faculty of Education and Social Sciences, Universidad Andres Bello, Viña del Mar 2520000, Chile
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202
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Marks E, Hallsworth C, Vogt F, Klein H, McKenna L. Cognitive behavioural therapy for insomnia (CBTi) as a treatment for tinnitus-related insomnia: a randomised controlled trial. Cogn Behav Ther 2023; 52:91-109. [PMID: 35762946 DOI: 10.1080/16506073.2022.2084155] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Insomnia is a significant difficulty and is reported by large proportion of people with tinnitus. Although cognitive behavioural therapy for insomnia (CBTi) might be an effective treatment, no controlled studies had been conducted to date. This randomised controlled trial evaluated the benefits of CBTi on a sample of 102 people with tinnitus-related insomnia. Participants were randomised to 1) CBTi, 2) Audiology-Based Care (ABC) or 3) Sleep Support Group (SSG). Primary outcomes included insomnia, sleep efficiency and total sleep time. Secondary outcomes measured sleep onset latency, sleep quality, tinnitus distress, psychological distress, functioning and quality of life. CBTi was superior at reducing insomnia and increasing sleep efficiency compared to ABC post-intervention and at 6-month follow-up. ABC was superior at reducing insomnia and increasing sleep efficiency compared to SSG. Both CBTi and ABC reported increased total sleep time compared to SSG at 6-month follow. More than 80% of participants in the CBTi group reported clinically meaningful improvements compared to 47% in ABC and 20% for those receiving social support. CBTi was more effective in reducing tinnitus distress and improving sleep quality, functioning and some aspects of mental health. CBTi and ABC offer effective treatments for tinnitus-related sleep disorder but CBTi offers a sizeable benefit.
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Affiliation(s)
| | | | - Florian Vogt
- Department of Psychology, University College London Hospitals NHS Foundation Trust, London, UK
| | | | - Laurence McKenna
- Department of Psychology, University College London Hospitals NHS Foundation Trust, London, UK
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203
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Jafar NKA, Bennett CJ, Moran LJ, Mansfield DR. Beyond Counting Sheep: Exploring the Link between Polycystic Ovary Syndrome and Sleep Health. Semin Reprod Med 2023; 41:45-58. [PMID: 38113883 DOI: 10.1055/s-0043-1777724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a common hormonal condition with reproductive, metabolic, and psychological sequelae that affects 8 to 13% of reproductive-aged women and 3 to 11% of adolescent girls. Sleep is often compromised in women with PCOS due to increased rates of sleep problems, with the most established problem being obstructive sleep apnea (OSA). OSA is highly prevalent in reproductive-aged adult women with PCOS, but not so in adolescence. The international evidence-based PCOS guideline to improve health outcomes in women with PCOS indicated routine screening to identify and alleviate symptoms of OSA. The guidelines, however, did not weigh other multidimensional constructs of sleep health such as sleep disturbances (e.g., sleep quality and quantity), beyond OSA. This is perhaps due to the lack of research and existing mixed findings in the area of PCOS and sleep health. This narrative review summarizes the current knowledge about OSA and expands further to include the limited knowledge about other sleep problems in PCOS among reproductive-aged women and adolescent girls. We broadly cover the prevalence, risk factors, and mechanisms of sleep problems in PCOS and their relationship with cardiometabolic and psychological health. A brief summary on treatment and intervention strategies for sleep problems in PCOS and future recommendations will be deliberated.
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Affiliation(s)
- Nur K Abdul Jafar
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Christie J Bennett
- Be Active Sleep and Eat (BASE) Facility, Department of Nutrition and Dietetics, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Darren R Mansfield
- Monash Lung and Sleep, Monash Health, Clayton, Victoria, Australia
- Faculty of Medicine, Nursing and Health Sciences, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
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204
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Yang L, Zhang J, Luo X, Yang Y, Zhao Y, Feng F, Liu S, Zhang C, Li Z, Wang C, Wang W, Jiang F, Zhang Y, Hu Y, Su C, Wu H, Yu H, Li SX, Wing YK, Luo Y, Zhang B. Effectiveness of one-week internet-delivered cognitive behavioral therapy for insomnia to prevent progression from acute to chronic insomnia: A two-arm, multi-center, randomized controlled trial. Psychiatry Res 2023; 321:115066. [PMID: 36716552 DOI: 10.1016/j.psychres.2023.115066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 01/19/2023] [Accepted: 01/22/2023] [Indexed: 01/27/2023]
Abstract
Acute insomnia is common and a substantial proportion of people with acute insomnia (i.e. 3 days to 3 months) transit into chronic insomnia (i.e. 3 months or longer). Therefore, early intervention for acute insomnia is vital to prevent chronicity. Previous trials with small sample sizes have shown that brief versions of both individual and group-based face-to-face cognitive behavioral therapy for insomnia (CBT-I) can improve insomnia symptoms among those with acute insomnia. However, it is unknown whether one-week internet-delivered cognitive behavioral therapy for insomnia (CBT-I) is effective in treating acute insomnia. This was a randomized controlled trial and 192 participants were randomly assigned to the CBT-I group (n = 95) or control group (n = 97). The primary outcome was the incidence of chronic insomnia, determined via a structured diagnostic questionnaire for insomnia disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Secondary outcomes were Insomnia Severity Index (ISI), Dysfunctional Beliefs and Attitudes about Sleep (DBAS), Epworth Sleepiness Scale (ESS), Pre-sleep Arousal Scale (PSAS), Ford Insomnia Response to Stress Test (FIRST), Sleep Hygiene and Practices Scale (SHPS), Hospital Anxiety and Depression Scale (HADS), and Short-Form 12-Item Health Survey version 2 (SF-12v2). At week 12, the incidence of chronic insomnia was significantly lower in the CBT-I group compared with control group (33.3% [27/81] vs. 65.8% [52/79]). Participants in the CBT-I group achieved significantly more improvements in ISI, ESS, PSAS, FIRST, SHPS, HADS-Depression, and the mental component summary and physical component summary of SF-12v2 than control group, but not DBAS and HADS-Anxiety. This one-week internet-delivered CBT-I program is an effective tool to prevent the chronicity of acute insomnia.
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Affiliation(s)
- Lulu Yang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China
| | - Jihui Zhang
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xian Luo
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China
| | - Yuan Yang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China
| | - Yuhan Zhao
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China
| | - Fei Feng
- Shenzhen Kangning Hospital, Shenzhen, China
| | - Shuai Liu
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China; The Third People's Hospital of Qinghai Province, Xining, China
| | - Chenxi Zhang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China
| | - Zhe Li
- Department of Sleep Medicine, Suzhou Guangji Hospital, Suzhou, China
| | - Chao Wang
- Department of Sleep Medicine, Henan Mental Hospital, Henan, China
| | - Wei Wang
- Department of Psychiatry, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Fan Jiang
- Outpatient Department, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yunshu Zhang
- Department of Sleep Medicine, Hebei Mental Health Center, Hebei, China
| | - Yuanyuan Hu
- Department of Sleep Medicine, Zhongshan Third People's Hospital, Zhongshan, China
| | - Changjun Su
- Department of Neurology, Tangdu Hospital, Air Force Military Medical University, Xi'an, China
| | - Huijuan Wu
- Department of Neurology, Second Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Huan Yu
- Sleep and Wake disorders' center of Fudan University, Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Shirley Xin Li
- Department of Psychology, The University of Hong Kong, Hong Kong SAR, China
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Ying Luo
- The Second People's Hospital of Guiyang, Guizhou, China
| | - Bin Zhang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China
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205
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Shepard CA, Rufino KA, Lee J, Tran T, Paddock K, Wu C, Oldham JM, Mathew SJ, Patriquin MA. Nighttime Sleep Quality and Daytime Sleepiness Predicts Suicide Risk in Adults Admitted to an Inpatient Psychiatric Hospital. Behav Sleep Med 2023; 21:129-141. [PMID: 35296204 DOI: 10.1080/15402002.2022.2050724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
As sleep problems have been identified as an important, yet understudied, predictor of suicide risk, the present study analyzed the relationship between daytime sleepiness and nighttime sleep disturbance in a high-risk population of adults admitted to an inpatient psychiatric hospital. Objectives were to (1) examine the time course of subjective daytime sleepiness, nighttime sleep disturbance, and suicide risk throughout inpatient psychiatric treatment, (2) examine pre- to post-treatment changes in sleep disturbance with treatment as usual in an inpatient psychiatric setting, and (3) investigate whether daytime sleepiness and nighttime sleep disturbance predicted suicide risk above and beyond anxiety and depression. Participants were 500 consecutively admitted adults admitted to an intermediate length of stay (4-6 weeks) inpatient psychiatric hospital (47% female; 18-87 years of age). Measures of sleep, suicide risk, depression, and anxiety were completed at admission, weeks 1 through 4, and at discharge. Latent growth curve modeling (LGM) and hierarchal linear modeling (HLM) were conducted. The LGM analysis demonstrated that daytime sleepiness, nighttime sleep disturbance, and suicide risk all improved throughout inpatient treatment. Further, HLM showed that daytime sleepiness predicted suicide risk above and beyond symptoms of anxiety, depression, major sleep medications, and prior suicidal ideation and attempts, while nighttime sleep disturbance predicted suicide risk above and beyond symptoms of anxiety, major sleep medications, and prior suicidal ideation and attempts. Findings indicate the need to reevaluate safety protocols that may impact sleep, particularly that may increase daytime sleepiness, and to develop evidence-based sleep interventions for individuals admitted to inpatient psychiatric hospitals.
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Affiliation(s)
| | - Katrina A Rufino
- The Menninger Clinic, Houston, TX, USA.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,University of Houston-Downtown, Houston, TX, USA
| | - Jaehoon Lee
- Department of Educational Psychology & Leadership, Texas Tech University, Lubbock, TX, USA
| | | | | | - Chester Wu
- The Menninger Clinic, Houston, TX, USA.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - John M Oldham
- The Menninger Clinic, Houston, TX, USA.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Sanjay J Mathew
- The Menninger Clinic, Houston, TX, USA.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. Debakey VA Medical Center, Houston, TX, USA
| | - Michelle A Patriquin
- The Menninger Clinic, Houston, TX, USA.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. Debakey VA Medical Center, Houston, TX, USA
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206
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Riha RL, Dodds S, Kotoulas SC, Morrison I. A case-control study of sexualised behaviour in sleep: A strong association with psychiatric comorbidity and relationship difficulties. Sleep Med 2023; 103:33-40. [PMID: 36746108 DOI: 10.1016/j.sleep.2023.01.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 01/09/2023] [Accepted: 01/23/2023] [Indexed: 01/26/2023]
Abstract
Sexualised behaviour in sleep (SBS) is a relatively rare parasomnia consisting of instinctive behaviours of a sexual nature occurring during non-rapid-eye movement (NREM) sleep. Little information exists at present regarding the clinical features and onset of this condition as well as its link to psychiatric comorbidity, other sleep disorders and history of adverse early life experience. Aims were to typify the condition further and compare features of SBS patients to those with other NREM parasomnias. METHODS Details of 335 consecutive patients presenting to a single tertiary sleep centre with non-rapid eye movement (NREM)-parasomnias over a 15-year period (2005-2020) were examined. Data were collated by reviewing case-notes for anthropometric data, past medical history, clinical findings, and video polysomnography. SBS patients were compared to a cohort of 270 non-SBS, NREM-sleep disorder patients (case-control) to ascertain whether they had any distinguishing features from other parasomnias classified in this group. RESULTS Sixty-five patients with SBS were identified: 58 males, 7 females (comprising 19.4% of the cohort overall). Mean age at presentation was 33(±9.5) years. Onset of behaviours was commoner in adulthood in the SBS cohort, whereas non-SBS, NREM-parasomnia onset (n = 270) was commoner in childhood: 61.1% and 52.9% respectively (p = 0.007). An association was identified between the presence of psychiatric diagnoses and onset of SBS (p = 0.028). Significant triggers for SBS behaviours included alcohol consumption (p < 0.001), intimate relationship difficulties (p = 0.009) and sleep deprivation (p = 0.028). Patients with SBS were significantly more likely to report sleepwalking as an additional NREM behaviour (p < 0.001). Males were more likely to present at clinic together with their bedpartner and females presented alone. A history of SBS appeared to be more common in those working in the armed forces or the police compared to those presenting with non-SBS, NREM-parasomnias (p = 0.004). CONCLUSIONS SBS is more common in clinical practice than previously described and presents with some distinguishing features within the NREM disorder category. This study is the first to identify that onset in childhood or lack of amnesia does not preclude the condition and that patterns of presentation differ between men and women. Sleepwalkers particularly should be asked about SBS. Comorbid psychiatric conditions, profession and intimate partner difficulties are strong determinants of the presentation.
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Affiliation(s)
- Renata L Riha
- Sleep Research Unit, The University of Edinburgh, Department of Sleep Medicine, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, Edinburgh, Scotland, UK
| | - Sophie Dodds
- Sleep Research Unit, The University of Edinburgh, Department of Sleep Medicine, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, Edinburgh, Scotland, UK
| | - Serafeim-Chrysovalantis Kotoulas
- Sleep Research Unit, The University of Edinburgh, Department of Sleep Medicine, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, Edinburgh, Scotland, UK
| | - Ian Morrison
- Sleep Research Unit, The University of Edinburgh, Department of Sleep Medicine, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, Edinburgh, Scotland, UK; Department of Neurology, Ninewells Hospital, Dundee, DD1 9SY, Scotland, UK
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207
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Liu X, Commodore-Mensah Y, Himmelfarb CR, Li J, Stoner L, Shahane A, Logan JG. Determinants of Daytime Sleepiness Among Middle-Aged Adults. Clin Nurs Res 2023; 32:571-579. [PMID: 36851893 DOI: 10.1177/10547738231156148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Daytime sleepiness is highly prevalent in middle-aged adults and has a detrimental impact on their quality of life. Our study examined the psychological and behavioral determinants of daytime sleepiness among adults aged 35 to 64 years. The main variables of interest were psychological factors (perceived stress and anxiety), physical activity factors (moderate-to-vigorous physical activity and sedentary behaviors), and dietary factors (fat, sugar, fruit, and vegetable intake). Partial correlation and multiple linear regression were conducted to determine their associations with daytime sleepiness, with adjustment for covariates. Our sample included 87 adults with a mean age of 47 ± 9 years. About 21% met the criterion for excessive daytime sleepiness. Greater anxiety, longer time spent in sedentary behaviors, and higher consumption of foods rich in trans fat, sugar, and calories were independently associated with higher daytime sleepiness levels. Targeted interventions or treatments are warranted to address the identified risk factors for middle-aged adults.
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Affiliation(s)
- Xiaoyue Liu
- Johns Hopkins University, Baltimore, MD, USA
| | | | | | - Junxin Li
- Johns Hopkins University, Baltimore, MD, USA
| | - Lee Stoner
- University of North Carolina at Chapel Hill, Chapel Hill, USA
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208
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Simjanoski M, de Azevedo Cardoso T, Wollenhaupt-Aguiar B, Pfaffenseller B, De Boni RB, Balanzá-Martínez V, Frey BN, Minuzzi L, Kapczinski F. Lifestyle Behaviors, Depression, and Anxiety Among Individuals Living in Canada During the COVID-19 Pandemic. Am J Lifestyle Med 2023; 17:181-193. [PMID: 36883127 PMCID: PMC9157275 DOI: 10.1177/15598276221102097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of our study was to investigate the association between lifestyle behaviors and symptoms of depression and anxiety during the COVID-19 pandemic in Canada. A web survey was conducted between July 3-August 3, 2020, across Canada. The main outcomes considered were a positive screening for depression, as evaluated by the PHQ-2 and positive screening for anxiety, as evaluated by the GAD-7. Lifestyle behaviors were assessed using the Short Multidimensional Lifestyle Inventory Evaluation-Confinement (SMILE-C), an instrument adapted for lifestyle behaviors during the COVID-19 pandemic. The total sample size included 404 participants, of which 24.3% had a positive screen for depression, 20.5% for anxiety, and 15.5% for both. We found significant differences in SMILE-C scores between individuals with a positive and individuals with a negative screen for depression (P < .001). Likewise, there were significant differences in SMILE-C scores between individuals with a positive and individuals with a negative screen for anxiety (P < .001). We found an association between unhealthy lifestyle behaviors and symptoms of depression and anxiety during the COVID-19 lockdown in Canada. The findings highlight the importance of lifestyle medicine (LM) education and targeted lifestyle interventions to promote healthy behaviors and help reduce the burden of mental disorders.
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Affiliation(s)
- Mario Simjanoski
- Neuroscience Graduate Program, McMaster University, Hamilton, Canada.,Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada
| | | | | | - Bianca Pfaffenseller
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada
| | - Raquel B De Boni
- Institute of Scientific and Technological Communication and Information in Health (ICICT), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Vicent Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain
| | - Benicio N Frey
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada.,Women's Health Concerns Clinic and Mood Disorders Program, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Luciano Minuzzi
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada
| | - Flavio Kapczinski
- Neuroscience Graduate Program, McMaster University, Hamilton, Canada.,Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada.,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
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209
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Chen S, Sun X, Zhu Q, Zhao Y, Tang J, Song H. Factors Influencing the Level of Depression and Anxiety of Community-Dwelling Patients with Schizophrenia in China during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4376. [PMID: 36901386 PMCID: PMC10001627 DOI: 10.3390/ijerph20054376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/18/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
UNLABELLED The coronavirus disease 2019 (COVID-19) poses a huge challenge to global public health. People with schizophrenia living in communities urgently need effective interventions to help them adjust to life and work, but they have not received enough attention. This study aims to assess the prevalence of anxiety and depression symptoms in community-dwelling patients with schizophrenia in China during the epidemic and to explore the possible influencing factors. METHODS Using a cross-sectional survey, we collected 15,165 questionnaires. Assessments included demographic information, concern about COVID-19-related information, sleep status, anxiety and depressive symptoms, and accompanying illnesses. The 7-item Generalized Anxiety Disorder (GAD-7) and the 9-item Patient Health Questionnaire (PHQ-9) were used to evaluate depression and anxiety levels. Group comparison was conducted by t-test, ANOVA, or chi-square test wherever suitable, with Bonferroni pairwise correction. Multivariate logistic regression was performed to identify predictors for anxiety and depression. RESULTS 16.9% of patients had at least moderate anxiety, and 34.9% had at least moderate depression. T-test showed that females scored higher on GAD-7 and PHQ-9 than males, and patients without accompanying long-standing diseases, who were not concerned about COVID-19, had lower GAD-7 and PHQ-9 scores. ANOVA showed that participants aged from 30 to 39, with higher education scored higher on GAD-7, and patients with better sleep, and having less concern about COVID-19, had lower GAD-7 and PHQ-9 scores. Regression analysis indicated that participant ages of 30-39 and 40-49 positively predicted anxiety, whereas patient ages of 30-39 years positively predicted depression. Patients with poor sleep, accompanying diseases, and concern about the COVID-19 pandemic were more likely to experience anxiety and depression. CONCLUSION During the pandemic, Chinese community-dwelling patients with schizophrenia had high rates of anxiety and depression. These patients deserve clinical attention and psychological intervention, especially those with risk factors.
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Affiliation(s)
- Shanshan Chen
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310000, China
| | - Xiaohua Sun
- Affiliated Mental Health Center, School of Medicine, Zhejiang University, Hangzhou Seventh People′s Hospital, The 4th Clinical College of Zhejiang Chinese Medical University, Hangzhou 310000, China
| | - Qisha Zhu
- Affiliated Mental Health Center, School of Medicine, Zhejiang University, Hangzhou Seventh People′s Hospital, The 4th Clinical College of Zhejiang Chinese Medical University, Hangzhou 310000, China
| | - Yuan Zhao
- Affiliated Mental Health Center, School of Medicine, Zhejiang University, Hangzhou Seventh People′s Hospital, The 4th Clinical College of Zhejiang Chinese Medical University, Hangzhou 310000, China
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310000, China
| | - Haidong Song
- Affiliated Mental Health Center, School of Medicine, Zhejiang University, Hangzhou Seventh People′s Hospital, The 4th Clinical College of Zhejiang Chinese Medical University, Hangzhou 310000, China
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210
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Madrid-Valero JJ, Gregory AM. Behaviour genetics and sleep: A narrative review of the last decade of quantitative and molecular genetic research in humans. Sleep Med Rev 2023; 69:101769. [PMID: 36933344 DOI: 10.1016/j.smrv.2023.101769] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/05/2023]
Abstract
During the last decade quantitative and molecular genetic research on sleep has increased considerably. New behavioural genetics techniques have marked a new era for sleep research. This paper provides a summary of the most important findings from the last ten years, on the genetic and environmental influences on sleep and sleep disorders and their associations with health-related variables (including anxiety and depression) in humans. In this review we present a brief summary of the main methods in behaviour genetic research (such as twin and genome-wide association studies). We then discuss key research findings on: genetic and environmental influences on normal sleep and sleep disorders, as well as on the association between sleep and health variables (highlighting a substantial role for genes in individual differences in sleep and their associations with other variables). We end by discussing future lines of enquiry and drawing conclusions, including those focused on problems and misconceptions associated with research of this type. In this last decade our knowledge about genetic and environmental influences on sleep and its disorders has expanded. Both, twin and genome-wide association studies show that sleep and sleep disorders are substantially influenced by genetic factors and for the very first time multiple specific genetic variants have been associated with sleep traits and disorders.
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Affiliation(s)
- Juan J Madrid-Valero
- Department of Health Psychology, Faculty of Health Sciences, University of Alicante, Spain.
| | - Alice M Gregory
- Department of Psychology, Goldsmiths, University of London, London, United Kingdom
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211
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Coelho J, Taillard J, Bernard A, Lopez R, Fond G, Boyer L, Lucas G, Alla F, Buysse DJ, Wallace ML, Verdun-Esquer C, Geoffroy PA, d’Incau E, Philip P, Micoulaud-Franchi JA. Emotional Exhaustion, a Proxy for Burnout, Is Associated with Sleep Health in French Healthcare Workers without Anxiety or Depressive Symptoms: A Cross-Sectional Study. J Clin Med 2023; 12:jcm12051895. [PMID: 36902682 PMCID: PMC10004252 DOI: 10.3390/jcm12051895] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/14/2023] [Accepted: 02/22/2023] [Indexed: 03/04/2023] Open
Abstract
Burnout is frequent among healthcare workers, and sleep problems are suspected risk factors. The sleep health framework provides a new approach to the promotion of sleep as a health benefit. The aim of this study was to assess good sleep health in a large sample of healthcare workers and to investigate its relationship with the absence of burnout among healthcare workers while considering anxiety and depressive symptoms. A cross-sectional Internet-based survey of French healthcare workers was conducted in summer 2020, at the end of the first COVID-19 lockdown in France (March to May 2020). Sleep health was assessed using the RU-SATED v2.0 scale (RegUlarity, Satisfaction, Alertness, Timing, Efficiency, Duration). Emotional exhaustion was used as a proxy for overall burnout. Of 1069 participating French healthcare workers, 474 (44.3%) reported good sleep health (RU-SATED > 8) and 143 (13.4%) reported emotional exhaustion. Males and nurses had a lower likelihood of emotional exhaustion than females and physicians, respectively. Good sleep health was associated with a 2.5-fold lower likelihood of emotional exhaustion and associations persisted among healthcare workers without significant anxiety and depressive symptoms. Longitudinal studies are needed to explore the preventive role of sleep health promotion in terms of the reduction in burnout risk.
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Affiliation(s)
- Julien Coelho
- SANPSY, UMR 6033, University of Bordeaux, F-33000 Bordeaux, France
- SANPSY, UMR 6033, CNRS, F-33000 Bordeaux, France
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, F-33000 Bordeaux, France
- Correspondence: ; Tel.: +33-64570-6212
| | - Jacques Taillard
- SANPSY, UMR 6033, University of Bordeaux, F-33000 Bordeaux, France
- SANPSY, UMR 6033, CNRS, F-33000 Bordeaux, France
| | - Adèle Bernard
- SANPSY, UMR 6033, University of Bordeaux, F-33000 Bordeaux, France
- SANPSY, UMR 6033, CNRS, F-33000 Bordeaux, France
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, F-33000 Bordeaux, France
| | - Régis Lopez
- Department of Neurology, Sleep Disorders Center, Gui-de-Chauliac Hospital, CHU Montpellier, F-34000 Montpellier, France
- Inserm, U1061, Université Montpellier 1, F-34000 Montpellier, France
| | - Guillaume Fond
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, 27, Boulevard Jean -Moulin, F-13000 Marseille, France
- Fondation FondaMental, F-94000 Créteil, France
| | - Laurent Boyer
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, 27, Boulevard Jean -Moulin, F-13000 Marseille, France
- Fondation FondaMental, F-94000 Créteil, France
| | - Guillaume Lucas
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, 27, Boulevard Jean -Moulin, F-13000 Marseille, France
| | - François Alla
- Pôle de Santé Publique, CHU Bordeaux, F-33000 Bordeaux, France
| | - Daniel J. Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Meredith L. Wallace
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | | | - Pierre-Alexis Geoffroy
- Département de Psychiatrie et D’addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat—Claude Bernard, F-75018 Paris, France
- GHU Paris—Psychiatry & Neurosciences, 1 Rue Cabanis, F-75014 Paris, France
- Inserm, FHU I2-D2, Université de Paris, NeuroDiderot, F-75019 Paris, France
| | - Emmanuel d’Incau
- SANPSY, UMR 6033, University of Bordeaux, F-33000 Bordeaux, France
- SANPSY, UMR 6033, CNRS, F-33000 Bordeaux, France
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, F-33000 Bordeaux, France
| | - Pierre Philip
- SANPSY, UMR 6033, University of Bordeaux, F-33000 Bordeaux, France
- SANPSY, UMR 6033, CNRS, F-33000 Bordeaux, France
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, F-33000 Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- SANPSY, UMR 6033, University of Bordeaux, F-33000 Bordeaux, France
- SANPSY, UMR 6033, CNRS, F-33000 Bordeaux, France
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, F-33000 Bordeaux, France
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212
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Spechler PA, Gutierrez RM, Tapert SF, Thompson WK, Paulus MP. The beneficial effect of sleep on behavioral health problems in youth is disrupted by prenatal cannabis exposure: A causal random forest analysis of Adolescent Brain Cognitive Development data. Child Dev 2023. [PMID: 36840387 DOI: 10.1111/cdev.13899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
Studies suggest prenatal cannabis exposure is associated with mood/behavioral problems in children. However, it is unclear if targeting modifiable domains like sleep behaviors would improve outcomes in exposed youth. Using a causal inference framework, the effect of changing sleep-hours on changing internalizing/externalizing problems in children was examined using the Adolescent Brain Cognitive Development™ study baseline (ages 9-10; collected during 2016-2018) and year-1 follow-up data (N = 9825; 4663 female; 5196 white). Average treatment effects (ATE) indicated that more sleep predicted less internalizing (ATE = -.34, SE = .08, p < .001) and externalizing (ATE = -.29, SE = .07, p < .001) problems over time. However, prenatal cannabis exposure moderated the ATE on internalizing (conditional-ATE = .91, SE = .39, p = .019), whereby participants with exposure (n = 605) did not show any effect of changing sleep-hours on mood (B = .09, SE = .24).
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Affiliation(s)
| | | | - Susan F Tapert
- University of California San Diego, San Diego, California, USA
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213
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Abstract
Despite sleep's fundamental role in maintaining and improving physical and mental health, many people get less than the recommended amount of sleep or suffer from sleeping disorders. This review highlights sleep's instrumental biological functions, various sleep problems, and sleep hygiene and lifestyle interventions that can help improve sleep quality. Quality sleep allows for improved cardiovascular health, mental health, cognition, memory consolidation, immunity, reproductive health, and hormone regulation. Sleep disorders, such as insomnia, sleep apnea, and circadian-rhythm-disorders, or disrupted sleep from lifestyle choices, environmental conditions, or other medical issues can lead to significant morbidity and can contribute to or exacerbate medical and psychiatric conditions. The best treatment for long-term sleep improvement is proper sleep hygiene through behavior and sleep habit modification. Recommendations to improve sleep include achieving 7 to 9 h of sleep, maintaining a consistent sleep/wake schedule, a regular bedtime routine, engaging in regular exercise, and adopting a contemplative practice. In addition, avoiding many substances late in the day can help improve sleep. Caffeine, alcohol, heavy meals, and light exposure later in the day are associated with fragmented poor-quality sleep. These sleep hygiene practices can promote better quality and duration of sleep, with corresponding health benefits.
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214
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Ding X, Ma S, Liu H, Wang H, Li N, Song Q, Su W, Liang M, Guo X, Sun L, Qin Q, Chen M, Sun Y. The relationships between sleep disturbances, resilience and anxiety among preschool children: A three-wave longitudinal study. J Psychosom Res 2023; 168:111203. [PMID: 36868111 DOI: 10.1016/j.jpsychores.2023.111203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 02/09/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023]
Abstract
OBJECTIVE This study, based on a three-wave longitudinal study, aimed to examine bidirectional relationships between sleep disturbances, resilience and anxiety symptoms among preschool children. METHODS In total, 1169 children in the junior class of preschools were investigated three times with an interval of one year, in Anhui Province, China. Children's sleep disturbances, resilience and anxiety symptoms were all assessed in the three-wave surveys. Then, 906 children at baseline (T1), 788 children in the first follow-up study (T2), and 656 children in the second follow-up study (T3) were included in the analysis. Autoregressive cross-lagged modeling analyses were performed to examine bidirectional relationships between sleep disturbances, resilience and anxiety symptoms using Mplus 8.3. RESULTS The mean age of the children was 3.6 ± 0.4 years at T1, 4.6 ± 0.4 years at T2, and 5.6 ± 0.4 years at T3, respectively. The results indicated that sleep disturbances at T1 significantly predicted anxiety symptoms at T2 (β = 0.111, P = 0.001); and sleep disturbances at T2 significantly predicted anxiety symptoms at T3 (β = 0.108, P = 0.008). Resilience only at T2 significantly predicted anxiety symptoms at T3 (β = -0.120, P = 0.002). Anxiety symptoms did not significantly predict the two variables (sleep disturbances and resilience) at any wave. CONCLUSION This study suggests that more sleep disturbances are longitudinally associated with subsequent high anxiety symptoms; inversely, high resilience will alleviate subsequent anxiety symptoms. These findings highlight the importance that early screening for sleep disturbances and anxiety, and strengthening resilience are beneficial to prevent preschool children from developing higher anxiety symptoms.
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Affiliation(s)
- Xiuxiu Ding
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Shaodi Ma
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Hao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Ning Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Qiuxia Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Wanying Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Liang Sun
- Fuyang Center for Disease Control and Prevention, No.19, Zhongnan Avenue, Fuyang 236069, Anhui, China
| | - Qirong Qin
- Ma'anshan Center for Disease Control and Prevention, No.849, Jiangdong Avenue, Ma'anshan 243011, Anhui, China
| | - Mingchun Chen
- Changfeng Center for Disease Control and Prevention, Hefei 231199, Anhui, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Chaohu Hospital, Anhui Medical University, No. 64 Chaohubei Road, Hefei 238000, Anhui, China.
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215
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Jacob L, Smith L, Kostev K, Oh H, Gyasi RM, López Sánchez GF, Song TJ, Tully MA, Haro JM, Yon DK, Shin JI, Koyanagi A. Food insecurity and insomnia-related symptoms among adults from low- and middle-income countries. J Sleep Res 2023:e13852. [PMID: 36808652 DOI: 10.1111/jsr.13852] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 02/23/2023]
Abstract
Little is known about the relationship between food insecurity and sleep problems in low- and middle-income countries, while the mediators of this association are largely unknown. Therefore, we investigated the association between food insecurity and insomnia-related symptoms in six low- and middle-income countries (i.e., China, Ghana, India, Mexico, Russia, South Africa), and the potential mediators of this relationship. Cross-sectional, nationally representative data from the Study on Global AGEing and Adult Health (2007-2010) were analysed. Past 12-month food insecurity was assessed with two questions on the frequency of eating less, and on hunger owing to a lack of food. Insomnia-related symptoms referred to severe or extreme sleep problems in the past 30 days. Multivariable logistic regression and mediation analysis were conducted. Data on 42,489 adults aged ≥18 years were analysed (mean [standard deviation] age 43.8 [14.4] years; 50.1% females). The prevalence of any food insecurity and insomnia-related symptoms was 11.9% and 4.4%, respectively. After adjustment, compared with no food insecurity, moderate (odds ratio = 1.53, 95% confidence interval = 1.11-2.10) and severe food insecurity (odds ratio = 2.35, 95% confidence interval = 1.56-3.55) were significantly associated with insomnia-related symptoms. Anxiety, perceived stress, and depression mediated 27.7%, 13.5%, and 12.5% of the relationship between any food insecurity and insomnia-related symptoms, respectively (total percentage = 43.3%). Food insecurity was positively associated with insomnia-related symptoms in adults from six low- and middle-income countries. Anxiety, perceived stress, and depression explained a substantial proportion of this relationship. Addressing food insecurity itself or the identified potential mediators among people with food insecurity may lead to a reduction in sleep problems among adults in low- and middle-income countries, pending confirmation with longitudinal studies.
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Affiliation(s)
- Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain.,Department of Physical Medicine and Rehabilitation, Lariboisière-Fernand Widal Hospital, AP-HP, University Paris Cité, Paris, France.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | | | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Razak M Gyasi
- Aging and Development Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University, Seoul, South Korea
| | - Mark A Tully
- School of Medicine, Ulster University, Londonderry, UK
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain.,Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
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216
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De Almeida BI, Smith TL, Delic A, Esquibel L, Galli J, Millsap L, Paz Soldán MM, Cortez MM, Rose J, Greenlee JE, Gundlapalli AV, Hill HR, Wong KH, Clardy SL. Neurologic Manifestations of Common Variable Immunodeficiency: Impact on Quality of Life. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2023; 10:10/3/e200088. [PMID: 36797058 PMCID: PMC9936420 DOI: 10.1212/nxi.0000000000200088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 12/01/2022] [Indexed: 02/18/2023]
Abstract
BACKGROUND AND OBJECTIVES Common variable immunodeficiency is a systemic disease and not solely a disease of humoral immunity. Neurologic symptoms associated with common variable immunodeficiency are underrecognized and warrant further study. This work aimed to characterize the neurologic symptoms reported by people living with common variable immunodeficiency. METHODS We conducted a single academic medical center study of neurologic symptoms reported by adults previously diagnosed with common variable immunodeficiency. We used a survey of common neurologic symptoms to determine the prevalence of these symptoms in a population with common variable immunodeficiency and further assessed these patient-reported symptoms with validated questionnaires and compared symptom burden with other neurologic conditions. RESULTS A volunteer sample of adults (aged 18 years or older) previously diagnosed with common variable immunodeficiency at the University of Utah Clinical Immunology/Immune Deficiency Clinic who were able to read and comprehend English and willing and able to answer survey-based questions were recruited. Of 148 eligible participants identified, 80 responded and 78 completed the surveys. The mean age of respondents was 51.3 years (range 20-78 years); 73.1% female and 94.8% White. Patients with common variable immunodeficiency reported many common neurologic symptoms (mean 14.6, SD 5.9, range 1-25), with sleep issues, fatigue, and headache reported by more than 85%. Validated questionnaires addressing specific neurologic symptoms supported these results. T-scores on Neuro QoL questionnaires for sleep (mean 56.4, SD 10.4) and fatigue (mean 54.1, SD 11) were higher, indicating more dysfunction, than in the reference clinical population (p < 0.005). The Neuro QoL questionnaire for cognitive function showed a lower T-score (mean 44.8, SD 11.1) than that in the reference general population (p < 0.005), indicating worse function in this domain. DISCUSSION Among survey respondents, there is a marked burden of neurologic symptoms. Given the impact of neurologic symptoms on health-related quality-of-life measures, clinicians should screen patients with common variable immunodeficiency for the presence of these symptoms and offer referral to neurologists and/or symptomatic treatment when indicated. Frequently prescribed neurologic medications may also affect the immune system, and neurologists should consider screening patients for immune deficiency before prescribing them.
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Affiliation(s)
- Bruno Ivo De Almeida
- From the Université de Bordeaux (B.I.D.A.), U de Biologie, France; Department of Neurology (B.I.D.A., T.L.S., A.D., L.E., J.G., M.M.P.S., M.M.C., J.R., J.E.G., K.-H.W., S.L.C.), University of Utah School of Medicine, Salt Lake City; George E. Wahlen Department of Veterans Affairs Medical Center (T.L.S., J.G., M.M.P.S., J.R., J.E.G., S.L.C.), Salt Lake City, UT; University of Utah School of Medicine (L.M.); Department of Internal Medicine, (A.V.G.), University of Utah School of Medicine; and Divisions of Immunology and Infectious Disease (H.R.H.), Departments of Pathology, Pediatrics and Medicine, University of Utah School of Medicine, Salt Lake City
| | - Tammy L Smith
- From the Université de Bordeaux (B.I.D.A.), U de Biologie, France; Department of Neurology (B.I.D.A., T.L.S., A.D., L.E., J.G., M.M.P.S., M.M.C., J.R., J.E.G., K.-H.W., S.L.C.), University of Utah School of Medicine, Salt Lake City; George E. Wahlen Department of Veterans Affairs Medical Center (T.L.S., J.G., M.M.P.S., J.R., J.E.G., S.L.C.), Salt Lake City, UT; University of Utah School of Medicine (L.M.); Department of Internal Medicine, (A.V.G.), University of Utah School of Medicine; and Divisions of Immunology and Infectious Disease (H.R.H.), Departments of Pathology, Pediatrics and Medicine, University of Utah School of Medicine, Salt Lake City
| | - Alen Delic
- From the Université de Bordeaux (B.I.D.A.), U de Biologie, France; Department of Neurology (B.I.D.A., T.L.S., A.D., L.E., J.G., M.M.P.S., M.M.C., J.R., J.E.G., K.-H.W., S.L.C.), University of Utah School of Medicine, Salt Lake City; George E. Wahlen Department of Veterans Affairs Medical Center (T.L.S., J.G., M.M.P.S., J.R., J.E.G., S.L.C.), Salt Lake City, UT; University of Utah School of Medicine (L.M.); Department of Internal Medicine, (A.V.G.), University of Utah School of Medicine; and Divisions of Immunology and Infectious Disease (H.R.H.), Departments of Pathology, Pediatrics and Medicine, University of Utah School of Medicine, Salt Lake City
| | - Lawanda Esquibel
- From the Université de Bordeaux (B.I.D.A.), U de Biologie, France; Department of Neurology (B.I.D.A., T.L.S., A.D., L.E., J.G., M.M.P.S., M.M.C., J.R., J.E.G., K.-H.W., S.L.C.), University of Utah School of Medicine, Salt Lake City; George E. Wahlen Department of Veterans Affairs Medical Center (T.L.S., J.G., M.M.P.S., J.R., J.E.G., S.L.C.), Salt Lake City, UT; University of Utah School of Medicine (L.M.); Department of Internal Medicine, (A.V.G.), University of Utah School of Medicine; and Divisions of Immunology and Infectious Disease (H.R.H.), Departments of Pathology, Pediatrics and Medicine, University of Utah School of Medicine, Salt Lake City
| | - Jonathan Galli
- From the Université de Bordeaux (B.I.D.A.), U de Biologie, France; Department of Neurology (B.I.D.A., T.L.S., A.D., L.E., J.G., M.M.P.S., M.M.C., J.R., J.E.G., K.-H.W., S.L.C.), University of Utah School of Medicine, Salt Lake City; George E. Wahlen Department of Veterans Affairs Medical Center (T.L.S., J.G., M.M.P.S., J.R., J.E.G., S.L.C.), Salt Lake City, UT; University of Utah School of Medicine (L.M.); Department of Internal Medicine, (A.V.G.), University of Utah School of Medicine; and Divisions of Immunology and Infectious Disease (H.R.H.), Departments of Pathology, Pediatrics and Medicine, University of Utah School of Medicine, Salt Lake City
| | - Leah Millsap
- From the Université de Bordeaux (B.I.D.A.), U de Biologie, France; Department of Neurology (B.I.D.A., T.L.S., A.D., L.E., J.G., M.M.P.S., M.M.C., J.R., J.E.G., K.-H.W., S.L.C.), University of Utah School of Medicine, Salt Lake City; George E. Wahlen Department of Veterans Affairs Medical Center (T.L.S., J.G., M.M.P.S., J.R., J.E.G., S.L.C.), Salt Lake City, UT; University of Utah School of Medicine (L.M.); Department of Internal Medicine, (A.V.G.), University of Utah School of Medicine; and Divisions of Immunology and Infectious Disease (H.R.H.), Departments of Pathology, Pediatrics and Medicine, University of Utah School of Medicine, Salt Lake City
| | - M Mateo Paz Soldán
- From the Université de Bordeaux (B.I.D.A.), U de Biologie, France; Department of Neurology (B.I.D.A., T.L.S., A.D., L.E., J.G., M.M.P.S., M.M.C., J.R., J.E.G., K.-H.W., S.L.C.), University of Utah School of Medicine, Salt Lake City; George E. Wahlen Department of Veterans Affairs Medical Center (T.L.S., J.G., M.M.P.S., J.R., J.E.G., S.L.C.), Salt Lake City, UT; University of Utah School of Medicine (L.M.); Department of Internal Medicine, (A.V.G.), University of Utah School of Medicine; and Divisions of Immunology and Infectious Disease (H.R.H.), Departments of Pathology, Pediatrics and Medicine, University of Utah School of Medicine, Salt Lake City
| | - Melissa M Cortez
- From the Université de Bordeaux (B.I.D.A.), U de Biologie, France; Department of Neurology (B.I.D.A., T.L.S., A.D., L.E., J.G., M.M.P.S., M.M.C., J.R., J.E.G., K.-H.W., S.L.C.), University of Utah School of Medicine, Salt Lake City; George E. Wahlen Department of Veterans Affairs Medical Center (T.L.S., J.G., M.M.P.S., J.R., J.E.G., S.L.C.), Salt Lake City, UT; University of Utah School of Medicine (L.M.); Department of Internal Medicine, (A.V.G.), University of Utah School of Medicine; and Divisions of Immunology and Infectious Disease (H.R.H.), Departments of Pathology, Pediatrics and Medicine, University of Utah School of Medicine, Salt Lake City
| | - John Rose
- From the Université de Bordeaux (B.I.D.A.), U de Biologie, France; Department of Neurology (B.I.D.A., T.L.S., A.D., L.E., J.G., M.M.P.S., M.M.C., J.R., J.E.G., K.-H.W., S.L.C.), University of Utah School of Medicine, Salt Lake City; George E. Wahlen Department of Veterans Affairs Medical Center (T.L.S., J.G., M.M.P.S., J.R., J.E.G., S.L.C.), Salt Lake City, UT; University of Utah School of Medicine (L.M.); Department of Internal Medicine, (A.V.G.), University of Utah School of Medicine; and Divisions of Immunology and Infectious Disease (H.R.H.), Departments of Pathology, Pediatrics and Medicine, University of Utah School of Medicine, Salt Lake City
| | - John E Greenlee
- From the Université de Bordeaux (B.I.D.A.), U de Biologie, France; Department of Neurology (B.I.D.A., T.L.S., A.D., L.E., J.G., M.M.P.S., M.M.C., J.R., J.E.G., K.-H.W., S.L.C.), University of Utah School of Medicine, Salt Lake City; George E. Wahlen Department of Veterans Affairs Medical Center (T.L.S., J.G., M.M.P.S., J.R., J.E.G., S.L.C.), Salt Lake City, UT; University of Utah School of Medicine (L.M.); Department of Internal Medicine, (A.V.G.), University of Utah School of Medicine; and Divisions of Immunology and Infectious Disease (H.R.H.), Departments of Pathology, Pediatrics and Medicine, University of Utah School of Medicine, Salt Lake City
| | - Adi V Gundlapalli
- From the Université de Bordeaux (B.I.D.A.), U de Biologie, France; Department of Neurology (B.I.D.A., T.L.S., A.D., L.E., J.G., M.M.P.S., M.M.C., J.R., J.E.G., K.-H.W., S.L.C.), University of Utah School of Medicine, Salt Lake City; George E. Wahlen Department of Veterans Affairs Medical Center (T.L.S., J.G., M.M.P.S., J.R., J.E.G., S.L.C.), Salt Lake City, UT; University of Utah School of Medicine (L.M.); Department of Internal Medicine, (A.V.G.), University of Utah School of Medicine; and Divisions of Immunology and Infectious Disease (H.R.H.), Departments of Pathology, Pediatrics and Medicine, University of Utah School of Medicine, Salt Lake City
| | - Harry R Hill
- From the Université de Bordeaux (B.I.D.A.), U de Biologie, France; Department of Neurology (B.I.D.A., T.L.S., A.D., L.E., J.G., M.M.P.S., M.M.C., J.R., J.E.G., K.-H.W., S.L.C.), University of Utah School of Medicine, Salt Lake City; George E. Wahlen Department of Veterans Affairs Medical Center (T.L.S., J.G., M.M.P.S., J.R., J.E.G., S.L.C.), Salt Lake City, UT; University of Utah School of Medicine (L.M.); Department of Internal Medicine, (A.V.G.), University of Utah School of Medicine; and Divisions of Immunology and Infectious Disease (H.R.H.), Departments of Pathology, Pediatrics and Medicine, University of Utah School of Medicine, Salt Lake City
| | - Ka-Ho Wong
- From the Université de Bordeaux (B.I.D.A.), U de Biologie, France; Department of Neurology (B.I.D.A., T.L.S., A.D., L.E., J.G., M.M.P.S., M.M.C., J.R., J.E.G., K.-H.W., S.L.C.), University of Utah School of Medicine, Salt Lake City; George E. Wahlen Department of Veterans Affairs Medical Center (T.L.S., J.G., M.M.P.S., J.R., J.E.G., S.L.C.), Salt Lake City, UT; University of Utah School of Medicine (L.M.); Department of Internal Medicine, (A.V.G.), University of Utah School of Medicine; and Divisions of Immunology and Infectious Disease (H.R.H.), Departments of Pathology, Pediatrics and Medicine, University of Utah School of Medicine, Salt Lake City
| | - Stacey L Clardy
- From the Université de Bordeaux (B.I.D.A.), U de Biologie, France; Department of Neurology (B.I.D.A., T.L.S., A.D., L.E., J.G., M.M.P.S., M.M.C., J.R., J.E.G., K.-H.W., S.L.C.), University of Utah School of Medicine, Salt Lake City; George E. Wahlen Department of Veterans Affairs Medical Center (T.L.S., J.G., M.M.P.S., J.R., J.E.G., S.L.C.), Salt Lake City, UT; University of Utah School of Medicine (L.M.); Department of Internal Medicine, (A.V.G.), University of Utah School of Medicine; and Divisions of Immunology and Infectious Disease (H.R.H.), Departments of Pathology, Pediatrics and Medicine, University of Utah School of Medicine, Salt Lake City.
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Luo L, Zeng X, Cao Y, Hu Y, Wen S, Tang K, Ding L, Wang X, Song N. The Associations between Meeting 24-Hour Movement Guidelines (24-HMG) and Mental Health in Adolescents-Cross Sectional Evidence from China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3167. [PMID: 36833861 PMCID: PMC9966615 DOI: 10.3390/ijerph20043167] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: This study determined the prevalence of adolescents that meet 24-HMGs alone and in combination, and their association with the risk of developing adolescent anxiety and depression. (2) Methods: Participants were drawn from 9420 K8 grade adolescents (age 14.53 ± 0.69 years; 54.78% boys) from the China Education Tracking Survey (CEPS) 2014-2015 tracking data. Data on depression and anxiety were collected from the results of the questionnaire in the CEPS for the adolescent mental health test. Compliance with the 24-HMG was defined as: physical activity time (PA) ≥ 60 min/day was defined as meeting the PA. Screen time (ST) ≤ 120 min/day was defined as meeting the ST. Adolescents aged 13 years achieved 9-11 h of sleep per night and adolescents aged 14-17 years achieved 8-10 h of sleep per night, defined as meeting sleep. Logistic regression models were used to examine the association between meeting and not meeting the recommendations and the risk of depression and anxiety in adolescents. (3) Results: Of the sample studied, 0.71% of adolescents met all three recommendations, 13.54% met two recommendations and 57.05% met one recommendation. Meeting sleep, meeting PA+ sleep, meeting ST + sleep, and meeting PA + ST + sleep were associated with a significantly lower risk of anxiety and depression in adolescents. Logistic regression results showed that differences in the effects of gender on the odds ratio (ORs) for depression and anxiety in adolescents were not significant. (4) Conclusions: This study determined the risk of developing depression and anxiety in adolescents who met the recommendations for 24-HMG alone and in combination. Overall, meeting more of the recommendations in the 24-HMGs was associated with lower anxiety and depression risk outcomes in adolescents. For boys, reducing the risk of depression and anxiety can be prioritised by meeting PA + ST + sleep, meeting ST + sleep and meeting sleep in the 24-HMGs. For girls, reducing the risk of depression and anxiety may be preferred by meeting PA + ST + sleep or meeting PA+ sleep and meeting sleep in 24-HMGs. However, only a small proportion of adolescents met all recommendations, highlighting the need to promote and support adherence to these behaviours.
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Affiliation(s)
- Lin Luo
- College of Physical Education, Guizhou Normal University, Guiyang 550001, China
- Basic Education Research Center, Southwest University, Chongqing 400715, China
| | - Xiaojin Zeng
- College of Physical Education, Guizhou Normal University, Guiyang 550001, China
| | - Yunxia Cao
- College of Physical Education, Guizhou Normal University, Guiyang 550001, China
| | - Yulong Hu
- College of Physical Education, Guizhou Normal University, Guiyang 550001, China
| | - Shaojing Wen
- College of Physical Education, Guizhou Normal University, Guiyang 550001, China
| | - Kaiqi Tang
- College of Physical Education, Guizhou Normal University, Guiyang 550001, China
| | - Lina Ding
- College of Physical Education, Guizhou Normal University, Guiyang 550001, China
| | - Xiangfei Wang
- Research Institute of Sports Science, Wuhan Sports University, Wuhan 430079, China
| | - Naiqing Song
- Basic Education Research Center, Southwest University, Chongqing 400715, China
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Muhammad T, Meher T, Siddiqui LA. Mediation of the association between multi-morbidity and sleep problems by pain and depressive symptoms among older adults: Evidence from the Longitudinal Aging Study in India, wave- 1. PLoS One 2023; 18:e0281500. [PMID: 36758012 PMCID: PMC9910705 DOI: 10.1371/journal.pone.0281500] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 01/19/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND There could be several possible mechanisms on how chronic conditions relate to sleep problems in older persons; for instance, pain and sleep have a strong link and depressive symptoms are similarly associated with sleep problems. The present study explored whether pain and depressive symptoms are mediators in the relationship between multi-morbidity and sleep problems among older adults. METHODS Study utilized data from the Longitudinal Aging Study in India (LASI) with a sample of 31,464 older adults age 60 years and above. Multivariable logistic regression along with mediation analysis using Karlson-Holm-Breen (KHB) method was conducted. RESULTS A proportion of 14.8% of the participants suffered from sleep problems, whereas, 22.5% and 8.7% of older adults had multi-morbidity and had depressive symptoms, respectively. Also, around 10.3% of older adults reported pain and received no medication for the relief of pain, whereas 29.3% of older adults reported pain and received some type of medication for the relief of pain. Older adults with multi-morbidity had higher odds of suffering from sleep problems [adjusted odds ratio (aOR):1.26, confidence interval (CI):1.10-1.45] than those who had no multi-morbidity. Older adults who reported pain but received no medication for the relief of pain [aOR: 1.90, CI: 1.64-2.22] or reported pain and received medication for the relief of pain [aOR: 1.82, CI:1.62-2.04] and those who had depressive symptoms [aOR: 2.21, CI:1.89-2.57%] had higher odds of suffering from sleep problems compared to those who did not report pain and had no depressive symptoms, respectively. Around 11.2% of the association of multi-morbidity with sleep problems was mediated by pain and 4.3% of such association was mediated by depressive symptoms. CONCLUSION Pain and depressive symptoms were found to mediate the association between multi-morbidity and sleep problems; therefore, reducing pain and depressive symptoms may be considered to improve sleep in older multi-morbid patients.
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Affiliation(s)
- T. Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, Maharashtra, India
- * E-mail:
| | - Trupti Meher
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Laeek Ahemad Siddiqui
- Department of Bio-Statistics and Epidemiology, International Institute for Population Sciences, Mumbai, Maharashtra, India
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Mason EC, Grierson AB, Sie A, Sharrock MJ, Li I, Chen AZ, Newby JM. Co-occurring insomnia and anxiety: a randomized controlled trial of internet cognitive behavioral therapy for insomnia versus internet cognitive behavioral therapy for anxiety. Sleep 2023; 46:6679359. [PMID: 36041459 DOI: 10.1093/sleep/zsac205] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/27/2022] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES Insomnia and anxiety are highly prevalent and frequently co-occur. Given limited therapeutic resources and time constraints, the aim of this study was to compare which treatment-internet cognitive behavioral therapy (CBT) for insomnia or internet CBT for anxiety-leads to the best outcomes in individuals with comorbid insomnia and anxiety. METHODS 120 participants with comorbid insomnia and clinical anxiety (as defined by scores above the clinical cutoff on the insomnia severity index (ISI) and the generalized anxiety disorder 7-item scale (GAD-7)) were randomized to receive internet-based cognitive behavioral therapy (iCBT) for insomnia or iCBT for anxiety. The primary outcome measures were the ISI and the generalized anxiety disorder 7-item scale. Primary outcome measures were assessed before treatment, at mid-treatment, at post-treatment, and 3 months after treatment. Secondary outcome measures assessed depression symptoms, distress, and sleep diary parameters. RESULTS Participants in both groups experienced large reductions in symptoms of insomnia, anxiety, depression, and distress, as well as improvements in sleep efficiency and total sleep time. Improvements were maintained at follow-up. Crucially, at the end of treatment, the insomnia treatment was more effective in reducing symptoms of insomnia than the anxiety treatment, and equally effective in reducing symptoms of anxiety. Treatment gains were maintained at 3-month follow-up, however, there were no differences between groups at that time point. CONCLUSIONS These results suggest that in the common case of a patient presenting with comorbid insomnia and anxiety, treatment for insomnia may be the most efficient treatment strategy. TRIAL REGISTRATION The trial was registered with the Australian and New Zealand Clinical Trials Registry, https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12618001141235. Trial ID: ACTRN12618001141235. Trial name: a comparison of internet-based CBT for insomnia versus internet-based CBT for anxiety in a comorbid sample.
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Affiliation(s)
- Elizabeth C Mason
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, Sydney, NSW, Australia.,School of Psychology, Faculty of Science, University of New South Wales, Sydney, NSW, Australia
| | - Ashlee B Grierson
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, Sydney, NSW, Australia
| | - Amanda Sie
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, Sydney, NSW, Australia
| | - Maria J Sharrock
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, Sydney, NSW, Australia
| | - Ian Li
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, Sydney, NSW, Australia
| | - Aileen Z Chen
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, Sydney, NSW, Australia
| | - Jill M Newby
- School of Psychology, Faculty of Science, University of New South Wales, Sydney, NSW, Australia.,Black Dog Institute, Randwick, NSW, Australia
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Yoo J, Slavish D, Dietch JR, Kelly K, Ruggero C, Taylor DJ. Daily reactivity to stress and sleep disturbances: unique risk factors for insomnia. Sleep 2023; 46:zsac256. [PMID: 36301838 PMCID: PMC9905776 DOI: 10.1093/sleep/zsac256] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 10/19/2022] [Indexed: 11/17/2022] Open
Abstract
STUDY OBJECTIVES To naturalistically measure sleep disturbances following stress exposure (i.e. sleep reactivity) and stress responses following sleep disturbances (i.e. stress reactivity) at the daily level and prospectively examine these reactivity measures as individual risk factors for insomnia. METHODS The study assessed 392 nurses' sleep and stress for 14 days using daily diaries and actigraphy. Self-reported insomnia symptoms were assessed at the end of the 14 days, as well as 6 and 11 months later. RESULTS In multilevel modeling, while negative fixed effects indicated that shorter total sleep time (TST) and lower sleep efficiency led to greater stress and vice versa, significant random effects indicated individual variability in sleep reactivity and stress reactivity. In latent score change modeling, greater sleep reactivity (lower diary-determined sleep efficiency following greater stress) and greater stress reactivity (greater stress following shorter diary-determined TST) at baseline were associated with greater insomnia symptoms at 11 months (b = 10.34, p = .026; b = 7.83, p = .03). Sleep reactivity and stress reactivity also interacted to predict insomnia symptoms, such that sleep reactivity was significantly associated with insomnia symptoms for those with high (+1 SD) stress reactivity (b = 17.23, p = .001), but not for those with low (-1 SD) stress reactivity (b = 5.16, p = .315). CONCLUSIONS Baseline stress reactivity and sleep reactivity independently as well as jointly predict greater insomnia symptoms 11 months later. The findings delineate processes underlying the stress-diathesis model of insomnia and highlight the utility of longitudinal and naturalistic measures of sleep and stress reactivity.
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Affiliation(s)
- Jiah Yoo
- Department of Psychology, University of Arizona, 1503 E University Blvd. Tucson, AZ 85721, USA
| | - Danica Slavish
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX 76203, USA
| | - Jessica R Dietch
- School of Psychological Science, Oregon State University, 2950 SW Jefferson Way, Corvallis, OR 97331, USA
| | - Kimberly Kelly
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX 76203, USA
| | - Camilo Ruggero
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX 76203, USA
| | - Daniel J Taylor
- Department of Psychology, University of Arizona, 1503 E University Blvd. Tucson, AZ 85721, USA
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Adverse childhood experiences and Chinese young adults' sleep quality: Moderation of resting respiratory sinus arrhythmia. Int J Psychophysiol 2023; 184:12-19. [PMID: 36521821 DOI: 10.1016/j.ijpsycho.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 12/03/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
This study examined the moderating roles of resting respiratory sinus arrhythmia (RSA) in the relations between adverse childhood experiences (ACEs) and sleep quality (i.e., sleep efficiency, perceived sleep quality, and daily disturbances) in young adulthood. Chinese young adults (N = 259; Mage = 25.85 years) reported on their adverse childhood experiences retrospectively and current sleep quality. Their electrocardiogram (ECG) and respiration data were recorded while they were seated resting and resting RSA scores were computed. Results indicated that ACEs were associated with poor perceived sleep quality and greater daily disturbances among young adults who showed low resting RSA. The associations were not significant among those who showed high resting RSA. These findings suggest that high resting RSA may serve as a protective factor for young adults' sleep against adverse childhood experiences and these effects were consistent for different biological sex and sexual orientation groups.
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Brooks Holliday S, Dong L, Haas A, Ghosh-Dastidar MB, Dubowitz T, Buysse DJ, Hale L, Troxel WM. Longitudinal associations between sleep and BMI in a low-income, predominantly Black American sample. Sleep Health 2023; 9:11-17. [PMID: 36456450 PMCID: PMC9992091 DOI: 10.1016/j.sleh.2022.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 10/04/2022] [Accepted: 10/27/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Black individuals and those experiencing socioeconomic disadvantage are at increased risk for sleep problems and obesity. This study adds to the limited extant literature examining longitudinal associations between objectively measured sleep and changes in body mass index (BMI) in Black Americans. DESIGN We focused on individuals with at least 1 observation of sleep and BMI at 1 of 3 study time points (2013, 2016, and 2018). We modeled longitudinal trends in BMI as a function of time, average of each sleep variable across assessments, and within-person deviations in each sleep variable over time. SETTING Data were collected via interviewer-administered at-home surveys and actigraphy in Pittsburgh, PA. PARTICIPANTS Our sample comprised 1115 low-income, primarily Black adults, including 862 women and 253 men. MEASUREMENTS Sleep measures included actigraphy-measured total sleep time, sleep efficiency, and wakefulness after sleep onset, as well as self-reported sleep quality. We also included objectively measured BMI. RESULTS In models adjusted for age, gender, and other sociodemographic covariates (eg, income, marital status), there were no significant longitudinal associations between total sleep time, sleep efficiency, wakefulness after sleep onset, or subjective sleep quality and changes in BMI. CONCLUSIONS This study provides further evidence that, among a sample of low-income Black adults, sleep problems are not longitudinally predictive of BMI. Although ample cross-sectional evidence demonstrates that sleep problems and obesity commonly co-occur, longitudinal evidence is mixed. Better understanding the overlap of sleep and obesity over time may contribute to prevention and intervention efforts.
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Affiliation(s)
| | - Lu Dong
- RAND Corporation, Santa Monica, California, USA
| | - Ann Haas
- RAND Corporation, Pittsburgh, Pennsylvania, USA
| | | | | | | | - Lauren Hale
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Yang Y, Liu X, Liu ZZ, Tein JY, Jia CX. Life stress, insomnia, and anxiety/depressive symptoms in adolescents: A three-wave longitudinal study. J Affect Disord 2023; 322:91-98. [PMID: 36372126 DOI: 10.1016/j.jad.2022.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 08/18/2022] [Accepted: 11/05/2022] [Indexed: 11/13/2022]
Abstract
PURPOSE Life stress has negative impacts on sleep and mental health. Little empirical work has investigated the associations between life stress, insomnia, and anxiety/depressive symptoms (ADS) in multi-wave longitudinal studies. This longitudinal study examined these associations in a large sample of adolescents. METHODS A total of 6995 adolescents (mean age = 14.86 years, 51.4 % male) participated in a 3-wave longitudinal study of behavior and health in Shandong, China. Standardized rating scales were used to assess life stress, insomnia, and ADS in 2015 (T1), 1 year later (T2), and 2 years later (T3). Three-wave longitudinal panel models were conducted to examine the prospective relationships between life stress, insomnia, and ADS. RESULTS The prevalence and persistence rates of insomnia and ADS across T1-T3 significantly increased with elevated life stress score (p < .001). Cross-lagged panel analysis showed that life stress, insomnia, and ADS at a later time point were significantly predicted by the same variable at earlier time points (all p < .01). Life stress, insomnia, and ADS significantly predicted each other bidirectionally over time (all p < .01). The relationship between life stress and ADS was partially mediated by insomnia. The relationship between life stress and insomnia was partially mediated by ADS. STUDY LIMITATION Life stress, insomnia, and ADS were all self-reports. CONCLUSIONS Life stress, insomnia, and ADS are prospectively bidirectionally related to one another. Insomnia was a mediator of life stress and subsequent ADS and vice versa. These findings underscore the importance of sleep and mental health assessment and intervention in adolescents following life stress.
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Affiliation(s)
- Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL, USA
| | - Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA.
| | - Zhen-Zhen Liu
- School of Psychology, Northeast Normal University, Changchun, China; Shandong University School of Public Health, Jinan, China
| | - Jenn-Yun Tein
- Department of Psychology, REACH Institute, Arizona State University, Tempe, AZ, USA
| | - Cun-Xian Jia
- Shandong University School of Public Health, Jinan, China
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Sleep and Mental Health Problems in Children and Adolescents. Sleep Med Clin 2023; 18:245-254. [PMID: 37120167 DOI: 10.1016/j.jsmc.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Previous reviews have described the links between sleep and mental health extensively. In this narrative review, we focus on literature published during the last decade investigating the links between sleep and mental health difficulties in childhood and adolescence. More specifically, we focus on the mental health disorders listed in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders. We also discuss possible mechanisms underlying these associations. The review ends with a discussion of possible future lines of enquiry.
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Jin H, Gonzalez JS, Pyatak E, Schneider S, Hoogendoorn CJ, Hernandez R, Lee PJ, Spruijt-Metz D. Within-person Relationships of Sleep Duration with Next-Day Stress and Affect in the Daily Life of Adults with Type-1 Diabetes. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.01.22.23284883. [PMID: 36747877 PMCID: PMC9901054 DOI: 10.1101/2023.01.22.23284883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Objective The objective of this study is to examine the within-person relationships between sleep duration and next-day stress and affect in the daily life of individuals with T1D. Methods Study participants were recruited in the Function and Emotion in Everyday Life with Type 1 Diabetes (FEEL-T1D) study. Sleep duration was derived by synthesizing objective (actigraphy) and self-report measures. General and diabetes-specific stress and positive and negative affect were measured using ecological momentary assessment. Multilevel regression was used to examine the within-person relationships between sleep duration and next-day stress and affect. Cross-level interactions were used to explore whether gender and baseline depression and anxiety moderated these within-person relationships. Results Adults with T1D (n=166) completed measurements for 14 days. The average age was 40.99 years, and 91 participants (54.82%) were female. The average sleep duration was 7.29 hours (SD=1.18 hours). Longer sleep was significantly associated with lower general stress (p<0.001) but not diabetes-specific stress (p=0.18) on the next day. There were significant within-person associations of longer sleep with lower levels on next-day negative affect (overall, p=0.002, disappoint, p=0.05; sad, p=0.05; tense, p<0.001; upset, p=0.008; anxious, p=0.04). There were no significant associations with positive affect. Examination of the interaction effects did not reveal significant differential relationships for men and women and for individuals with and without depression or anxiety at baseline. Conclusion Findings from this study suggest optimizing sleep duration as an important interventional target for better managing general stress and improving daily emotional wellbeing of individuals with T1D.
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Depression and Anxiety Mediate the Association between Sleep Quality and Self-Rated Health in Healthcare Students. Behav Sci (Basel) 2023; 13:bs13020082. [PMID: 36829311 PMCID: PMC9952798 DOI: 10.3390/bs13020082] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/10/2023] [Accepted: 01/13/2023] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES This study aimed to investigate factors associated with sleep quality in healthcare students and to determine whether depressive and anxiety symptoms may explain some of the associations between sleep quality and self-rated health. STUDY DESIGN This is a cross-sectional study at wave one. METHODS A total of 637 healthcare students were recruited via a stratified random sampling method in Hangzhou, China. The Sleep Quality Questionnaire (SQQ) and the four-item Patient Health Questionnaire (PHQ-4) were used to assess sleep quality and depressive and anxiety symptoms, respectively. Self-rated health was assessed via a self-developed questionnaire of both physical and psychological health. Structural equation modeling was used to examine the direct and indirect effects of sleep quality on self-rated health through depressive and anxiety symptoms. RESULTS Students engaged in part-time employment (p = 0.022), with poor perceived employment prospects (p = 0.009), and who did not participate in recreational sports (p = 0.008) had worse sleep quality. Structural equation modeling revealed a significant total effect of sleep quality on self-rated health (b = 0.592, p < 0.001), a significant direct effect of both sleep quality and depressive and anxiety symptoms on self-rated health (b = 0.277, 95% CI: 0.032-0.522), and a significant indirect effect of sleep quality on self-rated health through depressive and anxiety symptoms (b = 0.315, 95% CI: 0.174-0.457). CONCLUSIONS Depressive and anxiety symptoms partially explain the association between sleep quality and self-rated health. Intervening upon sleep quality, depressive, and anxiety symptoms may bolster the self-rated health of healthcare students.
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Corbo I, Forte G, Favieri F, Casagrande M. Poor Sleep Quality in Aging: The Association with Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20031661. [PMID: 36767029 PMCID: PMC9914898 DOI: 10.3390/ijerph20031661] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/13/2023] [Accepted: 01/14/2023] [Indexed: 05/13/2023]
Abstract
Sleep disturbances are common in the elderly. A primary sleep disorder can result from the physiological decline of aging; however, secondary sleep problems result from various causes involving physical and mental health. Since little is known about the relationships between sleep quality and mental health in aging, the present study aims to understand how different aspects generally associated with sleep (e.g., psychological and physiological factors, and sleep medication) may predict poor sleep quality in different stages of the lifespan. Therefore, we conducted several analyses (ANOVAs, Pearson correlations, and linear regressions) to test the hypotheses of the study. Accordingly, from a pool of 180 participants (elderly, middle-aged, and young adults), 143 individuals with poor sleep quality were selected. Different predictive patterns in the three groups emerged. Specifically, the use of sleep medication associated with worse sleep conditions is predicted by poor sleep quality in the elderly and by depression in young adults. In contrast, worsening sleep quality is predicted by depression in middle-aged adults. Previous studies focused on the transitions from good to poor sleep quality, while this is the first study to have examined the features of poor sleep quality in aging, highlighting different sleep patterns across the lifespan. This evidence should be considered from a preventive perspective.
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Affiliation(s)
- Ilaria Corbo
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy
- Correspondence: (I.C.); (M.C.)
| | - Giuseppe Forte
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, 00185 Rome, Italy
- Body and Action Laboratory, IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy
| | - Francesca Favieri
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy
- Body and Action Laboratory, IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy
| | - Maria Casagrande
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, 00185 Rome, Italy
- Correspondence: (I.C.); (M.C.)
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Cowan S, Lim S, Alycia C, Pirotta S, Thomson R, Gibson-Helm M, Blackmore R, Naderpoor N, Bennett C, Ee C, Rao V, Mousa A, Alesi S, Moran L. Lifestyle management in polycystic ovary syndrome - beyond diet and physical activity. BMC Endocr Disord 2023; 23:14. [PMID: 36647089 PMCID: PMC9841505 DOI: 10.1186/s12902-022-01208-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 11/09/2022] [Indexed: 01/18/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is a common condition affecting reproductive-aged women with reproductive, metabolic and psychological consequences. Weight and lifestyle (diet, physical activity and behavioural) management are first-line therapy in international evidence-based guidelines for PCOS. While these recommend following population-level diet and physical activity guidelines, there is ongoing interest and research in the potential benefit of including psychological and sleep interventions, as well as a range of traditional, complimentary and integrative medicine (TCIM) approaches, for optimal management of PCOS. There is limited evidence to recommend a specific diet composition for PCOS with approaches including modifying protein, carbohydrate or fat quality or quantity generally having similar effects on the presentations of PCOS. With regards to physical activity, promising evidence supports the provision of vigorous aerobic exercise, which has been shown to improve body composition, cardiorespiratory fitness and insulin resistance. Psychological and sleep interventions are also important considerations, with women displaying poor emotional wellbeing and higher rates of clinical and subclinical sleep disturbance, potentially limiting their ability to make positive lifestyle change. While optimising sleep and emotional wellbeing may aid symptom management in PCOS, research exploring the efficacy of clinical interventions is lacking. Uptake of TCIM approaches, in particular supplement and herbal medicine use, by women with PCOS is growing. However, there is currently insufficient evidence to support integration into routine clinical practice. Research investigating inositol supplementation have produced the most promising findings, showing improved metabolic profiles and reduced hyperandrogenism. Findings for other supplements, herbal medicines, acupuncture and yoga is so far inconsistent, and to reduce heterogeneity more research in specific PCOS populations, (e.g. defined age and BMI ranges) and consistent approaches to intervention delivery, duration and comparators are needed. While there are a range of lifestyle components in addition to population-recommendations for diet and physical activity of potential benefit in PCOS, robust clinical trials are warranted to expand the relatively limited evidence-base regarding holistic lifestyle management. With consumer interest in holistic healthcare rising, healthcare providers will be required to broaden their knowledge pertaining to how these therapies can be safely and appropriately utilised as adjuncts to conventional medical management.
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Affiliation(s)
- Stephanie Cowan
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia.
| | - Siew Lim
- Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia
| | - Chelsea Alycia
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Stephanie Pirotta
- Health and Social Care Unit, Monash University, Clayton, Victoria, Australia
| | - Rebecca Thomson
- Robinson Research Institute, The University of Adelaide, North Adelaide, South Australia, Australia
| | - Melanie Gibson-Helm
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
- Te Tātai Hauora o Hine - National Centre for Women's Health Research Aotearoa, Te Herenga Waka - Victoria University of Wellington, Wellington, New Zealand
| | - Rebecca Blackmore
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Negar Naderpoor
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Christie Bennett
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
| | - Carolyn Ee
- NICM Health Research Institute, Western Sydney University, Westmead, New South Wales, Australia
| | - Vibhuti Rao
- NICM Health Research Institute, Western Sydney University, Westmead, New South Wales, Australia
| | - Aya Mousa
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Simon Alesi
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Lisa Moran
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
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Kim M, Park I, An H, Yun B, Yoon JH. Teleworking Is Significantly Associated with Anxiety Symptoms and Sleep Disturbances among Paid Workers in the COVID-19 Era. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1488. [PMID: 36674241 PMCID: PMC9859403 DOI: 10.3390/ijerph20021488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
Due to social distancing during COVID-19, teleworking has spread in Korea. Accordingly, the effects of teleworking on physical and mental health have emerged. We aim to determine the association between teleworking and mental health, including anxiety symptoms and sleep disturbance, in paid workers. The data of paid workers from the Sixth Korean Working Conditions Survey, collected between October 2020 and April 2021, were analyzed. Gender stratification analysis and propensity score matching were performed for variables relevant to sociodemographic and occupational characteristics. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for each sex were analyzed using multivariable logistic regression, adjusting for sociodemographic and occupational characteristics. Among 28,633 participants, analyses were performed for anxiety symptoms (teleworkers vs. non-teleworkers; men: 12.1% vs. 4.9%; women: 13.5% vs. 5.3%) and sleep disturbance (men: 33.6% vs. 21.3%; women: 39.7% vs. 25.3%). In male teleworkers, the AORs for anxiety symptoms and sleep disturbance were 1.86 (95% CI: 1.14-3.04) and 1.52 (95% CI: 1.10-2.11), respectively. In female teleworkers, the AORs for anxiety symptoms and sleep disturbance were 1.66 (95% CI: 1.13-2.43) and 1.65 (95% CI: 1.28-2.14), respectively. Our results emphasize the importance of mental health and the need for continuous education and care for teleworkers, given the rapid increase in teleworking.
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Affiliation(s)
- Minji Kim
- Yonsei University College of Medicine, 50, Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Inho Park
- Yonsei University College of Medicine, 50, Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Hyojin An
- Yonsei University College of Medicine, 50, Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Byungyoon Yun
- Department of Preventive Medicine, Yonsei University College of Medicine, 50, Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Jin-Ha Yoon
- Department of Preventive Medicine, Yonsei University College of Medicine, 50, Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, 50, Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
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230
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Borges C, Ellis JG, Ruivo Marques D. The Role of Sleep Effort as a Mediator Between Anxiety and Depression. Psychol Rep 2023:332941221149181. [PMID: 36595381 DOI: 10.1177/00332941221149181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Depression, anxiety, and insomnia are all conditions that share a complex bidirectional relationship. Sleep effort is a construct with cognitive and behavioral components that perpetuates insomnia. Although many studies have examined the associations between these three variables, no studies have yet examined sleep effort as a mediating variable between anxiety and depression and vice versa. Online versions of the Hospital Anxiety and Depression Scale and the Glasgow Sleep Effort Scale were administered to a sample of 1927 higher education students aged 18-40 years (75.9% women and 76% from 18 to 23 years old). As part of the survey, participants also completed a sociodemographic questionnaire. Mediation analysis indicated that sleep effort mediates the relationship between depression and anxiety, when the former was the predictor and the latter was the criterion. Moreover, sleep effort also mediated the relationship between anxiety and depression when the former was the predictor and the latter was the criterion, albeit in a lesser extent. Sleep effort appears to play a bidirectional mediational role between depression and anxiety, being a potential target for intervention.
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Affiliation(s)
- Cristina Borges
- Department of Education and Psychology, 56062University of Aveiro, Aveiro, Portugal
| | - Jason G Ellis
- Northumbria Sleep Research Laboratory, Faculty of Health and Life Sciences, 5995Northumbria University, Newcastle, UK
| | - Daniel Ruivo Marques
- Department of Education and Psychology, 56062University of Aveiro, Aveiro, Portugal; CINEICC - Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal
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231
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Meurling J, Rondung E, Leiler A, Wasteson E, Andersson G, Richards D, Shahnavaz S, Bjärtå A. An online tiered screening procedure to identify mental health problems among refugees. BMC Psychiatry 2023; 23:7. [PMID: 36597066 PMCID: PMC9811744 DOI: 10.1186/s12888-022-04481-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 12/16/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Many refugees suffer from mental health problems due to stressful and traumatic events before, during, and after migration. However, refugees are facing a wide variety of barriers, limiting their access to mental health care. Internet-based tools, available in several languages, could be one way to increase the availability of mental health services for refugees. The present study aimed to develop and test a screening tool to screen for clinically relevant symptoms of psychiatric disorders common among refugees (i.e. Depression, Anxiety, Post-traumatic stress disorder, and Insomnia). We, designed, translated, and adapted an internet-based tiered screening procedure suitable for use with the largest refugee populations residing in Sweden. The tool aims to accurately identify symptoms of mental distress (Tier 1), differentiate between symptoms of specific psychiatric disorders (Tier 2), and assess symptom severity (Tier 3). We tested the overall efficiency of using a tiered screening procedure. METHODS Seven hundred fifty-seven refugees residing in Sweden, speaking any of the languages Arabic, Dari, Farsi, English, or Swedish, completed an online questionnaire following a three-tiered procedure with screening instruments for each tier. In this study, the Tier 3 scales were used as reference standards for clinically relevant symptoms, to evaluate screening efficiency in terms of accuracy and reduction of item burden in previous tiers. RESULTS The results show that the tiered procedure could reduce the item burden while maintaining high accuracy, with up to 86% correctly assessed symptoms and few false negatives with moderate symptoms and above (at most 9%), and very few with severe symptoms (at most 1.3%). DISCUSSION This study generated an accurate screening tool that efficiently identifies clinically relevant symptoms of common psychiatric disorders among refugees. Using an adapted online tiered procedure to screen for multiple mental health issues among refugees has the potential to facilitate screening and increase access to mental health services for refugees. We discuss the utility of the screening tool and the necessity of further evaluation.
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Affiliation(s)
- Jennifer Meurling
- Department of Psychology and Social work, Mid Sweden University, 831 25, Östersund, Sweden.
| | - Elisabet Rondung
- grid.29050.3e0000 0001 1530 0805Department of Psychology and Social work, Mid Sweden University, 831 25 Östersund, Sweden
| | - Anna Leiler
- grid.29050.3e0000 0001 1530 0805Department of Psychology and Social work, Mid Sweden University, 831 25 Östersund, Sweden
| | - Elisabet Wasteson
- grid.29050.3e0000 0001 1530 0805Department of Psychology and Social work, Mid Sweden University, 831 25 Östersund, Sweden
| | - Gerhard Andersson
- grid.5640.70000 0001 2162 9922Department of Behavioral Sciences and Learning, Linköping University, 581 83 Linköping, Sweden
| | - Derek Richards
- grid.8217.c0000 0004 1936 9705School of Psychology, Trinity College Dublin, College Green, Dublin 2, Ireland
| | - Shervin Shahnavaz
- grid.467087.a0000 0004 0442 1056Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Insititutet, & Stockholm Health Care Services, Region Stockholm, 171 77 Stockholm, Sweden
| | - Anna Bjärtå
- Department of Psychology and Social work, Mid Sweden University, 831 25, Östersund, Sweden.
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232
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Mendelevich VD, Mendelevich EG. [Insomnia in the context of affective disorders]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:43-48. [PMID: 37275997 DOI: 10.17116/jnevro202312305243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The article analyzes the current literature on the relationship of insomnia with affective disorders, in particular with depression and anxiety. Research shows that there is a strong multi-channel relationship between insomnia, depression, and anxiety, with insomnia being considered a risk factor for mood disorders more often than vice versa. The so-called insomnia paradox of bipolar disorder is described, the essence of which is that in manic episodes the frequency of insomnia is higher than in depressive episodes. The data of a network meta-analysis, which found an evidence base for the use of a variety of drugs used for the pharmacological treatment of insomnia in adults, are presented. Efficiency and convenience in taking the drug Valocordin-Doxylamine are noted.
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233
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Stevens DJ, Appleton S, Bickley K, Holtzhausen L, Adams R. Electroencephalographic Changes in Sleep During Acute and Subacute Phases After Sports-Related Concussion. Nat Sci Sleep 2023; 15:267-273. [PMID: 37155471 PMCID: PMC10122858 DOI: 10.2147/nss.s397900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 03/15/2023] [Indexed: 05/10/2023] Open
Abstract
Purpose Little is known about sleep after a concussion, a form of mild traumatic brain injury. Given the importance of sleep for both maintaining brain health and recovery from injury, we sought to examine sleep acutely and subacutely after concussion. Methods Athletes who experienced a sports-related concussion were invited to participate. Participants underwent overnight sleep studies within 7 days of the concussion (acute phase), and again eight-weeks after the concussion (subacute phase). Changes in sleep from both the acute and subacute phases were compared to population normative values. Additionally, changes in sleep from acute to subacute phase were analysed. Results When compared to normative data, the acute and subacute phases of concussion showed longer total sleep time (p < 0.005) and fewer arousals (p < 0.005). The acute phase showed longer rapid eye movement sleep latency (p = 0.014). The subacute phase showed greater total sleep spent in Stage N3% (p = 0.046), increased sleep efficiency (p < 0.001), shorter sleep onset latency (p = 0.013), and reduced wake after sleep onset (p = 0.013). Compared to the acute phase, the subacute phase experienced improved sleep efficiency (p = 0.003), reduced wake after sleep onset (p = 0.02), and reduced latencies for both stage N3 sleep (p = 0.014) and rapid eye movement sleep (p = 0.006). Conclusion This study indicated sleep during both the acute and subacute phases of SRC was characterised by longer and less disrupted sleep, along with improvements in sleep from the acute to subacute phases of SRC.
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Affiliation(s)
- David J Stevens
- Sleep Health, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia
- Correspondence: David J Stevens, Sleep Health, Flinders Health and Medical Research Institute, Flinders University, Level 2a, 5 Laffer Dve, Bedford Park, South Australia, 5041, Australia, Tel +61 7306 1816, Email
| | - Sarah Appleton
- Sleep Health, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia
| | - Kelsey Bickley
- Sleep Health, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia
| | - Louis Holtzhausen
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Section Sports Medicine, Faculty of Health Science, University of Pretoria, Pretoria, South Africa
- Department of Exercise and Sport Science, University of the Free State, Bloemfontein, South Africa
| | - Robert Adams
- Sleep Health, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia
- Respiratory and Sleep Services, Southern Adelaide Local Health Network, Bedford Park, South Australia, Australia
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234
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Qu D, Liu D, Cai C, Zhang X, Yu J, Zhang Q, Liu K, Wei Z, Tan J, Cui Z, Zhang X, Chen R. Process model of emotion regulation-based digital intervention for emotional problems. Digit Health 2023; 9:20552076231187476. [PMID: 37485331 PMCID: PMC10357066 DOI: 10.1177/20552076231187476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 06/26/2023] [Indexed: 07/25/2023] Open
Abstract
Background To address the lack of mental health practitioners in developing countries, the current study explored the feasibility of a newly developed self-guided digital intervention program TEA (training for emotional adaptation) in alleviating depressive and anxiety symptoms, as one of a few studies which adapted from theoretical models with effective intervention techniques. Methods The first part of this study involved 11 professional mental health practitioners giving feedback on the feasibility of the TEA; while the second part involved a mixed-method single-arm study with 32 participants recruited online, who went through the seven intervention sessions within 14 days. The questionnaires were collected before, after, 14 days after, and 30 days after intervention. Additionally, 10 participants were invited to semi-structured interviews regarding their suggestions. Results Practitioners thought that the TEA showed high professionalism (8.91/10) and is suitable for treating emotional symptoms (8.09/10). The generalized estimating equation model showed that the TEA significantly reduced participants' depressive and anxiety symptoms, while the effects of the intervention remained 30 days post intervention (Cohen's d > 1). Thematic analysis revealed three main themes about future improvement, including content improvement, interaction improvement, and bug-fixing. Conclusions To address the current needs for digital mental health intervention programs to account for the insufficient availability of mental health services in China, the current study provides preliminary evidence of the effectiveness of TEA, with the potential to address the urgent need for remote mental health services. Trial registration The study was registered at the Chinese Clinical Trial Register (ChiCTR), with number [ChiCTR2200065944].
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Affiliation(s)
- Diyang Qu
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Dongyu Liu
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Chengxi Cai
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Xuan Zhang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Jiaao Yu
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Quan Zhang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Kunxu Liu
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Ziqian Wei
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Jiajia Tan
- Academy of Arts & Design, Tsinghua University, Beijing, China
| | - Zaixu Cui
- Chinese Institute for Brain Research, Beijing, China
| | - Xiaoqian Zhang
- Department of Psychiatry, Tsinghua University Yuquan Hospital, Beijing, China
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China
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235
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Van Hout E, Contreras M, Mioshi E, Kishita N. Examining the Impact of Different Components of Sleep Quality on Anxiety Among Family Carers of People with Dementia. J Geriatr Psychiatry Neurol 2023; 36:63-72. [PMID: 35437043 PMCID: PMC9755697 DOI: 10.1177/08919887221093359] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Existing interventions for family carers of people with dementia tend to be less effective for anxiety than for depression. Therefore, identifying factors affecting carer anxiety is important to inform future interventions. This study conducted 2 multiple regression analyses using a sample of 91 family carers. The first regression model (∆R2 = .24), exploring the impact of demographic variables and carer stressors, demonstrated that hours of caring (β = .33) and overall sleep quality (β = .28) were significant predictors of anxiety. To further investigate the impact of sleep quality, the second model (∆R2 = .24) focussed on exploring the differential impact of various components of sleep quality on anxiety. Findings demonstrated that subjective sleep quality (β = .33) and sleep disturbances (β = .22) were significant predictors. Hours of caring per week, subjective sleep quality and sleep disturbances seem to be critical for treating anxiety in family carers. Future studies should investigate whether targeting these variables could improve carer anxiety.
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Affiliation(s)
- Elien Van Hout
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Milena Contreras
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Eneida Mioshi
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Naoko Kishita
- School of Health Sciences, University of East Anglia, Norwich, UK,Dr. Naoko Kishita, School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK.
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236
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Li H, Qin W, Li N, Feng S, Wang J, Zhang Y, Wang T, Wang C, Cai X, Sun W, Song Y, Han D, Liu Y. Effect of mindfulness on anxiety and depression in insomnia patients: A systematic review and meta-analysis. Front Psychiatry 2023; 14:1124344. [PMID: 36937735 PMCID: PMC10018191 DOI: 10.3389/fpsyt.2023.1124344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/07/2023] [Indexed: 03/06/2023] Open
Abstract
Background As a common clinical symptom, insomnia has a high incidence of combined mental illness and it is also a risk factor for the development of depression, anxiety and suicide. As a new concept in the field of health in recent years, mindfulness therapy can improve insomnia, anxiety and depression, which is a new way to solve such diseases. Objective This study aims to systematically evaluate the effects of mindfulness compared with conventional treatment on scores of the Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) in people with insomnia and anxiety-depressive symptoms. Methods Articles published before October 2022 were searched from seven databases and included in randomized controlled trials (RCTs) to evaluate mindfulness therapy. The assessment tool of Cochrane bias risk was used to evaluate the methodological quality of the literature. The main outcome indicators were HAMD and HAMA scores, and the secondary outcome indicators were SDS and SAS scores. Results Ten randomized controlled trials including 1,058 subjects were systematically evaluated and meta-analyzed in this study. In the main outcome indicators, there was a significant difference between mindfulness therapy and conventional treatment in reducing HAMD score (MD: -3.67, 95% CI: -5.22-2.11, p < 0.01) and HAMA score (MD: -3.23, 95% CI: -3.90-2.57, p < 0.01). In the secondary outcome indicators, mindfulness therapy also showed a significant difference in reducing SDS scores (MD: -6.49, 95% CI: -6.86-6.11, p < 0.01) and SAS scores (MD: -7.97, 95% CI: -9.68-6.27, p < 0.01) compared with conventional treatment. Conclusion For the people with insomnia, anxiety and depression, the use of conventional treatment with the addition of 4-12 weeks of mindfulness treatment can significantly improve anxiety and depression symptoms of patients. This is a new diagnosis and treatment idea recommended for insomniacs with or without anxiety and depression symptoms. Due to the methodological defects in the included study and the limited sample size of this paper, more well-designed randomized controlled trials are needed for verification.
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Affiliation(s)
- Hangyu Li
- School of Life and Science, Beijing University of Chinese Medicine, Beijing, China
| | - Wanli Qin
- School of Life and Science, Beijing University of Chinese Medicine, Beijing, China
| | - Nannan Li
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Shixing Feng
- Department of Neurology, Dongfang Hospital Beijing University of Chinese Medicine, Beijing, China
| | - Junqi Wang
- Dongzhimen Hospital Beijing University of Chinese Medicine, Beijing, China
| | - Yuan Zhang
- School of Life and Science, Beijing University of Chinese Medicine, Beijing, China
| | - Tianyi Wang
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Chenlu Wang
- School of Life and Science, Beijing University of Chinese Medicine, Beijing, China
| | - Xuanyi Cai
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Wen Sun
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Yang Song
- School of Humanities, Beijing University of Chinese Medicine, Beijing, China
| | - Dongran Han
- School of Life and Science, Beijing University of Chinese Medicine, Beijing, China
- *Correspondence: Dongran Han, ; Yixing Liu,
| | - Yixing Liu
- School of Management, Beijing University of Chinese Medicine, Beijing, China
- *Correspondence: Dongran Han, ; Yixing Liu,
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Cheung JMY, Menczel Schrire Z, Aji M, Rahimi M, Salomon H, Doggett I, Glozier N, Bartlett DJ, Wong K, Grunstein RR, Gordon CJ. Embedding digital sleep health into primary care practice: A triangulation of perspectives from general practitioners, nurses, and pharmacists. Digit Health 2023; 9:20552076231180970. [PMID: 37377559 PMCID: PMC10291541 DOI: 10.1177/20552076231180970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
Introduction While digital health interventions (DHIs) can potentially address the unmet needs for sleep health services, little is known about their implementation in practice. The current study aimed to explore primary care health providers' attitudes and beliefs towards DHIs for sleep and implementation into practice. Methods A cross-sectional online survey was administered to Australian primary care health professionals: general practitioners (GPs), community nurses, and community pharmacists. Semi-structured interviews were conducted within a sub-sample of participants exploring their experiences with DHIs and perceived barriers/facilitators for embedding DHIs into primary care. Semi-structured interviews were thematically analysed using the framework approach to contextualise survey findings. Results Ninety-six surveys were returned (GPs = 36, nurses = 30, and pharmacists = 30) and 45 interviews conducted (GPs = 17, nurses = 14, and pharmacists = 14). From the survey, GPs were more likely to endorse familiarity (p = 0.009) and use (p < 0.001) of sleep DHIs in clinical practice than pharmacists and nurses. GPs were more interested in utilising the diagnostic features within a sleep DHI (p = 0.009) compared to other professionals. Thematic analysis of the interviews revealed three major themes, contextualised by profession: (1) Scope for DHIs in Current Practice, (2) Practice Gaps and Training Needs, and (3) Envisioning a Model of Care Using Sleep DHIs. While DHIs can potentially improve care, greater clarity of care pathways and reimbursement structures are needed for integration into practice. Conclusion Primary care health professionals highlighted the training, care pathway and financial models required to realise the potential for translating findings from efficacy studies for DHIs into primary care to optimise sleep health.
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Affiliation(s)
- Janet MY Cheung
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, Australia
| | - Zoe Menczel Schrire
- Healthy Brain Ageing Program, The University of Sydney School of Psychology, Sydney, Australia
| | - Melissa Aji
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Matthew Rahimi
- CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, Syndey, Australia
| | - Helena Salomon
- CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, Syndey, Australia
| | - Iliana Doggett
- CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, Syndey, Australia
| | - Nicholas Glozier
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, Australia
| | - Delwyn J. Bartlett
- CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, Syndey, Australia
| | - Keith Wong
- CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, Syndey, Australia
| | - Ronald R. Grunstein
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, Australia
| | - Christopher J. Gordon
- Faculty of Medicine and Health, Sydney Nursing School, The University of Sydney, Sydney, Australia
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Mojsa-Kaja J, Szklarczyk-Smolana K, Niedzielska-Andres E, Kurpińska A, Suraj-Prażmowska J, Walczak M. COVID-19-related social isolation and symptoms of depression and anxiety in young men in Poland: Does insomnia mediate the relationship? PLoS One 2023; 18:e0285797. [PMID: 37200255 DOI: 10.1371/journal.pone.0285797] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 04/29/2023] [Indexed: 05/20/2023] Open
Abstract
The need for physical distancing due to COVID-19 mitigation efforts forced prolonged social isolation, which may affect sleep and lead to mental health problems. Previous research has shown that young adults are particularly vulnerable to psychological stress caused by social isolation, the negative psychological impact of the pandemic, and greater frequency and severity of sleep problems. Therefore, the main goal of the present study was to examine whether insomnia could constitute a mediation mechanism that explains the relationship between social isolation experienced during the COVID-19 pandemic and mental health outcomes (depression and anxiety) reported up to 1.5 years later. The study was conducted among young (M±SD; 24.08±3.75) men (N = 1025) in Poland. Data were collected by means of self-report questionnaires, including The Social Isolation Index, The Athens Insomnia Scale, The State-Trait Anxiety Inventory (STAI-S) and Beck's Depression Inventory (BDI-II). The results show that insomnia mediates the relationships between social isolation and both anxiety and depression. The current findings emphasize the role of insomnia in the relationships between social isolation experienced during COVID-19 and negative emotional states. From a clinical perspective, the results suggest that implementing therapeutic components that address social isolation in insomnia treatment programs may prevent the development of depression and anxiety symptoms among young men.
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Affiliation(s)
- Justyna Mojsa-Kaja
- Department of Neurobiology and Neuropsychology, Institute of Applied Psychology, Jagiellonian University, Krakow, Poland
| | - Klaudia Szklarczyk-Smolana
- Department of Neurobiology and Neuropsychology, Institute of Applied Psychology, Jagiellonian University, Krakow, Poland
| | - Ewa Niedzielska-Andres
- Chair and Department of Toxicology, Jagiellonian University Medical College, Krakow, Poland
| | - Anna Kurpińska
- Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University, Krakow, Poland
| | | | - Maria Walczak
- Chair and Department of Toxicology, Jagiellonian University Medical College, Krakow, Poland
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Peerenboom N, Aryal S, Blankenship JM, Swibas T, Zhai Y, Clay I, Lyden K. The Case for the Patient-Centric Development of Novel Digital Sleep Assessment Tools in Major Depressive Disorder. Digit Biomark 2023; 7:124-131. [PMID: 37901365 PMCID: PMC10601929 DOI: 10.1159/000533523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/17/2023] [Indexed: 10/31/2023] Open
Abstract
Background Depression imposes a major burden on public health as the leading cause of disability worldwide. Sleep disturbance is a core symptom of depression that affects the vast majority of patients. Nonetheless, it is frequently not resolved by depression treatment and may even be worsened through some pharmaceutical interventions. Disturbed sleep negatively impact patients' quality of life, and persistent sleep disturbance increases the risk of recurrence, relapse, and even suicide. However, the development of novel treatments that might improve sleep problems is hindered by the lack of reliable low-burden objective measures that can adequately assess disturbed sleep in this population. Summary Developing improved digital measurement tools that are fit for use in clinical trials for major depressive disorder could promote the inclusion of sleep as a focus for treatment, clinical drug development, and research. This perspective piece explores the path toward the development of novel digital measures, reviews the existing evidence on the meaningfulness of sleep in depression, and summarizes existing methods of sleep assessments, including the use of digital health technologies. Key Messages Our objective was to make a clear call to action and path forward for the qualification of new digital outcome measures which would enable assessment of sleep disturbance as an aspect of health that truly matters to patients, promoting sleep as an important outcome for clinical development, and ultimately ensure that disturbed sleep will not remain the forgotten symptom of depression.
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Affiliation(s)
| | | | | | | | - Yaya Zhai
- Vivosense Inc., Newport Coast, CA, USA
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Abstract
PURPOSE OF REVIEW There is increasing interest in the connection between sleep disturbances and mood disorders. The purpose of this review is to summarize and evaluate current research on the role of sleep disturbance in the development of depression, as well as to describe recent advances in treatments that improve both sleep and depression symptoms. RECENT FINDINGS Relevant publications included in this review cover a wide range of topics related to sleep and depression. Data from large longitudinal studies suggest that insomnia and evening circadian preference are unique risk factors for depression. Depression treatment studies indicate poorer outcomes for those with comorbid sleep disturbances. A few recent trials of cognitive behavioral therapy for insomnia and triple chronotherapy in unipolar depression have shown promising results. SUMMARY Sleep disturbance is a modifiable risk factor in the development and maintenance of depression. In the context of current depression, although the data is mixed, some evidence suggests treating sleep disturbance can improve overall outcomes. Recent evidence also suggests that treating sleep disturbance may prevent the future depressive episodes.
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241
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Knapik JJ, Caldwell JA, Steelman RA, Trone DW, Farina EK, Lieberman HR. Short sleep duration is associated with a wide variety of medical conditions among United States military service members. Sleep Med 2023; 101:283-295. [PMID: 36470164 DOI: 10.1016/j.sleep.2022.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This cross-sectional study investigated self-reported sleep duration and its association with a comprehensive range of clinically-diagnosed medical condition categories (CDMCs), as well as the relationship between short sleep duration (≤6 h) and demographic/lifestyle factors, among United States military service members (SMs). METHODS A stratified random sample of SMs (n = 20,819) completed an online questionnaire on usual daily hours of sleep and demographic/lifestyle characteristics. CDMCs for a six-month period prior to questionnaire completion were obtained from a comprehensive military electronic medical surveillance system and grouped into 33 CDMCs covering both broad and specific medical conditions. Prevalence of CDMCs was compared among three sleep duration categories (≤4, 5-6 and ≥7 h). RESULTS SMs reported a mean ± standard deviation of 6.3 ± 1.4 h of sleep per day. After adjustment for demographic/lifestyle characteristics, shorter sleep duration was associated with higher odds of a medical condition in 25 of 33 CDMCs, with most (n = 20) demonstrating a dose-response relationship. The five CDMCs with the largest differences between ≤4 vs ≥ 7 h sleep were: diseases of the nervous system (odds ratio [OR] = 2.9, 95% confidence interval [95%CI] = 2.4-3.4), mental/behavioral diseases (OR = 2.7, 95%CI = 2.3-3.2), diseases of the musculoskeletal system (OR = 1.9, 95%CI = 1.6-2.1), diseases of the circulatory system (OR = 1.7, 95%CI = 1.3-2.2), and diseases of the digestive system (OR = 1.6, 95%CI = 1.2-2.0). Six hours of sleep or less was independently associated with older age, less formal education, race, Hispanic ethnicity, higher body mass index, smoking, and military service branch. CONCLUSIONS In this young, physically active population, reporting shorter sleep duration was associated with a higher risk of multiple CDMCs.
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Affiliation(s)
- Joseph J Knapik
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA.
| | - John A Caldwell
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA; Laulima Government Solutions, 5301 Buckystown Pike, STE 460, Frederick, MD, 21704, USA
| | - Ryan A Steelman
- U.S. Army Public Health Center, 8252 Blackhawk Rd, Aberdeen Proving Ground, MD, 21010, USA
| | - Daniel W Trone
- Naval Health Research Center, Building 329, Ryne Rd, San Diego, CA, 92152, USA
| | - Emily K Farina
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
| | - Harris R Lieberman
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
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242
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Yamamoto M, Lim CT, Huang H, Spottswood M, Huang H. Insomnia in primary care: Considerations for screening, assessment, and management. THE JOURNAL OF MEDICINE ACCESS 2023; 7:27550834231156727. [PMID: 36938324 PMCID: PMC10021100 DOI: 10.1177/27550834231156727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 01/25/2023] [Indexed: 03/17/2023]
Abstract
Insomnia, including insomnia disorder, is a common but often overlooked complaint in primary care settings. It is a risk factor for various medical and psychiatric diagnoses and is associated with substantial health care costs. While cognitive behavioral therapy for insomnia (CBT-I) is the first-line treatment for insomnia disorder, access to CBT-I is limited. This article provides a pragmatic approach to screening, assessment, and treatment of insomnia in the primary care setting, promoting a population health approach. The authors review the role of CBT-I, treatment of comorbid conditions, and pharmacologic recommendations in working with primary care patients with insomnia. In addition, the authors highlight the potential utility of technology in improving access to insomnia care.
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Affiliation(s)
- Mari Yamamoto
- Department of Family Medicine,
University of Washington School of Medicine, Seattle, WA, USA
- Mari Yamamoto, Department of Family
Medicine, University of Washington School of Medicine, Seattle, WA 98125, USA.
| | - Christopher T Lim
- Department of Psychiatry, Boston
Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Heather Huang
- Departments of Internal Medicine and
Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison,
WI, USA
| | - Margaret Spottswood
- Department of Psychiatry, University of
Vermont College of Medicine, Burlington, VT, USA
- Community Health Centers of Burlington,
Burlington, VT, USA
| | - Hsiang Huang
- Department of Psychiatry, Cambridge
Health Alliance, Cambridge, MA, USA
- Harvard Medical School, Boston, MA,
USA
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243
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Torres-Granados GI, Santana-Miranda R, Barrera-Medina A, Cruz-Cruz C, Jiménez-Correa U, Rosenthal L, López-Naranjo F, Martínez-Núñez JM. The economic costs of insomnia comorbid with depression and anxiety disorders: an observational study at a sleep clinic in Mexico. Sleep Biol Rhythms 2023; 21:23-31. [PMID: 35975183 PMCID: PMC9372938 DOI: 10.1007/s41105-022-00412-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/28/2022] [Indexed: 01/07/2023]
Abstract
Significant advances documenting the costs associated with insomnia have been achieved. However, those related to insomnia associated with mood disorders remain understudied, even though insomnia is more severe in the presence of comorbid conditions such as depression and anxiety. The aim of this study was to determine the direct and indirect costs of insomnia associated with depression and anxiety disorders (DAD) from the perspective of the patient in a private healthcare system. This was an observational study of chronic insomnia associated with DAD at a private Sleep Disorders Clinic in Mexico City between 2019 and 2020. Patients were followed for up to one year. Healthcare resource utilization data were collected through clinical records. Direct and indirect costs associated with insomnia treatment were estimated through micro-costing. The estimated economic burden was projected to 5 years adjusting for inflation and discounting future costs. A deterministic sensitivity analysis was performed. The median cost of the first year of insomnia treatment associated with DAD was US$3537.57 per patient. The work productivity loss represented the highest economic burden (63.84%) followed by direct medical costs (28.32%), and the direct non-medical costs (7.85%). The estimated annual economic burden for patients treated in the private healthcare system in Mexico was US$293 million. The costs of insomnia associated with DAD at a private clinic in México were found to be high. The burden of the costs faced by these patients is substantial relative to the median income of the population. The economic costs at an individual and societal levels are substantial. Supplementary Information The online version contains supplementary material available at 10.1007/s41105-022-00412-6.
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Affiliation(s)
- Gustavo Ivan Torres-Granados
- Department of Biological Systems, Universidad Autónoma Metropolitana, Campus Xochimilco, Calzada del Hueso 1100, Col. Villa Quietud, 04960 Coyoacán, Mexico City, Mexico
| | - Rafael Santana-Miranda
- Clinic of Sleep Disorders, Research Division, School of Medicine, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - Andrés Barrera-Medina
- Clinic of Sleep Disorders, Research Division, School of Medicine, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - Copytzy Cruz-Cruz
- Department of Biological Systems, Universidad Autónoma Metropolitana, Campus Xochimilco, Calzada del Hueso 1100, Col. Villa Quietud, 04960 Coyoacán, Mexico City, Mexico
| | - Ulises Jiménez-Correa
- Clinic of Sleep Disorders, Research Division, School of Medicine, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico ,Postgraduate Program in Behavioral Neuroscience, Psychology Faculty, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | | | - Francisco López-Naranjo
- Department of Biological Systems, Universidad Autónoma Metropolitana, Campus Xochimilco, Calzada del Hueso 1100, Col. Villa Quietud, 04960 Coyoacán, Mexico City, Mexico
| | - Juan Manuel Martínez-Núñez
- Department of Biological Systems, Universidad Autónoma Metropolitana, Campus Xochimilco, Calzada del Hueso 1100, Col. Villa Quietud, 04960 Coyoacán, Mexico City, Mexico
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Limongi F, Siviero P, Trevisan C, Noale M, Catalani F, Ceolin C, Conti S, di Rosa E, Perdixi E, Remelli F, Prinelli F, Maggi S. Changes in sleep quality and sleep disturbances in the general population from before to during the COVID-19 lockdown: A systematic review and meta-analysis. Front Psychiatry 2023; 14:1166815. [PMID: 37124253 PMCID: PMC10134452 DOI: 10.3389/fpsyt.2023.1166815] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 03/27/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction This systematic review and meta-analysis aims to explore changes in sleep quality and sleep disturbances in the general population from before to during the COVID-19 lockdown. Methods The protocol was registered in PROSPERO (CRD42021256378) and the PRISMA guidelines were followed. The major databases and gray literature were systematically searched from inception to 28/05/2021 to identify observational studies evaluating sleep changes in the general population during the lockdown with respect to the pre-lockdown period. A random effects meta-analysis was undertaken for studies reporting (a) the means of the Pittsburgh Sleep Quality Index (PSQI) global scores or the means of the sleep onset latency (SOL) times (minutes - min) before and during the lockdown, (b) the percentages of poor sleep quality before and during the lockdown, or (c) the percentages of changes in sleep quality. Subgroup analysis by risk of bias and measurement tool utilized was carried out. A narrative synthesis on sleep efficiency, sleep disturbances, insomnia and sleep medication consumption was also performed. Results Sixty-three studies were included. A decline in sleep quality, reflected in a pooled increase in the PSQI global scores (standardized mean difference (SMD) = 0.26; 95% CI 0.17-0.34) and in SOL (SMD = 0.38 min; 95% CI 0.30-0.45) were found. The percentage of individuals with poor sleep quality increased during the lockdown (pooled relative risk 1.4; 95% CI 1.24-1.61). Moreover, 57.3% (95% CI 50.01-61.55) of the individuals reported a change in sleep quality; in 37.3% (95% CI 34.27-40.39) of these, it was a worsening. The studies included in the systematic review reported a decrease in sleep efficiency and an increase in sleep disturbances, insomnia, and in sleep medication consumption. Discussion Timely interventions are warranted in view of the decline in sleep quality and the increase in sleep disturbances uncovered and their potentially negative impact on health. Further research and in particular longitudinal studies using validated instruments examining the long-term impact of the lockdown on sleep variables is needed. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021256378, identifier CRD42021256378.
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Affiliation(s)
- Federica Limongi
- Aging Branch, Neuroscience Institute, National Research Council, Padova, Italy
| | - Paola Siviero
- Aging Branch, Neuroscience Institute, National Research Council, Padova, Italy
- *Correspondence: Paola Siviero, ; orcid.org/0000-0001-6567-5808
| | - Caterina Trevisan
- Aging Branch, Neuroscience Institute, National Research Council, Padova, Italy
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Marianna Noale
- Aging Branch, Neuroscience Institute, National Research Council, Padova, Italy
| | - Filippo Catalani
- Geriatric Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Chiara Ceolin
- Geriatric Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Silvia Conti
- Unit of Behavioral Neurology and Dementia Research Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Elisa di Rosa
- Department of General Psychology, University of Padova, Padova, Italy
| | - Elena Perdixi
- Unit of Behavioral Neurology and Dementia Research Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Francesca Remelli
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Federica Prinelli
- Epidemiology Unit, Institute of Biomedical Technologies, National Research Council, Milano, Italy
| | - Stefania Maggi
- Aging Branch, Neuroscience Institute, National Research Council, Padova, Italy
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Hoffart A, Burger J, Johnson SU, Ebrahimi OV. Daily dynamics and mechanisms of anxious symptomatology in the general population: A network study during the COVID-19 pandemic. J Anxiety Disord 2023; 93:102658. [PMID: 36455414 DOI: 10.1016/j.janxdis.2022.102658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/15/2022] [Accepted: 11/22/2022] [Indexed: 11/24/2022]
Abstract
To understand the interplay between anxiety symptoms and their maintaining psychological processes in the population, an analysis of longitudinal within-person relationships is required. A sample of 1706 individuals completed daily measures during a 40-day period with strict mitigation protocols. Data of 1368 individuals who completed at least 30 assessments were analyzed with the multilevel vector autoregressive (mlVAR) model. This model estimates a temporal, a contemporaneous, and a between-person network. Uncontrollability of worry, generalized worry, fear of being infected, fear of significant others being infected, and threat monitoring had the highest outstrength within the temporal network, indicating that daily fluctuations in these components were the most predictive of next-day fluctuations in other components. Of specific connections, both fear of self and fear of close others being infected predicted generalized worry and threat monitoring. In turn, generalized worry and threat monitoring engaged in several positive feedback loops with other anxiety symptoms and processes. Also, intolerance of uncertainty was predictive of other components. The findings align with the mechanisms both in the metacognitive therapy (MCT) model and in the intolerance of uncertainty model of generalized anxiety disorder (GAD).
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Affiliation(s)
- Asle Hoffart
- Research Institute, Modum Bad Psychiatric Hospital, Postboks 33, N-3370 Vikersund, Norway; Department of Psychology, University of Oslo, Forskningsveien 3 A, 0373 Oslo, Norway.
| | - Julian Burger
- Department of Psychological Methods, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WT Amsterdam, the Netherlands; Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands; University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
| | - Sverre Urnes Johnson
- Research Institute, Modum Bad Psychiatric Hospital, Postboks 33, N-3370 Vikersund, Norway; Department of Psychology, University of Oslo, Forskningsveien 3 A, 0373 Oslo, Norway.
| | - Omid V Ebrahimi
- Research Institute, Modum Bad Psychiatric Hospital, Postboks 33, N-3370 Vikersund, Norway; Department of Psychology, University of Oslo, Forskningsveien 3 A, 0373 Oslo, Norway.
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Sollenberger NA, Sequeira S, Forbes EE, Siegle GJ, Silk JS, Ladouceur CD, Ryan ND, Dahl RE, Mattfeld AT, McMakin DL. More time awake after sleep onset is linked to reduced ventral striatum response to rewards in youth with anxiety. J Child Psychol Psychiatry 2023; 64:83-90. [PMID: 35817759 PMCID: PMC9771920 DOI: 10.1111/jcpp.13669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Poor sleep and anxiety disorders are highly comorbid in youth, and each predicts altered ventral striatum (VS) response to rewards, which may impact mental health risk. Contrasting evidence suggests previously reported negative associations between sleep health and VS response may be stronger or weaker in youth with anxiety, indicating sensitivity to win/loss information or blunted reward processing, respectively. We cross-sectionally examined the role of sleep in VS response to rewards among youth with anxiety versus a no-psychiatric-diagnosis comparison (ND) group. We expected a group*sleep interaction on VS response to rewards but did not hypothesize directionality. METHODS As part of the pretreatment battery for a randomized clinical trial, 74 youth with anxiety and 31 ND youth (ages 9-14 years; n = 55 female) completed a monetary reward task during fMRI. During the same pretreatment window, actigraphy and diary-estimated sleep were collected over 5 days, and participants and their parents each reported participants' total sleep problems. We examined group*sleep interactions on VS response to monetary rewards versus losses via three mixed linear models corresponding to actigraphy, diary, and questionnaires, respectively. RESULTS Each model indicated group*sleep interactions on VS response to rewards. Actigraphy and diary-estimated time awake after sleep onset predicted reduced VS response in youth with anxiety but not ND youth. Parent-reported sleep problems similarly interacted with group, but simple slopes were nonsignificant. CONCLUSIONS Wake after sleep onset was associated with blunted reward response in youth with anxiety. These data suggest a potential pathway through which sleep could contribute to perturbed reward function and reward-related psychopathology (e.g., depression) in youth with anxiety.
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Affiliation(s)
- Nathan A. Sollenberger
- Psychology Department, Florida International University, Miami, Florida
- Center for Children and Families, Florida International University, Miami, Florida
| | | | | | | | | | | | - Neal D. Ryan
- Department of Psychiatry, University of Pittsburgh, PA
| | - Ronald E. Dahl
- School of Public Health, University of California, Berkeley, CA
| | - Aaron T. Mattfeld
- Psychology Department, Florida International University, Miami, Florida
- Center for Children and Families, Florida International University, Miami, Florida
| | - Dana L. McMakin
- Psychology Department, Florida International University, Miami, Florida
- Center for Children and Families, Florida International University, Miami, Florida
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247
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Bei B, Pinnington DM, Quin N, Shen L, Blumfield M, Wiley JF, Drummond SPA, Newman LK, Manber R. Improving perinatal sleep via a scalable cognitive behavioural intervention: findings from a randomised controlled trial from pregnancy to 2 years postpartum. Psychol Med 2023; 53:513-523. [PMID: 34231450 PMCID: PMC8738775 DOI: 10.1017/s0033291721001860] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Sleep disturbance is common in gestational parents during pregnancy and postpartum periods. This study evaluated the feasibility and efficacy of a scalable cognitive behavioural therapy (CBT) sleep intervention tailored for these periods. METHODS This is a two-arm, parallel-group, single-blind, superiority randomised controlled trial. Nulliparous females without severe medical/psychiatric conditions were randomised 1:1 to CBT or attention- and time-matched control. All participants received a 1 h telephone session and automated multimedia emails from the third trimester until 6 months postpartum. Outcomes were assessed with validated instruments at gestation weeks 30 (baseline) and 35 (pregnancy endpoint), and postpartum months 1.5, 3, 6 (postpartum endpoint), 12 and 24. RESULTS In total, 163 eligible participants (age M ± s.d. = 33.35 ± 3.42) were randomised. The CBT intervention was well accepted, with no reported adverse effect. Intention-to-treat analyses showed that compared to control, receiving CBT was associated with lower insomnia severity and sleep disturbance (two primary outcomes), and lower sleep-related impairment at the pregnancy endpoint (p values ⩽ 0.001), as well as at 24 months postpartum (p ranges 0.012-0.052). Group differences across the first postpartum year were non-significant. Participants with elevated insomnia symptoms at baseline benefitted substantially more from CBT (v. control), including having significantly lower insomnia symptoms throughout the first postpartum year. Group differences in symptoms of depression or anxiety were non-significant. CONCLUSIONS A scalable CBT sleep intervention is efficacious in buffering against sleep disturbance during pregnancy and benefitted sleep at 2-year postpartum, especially for individuals with insomnia symptoms during pregnancy. The intervention holds promise for implementation into routine perinatal care.
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Affiliation(s)
- Bei Bei
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
- Centre for Women’s Mental Health, Royal Women’s Hospital, Victoria, Australia
- Department of Psychiatry, University of Melbourne, Victoria, Australia
| | - Donna M. Pinnington
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
- Centre for Women’s Mental Health, Royal Women’s Hospital, Victoria, Australia
- Department of Psychiatry, University of Melbourne, Victoria, Australia
| | - Nina Quin
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
- Centre for Women’s Mental Health, Royal Women’s Hospital, Victoria, Australia
- Department of Psychiatry, University of Melbourne, Victoria, Australia
| | - Lin Shen
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Michelle Blumfield
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Victoria, Australia
| | - Joshua F. Wiley
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Sean P. A. Drummond
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Louise K. Newman
- Department of Psychiatry, University of Melbourne, Victoria, Australia
| | - Rachel Manber
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
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248
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Dennis CL, Birken CS, Brennenstuhl S, Wrottesley S, Marini F, Bell RC, Tremblay MS, Prioreschi A. Describing 24-hour movement behaviours among preconception and recently pregnant Canadian parents: who do we need to target? Behav Med 2023; 49:83-95. [PMID: 34809524 DOI: 10.1080/08964289.2021.1987854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This study aimed to describe adherence to 24-hour movement guidelines and determine factors associated with meeting guidelines in pregnancy planning and recently postpartum parents. A survey of preconception care attitudes and beliefs was conducted in Canadian adults who were pregnancy planning or ≤5 years postpartum. The Global Physical Activity Questionnaire was used to evaluate physical activity and sedentary time. Respondents reported the number of hours spent sleeping and using a screen per day. Multiple logistic regressions were run to determine factors (sociodemographic and health related) associated with meeting each individual movement guideline and number of guidelines met. 1080 females and 224 males provided survey data. 54.0% (n = 654) of the sample met the physical activity guideline, with no difference between females and males. More than 78.4% (n = 909) met the sedentary behavior guideline, 56.4% (n = 679) met the sleep guideline, and 15.4% (n = 187) met the screen time guideline. Only 5.0% (n = 60) of the sample met all four guidelines. Higher odds of meeting more guidelines were associated with parity and perceived health. Lower odds of meeting more guidelines were associated with obesity and overweight; and with depression. Most parents and parents-to-be are not meeting 24-hour movement guidelines. Interventions should focus on optimizing movement behaviors in the peri-partum period, while focusing on mental health, obesity, and general wellbeing.
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Affiliation(s)
- Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Catherine S Birken
- Faculty of Medicine, University of Toronto, Toronto, Canada.,Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Sarah Brennenstuhl
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Stephanie Wrottesley
- SAMRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Flavia Marini
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Rhonda C Bell
- Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.,Department of Pediatrics, University of Ottawa, Ottawa, Canada
| | - Alessandra Prioreschi
- SAMRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
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249
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Guo H, Zhou J, Chen H, Cao X. Prevalence and associated factors of poor sleep quality among Chinese retirees: A multicenter cross-sectional study. J Affect Disord 2023; 320:42-47. [PMID: 36179777 DOI: 10.1016/j.jad.2022.09.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/19/2022] [Accepted: 09/26/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Sleep problems are common among older adults worldwide. The present study aims to determine the prevalence of poor sleep quality and its independent factors among retired people in health check-ups population in China. METHOD In this multicenter, cross-sectional survey in 2017, a group of retired people was invited to participate in an online survey of health status, and their data, including socio-demographic information, lifestyle, and medical characteristics, were recorded. Binary logistic regression was used to analyze the independent factors responsible for poor sleep quality. RESULTS Data from 17,408 responders who met the inclusion criteria were analyzed; among them, 53.04 % (95 % CI = 52 %-54 %) reported poor sleep quality. Binary logistic regression showed that poor sleep quality was associated with a number of factors, including being female (OR = 1.42, 95 % CI = 1.32-1.53), being single (OR = 1.35, 95 % CI = 1.18-1.54), non-smoker (OR = 1.12, 95 % CI = 1.03-1.22), physical inactivity (OR = 1.14, 95 % CI = 1.05-1.23), poor self-rated health status (OR = 1.69, 95 % CI = 1.43-2.00), long-term medication use (OR = 1.05, 95 % CI = 1.07-1.23), chronic pain (OR = 1.33, 95 % CI = 1.22-1.45), comorbidity (OR = 1.16, 95 % CI = 1.07-1.25), and depressive symptoms (mild depression: OR = 2.14, 95 % CI = 1.96-2.34; moderate depression: OR = 4.00, 95 % CI = 3.49-4.58, moderately severe depression: OR = 4.15, 95 % CI = 3.47-4.97, severe depression: OR = 4.27, 95 % CI = 2.93-6.22); while age (OR = 0.99, 95 % CI = 0.99-1.00) was negatively related to poor sleep quality. CONCLUSION The prevalence of poor sleep quality in the studied population is relatively high (53.04 %). Sleep problems are common among Chinese retirees, especially older females, and have a great impact on their quality of life. People living with depression, chronic diseases, and chronic pain were at a higher risk of developing sleep disorders. Therefore, it is critical to formulate effective management strategies for Chinese retirees with poor sleep quality in the context of healthy aging.
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Affiliation(s)
- Huijuan Guo
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan Province 410011, China
| | - Jiansong Zhou
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan Province 410011, China
| | - Hui Chen
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan Province 410011, China
| | - Xia Cao
- Health Management Center, Hunan Chronic Disease Health Management Medical Research Center, The Third Xiangya Hospital, Central South University, Hunan Province 410013, China.
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250
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Enkvist H, Öhman A, Pitkänen M, Nordin M, Nordin S. Stress, mental ill-health and functional somatic syndromes in incident and chronic sleep disturbance in a general adult population. Health Psychol Behav Med 2023; 11:2184372. [PMID: 36925761 PMCID: PMC10013422 DOI: 10.1080/21642850.2023.2184372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Objective Sleep disturbance may constitute health problems for the afflicted individual, but documentation of its chronicity is sparse. The objective was to investigate the extent to which incident and chronic sleep disturbance are associated with stress, mental ill-health and functional somatic syndromes. Design This was a prospective, longitudinal study with 3-year interval between two assessments (T1 and T2), with a population-based sample forming groups with incident sleep disturbance (disturbance only at T2; n = 303), chronic sleep disturbance (disturbance at T1 and T2; n = 343) and without sleep disturbance (neither at T1 nor T2; n = 1421). Questionnaire data were used at T2 of physician-based diagnosis of anxiety disorder, depression, exhaustion syndrome, and functional somatic syndrome as well as of degree of stress, burnout, anxiety and depression. Results Significant associations were found between chronic sleep disturbance and all four diagnoses (odds ratios = 1.74-2.19), whereas incident sleep disturbance was associated only with exhaustion syndrome and depression (odds ratios = 2.18-2.37). Degree of stress, burnout, anxiety and depression increased significantly from the referents to incident and chronic sleep disturbance, in that order (eta2 = 0.083-0.166), except for the two latter groups not differing in depression. Conclusion The findings imply that healthcare professionals should be observant regarding various conditions of, apart from stress, mental ill-health and functional somatic syndromes in patients who present themselves with sleep disturbance, and in particular chronic disturbance.
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Affiliation(s)
| | - Albin Öhman
- Department of Psychology, Umeå University, Umeå, Sweden
| | | | - Maria Nordin
- Department of Psychology, Umeå University, Umeå, Sweden
| | - Steven Nordin
- Department of Psychology, Umeå University, Umeå, Sweden
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