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Dong B, Xue R, Li J, Ling S, Xing W, Liu Z, Yuan X, Pan J, Du R, Shen X, Zhang J, Zhang Y, Li Y, Zhong G. Ckip-1 3'UTR alleviates prolonged sleep deprivation induced cardiac dysfunction by activating CaMKK2/AMPK/cTNI pathway. MOLECULAR BIOMEDICINE 2024; 5:23. [PMID: 38871861 DOI: 10.1186/s43556-024-00186-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 05/14/2024] [Indexed: 06/15/2024] Open
Abstract
Sleep deprivation (SD) has emerged as a critical concern impacting human health, leading to significant damage to the cardiovascular system. However, the underlying mechanisms are still unclear, and the development of targeted drugs is lagging. Here, we used mice to explore the effects of prolonged SD on cardiac structure and function. Echocardiography analysis revealed that cardiac function was significantly decreased in mice after five weeks of SD. Real-time quantitative PCR (RT-q-PCR) and Masson staining analysis showed that cardiac remodeling marker gene Anp (atrial natriuretic peptide) and fibrosis were increased, Elisa assay of serum showed that the levels of creatine kinase (CK), creatine kinase-MB (CK-MB), ANP, brain natriuretic peptide (BNP) and cardiac troponin T (cTn-T) were increased after SD, suggesting that cardiac remodeling and injury occurred. Transcript sequencing analysis indicated that genes involved in the regulation of calcium signaling pathway, dilated cardiomyopathy, and cardiac muscle contraction were changed after SD. Accordingly, Western blotting analysis demonstrated that the cardiac-contraction associated CaMKK2/AMPK/cTNI pathway was inhibited. Since our preliminary research has confirmed the vital role of Casein Kinase-2 -Interacting Protein-1 (CKIP-1, also known as PLEKHO1) in cardiac remodeling regulation. Here, we found the levels of the 3' untranslated region of Ckip-1 (Ckip-1 3'UTR) decreased, while the coding sequence of Ckip-1 (Ckip-1 CDS) remained unchanged after SD. Significantly, adenovirus-mediated overexpression of Ckip-1 3'UTR alleviated SD-induced cardiac dysfunction and remodeling by activating CaMKK2/AMPK/cTNI pathway, which proposed the therapeutic potential of Ckip-1 3'UTR in treating SD-induced heart disease.
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Affiliation(s)
- Beilei Dong
- Nanjing University of Chinese Medicine, Nanjing, 210023, China
- National Key Laboratory of Space Medicine, China Astronaut Research and Training Center, Beijing, 100094, China
- Beijing Institute of Pharmacology and Toxicology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing, 100850, China
| | - Rui Xue
- Beijing Institute of Pharmacology and Toxicology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing, 100850, China.
| | - Jianwei Li
- National Key Laboratory of Space Medicine, China Astronaut Research and Training Center, Beijing, 100094, China
| | - Shukuan Ling
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou, Zhejiang, 325041, China
| | - Wenjuan Xing
- National Key Laboratory of Space Medicine, China Astronaut Research and Training Center, Beijing, 100094, China
| | - Zizhong Liu
- National Key Laboratory of Space Medicine, China Astronaut Research and Training Center, Beijing, 100094, China
| | - Xinxin Yuan
- National Key Laboratory of Space Medicine, China Astronaut Research and Training Center, Beijing, 100094, China
| | - Junjie Pan
- National Key Laboratory of Space Medicine, China Astronaut Research and Training Center, Beijing, 100094, China
| | - Ruikai Du
- National Key Laboratory of Space Medicine, China Astronaut Research and Training Center, Beijing, 100094, China
| | - Xinming Shen
- Nanjing University of Chinese Medicine, Nanjing, 210023, China
- Beijing Institute of Pharmacology and Toxicology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing, 100850, China
| | - Jingwen Zhang
- Beijing Institute of Pharmacology and Toxicology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing, 100850, China
| | - Youzhi Zhang
- Beijing Institute of Pharmacology and Toxicology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing, 100850, China.
| | - Yingxian Li
- National Key Laboratory of Space Medicine, China Astronaut Research and Training Center, Beijing, 100094, China.
| | - Guohui Zhong
- National Key Laboratory of Space Medicine, China Astronaut Research and Training Center, Beijing, 100094, China.
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Beyer JL, Dix E, Husain-Krautter S, Kyomen HH. Enhancing Brain Health and Well-Being in Older Adults: Innovations in Lifestyle Interventions. Curr Psychiatry Rep 2024:10.1007/s11920-024-01513-4. [PMID: 38842654 DOI: 10.1007/s11920-024-01513-4] [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] [Accepted: 05/27/2024] [Indexed: 06/07/2024]
Abstract
PURPOSE OF REVIEW This article will provide clinicians with guidance on helping older adult patients make lifestyle changes to enhance brain health and well-being. RECENT FINDINGS Evidence suggests that physical activity might be helpful in improving cognitive functioning. The data on the benefits of cognitive activity is inconsistent and not as robust. The MediDiet, DASH, and MIND diets have been associated with better cognitive health. Sleep hygiene and cognitive behavioral therapies are considered first line evidence-based treatments for insomnia and the maintenance of healthy sleep patterns. Mindfulness based interventions have been shown to reduce anxiety, depression, and stress, and can help some older adults manage pain more constructively. Evidence-based information regarding the four topics of exercise, nutrition, sleep, and mindfulness is reviewed, so that clinicians may be better able to optimize care for their older adult patients.
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Affiliation(s)
- John L Beyer
- Duke University School of Medicine, Durham, NC, 27710, USA
| | - Ebony Dix
- Yale School of Medicine, New Haven, CT, 06510, USA
| | | | - Helen H Kyomen
- Boston University Chobanian and Avedisian School of Medicine, Tufts University School of Medicine and Harvard Medical School, Boston, MA, 02115, USA.
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Xing M, Zhang L, Li J, Li Z, Yu Q, Li W. Development and validation of a novel sleep health score in the sleep heart health study. Eur J Intern Med 2024:S0953-6205(24)00189-4. [PMID: 38729786 DOI: 10.1016/j.ejim.2024.05.002] [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: 11/11/2023] [Revised: 04/14/2024] [Accepted: 05/03/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND There is a lack of consensus in evaluating multidimensional sleep health, especially concerning its implication for mortality. A validated multidimensional sleep health score is the foundation of effective interventions. METHODS We obtained data from 5706 participants in the Sleep Heart Health Study. First, random forest-recursive feature elimination algorithm was used to select potential predictive variables. Second, a sleep composite score was developed based on the regression coefficients from a Cox proportional hazards model evaluating the associations between selected sleep-related variables and mortality. Last, we validated the score by constructing Cox proportional hazards models to assess its association with mortality. RESULTS The mean age of participants was 63.2 years old, and 47.6% (2715/5706) were male. Six sleep variables, including average oxygen saturation (%), spindle density (C3), sleep efficiency (%), spindle density (C4), percentage of fast spindles (%) and percentage of rapid eye movement (%) were selected to construct this multidimensional sleep health score. The average sleep composite score in participants was 6.8 of 22 (lower is better). Participants with a one-point increase in sleep composite score had an 10% higher risk of death (hazard ratio = 1.10, 95% confidence interval: 1.08-1.12). CONCLUSIONS This study constructed and validated a novel multidimensional sleep health score to better predict death based on sleep, with significant associations between sleep composite score and all-cause mortality. Integrating questionnaire information and sleep microstructures, our sleep composite score is more appropriately applied for mortality risk stratification.
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Affiliation(s)
- Muqi Xing
- Department of Big Data in Health Science, School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Lingzhi Zhang
- Department of Big Data in Health Science, School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jiahui Li
- Department of Big Data in Health Science, School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Zihan Li
- Department of Big Data in Health Science, School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Qi Yu
- Department of Big Data in Health Science, School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Wenyuan Li
- Department of Big Data in Health Science, School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
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Wiechens B, Backhaus SJ, Oestreicher D, Beutner D, Schliephake H, Meyer-Marcotty P, Brockmeyer P. Assessment of oropharyngeal respiratory volume and sleep apnoea scores using peripheral arterial tonometry may improve diagnosis and treatment planning of combined dysgnathia therapy approaches. J Oral Rehabil 2024; 51:733-742. [PMID: 38100245 DOI: 10.1111/joor.13641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/16/2023] [Accepted: 12/03/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND Increased daytime sleepiness is a frequently reported symptom in patients with pronounced dysgnathia. OBJECTIVES This study investigated possible correlations using home peripheral arterial tonometry (PAT) and oropharyngeal airway volume determination in patients with dysgnathia and daytime sleepiness. METHODS Twenty patients (13 male, median age 27.6 ± 6.8 years) with abnormal sleep history and 10 skeletal neutral configured controls (6 male, median age 29.5 ± 4.2 years) with normal sleep history were examined. Patients and controls were evaluated for apnoea-hypopnoea index (AHI), respiratory disturbance index (RDI), oxygen desaturation index (ODI), snoring volume (dB), total sleep time (TST) and REM-percentage (REM). Airway volumetry was measured via CBCT. Individual user experience for PAT was assessed using the User Experience Questionnaire (UEQ). RESULTS Patients had significantly higher respiratory scores than controls. AHI increased 4.6-fold (p = .006), RDI 2.5-fold (p = .008) and ODI 6.4-fold (p < .001). Oropharyngeal volumes showed a 30% decrease (p = .003). dB, TST and REM showed no significant differences. AHI (r = -.51; p = .005), ODI (r = -.60; p < .001) and RDI (r = -.45; p = .016) correlated negatively with pharyngeal volume. Wits appraisal correlated negatively with oropharyngeal volume (r = -.47; p = .010) and positively with AHI (r = .41; p = .03) and ODI (r = .49; p = .007). dB and TST (r = -.49; p = .008) and REM and RDI (r = -.43; p = .02) correlated negatively. UEQ-KPI (2.17 ± 0.24) confirmed excellent usability of PAT. CONCLUSION Patients with mandibular retrognathia and abnormal sleep history showed significantly higher respiratory indices and smaller oropharyngeal volumes than neutrally configured controls. The dygnathia severity directly influenced the risk of obstructive sleep apnoea.
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Affiliation(s)
- Bernhard Wiechens
- Department of Orthodontics, University Medical Center Goettingen, Goettingen, Germany
| | - Sören J Backhaus
- Department of Cardiology and Pneumology University Medical Center Goettingen, Goettingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Goettingen, Goettingen, Germany
| | - David Oestreicher
- Department of Otorhinolaryngology, University Medical Center Goettingen, Goettingen, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, University Medical Center Goettingen, Goettingen, Germany
| | - Henning Schliephake
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, Goettingen, Germany
| | | | - Phillipp Brockmeyer
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, Goettingen, Germany
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Ibrahim A, Cesari M, Heidbreder A, Defrancesco M, Brandauer E, Seppi K, Kiechl S, Högl B, Stefani A. Sleep features and long-term incident neurodegeneration: a polysomnographic study. Sleep 2024; 47:zsad304. [PMID: 38001022 PMCID: PMC10925953 DOI: 10.1093/sleep/zsad304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
STUDY OBJECTIVES Sleep is altered early in neurodegenerative diseases (NDDs) and may contribute to neurodegeneration. Long-term, large sample-size studies assessing NDDs association with objective sleep measures are scant. We aimed to investigate whether video-polysomnography (v-PSG)-based sleep features are associated with long-term NDDs incidence. METHODS Retrospective cohort study of patients referred 2004-2007 to the Sleep Disorders Unit, Neurology, Medical University Innsbruck, Austria. All patients ≥ 18 years undergoing v-PSG and without NDDs at baseline or within 5 years were included. Main outcome was NDDs diagnosis ≥5 years after v-PSG. RESULTS Of 1454 patients assessed for eligibility, 999 (68.7%) met inclusion criteria (68.3% men; median age 54.9 (IQR 33.9-62.7) years). Seventy-five patients (7.5%) developed NDDs and 924 (92.5%) remained disease-free after a median of 12.8 (IQR 9.9-14.6) years. After adjusting for demographic, sleep, and clinical covariates, a one-percentage decrease in sleep efficiency, N3-, or rapid-eye-movement (REM)-sleep was associated with 1.9%, 6.5%, or 5.2% increased risk of incident NDDs (HR 1.019, 1.065, and 1.052). One-percentage decrease in wake within sleep period time represented a 2.2% reduced risk of incident NDDs (HR 0.978). Random-forest analysis identified wake, followed by N3 and REM-sleep percentages, as the most important feature associated with NDDs diagnosis. Additionally, multiple sleep features combination improved discrimination of incident NDDs compared to individual sleep stages (concordance-index 0.72). CONCLUSIONS These findings support contribution of sleep changes to NDDs pathogenesis and provide insights into the temporal window during which these differences are detectable, pointing to sleep as early NDDs marker and potential target of neuroprotective strategies.
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Affiliation(s)
- Abubaker Ibrahim
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Matteo Cesari
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Anna Heidbreder
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Michaela Defrancesco
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | - Elisabeth Brandauer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Klaus Seppi
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Stefan Kiechl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Birgit Högl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ambra Stefani
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
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Yan B, Gao Y, Zhang Z, Shi T, Chen Q. Nocturnal oxygen saturation is associated with all-cause mortality: a community-based study. J Clin Sleep Med 2024; 20:229-235. [PMID: 37772691 PMCID: PMC10835782 DOI: 10.5664/jcsm.10838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 09/30/2023]
Abstract
STUDY OBJECTIVES Observational studies have demonstrated the association between the single-point measurement of oxygen saturation (SpO2) level and mortality in the general population. This study aimed to evaluate whether nocturnal SpO2 level could predict all-cause mortality in a community-based population. METHODS The study samples were obtained from the Sleep Heart Health Study, which included 2,280 men and 2,606 women (mean age, 63.8 ± 11.1 years). A pulse oximeter based on overnight in-home polysomnography was used to monitor SpO2 levels during total sleep time (SpO2-TOTAL). Multivariable Cox proportional hazards analysis was performed to examine the association between nocturnal SpO2 and all-cause mortality. RESULTS During the follow-up period of 10.7 ± 3.0 years, 1,110 (22.7%) people died. After adjusting for confounding factors, multivariable Cox regression analysis showed that the average SpO2-TOTAL (hazard ratio [HR] 0.93; 95% confidence interval [CI] 0.90-0.96, P < .001) was associated with all-cause mortality. These findings remained stable in individuals with low and high apnea-hypopnea index levels. Additionally, maximum SpO2-TOTAL (HR, 0.91; 95% CI, 0.87-0.96; P = .001) and minimum SpO2-TOTAL (HR, 0.98; 95% CI, 0.97-0.99; P = .001) could predict all-cause mortality. A significant association between nocturnal hypoxemia and all-cause mortality was also observed. CONCLUSIONS Our findings highlight the importance of monitoring nocturnal SpO2 level and improving hypoxemia in the general populations. CITATION Yan B, Gao Y, Zhang Z, Shi T, Chen Q. Nocturnal oxygen saturation is associated with all-cause mortality: a community-based study. J Clin Sleep Med. 2024;20(2):229-235.
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Affiliation(s)
- Bin Yan
- Department of Clinical Research Center, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Yang Gao
- Department of Cardiovascular Surgery, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Zhanqin Zhang
- Department of Anesthesiology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Tao Shi
- Department of Cardiovascular Surgery, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Qiang Chen
- Department of Cardiovascular Surgery, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
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Zimberg IZ, Ftouni S, Magee M, Ferguson SA, Lockley SW, Rajaratnam SMW, Sletten TL. Circadian adaptation to night shift work is associated with higher REM sleep duration. Sleep Health 2024; 10:S112-S120. [PMID: 37914630 DOI: 10.1016/j.sleh.2023.08.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/31/2023] [Accepted: 08/31/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE To investigate the influence of the degree of circadian adaptation to night work on sleep architecture following night shift. METHODS Thirty four night workers (11 females; 33.8 ± 10.1years) completed a simulated night shift following 2-7 typical night shifts. Participants completed a laboratory-based simulated night shift (21:00-07:00 hours), followed by a recovery sleep opportunity (∼09:00-17:00 hours), recorded using polysomnography. Urinary 6-sulphatoxymelatonin (aMT6s) rhythm acrophase was used as a marker of circadian phase. Sleep duration and architecture were compared between individuals with aMT6s acrophase before (unadapted group, n = 22) or after (partially adapted group, n = 12) bedtime. RESULTS Bedtime occurred on average 2.16 hours before aMT6s acrophase in the partially adapted group and 3.91 hours after acrophase in the unadapted group. The partially adapted group had more sleep during the week before the simulated night than the unadapted group (6.47 ± 1.02 vs. 5.26 ± 1.48 hours, p = .02). After the simulated night shift, both groups had similar total sleep time (partially adapted: 6.68 ± 0.80 hours, unadapted: 6.63 ± 0.88 hours, p > .05). The partially adapted group had longer total rapid eye movement sleep duration than the unadapted group (106.79 ± 32.05 minutes vs. 77.90 ± 28.86 minutes, p = .01). After 5-hours, rapid eye movement sleep accumulation was higher in the partially adapted compared to the unadapted group (p = .02). Sleep latency and other stages were not affected by circadian adaptation. DISCUSSION Partial circadian adaptation to night shift was associated with longer rapid eye movement sleep duration during daytime sleep, highlighting the influence of entrainment between the sleep-wake cycle and the circadian pacemaker in night workers. The findings have important implications for sleep and subsequent alertness associated with shift work.
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Affiliation(s)
- Iona Z Zimberg
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Suzanne Ftouni
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Michelle Magee
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Sally A Ferguson
- Central Queensland University, Appleton Institute, Goodwood, South Australia, Australia
| | - Steven W Lockley
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Shantha M W Rajaratnam
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Tracey L Sletten
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia.
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Sun H, Adra N, Ayub MA, Ganglberger W, Ye E, Fernandes M, Paixao L, Fan Z, Gupta A, Ghanta M, Moura Junior VF, Rosand J, Westover MB, Thomas RJ. Assessing Risk of Health Outcomes From Brain Activity in Sleep: A Retrospective Cohort Study. Neurol Clin Pract 2024; 14:e200225. [PMID: 38173542 PMCID: PMC10759032 DOI: 10.1212/cpj.0000000000200225] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 10/04/2023] [Indexed: 01/05/2024]
Abstract
Background and Objectives Patterns of electrical activity in the brain (EEG) during sleep are sensitive to various health conditions even at subclinical stages. The objective of this study was to estimate sleep EEG-predicted incidence of future neurologic, cardiovascular, psychiatric, and mortality outcomes. Methods This is a retrospective cohort study with 2 data sets. The Massachusetts General Hospital (MGH) sleep data set is a clinic-based cohort, used for model development. The Sleep Heart Health Study (SHHS) is a community-based cohort, used as the external validation cohort. Exposure is good, average, or poor sleep defined by quartiles of sleep EEG-predicted risk. The outcomes include ischemic stroke, intracranial hemorrhage, mild cognitive impairment, dementia, atrial fibrillation, myocardial infarction, type 2 diabetes, hypertension, bipolar disorder, depression, and mortality. Diagnoses were based on diagnosis codes, brain imaging reports, medications, cognitive scores, and hospital records. We used the Cox survival model with death as the competing risk. Results There were 8673 participants from MGH and 5650 from SHHS. For all outcomes, the model-predicted 10-year risk was within the 95% confidence interval of the ground truth, indicating good prediction performance. When comparing participants with poor, average, and good sleep, except for atrial fibrillation, all other 10-year risk ratios were significant. The model-predicted 10-year risk ratio closely matched the observed event rate in the external validation cohort. Discussion The incidence of health outcomes can be predicted by brain activity during sleep. The findings strengthen the concept of sleep as an accessible biological window into unfavorable brain and general health outcomes.
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Affiliation(s)
- Haoqi Sun
- Department of Neurology (HS, NA, MAA, WG, EY, MF, LP, ZF, AG, MG, VFMJ, JR, MBW), Massachusetts General Hospital; Henry and Allison McCance Center for Brain Health at Mass General (HS, VFMJ, JR, MBW); Department of Neurology (HS, WG, AG, MG, VFMJ, MBW), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (MAA), Louisiana State University Health Sciences Center, Shreveport, LA; Department of Neurology (LP), Washington University School of Medicine in St. Louis, MO; and Division of Pulmonary (RJT), Critical Care and Sleep, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Noor Adra
- Department of Neurology (HS, NA, MAA, WG, EY, MF, LP, ZF, AG, MG, VFMJ, JR, MBW), Massachusetts General Hospital; Henry and Allison McCance Center for Brain Health at Mass General (HS, VFMJ, JR, MBW); Department of Neurology (HS, WG, AG, MG, VFMJ, MBW), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (MAA), Louisiana State University Health Sciences Center, Shreveport, LA; Department of Neurology (LP), Washington University School of Medicine in St. Louis, MO; and Division of Pulmonary (RJT), Critical Care and Sleep, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Muhammad Abubakar Ayub
- Department of Neurology (HS, NA, MAA, WG, EY, MF, LP, ZF, AG, MG, VFMJ, JR, MBW), Massachusetts General Hospital; Henry and Allison McCance Center for Brain Health at Mass General (HS, VFMJ, JR, MBW); Department of Neurology (HS, WG, AG, MG, VFMJ, MBW), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (MAA), Louisiana State University Health Sciences Center, Shreveport, LA; Department of Neurology (LP), Washington University School of Medicine in St. Louis, MO; and Division of Pulmonary (RJT), Critical Care and Sleep, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Wolfgang Ganglberger
- Department of Neurology (HS, NA, MAA, WG, EY, MF, LP, ZF, AG, MG, VFMJ, JR, MBW), Massachusetts General Hospital; Henry and Allison McCance Center for Brain Health at Mass General (HS, VFMJ, JR, MBW); Department of Neurology (HS, WG, AG, MG, VFMJ, MBW), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (MAA), Louisiana State University Health Sciences Center, Shreveport, LA; Department of Neurology (LP), Washington University School of Medicine in St. Louis, MO; and Division of Pulmonary (RJT), Critical Care and Sleep, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Elissa Ye
- Department of Neurology (HS, NA, MAA, WG, EY, MF, LP, ZF, AG, MG, VFMJ, JR, MBW), Massachusetts General Hospital; Henry and Allison McCance Center for Brain Health at Mass General (HS, VFMJ, JR, MBW); Department of Neurology (HS, WG, AG, MG, VFMJ, MBW), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (MAA), Louisiana State University Health Sciences Center, Shreveport, LA; Department of Neurology (LP), Washington University School of Medicine in St. Louis, MO; and Division of Pulmonary (RJT), Critical Care and Sleep, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Marta Fernandes
- Department of Neurology (HS, NA, MAA, WG, EY, MF, LP, ZF, AG, MG, VFMJ, JR, MBW), Massachusetts General Hospital; Henry and Allison McCance Center for Brain Health at Mass General (HS, VFMJ, JR, MBW); Department of Neurology (HS, WG, AG, MG, VFMJ, MBW), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (MAA), Louisiana State University Health Sciences Center, Shreveport, LA; Department of Neurology (LP), Washington University School of Medicine in St. Louis, MO; and Division of Pulmonary (RJT), Critical Care and Sleep, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Luis Paixao
- Department of Neurology (HS, NA, MAA, WG, EY, MF, LP, ZF, AG, MG, VFMJ, JR, MBW), Massachusetts General Hospital; Henry and Allison McCance Center for Brain Health at Mass General (HS, VFMJ, JR, MBW); Department of Neurology (HS, WG, AG, MG, VFMJ, MBW), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (MAA), Louisiana State University Health Sciences Center, Shreveport, LA; Department of Neurology (LP), Washington University School of Medicine in St. Louis, MO; and Division of Pulmonary (RJT), Critical Care and Sleep, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Ziwei Fan
- Department of Neurology (HS, NA, MAA, WG, EY, MF, LP, ZF, AG, MG, VFMJ, JR, MBW), Massachusetts General Hospital; Henry and Allison McCance Center for Brain Health at Mass General (HS, VFMJ, JR, MBW); Department of Neurology (HS, WG, AG, MG, VFMJ, MBW), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (MAA), Louisiana State University Health Sciences Center, Shreveport, LA; Department of Neurology (LP), Washington University School of Medicine in St. Louis, MO; and Division of Pulmonary (RJT), Critical Care and Sleep, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Aditya Gupta
- Department of Neurology (HS, NA, MAA, WG, EY, MF, LP, ZF, AG, MG, VFMJ, JR, MBW), Massachusetts General Hospital; Henry and Allison McCance Center for Brain Health at Mass General (HS, VFMJ, JR, MBW); Department of Neurology (HS, WG, AG, MG, VFMJ, MBW), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (MAA), Louisiana State University Health Sciences Center, Shreveport, LA; Department of Neurology (LP), Washington University School of Medicine in St. Louis, MO; and Division of Pulmonary (RJT), Critical Care and Sleep, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Manohar Ghanta
- Department of Neurology (HS, NA, MAA, WG, EY, MF, LP, ZF, AG, MG, VFMJ, JR, MBW), Massachusetts General Hospital; Henry and Allison McCance Center for Brain Health at Mass General (HS, VFMJ, JR, MBW); Department of Neurology (HS, WG, AG, MG, VFMJ, MBW), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (MAA), Louisiana State University Health Sciences Center, Shreveport, LA; Department of Neurology (LP), Washington University School of Medicine in St. Louis, MO; and Division of Pulmonary (RJT), Critical Care and Sleep, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Valdery F Moura Junior
- Department of Neurology (HS, NA, MAA, WG, EY, MF, LP, ZF, AG, MG, VFMJ, JR, MBW), Massachusetts General Hospital; Henry and Allison McCance Center for Brain Health at Mass General (HS, VFMJ, JR, MBW); Department of Neurology (HS, WG, AG, MG, VFMJ, MBW), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (MAA), Louisiana State University Health Sciences Center, Shreveport, LA; Department of Neurology (LP), Washington University School of Medicine in St. Louis, MO; and Division of Pulmonary (RJT), Critical Care and Sleep, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Jonathan Rosand
- Department of Neurology (HS, NA, MAA, WG, EY, MF, LP, ZF, AG, MG, VFMJ, JR, MBW), Massachusetts General Hospital; Henry and Allison McCance Center for Brain Health at Mass General (HS, VFMJ, JR, MBW); Department of Neurology (HS, WG, AG, MG, VFMJ, MBW), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (MAA), Louisiana State University Health Sciences Center, Shreveport, LA; Department of Neurology (LP), Washington University School of Medicine in St. Louis, MO; and Division of Pulmonary (RJT), Critical Care and Sleep, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - M Brandon Westover
- Department of Neurology (HS, NA, MAA, WG, EY, MF, LP, ZF, AG, MG, VFMJ, JR, MBW), Massachusetts General Hospital; Henry and Allison McCance Center for Brain Health at Mass General (HS, VFMJ, JR, MBW); Department of Neurology (HS, WG, AG, MG, VFMJ, MBW), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (MAA), Louisiana State University Health Sciences Center, Shreveport, LA; Department of Neurology (LP), Washington University School of Medicine in St. Louis, MO; and Division of Pulmonary (RJT), Critical Care and Sleep, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Robert J Thomas
- Department of Neurology (HS, NA, MAA, WG, EY, MF, LP, ZF, AG, MG, VFMJ, JR, MBW), Massachusetts General Hospital; Henry and Allison McCance Center for Brain Health at Mass General (HS, VFMJ, JR, MBW); Department of Neurology (HS, WG, AG, MG, VFMJ, MBW), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (MAA), Louisiana State University Health Sciences Center, Shreveport, LA; Department of Neurology (LP), Washington University School of Medicine in St. Louis, MO; and Division of Pulmonary (RJT), Critical Care and Sleep, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
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9
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Kozhemiako N, Buckley AW, Chervin RD, Redline S, Purcell SM. Mapping neurodevelopment with sleep macro- and micro-architecture across multiple pediatric populations. Neuroimage Clin 2023; 41:103552. [PMID: 38150746 PMCID: PMC10788305 DOI: 10.1016/j.nicl.2023.103552] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/30/2023] [Accepted: 12/12/2023] [Indexed: 12/29/2023]
Abstract
Profiles of sleep duration and timing and corresponding electroencephalographic activity reflect brain changes that support cognitive and behavioral maturation and may provide practical markers for tracking typical and atypical neurodevelopment. To build and evaluate a sleep-based, quantitative metric of brain maturation, we used whole-night polysomnography data, initially from two large National Sleep Research Resource samples, spanning childhood and adolescence (total N = 4,013, aged 2.5 to 17.5 years): the Childhood Adenotonsillectomy Trial (CHAT), a research study of children with snoring without neurodevelopmental delay, and Nationwide Children's Hospital (NCH) Sleep Databank, a pediatric sleep clinic cohort. Among children without neurodevelopmental disorders (NDD), sleep metrics derived from the electroencephalogram (EEG) displayed robust age-related changes consistently across datasets. During non-rapid eye movement (NREM) sleep, spindles and slow oscillations further exhibited characteristic developmental patterns, with respect to their rate of occurrence, temporal coupling and morphology. Based on these metrics in NCH, we constructed a model to predict an individual's chronological age. The model performed with high accuracy (r = 0.93 in the held-out NCH sample and r = 0.85 in a second independent replication sample - the Pediatric Adenotonsillectomy Trial for Snoring (PATS)). EEG-based age predictions reflected clinically meaningful neurodevelopmental differences; for example, children with NDD showed greater variability in predicted age, and children with Down syndrome or intellectual disability had significantly younger brain age predictions (respectively, 2.1 and 0.8 years less than their chronological age) compared to age-matched non-NDD children. Overall, our results indicate that sleep architectureoffers a sensitive window for characterizing brain maturation, suggesting the potential for scalable, objective sleep-based biomarkers to measure neurodevelopment.
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Affiliation(s)
- N Kozhemiako
- Brigham and Women's Hospital & Harvard Medical School, Boston, MA, USA
| | - A W Buckley
- Sleep & Neurodevelopment Core, National Institute of Mental Health, NIH, Bethesda, MD, USA
| | - R D Chervin
- Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - S Redline
- Brigham and Women's Hospital & Harvard Medical School, Boston, MA, USA; Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - S M Purcell
- Brigham and Women's Hospital & Harvard Medical School, Boston, MA, USA.
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10
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Iwagami M, Seol J, Hiei T, Tani A, Chiba S, Kanbayashi T, Kondo H, Tanaka T, Yanagisawa M. Association between electroencephalogram-based sleep characteristics and physical health in the general adult population. Sci Rep 2023; 13:21545. [PMID: 38066043 PMCID: PMC10709300 DOI: 10.1038/s41598-023-47979-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
We examined the associations between electroencephalogram (EEG)-based sleep characteristics and physical health parameters in general adults via a cross-sectional study recruiting 100 volunteers aged 30-59 years. Sleep characteristics were measured at home using a portable multichannel electroencephalography recorder. Using the k-means + + clustering method, according to 10 EEG-based parameters, participants were grouped into better (n = 39), middle (n = 46), and worse (n = 15) sleep groups. Comparing 50 physical health parameters among the groups, we identified four signals of difference (P < 0.05), including systolic (sBP) and diastolic blood pressure (dBP), γ-glutamyl transpeptidase (γ-GTP), and serum creatinine, where sBP reached a Bonferroni-corrected threshold (P < 0.001). The sBP was higher by 7.9 (95% confidence interval 1.9-13.9) and 15.7 (7.3-24.0) mmHg before adjustment and 5.4 (- 0.1-10.9) and 8.7 (1.1-16.3) mmHg after adjustment for age, sex, body mass index, smoking, drinking habits, and 3% oxygen desaturation index in the middle and worse sleep groups, respectively, than in the better group. As another approach, among 500 combinations of EEG-based and physical health parameters, there were 45 signals of correlation, of which 4 (N1% and sBP, dBP, γ-GTP, and triglycerides) reached a Bonferroni-corrected threshold (P < 0.0001). Thus, EEG-based sleep characteristics are associated with several physical health parameters, particularly sBP.
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Affiliation(s)
- Masao Iwagami
- International Institute for Integrative Sleep Medicine (IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Jaehoon Seol
- International Institute for Integrative Sleep Medicine (IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan (JNIOSH), Kawasaki, Kanagawa, 214-8585, Japan
- R&D Center for Tailor-Made QOL, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tetsuro Hiei
- S'UIMIN Inc., 1-51-1 Hatsudai, Shibuya, Tokyo, 151-0061, Japan
| | - Akihiro Tani
- S'UIMIN Inc., 1-51-1 Hatsudai, Shibuya, Tokyo, 151-0061, Japan
| | - Shigeru Chiba
- International Institute for Integrative Sleep Medicine (IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
- Ibaraki Prefectural Medical Center of Psychiatry, 654 Asahimachi, Kasama, Ibaraki, 309-1717, Japan
- Minamisaitama Hospital, 252 Masumori, Koshigaya, Ibaraki, 343-0012, Japan
| | - Takashi Kanbayashi
- International Institute for Integrative Sleep Medicine (IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
- Ibaraki Prefectural Medical Center of Psychiatry, 654 Asahimachi, Kasama, Ibaraki, 309-1717, Japan
| | - Hideaki Kondo
- International Institute for Integrative Sleep Medicine (IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
- Department of General Medicine, Institute of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8521, Japan
| | - Takashi Tanaka
- KRD Nihombashi, 4-4-2 Nihonbashi Honcho, Chuo, Tokyo, 103-0023, Japan
| | - Masashi Yanagisawa
- International Institute for Integrative Sleep Medicine (IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
- S'UIMIN Inc., 1-51-1 Hatsudai, Shibuya, Tokyo, 151-0061, Japan.
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11
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Ono T, Nishino N, Iwai Y, Iwai Y, Sakai N, Kuroki Y, Nishino S. Eurycoma longifolia (Tongkat Ali) enhances wakefulness during active periods but facilitates sleep during resting periods in C57BL/6 mice. Eur J Neurosci 2023; 58:4298-4309. [PMID: 37968729 DOI: 10.1111/ejn.16186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 10/14/2023] [Accepted: 10/23/2023] [Indexed: 11/17/2023]
Abstract
The effects of the Eurycoma longifolia (also known as Tongkat Ali [TA]) on sleep and wakefulness was evaluated in C57BL/6 mice. While TA has been used as an aphrodisiac in males, it exhibits various pharmacological effects. The most notable effect observed with TA was wake-enhancement during the second half of the active period, accompanied by significant elevations in core body temperature (CBT). In contrast, sleep was enhanced during the resting period (i.e., increase in rapid eye movement [REM] sleep and delta electroencephalography [EEG] power in non-REM sleep) with significant declines in CBT. The transition of TA's effects between resting and active periods was rapid. The results of the experiments in constant darkness indicate that TA prolongs the circadian tau and that this transition is governed by circadian clock mechanisms rather than light exposure. TA did not demonstrate efficacy in aiding sleep in an acute stress-induced insomnia model; thus, TA may be more suitable as a wake-enhancing agent for daytime sleepiness, as sleep propensity tends to accumulate towards the end of active period. Since TA amplifies the rest-activity pattern, prolongs circadian tau and increases REM sleep, thereby reversing some common symptoms seen in elderly subjects, it may also hold promise as a rejuvenating medicine.
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Affiliation(s)
- Taisuke Ono
- Sleep and Circadian Neurobiology Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA
- Department of Geriatric Medicine, Kanazawa Medical University, Kahoku, Japan
| | - Naoya Nishino
- Sleep and Circadian Neurobiology Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA
| | - Yusuke Iwai
- Sleep and Circadian Neurobiology Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA
| | - Yumi Iwai
- Sleep and Circadian Neurobiology Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA
| | - Noriaki Sakai
- Sleep and Circadian Neurobiology Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA
| | - Yutaka Kuroki
- D-LAB, Japan Tobacco Inc., Minato, Japan
- Delightex Pte. Ltd., Singapore
| | - Seiji Nishino
- Sleep and Circadian Neurobiology Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA
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12
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Zhang X, Molsberry SA, Pavlova M, Schwarzschild MA, Ascherio A, Gao X. Probable Parasomnias and Mortality: A Prospective Study in US Men. Mayo Clin Proc 2023; 98:1449-1457. [PMID: 37793724 DOI: 10.1016/j.mayocp.2023.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 06/08/2023] [Accepted: 06/26/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVE To examine the association between parasomnias, including rapid eye movement sleep behavior disorder (RBD) and sleep walking (SW), and mortality risk in a large-scale population-based cohort. METHODS This prospective cohort study was based on 25,695 participants from the Health Professionals Follow-up Study, a population-based cohort of male health professionals in the United States. Probable SW (pSW) and probable RBD (pRBD) were measured by questions adapted from the Mayo Sleep Questionnaire in 2012. All-cause mortality and cause-specific mortality were ascertained through the national registry, reports by the families, and the postal system from January 1, 2012, through June 30, 2018. RESULTS Of the studied population, 223 reported pSW and 2720 reported pRBD. During 6 years of follow-up (2012 to 2018), 4743 mortality cases were documented. The co-occurrence of both probable parasomnias was associated with higher all-cause mortality risk (Ptrend=.008), and the adjusted hazard ratio (HR) of mortality was 1.65 (95% CI, 1.20 to 2.28) compared with participants without either probable parasomnia after adjustment for major lifestyle, sleep, and metabolic risk factors, and chronic diseases. Significant associations were found for mortality attributed to neurodegenerative diseases (adjusted HR for both parasomnias vs none, 4.57; 95% CI, 2.62 to 7.97) and accidents (adjusted HR for both parasomnias vs none, 7.36; 95% CI, 2.95 to 18.4). Having pSW alone was associated with all-cause mortality, and pSW and pRBD were individually associated with mortality attributed to neurodegenerative diseases and accidents too (P<.05 for all). CONCLUSION Probable parasomnia was associated with a higher risk of all-cause mortality and mortality attributed to neurodegenerative diseases and accidents.
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Affiliation(s)
- Xinyuan Zhang
- Department of Nutritional Sciences, Pennsylvania State University, University Park, MA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Samantha A Molsberry
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; Social & Scientific Systems, Durham, NC
| | - Milena Pavlova
- Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | | | - Alberto Ascherio
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Xiang Gao
- Department of Nutritional Sciences, Pennsylvania State University, University Park, MA; Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
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13
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Chung J, Goodman M, Huang T, Wallace ML, Lutsey PL, Chen JT, Castro-Diehl C, Bertisch S, Redline S. Multi-dimensional sleep and mortality: The Multi-Ethnic Study of Atherosclerosis. Sleep 2023; 46:zsad048. [PMID: 37523657 PMCID: PMC10848217 DOI: 10.1093/sleep/zsad048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/30/2023] [Indexed: 08/02/2023] Open
Abstract
STUDY OBJECTIVES Multiple sleep characteristics are informative of health, sleep characteristics cluster, and sleep health can be described as a composite of positive sleep attributes. We assessed the association between a sleep score reflecting multiple sleep dimensions, and mortality. We tested the hypothesis that more favorable sleep (higher sleep scores) is associated with lower mortality. METHODS The Multi-Ethnic Study of Atherosclerosis (MESA) is a racially and ethnically-diverse multi-site, prospective cohort study of US adults. Sleep was measured using unattended polysomnography, 7-day wrist actigraphy, and validated questionnaires (2010-2013). 1726 participants were followed for a median of 6.9 years (Q1-Q3, 6.4-7.4 years) until death (171 deaths) or last contact. Survival models were used to estimate the association between the exposure of sleep scores and the outcome of all-cause mortality, adjusting for socio-demographics, lifestyle, and medical comorbidities; follow-up analyses examined associations between individual metrics and mortality. The exposure, a sleep score, was constructed by an empirically-based Principal Components Analysis on 13 sleep metrics, selected a priori. RESULTS After adjusting for multiple confounders, a 1 standard deviation (sd) higher sleep score was associated with 25% lower hazard of mortality (Hazard Ratio [HR]: 0.75; 95% Confidence interval: [0.65, 0.87]). The largest drivers of this association were: night-to-night sleep regularity, total sleep time, and the Apnea-Hypopnea Index. CONCLUSION More favorable sleep across multiple characteristics, operationalized by a sleep score, is associated with lower risk of death in a diverse US cohort of adults. Results suggest that interventions that address multiple dimensions may provide novel approaches for improving health.
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Affiliation(s)
- Joon Chung
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Matthew Goodman
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Tianyi Huang
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | | | - Pamela L Lutsey
- Division of Epidemiology and Community Health, School of Public Health, the University of Minnesota, Minneapolis, MN, USA
| | - Jarvis T Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Suzanne Bertisch
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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14
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André C, Martineau-Dussault MÈ, Daneault V, Blais H, Frenette S, Lorrain D, Hudon C, Bastien C, Petit D, Lafrenière A, Thompson C, Montplaisir J, Gosselin N, Carrier J. REM sleep is associated with the volume of the cholinergic basal forebrain in aMCI individuals. Alzheimers Res Ther 2023; 15:151. [PMID: 37684650 PMCID: PMC10485959 DOI: 10.1186/s13195-023-01265-y] [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: 05/04/2023] [Accepted: 06/29/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND Rapid-eye movement (REM) sleep highly depends on the activity of cholinergic basal forebrain (BF) neurons and is reduced in Alzheimer's disease. Here, we investigated the associations between the volume of BF nuclei and REM sleep characteristics, and the impact of cognitive status on these links, in late middle-aged and older participants. METHODS Thirty-one cognitively healthy controls (66.8 ± 7.2 years old, 13 women) and 31 participants with amnestic Mild Cognitive Impairment (aMCI) (68.3 ± 8.8 years old, 7 women) were included in this cross-sectional study. All participants underwent polysomnography, a comprehensive neuropsychological assessment and Magnetic Resonance Imaging examination. REM sleep characteristics (i.e., percentage, latency and efficiency) were derived from polysomnographic recordings. T1-weighted images were preprocessed using CAT12 and the DARTEL algorithm, and we extracted the gray matter volume of BF regions of interest using a probabilistic atlas implemented in the JuBrain Anatomy Toolbox. Multiple linear regressions were performed between the volume of BF nuclei and REM sleep characteristics controlling for age, sex and total intracranial volume, in the whole cohort and in subgroups stratified by cognitive status. RESULTS In the whole sample, lower REM sleep percentage was significantly associated to lower nucleus basalis of Meynert (Ch4) volume (β = 0.32, p = 0.009). When stratifying the cohort according to cognitive status, lower REM sleep percentage was significantly associated to both lower Ch4 (β = 0.48, p = 0.012) and total BF volumes (β = 0.44, p = 0.014) in aMCI individuals, but not in cognitively unimpaired participants. No significant associations were observed between the volume of the BF and wake after sleep onset or non-REM sleep variables. DISCUSSION These results suggest that REM sleep disturbances may be an early manifestation of the degeneration of the BF cholinergic system before the onset of dementia, especially in participants with mild memory deficits.
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Affiliation(s)
- Claire André
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Recherche CIUSSS NIM, 5400 Boul Gouin O, Montréal, QC, H4J 1C5, Canada
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Marie-Ève Martineau-Dussault
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Recherche CIUSSS NIM, 5400 Boul Gouin O, Montréal, QC, H4J 1C5, Canada
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Véronique Daneault
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Recherche CIUSSS NIM, 5400 Boul Gouin O, Montréal, QC, H4J 1C5, Canada
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
- Functional Neuroimaging Unit, University of Montreal Geriatric Institute, 4565 Queen-Mary Road, Montreal, QC, H3W 1W5, Canada
| | - Hélène Blais
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Recherche CIUSSS NIM, 5400 Boul Gouin O, Montréal, QC, H4J 1C5, Canada
| | - Sonia Frenette
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Recherche CIUSSS NIM, 5400 Boul Gouin O, Montréal, QC, H4J 1C5, Canada
| | - Dominique Lorrain
- Research Centre On Aging, University Institute of Geriatrics of Sherbrooke, CIUSSS de L'Estrie-CHUS, Sherbrooke, QC, Canada
- Department of Psychology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Carol Hudon
- CERVO Research Centre, Québec City, QC, Canada
- School of Psychology, Université Laval, Québec City, QC, Canada
| | - Célyne Bastien
- CERVO Research Centre, Québec City, QC, Canada
- School of Psychology, Université Laval, Québec City, QC, Canada
| | - Dominique Petit
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Recherche CIUSSS NIM, 5400 Boul Gouin O, Montréal, QC, H4J 1C5, Canada
- Département de Psychiatrie, Université de Montréal, Montréal, QC, Canada
| | - Alexandre Lafrenière
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Recherche CIUSSS NIM, 5400 Boul Gouin O, Montréal, QC, H4J 1C5, Canada
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Cynthia Thompson
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Recherche CIUSSS NIM, 5400 Boul Gouin O, Montréal, QC, H4J 1C5, Canada
| | - Jacques Montplaisir
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Recherche CIUSSS NIM, 5400 Boul Gouin O, Montréal, QC, H4J 1C5, Canada
- Département de Psychiatrie, Université de Montréal, Montréal, QC, Canada
| | - Nadia Gosselin
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Recherche CIUSSS NIM, 5400 Boul Gouin O, Montréal, QC, H4J 1C5, Canada
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Julie Carrier
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Recherche CIUSSS NIM, 5400 Boul Gouin O, Montréal, QC, H4J 1C5, Canada.
- Department of Psychology, Université de Montréal, Montreal, QC, Canada.
- Functional Neuroimaging Unit, University of Montreal Geriatric Institute, 4565 Queen-Mary Road, Montreal, QC, H3W 1W5, Canada.
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Siddiquee AT, Lee SK, Kim S, Lee MH, Kim HJ, Shin C. All-cause and major-cause mortality associated with sleep latency in the Korean Genome and Epidemiology Study (KoGES): a population-based prospective cohort study. THE LANCET. HEALTHY LONGEVITY 2023; 4:e316-e325. [PMID: 37421960 DOI: 10.1016/s2666-7568(23)00080-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 07/10/2023] Open
Abstract
BACKGROUND The all-cause and cause-specific mortality risk associated with sleep latencies in the general adult population is unknown. We aimed to investigate the association of habitual prolonged sleep latency with long-term all-cause and cause-specific mortality in adults. METHODS The Korean Genome and Epidemiology Study (KoGES) is a population-based prospective cohort study comprising community-dwelling men and women aged 40-69 years from Ansan, South Korea. The cohort was studied bi-annually from April 17, 2003, to Dec 15, 2020, and the current analysis included all individuals who completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire between April 17, 2003, and Feb 23, 2005. The final study population comprised 3757 participants. Data were analysed from Aug 1, 2021, to May 31, 2022. The main exposure was sleep latency groups based on the PSQI questionnaire: fell asleep in 15 min or less, fell asleep in 16-30 min, occasional prolonged sleep latency (fell asleep in >30 min once or twice a week in the past month) and habitual prolonged sleep latency (fell asleep in >60 min more than once a week or fell asleep in >30 min ≥3 times a week, or both) in the past month at baseline. Outcomes were all-cause and cause-specific (cancer, cardiovascular disease, and other causes) mortality reported during the 18-year study period. Cox proportional hazards regression models were used to examine the prospective relationship between sleep latency and all-cause mortality, and competing risk analyses were done to investigate the association of sleep latency with cause-specific mortality. FINDINGS During a median follow-up of 16·7 years (IQR 16·3-17·4), 226 deaths were reported. After adjusting for demographic characteristics, physical characteristics, lifestyle factors, chronic conditions, and sleep variables, self-reported habitual prolonged sleep latency was associated with an increased risk of all-cause mortality (hazard ratio [HR] 2·22, 95% CI 1·38-3·57) compared to the reference group (those who fell asleep in 16-30 min). In the fully adjusted model, habitual prolonged sleep latency was associated with a more than doubled risk of dying from cancer compared to the reference group (HR 2·74, 95% CI 1·29-5·82). No significant association was observed between habitual prolonged sleep latency and deaths from cardiovascular disease and other causes. INTERPRETATION In this population-based prospective cohort study, habitual prolonged sleep latency was independently associated with an increased risk of all-cause and cancer-specific mortality in adults (independently of demographic characteristics, lifestyle factors, chronic morbidities, and other sleep variables). Although further studies are warranted to investigate the causality of the relationship, strategies or interventions to prevent habitual prolonged sleep latencies might enhance longevity in the general adult population. FUNDING Korea Centers for Disease Control and Prevention.
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Affiliation(s)
- Ali Tanweer Siddiquee
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, South Korea
| | - Seung Ku Lee
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, South Korea
| | - Soriul Kim
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, South Korea
| | - Min-Hee Lee
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, South Korea
| | - Hyeon Jin Kim
- Department of Neurology, Korea University Ansan Hospital, Ansan, South Korea
| | - Chol Shin
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, South Korea; Biomedical Research Center, Korea University Ansan Hospital, Ansan, South Korea.
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16
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Kawamura A, Yoshiike T, Matsuo M, Kadotani H, Oike Y, Kawasaki M, Kurumai Y, Nagao K, Takami M, Yamada N, Kuriyama K. Comparison of the usability of an automatic sleep staging program via portable 1-channel electroencephalograph and manual sleep staging with traditional polysomnography. Sleep Biol Rhythms 2023; 21:85-95. [PMID: 38468906 PMCID: PMC10899901 DOI: 10.1007/s41105-022-00421-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/16/2022] [Indexed: 10/15/2022]
Abstract
Automatic algorithms are a proposed alternative to manual assessment of polysomnography data for analyzing sleep structure; however, none are acceptably accurate for clinical use. We investigated the feasibility of an automated sleep stage scoring system called Sleep Scope, which is intended for use with portable 1-channel electroencephalograph, and compared it with the traditional polysomnography scoring method. Twenty-six outpatients and fourteen healthy volunteers underwent Sleep Scope and polysomnography assessments simultaneously. Polysomnography records were manually scored by three sleep experts. Sleep Scope records were scored using a dedicated auto-staging algorithm. Sleep parameters, including total sleep time, sleep latency, wake after sleep onset, and sleep efficiency, were calculated. The epoch-by-epoch pairwise concordance based on the classification of sleep into five stages (i.e., wake, rapid eye movement, N1, N2, and N3) was also evaluated after validating homogeneity and bias between Sleep Scope and polysomnography. Compared with polysomnography, Sleep Scope seemed to overestimate sleep latency by approximately 3 min, but there was no consistent tendency in bias in other sleep parameters. The Κ values ranged from 0.66 to 0.75 for experts' inter-rater polysomnography scores and from 0.62 to 0.67 for Sleep Scope versus polysomnography scores, which indicated sufficient agreement in the determination of sleep stages based on the Landis and Koch criteria. We observed sufficient concordance between Sleep Scope and polysomnography despite lower concordance in sleep disorder patients. Thus, this auto-staging system might serve as a novel clinical tool for reducing the time and expenses required of medical staff and patients. Supplementary Information The online version contains supplementary material available at 10.1007/s41105-022-00421-5.
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Affiliation(s)
- Aoi Kawamura
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8551 Japan
| | - Takuya Yoshiike
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8551 Japan
| | - Masahiro Matsuo
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
| | - Hiroshi Kadotani
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
| | - Yuki Oike
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
| | - Midori Kawasaki
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
| | - Yuichi Kurumai
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
| | - Kentaro Nagao
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8551 Japan
| | - Masanori Takami
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
| | - Naoto Yamada
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
| | - Kenichi Kuriyama
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8551 Japan
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17
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Heglum HSA, Drews HJ, Kallestad H, Vethe D, Langsrud K, Sand T, Engstrøm M. Contact-free radar recordings of body movement can reflect ultradian dynamics of sleep. J Sleep Res 2022; 31:e13687. [PMID: 35794011 PMCID: PMC9786343 DOI: 10.1111/jsr.13687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/17/2022] [Accepted: 06/17/2022] [Indexed: 12/30/2022]
Abstract
This work aimed to evaluate if a contact-free radar sensor can be used to observe ultradian patterns in sleep physiology, by way of a data processing tool known as Locomotor Inactivity During Sleep (LIDS). LIDS was designed as a simple transformation of actigraphy recordings of wrist movement, meant to emphasise and enhance the contrast between movement and non-movement and to reveal patterns of low residual activity during sleep that correlate with ultradian REM/NREM cycles. We adapted the LIDS transformation for a radar that detects body movements without direct contact with the subject and applied it to a dataset of simultaneous recordings with polysomnography, actigraphy, and radar from healthy young adults (n = 12, four nights of polysomnography per participant). Radar and actigraphy-derived LIDS signals were highly correlated with each other (r > 0.84), and the LIDS signals were highly correlated with reduced-resolution polysomnographic hypnograms (rradars >0.80, ractigraph >0.76). Single-harmonic cosine models were fitted to LIDS signals and hypnograms; significant differences were not found between their amplitude, period, and phase parameters. Mixed model analysis revealed similar slopes of decline per cycle for radar-LIDS, actigraphy-LIDS, and hypnograms. Our results indicate that the LIDS technique can be adapted to work with contact-free radar measurements of body movement; it may also be generalisable to data from other body movement sensors. This novel metric could aid in improving sleep monitoring in clinical and real-life settings, by providing a simple and transparent way to study ultradian dynamics of sleep using nothing more than easily obtainable movement data.
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Affiliation(s)
- Hanne Siri Amdahl Heglum
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health SciencesNorwegian University of Science and Technology (NTNU)TrondheimNorway,Novelda ASTrondheimNorway
| | - Henning Johannes Drews
- Department of Mental HealthNorwegian University of Science and TechnologyTrondheimNorway,Department of Public HealthUniversity of CopenhagenCopenhagenDenmark
| | - Håvard Kallestad
- Department of Mental HealthNorwegian University of Science and TechnologyTrondheimNorway,Division of Mental Health CareSt Olavs University HospitalTrondheimNorway
| | - Daniel Vethe
- Department of Mental HealthNorwegian University of Science and TechnologyTrondheimNorway,Division of Mental Health CareSt Olavs University HospitalTrondheimNorway
| | - Knut Langsrud
- Department of Mental HealthNorwegian University of Science and TechnologyTrondheimNorway,Division of Mental Health CareSt Olavs University HospitalTrondheimNorway
| | - Trond Sand
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health SciencesNorwegian University of Science and Technology (NTNU)TrondheimNorway,Department of Neurology and Clinical NeurophysiologySt Olavs University HospitalTrondheimNorway
| | - Morten Engstrøm
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health SciencesNorwegian University of Science and Technology (NTNU)TrondheimNorway,Department of Neurology and Clinical NeurophysiologySt Olavs University HospitalTrondheimNorway
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18
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Hu Z, Tian Y, Song X, Zeng F, Hu K, Yang A. The effect and relative importance of sleep disorders for all-cause mortality in middle-aged and older asthmatics. BMC Geriatr 2022; 22:855. [DOI: 10.1186/s12877-022-03587-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 11/04/2022] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Previous studies observed that sleep disorders potentially increased the risk of asthma and asthmatic exacerbation. We aimed to examine whether excessive daytime sleepiness (EDS), probable insomnia, objective short sleep duration (OSSD), and obstructive sleep apnea (OSA) affect all-cause mortality (ACM) in individuals with or without asthma.
Methods
We extracted relevant data from the Sleep Heart Health Study established in 1995–1998 with an 11.4-year follow-up. Multivariate Cox regression analysis with a proportional hazards model was used to estimate the associations between ACM and four sleep disorders among asthmatic patients and individuals without asthma. Dose-response analysis and machine learning (random survival forest and CoxBoost) further evaluated the impact of sleep disorders on ACM in asthmatic patients.
Results
A total of 4538 individuals with 990 deaths were included in our study, including 357 asthmatic patients with 64 deaths. Three multivariate Cox regression analyses suggested that OSSD (adjusted HR = 2.67, 95% CI: 1.23–5.77) but not probable insomnia, EDS or OSA significantly increased the risk of ACM in asthmatic patients. Three dose-response analyses also indicated that the extension of objective sleep duration was associated with a reduction in ACM in asthmatic patients compared to very OSSD patients. Severe EDS potentially augmented the risk of ACM compared with asthmatics without EDS (adjusted HR = 3.08, 95% CI: 1.11–8.56). Machine learning demonstrated that OSSD of four sleep disorders had the largest relative importance for ACM in asthmatics, followed by EDS, OSA and probable insomnia.
Conclusions
This study observed that OSSD and severe EDS were positively associated with an increase in ACM in asthmatic patients. Periodic screening and effective intervention of sleep disorders are necessary for the management of asthma.
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19
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Utsumi T, Yoshiike T, Kaneita Y, Aritake-Okada S, Matsui K, Nagao K, Saitoh K, Otsuki R, Shigeta M, Suzuki M, Kuriyama K. The association between subjective-objective discrepancies in sleep duration and mortality in older men. Sci Rep 2022; 12:18650. [PMID: 36333394 PMCID: PMC9636161 DOI: 10.1038/s41598-022-22065-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
A discrepancy in subjective and objective estimations of sleep duration, which often diverge, could have long-term adverse effects on health outcomes in older adults. Using data from 2674 older adult men (≥ 65 years of age) of the Osteoporotic Fractures in Men Sleep Study, we assessed the longitudinal association between misperception index (MI), calculated as MI = (objective sleep duration - subjective sleep duration)/objective sleep duration, and all-cause mortality. During the follow-up with a mean (standard deviation) of 10.8 (4.2) years, 1596 deaths were observed. As a continuous variable, MI showed a linear relationship with all-cause mortality after adjusting for multiple covariates, including polysomnography-measured objective sleep duration [fully adjusted hazard ratio (HR), 0.69; 95% confidence interval [CI], 0.56-0.84]. As a categorical variable, the lowest MI quartile (vs. the interquartile MI range) was associated with increased mortality (fully adjusted HR, 1.28; 95% CI, 1.12-1.46), whereas the highest MI quartile was not associated with mortality (fully adjusted HR, 0.97; 95% CI, 0.85-1.11). The subjective overestimation of sleep duration may be a risk factor for all-cause mortality in older men. Future studies should examine why subjective overestimation of sleep duration is associated with all-cause mortality from a physiological perspective.
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Affiliation(s)
- Tomohiro Utsumi
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
- Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan
| | - Takuya Yoshiike
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
| | - Yoshitaka Kaneita
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Sayaka Aritake-Okada
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
- Department of Health Sciences, Saitama Prefectural University, Saitama, Japan
| | - Kentaro Matsui
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
- Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kentaro Nagao
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kaori Saitoh
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
- Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan
| | - Rei Otsuki
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
- Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan
| | - Masahiro Shigeta
- Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan
| | - Masahiro Suzuki
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
- Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan
| | - Kenichi Kuriyama
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan.
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20
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Seol J, Lee J, Park I, Tokuyama K, Fukusumi S, Kokubo T, Yanagisawa M, Okura T. Bidirectional associations between physical activity and sleep in older adults: a multilevel analysis using polysomnography. Sci Rep 2022; 12:15399. [PMID: 36100642 PMCID: PMC9470065 DOI: 10.1038/s41598-022-19841-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 09/05/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractAlthough recent studies have examined the bidirectional associations between physical activity and sleep parameters, few have focused on older adults utilizing objective assessments, such as polysomnography. This micro-longitudinal observational study included 92 Japanese older adults (aged 65–86 years) who underwent objective evaluations of sleep quality using polysomnography and completed subjective sleep-related questionnaires. Activity levels were assessed using an accelerometer. Polysomnography, subjective sleep-related questionnaires, and accelerometer were administered for 7 consecutive days. Multilevel models (participant-, day-level) were used to examine the temporal associations of objective and subjective sleep parameters with sedentary behavior and physical activity. In the day-level analysis, higher levels of sedentary behavior during daytime were associated with longer rapid eye movement (REM) sleep, shorter REM latency, lower levels of non-REM sleep (stage N3), and reduced delta power during daytime. Higher levels of low-intensity physical activity during daytime were associated with lower levels of REM sleep, longer REM latency, and increased stage N3 sleep in the day-level analysis. Higher levels of moderate-to-vigorous physical activity were associated with increased REM latency. Longer subjective sleep time was associated with increased next-day moderate-to-vigorous physical activity. Thus, low-intensity physical activity may provide objective benefits related to deep sleep parameters in older adults.
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21
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Brink-Kjaer A, Leary EB, Sun H, Westover MB, Stone KL, Peppard PE, Lane NE, Cawthon PM, Redline S, Jennum P, Sorensen HBD, Mignot E. Age estimation from sleep studies using deep learning predicts life expectancy. NPJ Digit Med 2022; 5:103. [PMID: 35869169 PMCID: PMC9307657 DOI: 10.1038/s41746-022-00630-9] [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: 01/10/2022] [Accepted: 06/10/2022] [Indexed: 11/11/2022] Open
Abstract
Sleep disturbances increase with age and are predictors of mortality. Here, we present deep neural networks that estimate age and mortality risk through polysomnograms (PSGs). Aging was modeled using 2500 PSGs and tested in 10,699 PSGs from men and women in seven different cohorts aged between 20 and 90. Ages were estimated with a mean absolute error of 5.8 ± 1.6 years, while basic sleep scoring measures had an error of 14.9 ± 6.29 years. After controlling for demographics, sleep, and health covariates, each 10-year increment in age estimate error (AEE) was associated with increased all-cause mortality rate of 29% (95% confidence interval: 20-39%). An increase from -10 to +10 years in AEE translates to an estimated decreased life expectancy of 8.7 years (95% confidence interval: 6.1-11.4 years). Greater AEE was mostly reflected in increased sleep fragmentation, suggesting this is an important biomarker of future health independent of sleep apnea.
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Affiliation(s)
- Andreas Brink-Kjaer
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark.
- Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet, Denmark.
- Stanford Center for Sleep Sciences and Medicine, Stanford University, Palo Alto, CA, USA.
| | - Eileen B Leary
- Stanford Center for Sleep Sciences and Medicine, Stanford University, Palo Alto, CA, USA
| | - Haoqi Sun
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - M Brandon Westover
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Katie L Stone
- Research Institute, California Pacific Medical Center, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Paul E Peppard
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Nancy E Lane
- Department of Medicine, University of Davis School of Medicine, Sacramento, CA, USA
| | - Peggy M Cawthon
- Research Institute, California Pacific Medical Center, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Susan Redline
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Poul Jennum
- Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet, Denmark
| | - Helge B D Sorensen
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Emmanuel Mignot
- Stanford Center for Sleep Sciences and Medicine, Stanford University, Palo Alto, CA, USA.
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22
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Treatment initiation and utilization patterns of pharmacotherapies for early-onset idiopathic restless legs syndrome. Sleep Med 2022; 96:70-78. [DOI: 10.1016/j.sleep.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/27/2022] [Accepted: 05/06/2022] [Indexed: 11/23/2022]
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23
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Saito T, Suzuki H, Kishi A. Predictive Modeling of Mental Illness Onset Using Wearable Devices and Medical Examination Data: Machine Learning Approach. Front Digit Health 2022; 4:861808. [PMID: 35493532 PMCID: PMC9046696 DOI: 10.3389/fdgth.2022.861808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/08/2022] [Indexed: 11/18/2022] Open
Abstract
The prevention and treatment of mental illness is a serious social issue. Prediction and intervention, however, have been difficult because of lack of objective biomarkers for mental illness. The objective of this study was to use biometric data acquired from wearable devices as well as medical examination data to build a predictive model that can contribute to the prevention of the onset of mental illness. This was an observational study of 4,612 subjects from the health database of society-managed health insurance in Japan provided by JMDC Inc. The inputs to the predictive model were 3-months of continuous wearable data and medical examinations within and near that period; the output was the presence or absence of mental illness over the following month, as defined by insurance claims data. The features relating to the wearable data were sleep, activity, and resting heart rate, measured by a consumer-grade wearable device (specifically, Fitbit). The predictive model was built using the XGBoost algorithm and presented an area-under-the-receiver-operating-characteristic curve of 0.712 (SD = 0.02, a repeated stratified group 10-fold cross validation). The top-ranking feature importance measure was wearable data, and its importance was higher than the blood-test values from medical examinations. Detailed verification of the model showed that predictions were made based on disrupted sleep rhythms, mild physical activity duration, alcohol use, and medical examination data on disrupted eating habits as risk factors. In summary, the predictive model showed useful accuracy for grouping the risk of mental illness onset, suggesting the potential of predictive detection, and preventive intervention using wearable devices. Sleep abnormalities in particular were detected as wearable data 3 months prior to mental illness onset, and the possibility of early intervention targeting the stabilization of sleep as an effective measure for mental illness onset was shown.
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Affiliation(s)
| | | | - Akifumi Kishi
- Graduate School of Education, The University of Tokyo, Tokyo, Japan
- *Correspondence: Akifumi Kishi
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24
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Zhao B, Jin X, Yang J, Ma Q, Yang Z, Wang W, Bai L, Ma X, Yan B. Increased Rapid Eye Movement Sleep Is Associated With a Reduced Risk of Heart Failure in Middle-Aged and Older Adults. Front Cardiovasc Med 2022; 9:771280. [PMID: 35425819 PMCID: PMC9001949 DOI: 10.3389/fcvm.2022.771280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 03/04/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives Rapid eye movement (REM) sleep is closely related to all-cause mortality. The aim of this study is to explore the role of REM sleep on the incident heart failure (HF). Methods We selected 4490 participants (2480 women and 2010 men; mean age, 63.2 ± 11.0 years) from the Sleep Heart Health Study. HF was identified as the first occurrence during a mean follow-up period of 10.9 years. REM sleep including percentage of REM sleep and total REM sleep time were monitored using in-home polysomnography at baseline. Multivariable Cox regression analysis was utilized to explore the relationship between REM sleep and HF. Results In total, 436 (9.7%) cases of HF were observed during the entire follow-up period. After adjusting for potential covariates, an increased percentage of REM sleep (per 5%) was independently associated with a reduced incidence of HF [hazard ratio (HR) 0.88, 95% confidence interval (CI) 0.82–0.94, P < 0.001]. A similar result was also found between total REM sleep time (increased per 5 min) and incident HF (HR 0.97, 95% CI 0.95–0.99, P < 0.001). Moreover, the fourth quartile of both percentage of REM sleep (HR 0.65, 95% CI 0.48–0.88, P = 0.005) and total REM sleep time (HR 0.64, 95% CI 0.45–0.90, P = 0.010) had lower risk of incident HF when compared with the first quartile. Conclusion An increased percentage of REM sleep and total REM sleep time were associated with a reduced risk of HF. REM sleep may be a predictor of the incident HF. Clinical Trial Registration [ClinicalTrials.gov], identifier [NCT00005275].
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Affiliation(s)
- Binbin Zhao
- Department of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Xiaoying Jin
- Department of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jian Yang
- Department of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Department of Clinical Research Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Qingyan Ma
- Department of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Zai Yang
- Department of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Wei Wang
- Department of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Ling Bai
- Department of Clinical Research Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Department of Cardiology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Xiancang Ma
- Department of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Bin Yan
- Department of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Department of Clinical Research Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- *Correspondence: Bin Yan,
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Ito H, Tsuneki H, Sasaoka T, Toyooka N, Matsuo M, Yamazaki M. Suvorexant and mirtazapine improve chronic pain-related changes in parameters of sleep and voluntary physical performance in mice with sciatic nerve ligation. PLoS One 2022; 17:e0264386. [PMID: 35213655 PMCID: PMC8880854 DOI: 10.1371/journal.pone.0264386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 02/09/2022] [Indexed: 11/19/2022] Open
Abstract
Both chronic pain and sleep disorders are associated with a reduction in the quality of life. They can be both a cause and a consequence of each other, and should therefore be simultaneously treated. However, optimal treatments for chronic pain-related sleep disorders are not well established. Here, we aimed to investigate the effects of suvorexant, a novel sleep drug, and mirtazapine, a noradrenergic and specific serotonergic antidepressant, on pain-related changes in sleep parameters in a preclinical chronic pain mice model, by partial sciatic nerve ligation. We evaluated the quantity, duration, and depth of sleep by analyzing the electroencephalogram and voluntary activity by counting the number of wheel rotations to determine various symptoms of sleep disorders, including reduced total sleep time, fragmentation, low quality, and impaired activity in the daytime. Suvorexant and mirtazapine normalized the reduction in sleep time and fragmented sleep, further regaining the sleep depth at sleep onset in the chronic pain state in nerve-ligated mice. Mirtazapine also increased the percentage of rapid eye movement sleep in mice. Suvorexant decreased voluntary activity, which was prolonged after administration; however, mirtazapine did not decrease it. Although the effects of suvorexant and mirtazapine on sleep and activity are different, both suvorexant and mirtazapine could be potential therapeutic agents for chronic pain-related sleep disorders.
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Affiliation(s)
- Hisakatsu Ito
- Department of Anesthesiology, University of Toyama, Toyama, Japan
- * E-mail:
| | - Hiroshi Tsuneki
- Department of Clinical Pharmacology, University of Toyama, Toyama, Japan
| | - Toshiyasu Sasaoka
- Department of Clinical Pharmacology, University of Toyama, Toyama, Japan
| | - Naoki Toyooka
- Faculty of Engineering, University of Toyama, Toyama, Japan
| | - Mitsuhiro Matsuo
- Department of Anesthesiology, University of Toyama, Toyama, Japan
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Karavaev AS, Skazkina VV, Borovkova EI, Prokhorov MD, Hramkov AN, Ponomarenko VI, Runnova AE, Gridnev VI, Kiselev AR, Kuznetsov NV, Chechurin LS, Penzel T. Synchronization of the Processes of Autonomic Control of Blood Circulation in Humans Is Different in the Awake State and in Sleep Stages. Front Neurosci 2022; 15:791510. [PMID: 35095399 PMCID: PMC8789746 DOI: 10.3389/fnins.2021.791510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 12/09/2021] [Indexed: 01/09/2023] Open
Abstract
The influence of higher nervous activity on the processes of autonomic control of the cardiovascular system and baroreflex regulation is of considerable interest, both for understanding the fundamental laws of the functioning of the human body and for developing methods for diagnostics and treatment of pathologies. The complexity of the analyzed systems limits the possibilities of research in this area and requires the development of new tools. Earlier we propose a method for studying the collective dynamics of the processes of autonomic control of blood circulation in the awake state and in different stages of sleep. The method is based on estimating a quantitative measure representing the total percentage of phase synchronization between the low-frequency oscillations in heart rate and blood pressure. Analysis of electrocardiogram and invasive blood pressure signals in apnea patients in the awake state and in different sleep stages showed a high sensitivity of the proposed measure. It is shown that in slow-wave sleep the degree of synchronization of the studied rhythms is higher than in the awake state and lower than in sleep with rapid eye movement. The results reflect the modulation of the processes of autonomic control of blood circulation by higher nervous activity and can be used for the quantitative assessment of this modulation.
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Affiliation(s)
- Anatoly S. Karavaev
- Department of Basic Research in Neurocardiology, Institute of Cardiological Research, Saratov State Medical University, Saratov, Russia
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
- Laboratory of Nonlinear Dynamics Modeling, Saratov Branch of the Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia
| | - Viktoriia V. Skazkina
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
- LUT School of Engineering Science, LUT University, Lappeenranta, Finland
| | - Ekaterina I. Borovkova
- Department of Basic Research in Neurocardiology, Institute of Cardiological Research, Saratov State Medical University, Saratov, Russia
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
- Laboratory of Nonlinear Dynamics Modeling, Saratov Branch of the Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia
| | - Mikhail D. Prokhorov
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
- Laboratory of Nonlinear Dynamics Modeling, Saratov Branch of the Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia
| | | | - Vladimir I. Ponomarenko
- Laboratory of Nonlinear Dynamics Modeling, Saratov Branch of the Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia
| | - Anastasiya E. Runnova
- Department of Basic Research in Neurocardiology, Institute of Cardiological Research, Saratov State Medical University, Saratov, Russia
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
| | - Vladimir I. Gridnev
- Department of Basic Research in Neurocardiology, Institute of Cardiological Research, Saratov State Medical University, Saratov, Russia
| | - Anton R. Kiselev
- Department of Basic Research in Neurocardiology, Institute of Cardiological Research, Saratov State Medical University, Saratov, Russia
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
- Coordinating Center for Fundamental Research, National Medical Research Center for Therapy and Preventive Medicine, Moscow, Russia
| | - Nikolay V. Kuznetsov
- LUT School of Engineering Science, LUT University, Lappeenranta, Finland
- Faculty of Mathematics and Mechanics, St. Petersburg State University, St. Petersburg, Russia
- Institute for Problems in Mechanical Engineering RAS, St. Petersburg, Russia
| | - Leonid S. Chechurin
- LUT School of Engineering Science, LUT University, Lappeenranta, Finland
- Faculty of Mathematics and Mechanics, St. Petersburg State University, St. Petersburg, Russia
| | - Thomas Penzel
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
- Interdisciplinary Sleep Medicine Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Mortality associated with nonrestorative short sleep or nonrestorative long time-in-bed in middle-aged and older adults. Sci Rep 2022; 12:189. [PMID: 34997027 PMCID: PMC8741976 DOI: 10.1038/s41598-021-03997-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/14/2021] [Indexed: 11/30/2022] Open
Abstract
Associations of sleep duration with human health could differ depending on whether sleep is restorative. Using data from 5804 participants of the Sleep Heart Health Study, we examined the longitudinal association of sleep restfulness combined with polysomnography-measured total sleep time (TST) or time in bed (TIB), representing different sleeping behaviors, with all-cause mortality. Among middle-aged adults, compared with restful intermediate TST quartile, the lowest TST quartile with feeling unrested was associated with higher mortality (hazard ratio [HR], 1.54; 95% confidence interval [CI] 1.01–2.33); the highest TST quartile with feeling rested was associated with lower mortality (HR, 0.55; 95% CI 0.32–0.97). Among older adults, the highest TIB quartile with feeling unrested was associated with higher mortality, compared with restful intermediate TIB quartile (HR, 1.57; 95% CI 1.23–2.01). Results suggest a role of restorative sleep in differentiating the effects of sleep duration on health outcomes in midlife and beyond.
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Barbato G. REM Sleep: An Unknown Indicator of Sleep Quality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12976. [PMID: 34948586 PMCID: PMC8702162 DOI: 10.3390/ijerph182412976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/01/2021] [Accepted: 12/08/2021] [Indexed: 11/17/2022]
Abstract
Standard polysomnographic analysis of sleep has not provided evidence of an objective measure of sleep quality; however, factors such as sleep duration and sleep efficiency are those more consistently associated with the subjective perception of sleep quality. Sleep reduction as currently occurs in our 24/7 society has had a profound impact on sleep quality; the habitual sleep period should fit within what is a limited nighttime window and may not be sufficient to satisfy the whole sleep process; moreover, the use of artificial light during the evening and early night hours can delay and disturb the circadian rhythms, especially affecting REM sleep. The correct phase relationship of the sleep period with the circadian pacemaker is an important factor to guarantee adequate restorative sleep duration and sleep continuity, thus providing the necessary background for a good night's sleep. Due to the fact that REM sleep is controlled by the circadian clock, it can provide a window-like mechanism that defines the termination of the sleep period when there is still the necessity to complete the sleep process (not only wake-related homeostasis) and to meet the circadian end of sleep timing. An adequate amount of REM sleep appears necessary to guarantee sleep continuity, while periodically activating the brain and preparing it for the return to consciousness.
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Affiliation(s)
- Giuseppe Barbato
- Department of Psychology, Università degli Studi della Campania Luigi Vanvitelli, 80122 Caserta, Italy
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Luo J, Wang X, Guo Z, Xiao Y, Cao W, Zhang L, Su L, Guo J, Huang R. Endothelial Function and Arterial Stiffness Should Be Measured to Comprehensively Assess Obstructive Sleep Apnea in Clinical Practice. Front Cardiovasc Med 2021; 8:716916. [PMID: 34676249 PMCID: PMC8523814 DOI: 10.3389/fcvm.2021.716916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 09/06/2021] [Indexed: 11/21/2022] Open
Abstract
Objective: An effective clinical tool to assess endothelial function and arterial stiffness in patients with obstructive sleep apnea (OSA) is lacking. This study evaluated the clinical significance of subclinical markers for OSA management in males without serious complications. Patients/Methods: Males without serious complications were consecutively recruited. Clinical data, biomarker tests, reactive hyperemia index (RHI), and augmentation index at 75 beats/min (AIx75) measured by peripheral arterial tonometry were collected. An apnea hypopnea index (AHI) cutoff of ≥15 events/h divided the patients into two groups. Results: Of the 75 subjects, 42 had an AHI ≥15 events/h. Patients with an AHI ≥15 events/h had higher high-sensitivity C-reactive protein, tumor necrosis factor-alpha (TNF-α), vascular endothelial growth factor, and AIx75 values than the control group but no statistical difference in RHI was observed. After controlling for confounders, TNF-α was negatively correlated with the average oxygen saturation (r = −0.258, P = 0.043). RHI was correlated with the rapid eye movement (REM) stage percentage (r = 0.306, P = 0.016) but not with AHI (P > 0.05). AIx75 was positively correlated with the arousal index (r = 0.289, P = 0.023) but not with AHI (r = 0.248, P = 0.052). Conclusions: In males with OSA without severe complications, TNF-α and AIx75 are independently related to OSA. The role of RHI in OSA management requires further elucidation. These markers combined can comprehensively evaluate OSA patients to provide more evidence for the primary prevention of coronary heart disease and treatment response assessment.
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Affiliation(s)
- Jinmei Luo
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Xiaona Wang
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Zijian Guo
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yi Xiao
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Wenhao Cao
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Li Zhang
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Linfan Su
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Junwei Guo
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Rong Huang
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
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30
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A Novel EEG Derived Measure of Disrupted Delta Wave Activity during Sleep Predicts All-Cause Mortality Risk. Ann Am Thorac Soc 2021; 19:649-658. [PMID: 34672877 DOI: 10.1513/annalsats.202103-315oc] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
RATIONALE Conventional markers of sleep disturbance, based on manual electroencephalography scoring, may not adequately capture important features of more fundamental electroencephalography-related sleep disturbance. OBJECTIVES This study aimed to determine if more comprehensive power-spectral measures of delta wave activity during sleep are stronger independent predictors of mortality than conventional sleep quality and disturbance metrics. METHODS Power spectral analysis of the delta frequency band and spectral entropy-based markers to quantify disruption of electroencephalography delta power during sleep were performed to examine potential associations with mortality risk in the Sleep Heart Health Study cohort (N = 5804). Adjusted Cox proportional hazard models were used to determine the association between disrupted delta wave activity at baseline and all-cause mortality over an ~11y follow-up period. RESULTS Disrupted delta electroencephalography power during sleep was associated with a 32% increased risk of all-cause mortality compared with no fragmentation (hazard ratios 1.32 [95% confidence interval 1.14, 1.50], after adjusting for total sleep time and other clinical and life-style related covariates including sleep apnea. The association was of similar magnitude to a reduction in total sleep time from 6.5h to 4.25h. Conventional measures of sleep quality, including wake after sleep onset and arousal index were not predictive of all-cause mortality. CONCLUSIONS Delta wave activity disruption during sleep is strongly associated with all-cause mortality risk, independent of traditional potential confounders. Future investigation into the potential role of delta sleep disruption on other specific adverse health consequences such as cardiometabolic, mental health and safety outcomes has considerable potential to provide unique neurophysiological insight.
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31
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Vallat R, Walker MP. An open-source, high-performance tool for automated sleep staging. eLife 2021; 10:70092. [PMID: 34648426 PMCID: PMC8516415 DOI: 10.7554/elife.70092] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 09/29/2021] [Indexed: 12/02/2022] Open
Abstract
The clinical and societal measurement of human sleep has increased exponentially in recent years. However, unlike other fields of medical analysis that have become highly automated, basic and clinical sleep research still relies on human visual scoring. Such human-based evaluations are time-consuming, tedious, and can be prone to subjective bias. Here, we describe a novel algorithm trained and validated on +30,000 hr of polysomnographic sleep recordings across heterogeneous populations around the world. This tool offers high sleep-staging accuracy that matches human scoring accuracy and interscorer agreement no matter the population kind. The software is designed to be especially easy to use, computationally low-demanding, open source, and free. Our hope is that this software facilitates the broad adoption of an industry-standard automated sleep staging software package.
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Affiliation(s)
- Raphael Vallat
- Center for Human Sleep Science, Department of Psychology, University of California, Berkeley, Berkeley, United States
| | - Matthew P Walker
- Center for Human Sleep Science, Department of Psychology, University of California, Berkeley, Berkeley, United States
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32
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Pépin JL, Bailly S, Mordret E, Gaucher J, Tamisier R, Ben Messaoud R, Arnal PJ, Mignot E. Greatest changes in objective sleep architecture during COVID-19 lockdown in night owls with increased REM sleep. Sleep 2021; 44:zsab075. [PMID: 33769511 PMCID: PMC8083638 DOI: 10.1093/sleep/zsab075] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 02/26/2021] [Indexed: 12/25/2022] Open
Abstract
STUDY OBJECTIVES The COVID-19 pandemic has had dramatic effects on society and people's daily habits. In this observational study, we recorded objective data on sleep macro- and microarchitecture repeatedly over several nights before and during the COVID-19 government-imposed lockdown. The main objective was to evaluate changes in patterns of sleep duration and architecture during home confinement using the pre-confinement period as a control. METHODS Participants were regular users of a sleep-monitoring headband that records, stores, and automatically analyzes physiological data in real time, equivalent to polysomnography. We measured sleep onset duration, total sleep time, duration of sleep stages (N2, N3, and rapid eye movement [REM]), and sleep continuity. Via the user's smartphone application, participants filled in questionnaires on how lockdown changed working hours, eating behavior, and daily life at home. They also filled in the Insomnia Severity Index, reduced Morningness-Eveningness Questionnaire, and Hospital Anxiety and Depression Scale questionnaires, allowing us to create selected subgroups. RESULTS The 599 participants were mainly men (71%) of median age 47 (interquartile range: 36-59). Compared to before lockdown, during lockdown individuals slept more overall (mean +3·83 min; SD: ±1.3), had less deep sleep (N3), more light sleep (N2), and longer REM sleep (mean +3·74 min; SD: ±0.8). They exhibited less weekend-specific changes, suggesting less sleep restriction during the week. Changes were most pronounced in individuals reporting eveningness preferences, suggesting relative sleep deprivation in this population and exacerbated sensitivity to societal changes. CONCLUSION This unique dataset should help us understand the effects of lockdown on sleep architecture and on our health.
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Affiliation(s)
- Jean-Louis Pépin
- HP2 Laboratory, INSERM U1042, University Grenoble Alpes, Grenoble, France
- EFCR Laboratory, Grenoble Alpes University Hospital, Grenoble, France
| | - Sébastien Bailly
- HP2 Laboratory, INSERM U1042, University Grenoble Alpes, Grenoble, France
- EFCR Laboratory, Grenoble Alpes University Hospital, Grenoble, France
| | | | - Jonathan Gaucher
- HP2 Laboratory, INSERM U1042, University Grenoble Alpes, Grenoble, France
- EFCR Laboratory, Grenoble Alpes University Hospital, Grenoble, France
| | - Renaud Tamisier
- HP2 Laboratory, INSERM U1042, University Grenoble Alpes, Grenoble, France
- EFCR Laboratory, Grenoble Alpes University Hospital, Grenoble, France
| | - Raoua Ben Messaoud
- HP2 Laboratory, INSERM U1042, University Grenoble Alpes, Grenoble, France
- EFCR Laboratory, Grenoble Alpes University Hospital, Grenoble, France
| | | | - Emmanuel Mignot
- Center for Sleep Sciences and Medicine, Stanford University, Palo Alto, CA, USA
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Wallace ML, Coleman TS, Mentch LK, Buysse DJ, Graves JL, Hagen EW, Hall MH, Stone KL, Redline S, Peppard PE. Physiological sleep measures predict time to 15-year mortality in community adults: Application of a novel machine learning framework. J Sleep Res 2021; 30:e13386. [PMID: 33991144 DOI: 10.1111/jsr.13386] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 03/30/2021] [Accepted: 04/20/2021] [Indexed: 12/13/2022]
Abstract
Clarifying whether physiological sleep measures predict mortality could inform risk screening; however, such investigations should account for complex and potentially non-linear relationships among health risk factors. We aimed to establish the predictive utility of polysomnography (PSG)-assessed sleep measures for mortality using a novel permutation random forest (PRF) machine learning framework. Data collected from the years 1995 to present are from the Sleep Heart Health Study (SHHS; n = 5,734) and the Wisconsin Sleep Cohort Study (WSCS; n = 1,015), and include initial assessments of sleep and health, and up to 15 years of follow-up for all-cause mortality. We applied PRF models to quantify the predictive abilities of 24 measures grouped into five domains: PSG-assessed sleep (four measures), self-reported sleep (three), health (eight), health behaviours (four), and sociodemographic factors (five). A 10-fold repeated internal validation (WSCS and SHHS combined) and external validation (training in SHHS; testing in WSCS) were used to compute unbiased variable importance metrics and associated p values. We observed that health, sociodemographic factors, and PSG-assessed sleep domains predicted mortality using both external validation and repeated internal validation. The PSG-assessed sleep efficiency and the percentage of sleep time with oxygen saturation <90% were among the most predictive individual measures. Multivariable Cox regression also revealed the PSG-assessed sleep domain to be predictive, with very low sleep efficiency and high hypoxaemia conferring the highest risk. These findings, coupled with the emergence of new low-burden technologies for objectively assessing sleep and overnight oxygen saturation, suggest that consideration of physiological sleep measures may improve risk screening.
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Affiliation(s)
- Meredith L Wallace
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Statistics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Timothy S Coleman
- Department of Statistics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lucas K Mentch
- Department of Statistics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Erika W Hagen
- Department of Population Health Sciences, University of Wisconsin, Madison, WI, USA
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Katie L Stone
- California Pacific Medical Center Research Institute, San Francisco, CA, USA
| | - Susan Redline
- Departments of Medicine, Brigham and Women's Hospital, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Paul E Peppard
- Department of Population Health Sciences, University of Wisconsin, Madison, WI, USA
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34
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Preoperative REM sleep is associated with complication development after colorectal surgery. Surg Endosc 2021; 36:2532-2540. [PMID: 33978851 DOI: 10.1007/s00464-021-08541-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/04/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND While total sleep duration and rapid eye movement (REM) sleep duration have been associated with long-term mortality in non-surgical cohorts, the impact of preoperative sleep on postoperative outcomes has not been well studied. METHODS In this secondary analysis of a prospective observational cohort study, patients who recorded at least 1 sleep episode using a consumer wearable device in the 7 days before elective colorectal surgery were included. 30-day postoperative outcomes among those who did and did not receive at least 6 h of total sleep, as well as those who did and did not receive at least 1 h of rapid eye movement (REM) sleep, were compared. RESULTS 34 out of 95 (35.8%) patients averaged at least 6 h of sleep per night, while 44 out of 82 (53.7%) averaged 1 h or more of REM sleep. Patients who slept less than 6 h had similar postoperative outcomes compared to those who slept 6 h or more. Patients who averaged less than 1 h of REM sleep, compared to those who achieved 1 h or more of REM sleep, had significantly higher rates of complication development (29.0% vs. 9.1%, P = 0.02), and return to the OR (10.5% vs. 0%, P = 0.04). After adjustment for confounding factors, increased REM sleep duration remained significantly associated with decreased complication development (increase in REM sleep from 50 to 60 min: OR 0.72, P = 0.009; REM sleep ≥ 1 h: OR 0.22, P = 0.03). CONCLUSION In this cohort of patients undergoing elective colorectal surgery, those who developed a complication within 30 days were less likely to average at least 1 h of REM sleep in the week before surgery than those who did not develop a complication. Preoperative REM sleep duration may represent a risk factor for surgical complications; however additional research is necessary to confirm this relationship.
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35
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Li IC, Lin TW, Lee TY, Lo Y, Jiang YM, Kuo YH, Chen CC, Chang FC. Oral Administration of Armillaria mellea Mycelia Promotes Non-Rapid Eye Movement and Rapid Eye Movement Sleep in Rats. J Fungi (Basel) 2021; 7:jof7050371. [PMID: 34068650 PMCID: PMC8151341 DOI: 10.3390/jof7050371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 12/02/2022] Open
Abstract
The present study aimed to explore whether water and ethanol extracts of Armillaria mellea mycelia produce sedative and hypnotic effects in rats. Male Sprague–Dawley rats were surgically implanted with two electroencephalogram electrodes on the skull and an electromyogram electrode on neck muscle to evaluate the alterations in rapid eye movement (REM) and non-REM (NREM) sleep after oral administration of the water and ethanol extracts. Following post-surgical recovery, thirty-six rats were randomly divided into four treatment groups and two control groups. They were treated orally with vehicle, 75 and 150 mg/kg doses of water and ethanolic extracts 15 min prior to the onset of dark (active) period. Electroencephalography results showed that the low dose of A. mellea mycelia water extract increased REM sleep time while the high dose enhanced both REM and NREM sleep times during the subsequent light (rest) period. On the other hand, although the low dose of A. mellea mycelia ethanolic extract did not alter both NREM sleep and REM sleep during the dark and light periods, the high dose increased both REM and NREM sleep during the light periods in naive rats. The HPLC-DAD analyses of both extracts allowed the identification of GABA and seven sesquiterpenoids. Based on these findings, the present study showed for the first time that water and ethanolic extracts of A. mellea mycelia, containing a source of biologically active compounds, could increase both NREM sleep and REM sleep during the rest period and may be useful for the treatment of insomnia.
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Affiliation(s)
- I-Chen Li
- Biotech Research Institute, Grape King Bio Ltd., Taoyuan 320, Taiwan; (I.-C.L.); (T.-W.L.); (Y.-M.J.); (Y.-H.K.)
| | - Ting-Wei Lin
- Biotech Research Institute, Grape King Bio Ltd., Taoyuan 320, Taiwan; (I.-C.L.); (T.-W.L.); (Y.-M.J.); (Y.-H.K.)
| | - Tung-Yen Lee
- Department of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei 106, Taiwan; (T.-Y.L.); (Y.L.)
| | - Yun Lo
- Department of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei 106, Taiwan; (T.-Y.L.); (Y.L.)
| | - Yih-Min Jiang
- Biotech Research Institute, Grape King Bio Ltd., Taoyuan 320, Taiwan; (I.-C.L.); (T.-W.L.); (Y.-M.J.); (Y.-H.K.)
| | - Yu-Hsuan Kuo
- Biotech Research Institute, Grape King Bio Ltd., Taoyuan 320, Taiwan; (I.-C.L.); (T.-W.L.); (Y.-M.J.); (Y.-H.K.)
| | - Chin-Chu Chen
- Biotech Research Institute, Grape King Bio Ltd., Taoyuan 320, Taiwan; (I.-C.L.); (T.-W.L.); (Y.-M.J.); (Y.-H.K.)
- Institute of Food Science and Technology, National Taiwan University, Taipei 106, Taiwan
- Department of Bioscience Technology, Chung Yuan Christian University, Taoyuan 320, Taiwan
- Department of Food Science, Nutrition and Nutraceutical Biotechnology, Shih Chien University, Taipei 104, Taiwan
- Correspondence: (C.-C.C.); (F.-C.C.)
| | - Fang-Chia Chang
- Department of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei 106, Taiwan; (T.-Y.L.); (Y.L.)
- Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei 106, Taiwan
- Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan
- Correspondence: (C.-C.C.); (F.-C.C.)
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36
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Paul M. The Impact of Obstructive Sleep Apnea on the Sleep of Critically Ill Patients. Crit Care Nurs Clin North Am 2021; 33:173-192. [PMID: 34023084 DOI: 10.1016/j.cnc.2021.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Obstructive sleep apnea is becoming increasingly prevalent in society and thus critical care practitioners need to be prepared to care for these patients in the intensive care unit. Preparation begins with equipping the critical care nurse with the knowledge necessary to provide interventions which can enhance patient outcomes and mitigate complications.
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Affiliation(s)
- Michaelynn Paul
- Walla Walla University, School of Nursing, 10345 Southeast Market Street, Portland, OR 97216, USA.
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37
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Duncker D, Ding WY, Etheridge S, Noseworthy PA, Veltmann C, Yao X, Bunch TJ, Gupta D. Smart Wearables for Cardiac Monitoring-Real-World Use beyond Atrial Fibrillation. SENSORS (BASEL, SWITZERLAND) 2021; 21:2539. [PMID: 33916371 PMCID: PMC8038592 DOI: 10.3390/s21072539] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 01/17/2023]
Abstract
The possibilities and implementation of wearable cardiac monitoring beyond atrial fibrillation are increasing continuously. This review focuses on the real-world use and evolution of these devices for other arrhythmias, cardiovascular diseases and some of their risk factors beyond atrial fibrillation. The management of nonatrial fibrillation arrhythmias represents a broad field of wearable technologies in cardiology using Holter, event recorder, electrocardiogram (ECG) patches, wristbands and textiles. Implementation in other patient cohorts, such as ST-elevation myocardial infarction (STEMI), heart failure or sleep apnea, is feasible and expanding. In addition to appropriate accuracy, clinical studies must address the validation of clinical pathways including the appropriate device and clinical decisions resulting from the surrogate assessed.
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Affiliation(s)
- David Duncker
- Hannover Heart Rhythm Center, Department of Cardiology and Angiology, Hannover Medical School, 30625 Hannover, Germany;
| | - Wern Yew Ding
- Liverpool Centre for Cardiovascular Science, Liverpool Heart and Chest Hospital, University of Liverpool, Liverpool L1 8JX, UK; (W.Y.D.); (D.G.)
| | - Susan Etheridge
- Department of Pediatrics, University of Utah, Salt Lake City, UT 84108, USA;
| | - Peter A. Noseworthy
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN 55902, USA; (P.A.N.); (X.Y.)
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55902, USA
| | - Christian Veltmann
- Hannover Heart Rhythm Center, Department of Cardiology and Angiology, Hannover Medical School, 30625 Hannover, Germany;
| | - Xiaoxi Yao
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN 55902, USA; (P.A.N.); (X.Y.)
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55902, USA
| | - T. Jared Bunch
- Department of Medicine, School of Medicine, University of Utah, Salt Lake City, UT 84108, USA;
| | - Dhiraj Gupta
- Liverpool Centre for Cardiovascular Science, Liverpool Heart and Chest Hospital, University of Liverpool, Liverpool L1 8JX, UK; (W.Y.D.); (D.G.)
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38
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Leary EB, Stone KL, Mignot E. Living to Dream-Reply. JAMA Neurol 2021; 78:495-496. [PMID: 33646274 DOI: 10.1001/jamaneurol.2021.0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | - Katie L Stone
- University of California, San Francisco, San Francisco.,California Pacific Medical Center Research Institute, San Francisco
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39
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Bliwise DL, Trotti LM. Living to Dream. JAMA Neurol 2021; 78:495. [PMID: 33646279 DOI: 10.1001/jamaneurol.2021.0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Donald L Bliwise
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
| | - Lynn Marie Trotti
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
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40
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Yeh WC, Lai CL, Wu MN, Lin HC, Lee KW, Li YS, Hsu CY. Rapid eye movement sleep disturbance in patients with refractory epilepsy: A polysomnographic study. Sleep Med 2021; 81:101-108. [PMID: 33647761 DOI: 10.1016/j.sleep.2021.02.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/26/2021] [Accepted: 02/02/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE/BACKGROUND Patients with epilepsy have disrupted sleep architecture and a higher prevalence of sleep disturbance. Moreover, obstructive sleep apnea (OSA) is more common among patients with refractory epilepsy. Few studies have compared subjective sleep quality, sleep architecture, and prevalence of OSA between patients with refractory epilepsy and those with medically controlled epilepsy. Therefore, this study aimed to evaluate the differences in sleep quality, sleep architecture, and prevalence of OSA between patients with refractory epilepsy and patients with medically controlled epilepsy. PATIENTS This retrospective case-control study included 38 patients with refractory epilepsy and 96 patients with medically controlled epilepsy. Sleep parameters and indices of sleep-related breathing disorders were recorded by standard in-laboratory polysomnography. The scores from sleep questionnaires on sleep quality and daytime sleepiness were compared between the two groups. RESULTS Patients with refractory epilepsy versus medically controlled epilepsy had statistically significantly decreased rapid eye movement (REM) sleep (13.5 ± 6.1% vs. 16.2 ± 6.1%) and longer REM latency (152.2 ± 84.1 min vs. 117.2 ± 61.9 min). Further, no differences were found in the prevalence of sleep-related breathing disorders, subjective sleep quality, prevalence of daytime sleepiness, and quality of life. Although not statistically significant, patients with refractory epilepsy have a lower rate of OSA compared with those with medically controlled epilepsy (21.1% vs. 30.2%). CONCLUSIONS Patients with refractory epilepsy had more disrupted REM sleep regulation than those with medically controlled epilepsy. Although patients with epilepsy have a higher risk of OSA, in this study patients with refractory epilepsy were not susceptible to OSA.
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Affiliation(s)
- Wei-Chih Yeh
- Department of Neurology, Kaohsiung Medical University Hospital, 100, Tzyou 1st Rd., Kaohsiung City, 80754, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung City, 80708, Taiwan.
| | - Chiou-Lian Lai
- Department of Neurology, Kaohsiung Medical University Hospital, 100, Tzyou 1st Rd., Kaohsiung City, 80754, Taiwan; Department of Neurology, College of Medicine, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung City, 80708, Taiwan.
| | - Meng-Ni Wu
- Department of Neurology, Kaohsiung Medical University Hospital, 100, Tzyou 1st Rd., Kaohsiung City, 80754, Taiwan; Department of Neurology, College of Medicine, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung City, 80708, Taiwan.
| | - Hsun-Chang Lin
- Department of Neurology, Health and Welfare Ministry Pingtung Hospital, No. 270, Ziyou Rd., Pingtung City, Pingtung County, 900, Taiwan.
| | - Kuo-Wei Lee
- Department of Neurology, Kaohsiung Municipal Siaogang Hospital, No. 482, Shanming Rd., Siaogang Dist., Kaohsiung City, 812, Taiwan.
| | - Ying-Sheng Li
- Department of Neurology, Kaohsiung Medical University Hospital, 100, Tzyou 1st Rd., Kaohsiung City, 80754, Taiwan.
| | - Chung-Yao Hsu
- Department of Neurology, Kaohsiung Medical University Hospital, 100, Tzyou 1st Rd., Kaohsiung City, 80754, Taiwan; Department of Neurology, College of Medicine, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung City, 80708, Taiwan.
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41
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Drews HJ, Drews A. Couple Relationships Are Associated With Increased REM Sleep-A Proof-of-Concept Analysis of a Large Dataset Using Ambulatory Polysomnography. Front Psychiatry 2021; 12:641102. [PMID: 34040553 PMCID: PMC8141649 DOI: 10.3389/fpsyt.2021.641102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 04/07/2021] [Indexed: 11/24/2022] Open
Abstract
Background/Objectives: Rapid Eye Movement (REM) sleep is associated with memory consolidation and several health effects including stress response, mental health, and longevity. Recently, it has been shown that regularly co-sleeping couples have increased and stabilized REM sleep when co-sleeping as compared to sleeping individually. However, it remained unclear whether this is due to a specific effect of altering the usual sleeping environment by partner deprivation or due to a generalizable REM-sleep promoting effect of couple relationships. The present study aims to clarify this ambiguity. Methods: Married or never married individuals were taken from the Sleep Heart Health Study (n = 5,804) and matched regarding sociodemographic and health parameters. Matching was done using propensity score matching (1:1, nearest neighbor) and resulted in two groups of n = 69 each (married vs. never married). After confirmation of successful matching, samples were compared regarding REM sleep and other polysomnographic parameters (paired Students t-tests or Wilcoxon signed-rank tests). Results: Married individuals showed significantly higher levels of total and relative REM sleep as compared to never married individuals (all p's ≤ 0.003). Neither other sleep stages nor REM-sleep fragmentation differed between groups (all p's ≥ 0.29). Results regarding number of sleep cycles were ambiguous. Conclusion: This is the first between-subjects study to show that couple relationships are associated with increased REM sleep. This finding represents a necessary (but not sufficient) condition for the previously hypothesized self-enhancing feedback loop of REM sleep and sociality as well as for REM-sleep promotion as a mechanism through which couple relationships prevent mental illness.
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Affiliation(s)
- Henning Johannes Drews
- Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Psychiatry and Psychotherapy, Christian-Albrechts-University, Kiel, Germany
| | - Annika Drews
- Department of Climate and Environment, SINTEF Ocean AS, Trondheim, Norway
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42
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Abstract
With the advent of wearable biometric technology like smart watches, "hacking" our bodies' functions and cycles has become a tool in the never-ending quest for better health. And sleep is no exception. For example, a staggering one-third of Americans don't get enough sleep, according to the Centers for Disease Control and Prevention (CDC).
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43
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Lu H, Wu PF, Li RZ, Zhang W, Huang GX. Sleep Duration and Stroke: A Mendelian Randomization Study. Front Neurol 2020; 11:976. [PMID: 33117250 PMCID: PMC7575720 DOI: 10.3389/fneur.2020.00976] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 07/27/2020] [Indexed: 12/15/2022] Open
Abstract
Study Objectives: To clarify the effects of sleep duration on stroke and stroke subtypes, we adopted a Mendelian randomization (MR) approach to evaluate their causal relationship. Methods: A genome-wide association study including 446,118 participants from UK biobank was used to identify instruments for short sleep, long sleep and sleep duration. Summary-level data for all stroke, ischemic stroke, intracerebral hemorrhage, and their subtypes were obtained from meta-analyses conducted by the MEGASTROKE consortium. MR analyses were performed using the inverse-variance-weighted method, weighted median estimator, MR pleiotropy residual sum and outlier (MR-PRESSO) test, and MR-Egger regression. Sensitivity analyses were further performed using leave-one-out analysis, MR-PRESSO global test and Cochran's Q test to verify the robustness of our findings. Results: By two-sample MR, we didn't find causal associations between sleep duration and risk of stroke. However, in the subgroup analysis, we found weak evidence for short sleep in increasing risk of cardio-embolic stroke (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.11–1.60; P = 0.02) and long sleep in increasing risk of large artery stroke [OR, 1.41; 95% CI, 1.02–1.95; P = 0.04]. But the associations were not significant after Bonferroni correction for multiple comparisons. Conclusions: Our study suggests that sleep duration is not causally associated with risk of stroke and its subtypes.
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Affiliation(s)
- Hui Lu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Peng-Fei Wu
- Center for Medical Genetics & Hunan Provincial Key Laboratory for Medical Genetics, School of Life Sciences, Central South University, Changsha, China.,Department of Neurology, Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, MA, United States
| | - Rui-Zhuo Li
- School of Medicine, South China University of Technology, Guangzhou, China
| | - Wan Zhang
- Department of Neurology, Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, MA, United States.,Biology Department, College of Arts & Sciences, Boston University, Boston, MA, United States
| | - Guo-Xiang Huang
- Department of Neurology, Affiliated Hospital of Nantong University, Nantong, China
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44
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Jaffee MS, Ashbrook LH, Pavlova MK. Should Neurologists Be Concerned With REM Sleep Quantity? JAMA Neurol 2020; 77:1209-1210. [DOI: 10.1001/jamaneurol.2020.2122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
| | - Liza H. Ashbrook
- Department of Neurology, University of California, San Francisco, San Francisco
| | - Milena K. Pavlova
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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