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Lu G, Chen F, Guo C, Wu J. Acupuncture for senile insomnia: A systematic review of acupuncture point. Arch Gerontol Geriatr 2024; 127:105586. [PMID: 39096556 DOI: 10.1016/j.archger.2024.105586] [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: 06/02/2024] [Revised: 07/12/2024] [Accepted: 07/24/2024] [Indexed: 08/05/2024]
Abstract
OBJECTIVE Insomnia is one of the most common diseases among the elderly. The elderly with long-term insomnia are more likely to have symptoms such as vertigo, fatigue, and immunity decline. Acupuncture is increasingly being used to treat insomnia. The purpose of this review is to summarize the critical acupoints in the treatment of senile insomnia and evaluate the effectiveness of the treatment. To provide a research basis for acupuncture treatment of senile insomnia in the future. METHODS We will search the clinical studies on acupuncture in the treatment of senile insomnia published by CNKI (China National Knowledge Infrastructure), Wanfang (Wan Fang Data Knowledge Service Platform), CSTJ (China Science and Technology Journal Database), Pubmed, and ScienceDirect before December 31, 2023. Acupoint will be analyzed using TCMISS (TCM Inheritance Assistance Platform). RESULTS 265 literatures were retrieved, and 94 were selected as the criteria. The results showed that there were 90 acupoints related to treatment. The acupoints with the highest frequency were shenmen (HT7), sanyinjiao (SP6), baihui (GV20), zusanli (ST36), neiguan (PC6), xinshu (BL15), taixi (KI3), and sishencong (EX-HN1) anmian (JLSXX-QX), shenshu (BL23). The most frequently used meridians were bladder meridian (BL), governor vessel (GV), and stomach meridian (ST). They were mainly distributed in the lower limbs and head. The most frequent specific points are the five transport points and source points. The most frequently used combinations are "shenmen (HT7) - sanyinjiao (SP6)", "shenmen (HT7) - baihui (GV20)", and "shenmen (HT7) - neiguan (PC6)". Association rule analysis showed that the acupoints with the highest confidence were shenmen (HT7), neiguan (PC6), and sanyinjiao (SP6). Network topology analysis showed that sanyinjiao (SP6), zusanli (ST36), and shenmen (HT7) were the core acupuncture points for the treatment of senile insomnia. CONCLUSION The primary Acupuncture acupoints for senile insomnia are shenmen (HT7), sanyinjiao (SP6), baihui (GV20), zusanli (ST36), and neiguan (PC6), indicating that these acupoints have a strong correlation with senile insomnia. Sanyinjiao (SP6), zusanli (ST36), and shenmen (HT7) may be the core acupuncture acupoints for the treatment of senile insomnia.
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Affiliation(s)
- Geling Lu
- College of Jiamusi, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang 154007, China
| | - Fei Chen
- Institute of Traditional Chinese Medicine, Heilongjiang University of Chinese Medicine Harbin 150040, China
| | - Chen Guo
- Institute of Traditional Chinese Medicine, Heilongjiang University of Chinese Medicine Harbin 150040, China
| | - Jianli Wu
- Institute of Traditional Chinese Medicine, Heilongjiang University of Chinese Medicine Harbin 150040, China.
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Safavi HP, Bouzari M. Fading Focus: Addressing the Association Between Challenge Stressors, Role Blurring, Insomnia, Fatigue, and Workplace Cognitive Failure. Eval Health Prof 2024; 47:304-318. [PMID: 39025828 DOI: 10.1177/01632787241264597] [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] [Indexed: 07/20/2024]
Abstract
The primary goal of the present study is to inspect the plausible job-related (i.e., challenge stressors and role blurring) and individual factors (i.e., fatigue and insomnia) that potentially lead to work-related cognitive failures among healthcare staff. Through the judgmental sampling technique, data was collected from healthcare personnel in Iran. The results revealed that challenge stressors in the form of time pressure, job responsibility, and work overload are significantly related to role blurring. Moreover, role blurring increases fatigue and insomnia among medical staff, and both insomnia and fatigue cause workplace cognitive failure. The results also confirm the mediation effect of role blurring in the association between challenge stressors, insomnia, and fatigue. According to the results, insomnia and fatigue similarly mediate the role blurring on workplace cognitive failure association. Theoretical implications, useful suggestions for practitioners, and prospective research avenues are debated in the study.
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Shafiee A, Teymouri Athar MM, Seighali N, Amini MJ, Hajishah H, Arabazadeh Bahri R, Akhoundi A, Beiky M, Sarvipour N, Maleki S, Zandifar A, Bakhtiyari M. The prevalence of depression, anxiety, and sleep disturbances among medical students and resident physicians in Iran: A systematic review and meta-analysis. PLoS One 2024; 19:e0307117. [PMID: 39178292 PMCID: PMC11343466 DOI: 10.1371/journal.pone.0307117] [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: 09/13/2023] [Accepted: 06/29/2024] [Indexed: 08/25/2024] Open
Abstract
BACKGROUND We sought to conduct this comprehensive systematic review and meta-analysis to assess the prevalence of depression, anxiety, and sleep disturbance in Iranian medical students and resident physicians. METHODS A systematic search was conducted on 23 December 2023 in PubMed/MEDLINE, Web of Science, Scopus, and Iranian national databases. We pooled the prevalence of individual studies using the random effect model. RESULTS Our systematic search showed 36 articles that meet the eligibility criteria. Most included studies were cross-sectional. The most used questionnaire to assess depression, anxiety, and sleep disturbance were Beck Depression Inventory (BDI), The Depression, Anxiety and Stress Scale-21 Items (DASS-21), and The Pittsburgh Sleep Quality Index (PSQI), respectively. The overall prevalence of depression, anxiety, and sleep disturbance among Iranian medical students were 43% (95%CI: 33%-53%%, I2 = 98%), 44% (95%CI: 31%-58%%, I2 = 99%), 48% (95%CI: 39%-56%%, I2 = 97%), respectively. The results of subgroup and meta-regression analyses showed questionnaires used and the place of the medical school were significantly associated with the prevalence of aforementioned outcomes. Funnel plot and Begg's regression test did not show a significant source of funnel plot asymmetry for depression, anxiety, and sleep disturbance. CONCLUSION In conclusion, our study showed that nearly half of the medical students had some type of depression, anxiety, and sleep disturbance problems. To address this serious national public health issue, efficient preventive measures, routine screenings, and prompt interventions are required.
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Affiliation(s)
- Arman Shafiee
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Niloofar Seighali
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohammad Javad Amini
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Hamed Hajishah
- Student Research Committee, School of Medicine, Islamic Azad University of Medical Sciences, Tehran, Iran
| | | | - Amirhossein Akhoundi
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Maryam Beiky
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Nastaran Sarvipour
- Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Saba Maleki
- School of Medicine, Guilan University of Medical Sciences (GUMS), Rasht, Guilan Province, Iran
| | - Atefeh Zandifar
- Department of Psychiatry, Alborz University of Medical Sciences, Karaj, Iran
| | - Mahmood Bakhtiyari
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
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van den Broek JLPM, Gottlieb LA, Vermeer JR, Overeem S, Dekker LRC. When the Clock Strikes A-fib. JACC Clin Electrophysiol 2024; 10:1916-1928. [PMID: 39093277 DOI: 10.1016/j.jacep.2024.05.035] [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: 01/31/2024] [Revised: 05/09/2024] [Accepted: 05/25/2024] [Indexed: 08/04/2024]
Abstract
Within the broad spectrum of atrial fibrillation (AF) symptomatology, there is a striking subset of patients with predominant or even solitary nocturnal onset of the arrhythmia. This review covers AF with nocturnal onset, with the aim of defining this distinctive subgroup among patients with AF. A periodicity analysis is provided showing a clear increased onset between 10:00 pm and 7:00 am. Multiple interacting mechanisms are discussed, such as circadian modulation of electrophysiological properties, vagal tone, and sleep disorders, as well as the potential interaction and synergism between these factors, to provide a better understanding of this clinical entity. Lastly, potential therapeutic targets for AF with nocturnal onset are addressed such as upstream therapy for underlying comorbidities, type of drug and timing of drug administration and pulmonary vein isolation, ablation of the ganglionated plexus, and autonomic nervous system modulation. Understanding the underlying AF mechanisms in the individual patient with nocturnal onset will contribute to patient-specific therapy.
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Affiliation(s)
- Johannes L P M van den Broek
- Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, the Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.
| | | | - Jasper R Vermeer
- Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, the Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Sebastiaan Overeem
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands; Kempenhaeghe Centre for Sleep Medicine, Heeze, the Netherlands
| | - Lukas R C Dekker
- Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, the Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
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Durak A, Catikkas NM. Is caregiver sleep quality an important clinical issue? Sleep Biol Rhythms 2024; 22:403-410. [PMID: 38962792 PMCID: PMC11217237 DOI: 10.1007/s41105-024-00523-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/06/2024] [Indexed: 07/05/2024]
Abstract
Sleep quality is directly related to general health and quality of life. Caregivers' sleep disturbances affect not only their own health, but also the optimal care of their patients, with negative consequences such as neglect and medication errors. This study was conducted prospectively in the palliative care unit. The participants were divided into two groups: the caregivers and the control group. The caregiver groups were categorized into two subgroups: family and paid caregivers. The sleep quality of the caregivers was evaluated with the Pittsburgh Sleep Quality Index (PSQI). The demographics, body mass index, educational level, the presence of chronic diseases and medications, need for spiritual support, daytime sleepiness, duration of caregiving, nighttime awakening, and tea/coffee consumption were recorded. The study included 250 caregivers (female: 74.8%, mean age: 50.6 ± 12.1) and 103 control group members. Family caregivers significantly had an advanced age, lower educational level, more chronic diseases, and medications, need for spiritual support, and longer duration of caregiving compared to the paid caregivers (p = 0.018, < 0.001, 0.001, 0.005, < 0.001, and 0.003, respectively). The total PSQI scores of caregivers were significantly higher in the FDR, family group, females, those with need of spiritual support, and tea/coffee consumption close to bedtime (p = 0.002 < 0.004. 0.026. < 0.001, and 0.022, respectively). The fact that the sleep quality of family group caregivers is worse than that of paid caregivers may prevent healthy medical service delivery. The provision of care by paid professional caregivers will improve quality of care and quality of life.
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Affiliation(s)
- Ayfer Durak
- Division of Geriatrics, Department of Internal Medicine, Hamidiye Faculty of Medicine, Sancaktepe Prof. Dr. Ilhan Varank Training and Research Hospital, University of Health Sciences Istanbul, Sancaktepe, 34785 Istanbul, Turkey
| | - Nezahat Muge Catikkas
- Division of Geriatrics, Department of Internal Medicine, Hamidiye Faculty of Medicine, Sancaktepe Prof. Dr. Ilhan Varank Training and Research Hospital, University of Health Sciences Istanbul, Sancaktepe, 34785 Istanbul, Turkey
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Mathew D, Rangasamy M. Effect of Yoga Therapy on Insomnia Severity and Systolic Blood Pressure in Aged Women: A 12-Week Intervention Study Conducted in Kerala. Cureus 2024; 16:e57169. [PMID: 38681468 PMCID: PMC11056023 DOI: 10.7759/cureus.57169] [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: 03/09/2024] [Accepted: 03/28/2024] [Indexed: 05/01/2024] Open
Abstract
This study aimed to investigate the effects of a 12-week yoga therapy intervention on insomnia severity and systolic blood pressure in older women experiencing insomnia. A sample of 30 participants, aged between 60 and 70 years, underwent interventions, starting with an initial full-day workshop followed by 60-minute sessions held six days per week in the mornings. Women screening positive for insomnia using the Insomnia Severity Index Questionnaire were eligible for participation. The majority of participants were aged between 60 and 65 years, with a slight majority residing with a spouse. Economically, the group exhibited a diverse distribution, with a significant proportion classified as middle class. Educationally, the group also displayed a varied profile, with a range of educational qualifications. Pretests and post-tests were conducted to assess outcomes. The results revealed a significant reduction in Insomnia Severity Scores, with a mean decrease of 5.17 (±1.05), indicating a substantial effect size, from an initial average of 23.03 (±2.47) to 17.87 (±2.61) after the intervention. Similarly, there was a significant decrease in systolic blood pressure, with scores declining by a mean of 9.67 (±6.87), demonstrating a considerable effect size, from an average of 140.33 (±8.65) to 130.67 (±7.52). These findings suggest that yoga therapy holds promise as a non-pharmacological approach for alleviating insomnia symptoms and reducing systolic blood pressure in older women experiencing insomnia.
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Affiliation(s)
- Deepak Mathew
- Yoga Sciences and Therapy, Meenakshi Academy of Higher Education & Research (MAHER), Chennai, IND
| | - Muthulakshmi Rangasamy
- Physiology, Meenakshi Medical College Hospital & Research Institute (MMCHRI), Chennai, IND
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Ahn E, Baek Y, Park JE, Lee S, Jin HJ. Elevated prevalence and treatment of sleep disorders from 2011 to 2020: a nationwide population-based retrospective cohort study in Korea. BMJ Open 2024; 14:e075809. [PMID: 38309764 PMCID: PMC10840067 DOI: 10.1136/bmjopen-2023-075809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 01/17/2024] [Indexed: 02/05/2024] Open
Abstract
OBJECTIVES This study used National Health Insurance claims data from Korea to report the prevalence of sleep disorders and treatment status, including traditional Korean medicine, in the last 10 years. METHODS This is a retrospective cohort study in Korea. All diagnosis and prescription data, including herbal medicine claims, from the Health Insurance Review and Assessment Service from 2011 to 2020 were reviewed. Prevalence estimation, direct medical expenses and prescribed amounts for sleep disorders were recorded. RESULTS The prevalence of sleep disorders increased from 3 867 975 (7.62%) in 2011 to 7 446 846 (14.41%) in 2020, nearly doubling over 10 years. Insomnia was observed in 91.44% (n=9 011 692) of the patients. The mean number of hospital visits per patient for sleep disorders was 11.5 (±26.62). Benzodiazepines are the most commonly prescribed medications for sleep disorders, and gamma-isoyosan is the most frequently prescribed herbal medicine. CONCLUSIONS Sleep disorders are continuously increasing, as is the use of medical services-personal and social medical expenses are also increasing accordingly. Sleep disorders should be recognised as a significant health problem that needs to be actively addressed to improve quality of life.
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Affiliation(s)
- Eunkyoung Ahn
- Korean Medicine Data Division, Korea Institute of Oriental Medicine, Yuseong-gu, Daejeon, Korea (the Republic of)
| | - Younghwa Baek
- Korean Medicine Data Division, Korea Institute of Oriental Medicine, Yuseong-gu, Daejeon, Korea (the Republic of)
| | - Ji-Eun Park
- Korean Medicine Data Division, Korea Institute of Oriental Medicine, Yuseong-gu, Daejeon, Korea (the Republic of)
| | - Siwoo Lee
- Korean Medicine Data Division, Korea Institute of Oriental Medicine, Yuseong-gu, Daejeon, Korea (the Republic of)
| | - Hee-Jeong Jin
- Korean Medicine Data Division, Korea Institute of Oriental Medicine, Yuseong-gu, Daejeon, Korea (the Republic of)
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Ramirez O. Predictors of Symptoms of Depression Among Black Seventh-Day Adventists in the United States. JOURNAL OF RELIGION AND HEALTH 2024; 63:567-576. [PMID: 37318669 DOI: 10.1007/s10943-023-01847-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 06/16/2023]
Abstract
The purpose of this study was to estimate a regression model that best predict symptoms of depression among Black Seventh-day Adventists in the United States. The sample (n = 3,570) was drawn from the Biopsychosocial Religion and Health Study, a sub-study of the larger Adventist Health Study-2 consisting of a random sample (n = 10,998) of Adventists. The results of the study showed that poor sleep quality, hostility, stress, and perceived discrimination were all predictors of symptoms of depression, while religious involvement decreased the likelihood of experiencing those symptoms.
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Affiliation(s)
- Octavio Ramirez
- Department of Social Work, Fort Hays State University, 600 Park St., Hays, KS, 67601, USA.
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Kelmanson IA. [Trait and state anxiety, symptoms of insomnia and their influence on daytime functioning in adolescent girls]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:66-71. [PMID: 38934668 DOI: 10.17116/jnevro202412405266] [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] [Indexed: 06/28/2024]
Abstract
OBJECTIVE To investigate the relationship between symptoms of trait anxiety, state anxiety and symptoms of insomnia and the degree of their influence on daytime functioning disorders in adolescent girls. MATERIAL AND METHODS The study included 50 healthy adolescent girls, senior school students, aged 15-17 years, selected as simple random sample. Insomnia symptoms and their impact on daytime functioning were assessed using the SLEEP-50 (S-50) questionnaire. Trait and state anxiety were assessed using the Spielberger questionnaire. The method of path analysis was used to identify significant associations. RESULTS There was a positive association of the severity of daytime functioning disorders with the severity of insomnia symptoms (β=0.45; p<0.001) and the level of trait anxiety (β=0.34; p=0.004). Trait anxiety was also a significant predictor of state anxiety (p<0.001), with a direct relationship between these parameters (β=0.62). Positive covariation of insomnia symptoms severity and state anxiety was found (β=0.53; p<0.001). CONCLUSION Improving sleep quality and daytime functioning in adolescents with insomnia symptoms should take into account personality characteristics. High levels of trait anxiety increase the negative effects of insomnia on the impaired daytime functioning.
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Affiliation(s)
- I A Kelmanson
- Almazov National Medical Research Centre, St. Petersburg, Russia
- Saint-Petersburg State Institute for Psychology and Social Work, St. Petersburg, Russia
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McLeish AC, Hartson KR, Walker KL, Hart JL. Associations between sleep disturbance, physical activity, and anxiety sensitivity among college students during the COVID-19 pandemic. PSYCHOL HEALTH MED 2023; 28:2512-2525. [PMID: 36799461 DOI: 10.1080/13548506.2023.2179082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 02/06/2023] [Indexed: 02/18/2023]
Abstract
The present study sought to examine associations between anxiety sensitivity and both sleep and physical activity among college students, who are particularly vulnerable to sleep disturbance, decreased physical activity, and the development of psychopathology, especially in the wake of the COVID-19 pandemic. Participants were 683 college students (Mage = 20.33, SD = 3.58; 72% female; 70.3% White) who completed self-report measures online for course credit. Results indicated that after controlling for the effects of age, gender identity, and race, greater sleep disturbance was significantly associated with higher overall anxiety sensitivity (7% unique variance; β = 0.27, t = 6.67, p < .001) as well as its three subdomains (physical concerns: 4% variance; β = 0.21, t = 4.97, p < .001; cognitive concerns: 6% variance; β = 0.25, t = 6.17, p < .001; social concerns: 6% variance; β = 0.26, t = 6.22, p < .001). Additionally, more time spent walking was associated with greater anxiety sensitivity physical concerns (1% variance; β = 0.11, t = 2.52, p = .012) and greater vigorous intensity physical activity was associated with lower anxiety sensitivity social concerns (1% variance; β = -0.13, t = -2.76, p = .006). These findings suggest that sleep problems may be more universally relevant to anxiety sensitivity than physical activity and interventions to promote healthier sleep may be useful for decreasing anxiety sensitivity in college students.
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Affiliation(s)
- Alison C McLeish
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY, USA
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, USA
| | | | - Kandi L Walker
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY, USA
- Department of Communication, University of Louisville, Louisville, KY, USA
| | - Joy L Hart
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY, USA
- Department of Communication, University of Louisville, Louisville, KY, USA
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Lin YP, Ding RS, Yin CH, Chen YS, Chen JS, Chang ST. Effects of Intravascular Photobiomodulation on Insomnia, Muscle Soreness, and Biochemistry Profiles: An Eight-Year Retrospective Cohort. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1006. [PMID: 37374210 PMCID: PMC10305368 DOI: 10.3390/medicina59061006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/03/2023] [Accepted: 05/18/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Although cognitive-behavioral therapy is the first-line treatment for insomnia, pharmacotherapy is often prescribed to treat insomnia and related symptoms. In addition, muscle relaxants are commonly prescribed to alleviate muscle soreness when the pain is unbearable. However, pharmacotherapy can lead to numerous side effects. The non-drug strategy intravascular laser irradiation of blood (iPBM) has been advocated to improve pain, wound healing, blood circulation, and blood cell function to relieve insomnia and muscle soreness symptoms. Therefore, we assessed whether iPBM improves blood parameters and compared drug use before and after iPBM therapy. METHODS Consecutive patients who received iPBM therapy between January 2013 and August 2021 were reviewed. The associations between laboratory data, pharmacotherapies, and iPBM therapy were retrospectively analyzed. We compared patient characteristics, blood parameters, and drug use within the three months before the first treatment and the three months after the last treatment. We also compared the changes before and after treatment in patients who received ≥10 or 1-9 iPBM treatments. RESULT We assessed 183 eligible patients who received iPBM treatment. Of them, 18 patients reported insomnia disturbance, and 128 patients reported pain in any part of their body. After the treatment, HGB and HCT significantly increased after treatment in both the ≥10 and 1-9 iPBM treatment groups (HGB p < 0.001 and p = 0.046; HCT p < 0.001 and p = 0.029, respectively). Pharmacotherapy analysis revealed no significant differences in drug use before and after treatment, though drug use tended to decrease after iPBM. CONCLUSIONS iPBM therapy is an efficient, beneficial, and feasible treatment that increases HGB and HCT. While the results of this study do not support the suggestion that iPBM reduces drug use, further larger studies using symptom scales are needed to confirm the changes in insomnia and muscle soreness after iPBM treatment.
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Affiliation(s)
- Yen-Po Lin
- Department of Medical Education, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
- Department of Medical Education, National Cheng Kung University Hospital, Tainan 704, Taiwan
| | - Ruei-Sian Ding
- Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
| | - Chun-Hao Yin
- Institute of Health Care Management, National Sun Yat-sen University, Kaohsiung 804, Taiwan
| | - Yao-Shen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
| | - Jin-Shuen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
| | - Shin-Tsu Chang
- Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 114, Taiwan
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Meaklim H, Junge MF, Varma P, Finck WA, Jackson ML. Beyond Stress: Altered Sleep-Wake Patterns are a Key Behavioral Risk Factor for Acute Insomnia During Times of Crisis. Behav Sleep Med 2023; 21:208-225. [PMID: 35604338 DOI: 10.1080/15402002.2022.2074996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND Stress is a common precipitant of acute insomnia; however, reducing stress during times of crisis is challenging. This study aimed to determine which modifiable factors, beyond stress, were associated with acute insomnia during a major crisis, the COVID-19 pandemic. PARTICIPANTS/METHODS A global online survey assessed sleep/circadian, stress, mental health, and lifestyle factors between April-May 2020. Logistic regression models analyzed data from 1319 participants (578 acute insomnia, 731 good sleepers), adjusted for demographic differences. RESULTS Perceived stress was a significant predictor of acute insomnia during the pandemic (OR 1.23, 95% CI1.19-1.27). After adjusting for stress, individuals who altered their sleep-wake patterns (OR 3.36, CI 2.00-5.67) or increased technology use before bed (OR 3.13, CI 1.13-8.65) were at increased risk of acute insomnia. Other sleep factors associated with acute insomnia included changes in dreams/nightmares (OR 2.08, CI 1.32-3.27), increased sleep effort (OR 1.99, CI1.71-2.31) and cognitive pre-sleep arousal (OR 1.18, CI 1.11-1.24). For pandemic factors, worry about contracting COVID-19 (OR 3.08, CI 1.18-8.07) and stringent government COVID-19 restrictions (OR 1.12, CI =1.07-1.18) were associated with acute insomnia. Anxiety (OR 1.02, CI 1.01-1.05) and depressive (OR 1.29, CI 1.22-1.37) symptoms were also risk factors. A final hierarchical regression model revealed that after accounting for stress, altered sleep-wake patterns were a key behavioral predictor of acute insomnia (OR 2.60, CI 1.68-5.81). CONCLUSION Beyond stress, altered sleep-wake patterns are a key risk factor for acute insomnia. Modifiable behaviors such as maintaining regular sleep-wake patterns appear vital for sleeping well in times of crisis.
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Affiliation(s)
- Hailey Meaklim
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Moira F Junge
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.,The Sleep Health Foundation, Blacktown, New South Wales, Australia
| | - Prerna Varma
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Wendy A Finck
- Faculty of Education, Monash University, Clayton, Victoria, Australia
| | - Melinda L Jackson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
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Sun L, Li K, Zhang Y, Zhang L. Sleep-related healthcare use prevalence among adults with insomnia symptoms in Hebei, China: a population-based cross-sectional study. BMJ Open 2022; 12:e057331. [PMID: 35977764 PMCID: PMC9389099 DOI: 10.1136/bmjopen-2021-057331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE This study investigated the prevalence of sleep-related healthcare use and the factors associated with it among adults with different insomnia symptoms. DESIGN AND SETTING This was a population-based study with a cross-sectional design conducted in Hebei province, China. PARTICIPANTS Participants were community residents aged 18 years and above; a total of 21 376 valid questionnaires were analysed. PRIMARY AND SECONDARY OUTCOME MEASURES The Athens Insomnia Scale (AIS) was used to evaluate participants' insomnia symptoms. Variables such as sleep-related healthcare use, chronic disease, living alone and sociodemographics were assessed for all the participants. RESULTS Among adults with any insomnia symptoms, only 2.1% used sleep-related healthcare in the past year. Even for adults with insomnia, the prevalence of sleep-related healthcare use was only 6.2%. Furthermore, the prevalence rates of sleep-related healthcare use among adults with sleep induction, night awakenings, earlier awakening, sleep duration, sleep quality, daytime well-being, daytime functioning, and daytime sleepiness were 3.1%, 2.9%, 3.6%, 3.4%, 3.9%, 4.9%, 4.6% and 2.8%, respectively. The following factors were associated with sleep-related healthcare use among adults with insomnia: male (adjusted OR (aOR)=0.52, p<0.01), younger age (aOR=1.02, p<0.01), rural region (aOR=0.45, p<0.001) and AIS score (aOR=1.23, p<0.001). The same factors were also associated with sleep-related healthcare use among adults with insomnia symptoms. CONCLUSIONS The prevalence of sleep-related healthcare use among adults with insomnia symptoms is very low. Young men from rural areas with insomnia symptoms tend not to use healthcare. As such, it is necessary to form policies and strategies to promote sleep-related healthcare use among rural young men with insomnia symptoms.
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Affiliation(s)
- Long Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, People's Republic of China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, Shandong Province, People's Republic of China
| | - Keqing Li
- Hebei Key Laboratory of Major Mental and Behavioral Disorders, Hebei provincial Mental Health Center, Baoding, Hebei Province, People's Republic of China
- Department of Sleep medicine, The Sixth Clinical Medical College of Hebei University, Baoding, Hebei Province, People's Republic of China
| | - Yunshu Zhang
- Hebei Key Laboratory of Major Mental and Behavioral Disorders, Hebei provincial Mental Health Center, Baoding, Hebei Province, People's Republic of China
- Department of Sleep medicine, The Sixth Clinical Medical College of Hebei University, Baoding, Hebei Province, People's Republic of China
| | - Lili Zhang
- Hebei Key Laboratory of Major Mental and Behavioral Disorders, Hebei provincial Mental Health Center, Baoding, Hebei Province, People's Republic of China
- Department of Sleep medicine, The Sixth Clinical Medical College of Hebei University, Baoding, Hebei Province, People's Republic of China
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14
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Benito-Villena R, Guerrero-Martínez I, Naveiro-Fuentes M, Cano-Ibánez N, Femia-Marzo P, Gallo-Vallejo JL, Mozas-Moreno J, Amezcua-Prieto C. Walking Promotion in Pregnancy and Its Effects on Insomnia: Results of Walking_Preg Project (WPP) Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10012. [PMID: 36011647 PMCID: PMC9408512 DOI: 10.3390/ijerph191610012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
Introduction: Insomnia is a frequent condition during pregnancy. The aim of this study was to assess if a walking promotion program from the 12th Gestational Week (GW) of pregnancy helps to prevent insomnia and improve the quality of sleep at third trimester. Materials and Methods: A prospective, randomized, and controlled trial was conducted with 270 pregnant women divided into 3 groups in parallel: maximum intervention group, I1 (pedometer and goal of 10,000 steps/day), minimum intervention group, I2 (pedometer without a goal), and control group (no intervention). All groups received recommendations about physical activity in pregnancy. A structured interview was performed at 13th, 20th, and 32nd GW, collecting pedometer mean steps/day, Athens Insomnia Scale (AIS), and Pittsburgh questionnaire (PSQI). Lineal regression models were conducted to determine the association between mean steps/day at 31st GW and AIS or PSQI score. Results: At 19th GW, groups I1 and I2 reached a mean of 6267 steps/day (SD = 3854) and 5835 steps/day (SD = 2741), respectively (p > 0.05). At 31st GW mean steps/day was lower for I2 (p < 0.001). Insomnia and poor sleep quality prevalence increased through pregnancy, but no differences between groups, within trimesters, were found (p > 0.05). Lineal regression showed no association between the average steps/day at third trimester of pregnancy and AIS and PSQI scores. Conclusions: Our walking promotion program based on pedometers did not help to prevent insomnia in the third trimester of pregnancy.
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Affiliation(s)
- Rebeca Benito-Villena
- Obstetrics and Gynecology Service, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- PhD Program in Clinical Medicine and Public Health, University of Granada, 18016 Granada, Spain
| | - Ingrid Guerrero-Martínez
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain
| | - Mariña Naveiro-Fuentes
- Obstetrics and Gynecology Service, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
| | - Naomi Cano-Ibánez
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Instituto de Investigación Biosanitaria (ibs.Granada), 18014 Granada, Spain
| | - Pedro Femia-Marzo
- Unit of Biostatistics, Department of Statistics and O.R., Faculty of Medicine, University of Granada, 18016 Granada, Spain
| | - José Luis Gallo-Vallejo
- Obstetrics and Gynecology Service, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- Department of Obstetrics and Gynecology, Universidad de Granada, 18016 Granada, Spain
| | - Juan Mozas-Moreno
- Obstetrics and Gynecology Service, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Instituto de Investigación Biosanitaria (ibs.Granada), 18014 Granada, Spain
- Department of Obstetrics and Gynecology, Universidad de Granada, 18016 Granada, Spain
| | - Carmen Amezcua-Prieto
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Instituto de Investigación Biosanitaria (ibs.Granada), 18014 Granada, Spain
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15
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CPAP Adherence Assessment via Gaussian Mixture Modeling of Telemonitored Apnea Therapy. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12157618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Sleep disorders pose serious cardiovascular threats if not treated effectively. However, adherence to Continuous Positive Airway Pressure (CPAP), the most recommended therapy, is known to be challenging to monitor. Telemonitored CPAP equipment has improved the follow-up of CPAP adherence (hours of use per night) by producing far larger amounts of data collected daily. The analysis of such data have relied on averaging the entire therapeutic history and interpreting it without a proper reference concerning the level of adherence. By contrast, we contribute with an unsupervised machine-learning methodology that (i) translates the adherence data to a scale of discrete numbers that hold correspondence to the most usual 30-day-long patterns as observed in a real-word database; (ii) avoids the loss of information aggregation problem by creating summaries of the time series that capture the dynamic nature of the everyday-use CPAP. Our experiments have detected eight particular adherence behaviors validated with information-oriented statistical criteria; we successfully applied them to the time series of a French hospital to produce summaries that reflect the adherence of any 30 days of interest. Our method can aid physicians in more precisely evaluating the therapy adherence, as well as fostering systems to alert of problems in the treatment automatically.
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16
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Ribeiro A, Gabriel R, Garcia B, Cuccio C, Aqeel W, Moreno A, Landeen C, Hurley A, Kavey N, Pfaff D. Temporal relations between peripheral and central arousals in good and poor sleepers. Proc Natl Acad Sci U S A 2022; 119:e2201143119. [PMID: 35696573 PMCID: PMC9231500 DOI: 10.1073/pnas.2201143119] [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: 01/20/2022] [Accepted: 05/12/2022] [Indexed: 12/15/2022] Open
Abstract
Good sleepers and patients with insomnia symptoms (poor sleepers) were tracked with two measures of arousal; conventional polysomnography (PSG) for electroencephalogram (EEG) assessed cortical arousals, and a peripheral arterial tonometry device was used for the detection of peripheral nervous system (PNS) arousals associated with vasoconstrictions. The relationship between central (cortical) and peripheral (autonomic) arousals was examined by evaluating their close temporal dynamics. Cortical arousals almost invariably were preceded and followed by peripheral activations, while large peripheral autonomic arousals were followed by cortical arousals only half of the time. The temporal contiguity of these two types of arousals was altered in poor sleepers, and poor sleepers displayed a higher number of cortical and peripheral arousals compared with good sleepers. Given the difference in the number of peripheral autonomic arousals between good and poor sleepers, an evaluation of such arousals could become a means of physiologically distinguishing poor sleepers.
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Affiliation(s)
- Ana Ribeiro
- Laboratory of Neurobiology and Behavior, The Rockefeller University, New York, NY 10065
- Division of Natural Sciences, College of Mount Saint Vincent, New York, NY 10471
| | - Rachel Gabriel
- Division of Natural Sciences, College of Mount Saint Vincent, New York, NY 10471
| | - Bernardo Garcia
- Division of Natural Sciences, College of Mount Saint Vincent, New York, NY 10471
| | - Casey Cuccio
- Division of Natural Sciences, College of Mount Saint Vincent, New York, NY 10471
| | - William Aqeel
- Division of Natural Sciences, College of Mount Saint Vincent, New York, NY 10471
| | - Alejandro Moreno
- Division of Natural Sciences, College of Mount Saint Vincent, New York, NY 10471
| | - Colby Landeen
- Division of Natural Sciences, College of Mount Saint Vincent, New York, NY 10471
| | - Arlene Hurley
- Laboratory of Neurobiology and Behavior, The Rockefeller University, New York, NY 10065
| | - Neil Kavey
- Laboratory of Neurobiology and Behavior, The Rockefeller University, New York, NY 10065
- Department of Psychiatry, Columbia University, New York, NY 10032
| | - Donald Pfaff
- Laboratory of Neurobiology and Behavior, The Rockefeller University, New York, NY 10065
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17
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A Holistic Strategy for Classification of Sleep Stages with EEG. SENSORS 2022; 22:s22093557. [PMID: 35591246 PMCID: PMC9103466 DOI: 10.3390/s22093557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/03/2022] [Accepted: 05/05/2022] [Indexed: 02/01/2023]
Abstract
Manual sleep stage scoring is usually implemented with the help of sleep specialists by means of visual inspection of the neurophysiological signals of the patient. As it is a very hectic task to perform, automated sleep stage classification systems were developed in the past, and advancements are being made consistently by researchers. The various stages of sleep are identified by these automated sleep stage classification systems, and it is quite an important step to assist doctors for the diagnosis of sleep-related disorders. In this work, a holistic strategy named as clustering and dimensionality reduction with feature extraction cum selection for classification along with deep learning (CDFCD) is proposed for the classification of sleep stages with EEG signals. Though the methodology follows a similar structural flow as proposed in the past works, many advanced and novel techniques are proposed under each category in this work flow. Initially, clustering is applied with the help of hierarchical clustering, spectral clustering, and the proposed principal component analysis (PCA)-based subspace clustering. Then the dimensionality of it is reduced with the help of the proposed singular value decomposition (SVD)-based spectral algorithm and the standard variational Bayesian matrix factorization (VBMF) technique. Then the features are extracted and selected with the two novel proposed techniques, such as the sparse group lasso technique with dual-level implementation (SGL-DLI) and the ridge regression technique with limiting weight scheme (RR-LWS). Finally, the classification happens with the less explored multiclass Gaussian process classification (MGC), the proposed random arbitrary collective classification (RACC), and the deep learning technique using long short-term memory (LSTM) along with other conventional machine learning techniques. This methodology is validated on the sleep EDF database, and the results obtained with this methodology have surpassed the results of the previous studies in terms of the obtained classification accuracy reporting a high accuracy of 93.51% even for the six-classes classification problem.
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18
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Griffiths C, da Silva KM, Leathlean C, Jiang H, Ang CS, Searle R. Investigation of physical activity, sleep, and mental health recovery in treatment resistant depression (TRD) patients receiving repetitive transcranial magnetic stimulation (rTMS) treatment. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022; 8:100337. [PMID: 35619990 PMCID: PMC9025392 DOI: 10.1016/j.jadr.2022.100337] [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: 06/28/2021] [Revised: 02/12/2022] [Accepted: 03/15/2022] [Indexed: 11/25/2022] Open
Abstract
Background Repetitive transcranial magnetic stimulation (rTMS) is effective in treating depression; however, the effect on physical activity, sleep and recovery is unclear. This study investigated rTMS effect on physical activity and sleep through providing patients with a Fitbit and software apps; and reports the impact of rTMS on depression, anxiety and mental health recovery. Methods Study design was a pre and post data collection without a control, with twenty-four participants with treatment-resistant depression (TRD). Measures used were Fitbit activity and sleep data, and patient-rated Recovering Quality of Life (ReQoL-20), Patient Health Questionnaire (PHQ-9) and Generalised Anxiety Disorder (GAD-7). Results Response and remission rates were, respectively: 34.8% and 39% for PHQ-9; 34.8% and 47.8% for GAD-7. ReQoL-20 response and reliable improvement were 29.4% and 53%. PHQ-9, GAD-7 and ReQol-20 scores significantly improved, with large effect sizes. Analysis of Fitbit activity and sleep data yielded non-significant results. The Fitbit data machine learning model classified two levels of depression to 82% accuracy. Limitations rTMS treatment was open-label and adjunct to existing antidepressant medication. No control group. Female patients were overrepresented. Conclusions Improvements on the ReQoL-20 and aspects of sleep and activity indicate the positive impact of rTMS on the individual's real world functioning and quality of life. A wearable activity tracker can provide feedback to patients and clinicians on sleep, physical activity and depression levels. Further research could be undertaken through a sufficiently powered RCT comparing rTMS versus rTMS with use of a Fitbit, its software applications, and sleep and physical activity advice.
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Affiliation(s)
- Chris Griffiths
- Northamptonshire Healthcare NHS Foundation Trust, United Kingdom
| | | | - Chloe Leathlean
- Northamptonshire Healthcare NHS Foundation Trust, United Kingdom
| | - Harmony Jiang
- Northamptonshire Healthcare NHS Foundation Trust, United Kingdom
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19
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Yuksel D, Kiss O, Prouty DE, Baker FC, de Zambotti M. Clinical characterization of insomnia in adolescents - an integrated approach to psychopathology. Sleep Med 2022; 93:26-38. [PMID: 35398628 PMCID: PMC9058217 DOI: 10.1016/j.sleep.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/24/2022] [Accepted: 03/10/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES/BACKGROUND Insomnia in adolescence is common and debilitating yet it remains poorly understood. Here, we examine the complexity of clinical, behavioral, and psychosocial factors characterizing insomnia in adolescents. METHODS Ninety-five adolescents (16-19 years) with (N = 47, 31 female) and without (N = 48, 28 female) insomnia symptoms participated. In the insomnia group, 26 (20 female) met full DSM-5 criteria for insomnia disorder, while 21 (11 female) met partial criteria. Participants completed a clinical interview and assessments of clinical, behavioral, and psychosocial dimensions associated with insomnia. GLMs and network analyses were used to evaluate group and sex differences in severity and inter-relationships between symptoms. RESULTS Adolescents with insomnia symptomatology had lower sleep hygiene and thought control, more depressive symptoms and dysfunctional sleep-related cognitions, and more substance use as a coping behavior than healthy controls. They also indicated higher neuroticism, stress levels, and sleep stress reactivity (p < 0.05), but no difference in adverse childhood experiences, than controls. Girls compared to boys with insomnia reported lower sleep quality, and more pre-sleep cognitive activity and sleep stress reactivity (p < 0.05). Compared to healthy girls, girls in the insomnia group reported lower sleep hygiene and higher agreeableness. Network analyses confirmed profound group differences in network topology, with the insomnia group having different levels of centrality and relationships between clinical characteristics compared with controls. CONCLUSIONS Findings highlight clinical and sex-specific characteristics of adolescent insomnia, with network analyses revealing a complex interplay between clinical, behavioral, and psychosocial domains. Adolescents with insomnia symptoms, particularly girls, may benefit from interventions to improve negative cognition, mood, and stress, and behavioral strategies to counteract sleep-related maladaptive behaviors.
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20
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Decker AN, Fischer AR, Gunn HE. Socio-Ecological Context of Sleep: Gender Differences and Couples' Relationships as Exemplars. Curr Psychiatry Rep 2022; 24:831-840. [PMID: 36401678 PMCID: PMC9676909 DOI: 10.1007/s11920-022-01393-6] [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: 10/28/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE OF REVIEW We summarized recent findings on insufficient sleep and insomnia, two prominent sleep issues that impact public health. We demonstrate the socio-ecologial impact of sleep health with findings on gender and couples' relationships as exemplars. RECENT FINDINGS Robust gender differences in sleep duration and insomnia are due to biological and socio-ecological factors. Gender differences in insufficient sleep vary by country of origin and age whereas gender differences in insomnia reflect minoritized identities (e.g., sexual, gender). Co-sleeping with a partner is associated with longer sleep and more awakenings. Gender differences and couples' sleep were affected by intersecting social and societal influences, which supports a socio-ecological approach to sleep. Recent and seminal contributions to sleep health highlight the importance of observing individual sleep outcomes in a socio-ecological context. Novel methodology, such as global measures of sleep health, can inform efforts to improve sleep and, ultimately, public health.
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Affiliation(s)
- Andrea N. Decker
- Department of Psychology, The University of Alabama, 505 Hackberry Lane, Tuscaloosa, AL 35401 USA
| | - Alexandra R. Fischer
- Department of Psychology, The University of Alabama, 505 Hackberry Lane, Tuscaloosa, AL 35401 USA
| | - Heather E. Gunn
- Department of Psychology, The University of Alabama, 505 Hackberry Lane, Tuscaloosa, AL 35401 USA
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21
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Sun Y, Wang H, Jin T, Qiu F, Wang X. Prevalence of Sleep Problems Among Chinese Medical Students: A Systematic Review and Meta-Analysis. Front Psychiatry 2022; 13:753419. [PMID: 35356717 PMCID: PMC8959348 DOI: 10.3389/fpsyt.2022.753419] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 02/02/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Sleep is a necessary physiological process, which is closely related to cognitive function, emotion, memory, endocrine balance, and immunity. The prevalence of sleep problems continues to rise in Chinese medical students, which has a potential influence on living and work. OBJECTIVE This study aimed to observe the prevalence of sleep problems among medical students in China. METHOD The included cross-sectional studies on the prevalence of sleep problems of medical students in China were retrieved from PubMed, Embase, the Cochrane Database of Systematic Reviews, CNKI, and Wanfang database. An 11-item checklist recommended by the Agency for Healthcare Research and Quality was adopted to evaluate the methodological quality of the included studies. Software Stata 12.0, SPSS 26.0, and R were used to analyze the data. Registration: PROSPERO, CRD 42021237303. RESULT The prevalence of sleep problems among Chinese medical students was 27.38%. The subgroup analysis showed significant differences in the prevalence of sleep problems among different regions, educational backgrounds, grades, and University types. The region, latitude, and gross domestic product (GDP) were significant heterogeneous sources of sleep problems. The prevalence is positively correlated with latitude and negatively correlated with GDP per capita. Regular screening and appropriate intervention are recommended for these mental health problems. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021237303, identifier: CRD42021237303.
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Affiliation(s)
- Yuanlong Sun
- Department of Internal Medicine, Shuguang Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Cardiovascular Department, Cardiovascular Research Institute of Traditional Chinese Medicine, Shuguang Hospital Affiliated With Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Huiying Wang
- Cardiovascular Department, Cardiovascular Research Institute of Traditional Chinese Medicine, Shuguang Hospital Affiliated With Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Tao Jin
- Department of Internal Medicine, Shuguang Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Cardiovascular Department, Cardiovascular Research Institute of Traditional Chinese Medicine, Shuguang Hospital Affiliated With Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fei Qiu
- Department of Internal Medicine, Shuguang Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaolong Wang
- Cardiovascular Department, Cardiovascular Research Institute of Traditional Chinese Medicine, Shuguang Hospital Affiliated With Shanghai University of Traditional Chinese Medicine, Shanghai, China
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22
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Vejendla A, Talari S, Moturu R, Boddapati SNM, Kola AE. Method development and validation for Cabotegravir and Rilpivirine by using HPLC and its degradants are characterized by LCMS and FTIR. FUTURE JOURNAL OF PHARMACEUTICAL SCIENCES 2021. [DOI: 10.1186/s43094-021-00355-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Abstract
Background
Using a Symmetry C18 (4.6 × 150 mm, 3.5) column, a high-performance liquid chromatographic method for quantification of Rilpivirine and Cabotegravir in active pharmaceutical ingredients was developed and validated. The mobile phase is made up of buffer, acetonitrile, and 0.1 percent formic acid in a 20:80v/v ratio. The flow rate was kept constant at 1.0 ml/min, and detection was accomplished through absorption at 231 nm with a photodiode array detector.
Results
The calibration curve was linear, with a regression coefficient (R2) value of 0.999 and concentrations ranging from 30 to 450 g/ml of Rilpivirine and 20–300 g/ml of Cabotegravir. The method's LOD and LOQ were 0.375 g/ml, 1.238 g/ml, and 0.25 g/ml, 0.825 g/ml for Rilpivirine and Cabotegravir, respectively.
Conclusions
In the forced degradation studies, the degradants were characterized by using LCMS and FTIR. The current application was found to be simple, economical, and suitable, and validated according to ICH guidelines.
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23
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Marcus GM, Vittinghoff E, Whitman IR, Joyce S, Yang V, Nah G, Gerstenfeld EP, Moss JD, Lee RJ, Lee BK, Tseng ZH, Vedantham V, Olgin JE, Scheinman MM, Hsia H, Gladstone R, Fan S, Lee E, Fang C, Ogomori K, Fatch R, Hahn JA. Acute Consumption of Alcohol and Discrete Atrial Fibrillation Events. Ann Intern Med 2021; 174:1503-1509. [PMID: 34461028 DOI: 10.7326/m21-0228] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Patients' self-reports suggest that acute alcohol consumption may trigger a discrete atrial fibrillation (AF) event. OBJECTIVE To objectively ascertain whether alcohol consumption heightens risk for an AF episode. DESIGN A prospective, case-crossover analysis. SETTING Ambulatory persons in their natural environments. PARTICIPANTS Consenting patients with paroxysmal AF. MEASUREMENTS Participants were fitted with a continuous electrocardiogram (ECG) monitor and an ankle-worn transdermal ethanol sensor for 4 weeks. Real-time documentation of each alcoholic drink consumed was self-recorded using a button on the ECG recording device. Fingerstick blood tests for phosphatidylethanol (PEth) were used to corroborate ascertainments of drinking events. RESULTS Of 100 participants (mean age, 64 years [SD, 15]; 79% male; 85% White), 56 had at least 1 episode of AF. Results of PEth testing correlated with the number of real-time recorded drinks and with events detected by the transdermal alcohol sensor. An AF episode was associated with 2-fold higher odds of 1 alcoholic drink (odds ratio [OR], 2.02 [95% CI, 1.38 to 3.17]) and greater than 3-fold higher odds of at least 2 drinks (OR, 3.58 [CI, 1.63 to 7.89]) in the preceding 4 hours. Episodes of AF were also associated with higher odds of peak blood alcohol concentration (OR, 1.38 [CI, 1.04 to 1.83] per 0.1% increase in blood alcohol concentration) and the total area under the curve of alcohol exposure (OR, 1.14 [CI, 1.06 to 1.22] per 4.7% increase in alcohol exposure) inferred from the transdermal ethanol sensor in the preceding 12 hours. LIMITATION Confounding by other time-varying exposures that may accompany alcohol consumption cannot be excluded, and the findings from the current study of patients with AF consuming alcohol may not apply to the general population. CONCLUSION Individual AF episodes were associated with higher odds of recent alcohol consumption, providing objective evidence that a modifiable behavior may influence the probability that a discrete AF event will occur. PRIMARY FUNDING SOURCE National Institute on Alcohol Abuse and Alcoholism.
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Affiliation(s)
- Gregory M Marcus
- University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.)
| | - Eric Vittinghoff
- University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.)
| | - Isaac R Whitman
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania (I.R.W.)
| | - Sean Joyce
- University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.)
| | - Vivian Yang
- University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.)
| | - Gregory Nah
- University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.)
| | - Edward P Gerstenfeld
- University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.)
| | - Joshua D Moss
- University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.)
| | - Randall J Lee
- University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.)
| | - Byron K Lee
- University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.)
| | - Zian H Tseng
- University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.)
| | - Vasanth Vedantham
- University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.)
| | - Jeffrey E Olgin
- University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.)
| | - Melvin M Scheinman
- University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.)
| | - Henry Hsia
- University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.)
| | - Rachel Gladstone
- University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.)
| | - Shannon Fan
- University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.)
| | - Emily Lee
- University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.)
| | - Christina Fang
- University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.)
| | - Kelsey Ogomori
- University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.)
| | - Robin Fatch
- University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.)
| | - Judith A Hahn
- University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.)
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24
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da Estrela C, McGrath J, Booij L, Gouin JP. Heart Rate Variability, Sleep Quality, and Depression in the Context of Chronic Stress. Ann Behav Med 2021; 55:155-164. [PMID: 32525208 DOI: 10.1093/abm/kaaa039] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Disrupted sleep quality is one of the proposed mechanisms through which chronic stress may lead to depression. However, there exist significant individual differences in sleep reactivity, which is the extent to which one experiences sleep disturbances in response to stress. PURPOSE The aim of the current study was to investigate whether low high-frequency heart rate variability (HRV), as a psychophysiological marker of poor emotional and physiological arousal regulation, predicts stress-related sleep disturbances associated with greater risk of depression symptoms. METHODS Using a chronic caregiving stress model, 125 mothers of adolescents with developmental disorders and 97 mothers of typically developing adolescents had their resting HRV and HRV reactivity recorded and completed a measure of depressive symptoms, as well as a 7 day sleep diary to assess their sleep quality. A moderated mediation model tested whether sleep quality mediated the association between chronic stress exposure and depressive symptoms and whether HRV moderated this mediation. RESULTS After controlling for participant age, body mass index, ethnicity, socioeconomic status, and employment status, poor sleep quality mediated the association between chronic stress and depressive symptoms. Resting HRV moderated this indirect effect such that individuals with lower HRV were more likely to report poorer sleep quality in the context of chronic stressor exposure, which, in turn, was related to greater depressive symptoms. CONCLUSIONS Lower HRV, a potential biomarker of increased sleep reactivity to stress, is associated with greater vulnerability to stress-related sleep disturbances, which, in turn, increases the risk for elevated depressive symptoms in response to chronic stress.
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Affiliation(s)
- Chelsea da Estrela
- Department of Psychology, Concordia University, Montréal, Canada.,Center for Clinical Research in Health, Concordia University, Montréal, Canada
| | - Jennifer McGrath
- Department of Psychology, Concordia University, Montréal, Canada.,Center for Clinical Research in Health, Concordia University, Montréal, Canada.,PERFORM Center, Concordia University, Montréal, Canada
| | - Linda Booij
- Department of Psychology, Concordia University, Montréal, Canada.,Center for Clinical Research in Health, Concordia University, Montréal, Canada.,PERFORM Center, Concordia University, Montréal, Canada
| | - Jean-Philippe Gouin
- Department of Psychology, Concordia University, Montréal, Canada.,Center for Clinical Research in Health, Concordia University, Montréal, Canada.,PERFORM Center, Concordia University, Montréal, Canada
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25
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Mei S, Liang L, Ren H, Hu Y, Qin Z, Cao R, Li C, Fei J, Yuan T, Meng C, Guo X, Lv J, Hu Y. Association Between Perceived Stress and Post-Traumatic Stress Disorder Among Medical Staff During the COVID-19 Epidemic in Wuhan City. Front Public Health 2021; 9:666460. [PMID: 34395359 PMCID: PMC8356076 DOI: 10.3389/fpubh.2021.666460] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/21/2021] [Indexed: 12/23/2022] Open
Abstract
Objective: The study aimed to examine the relationship between perceived stress and post-traumatic stress disorder (PTSD) among frontline medical staff during the lockdown in Wuhan city, China, due to the COVID-19 outbreak. Methods: The study was conducted in August 2020, which included 516 medical staff between 21 to 65 years. The PTSD Checklist-Civilian, Perceived Stress Scale, Insomnia Severity Index, and Compassion Fatigue Short Scale were used. Results: The results indicated that 10.5% of the medical staff experienced PTSD symptoms, and insomnia severity mediated the effect of perceived stress on PTSD. In addition, compassion fatigue moderated the association between perceived stress and PTSD. Conclusion: The study elucidated the mechanisms underlying the association between perceived stress and PTSD. Moreover, it emphasized the importance of long-term monitoring of the mental health status of frontline medical staff who supported Wuhan. The results can serve as reference for relevant medical and health departments to formulate active interventions and preventive measures against PTSD for unsung heroes who put their lives on the line during difficult times.
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Affiliation(s)
- Songli Mei
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Leilei Liang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hui Ren
- The First Hospital of Jilin University, Changchun, China
| | - Yueyang Hu
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Zeying Qin
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Ruilin Cao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Chuanen Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Junsong Fei
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Tongshuang Yuan
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Cuicui Meng
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xinmeng Guo
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Jianping Lv
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Yuanchao Hu
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
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26
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Kusmakar S, Karmakar C, Zhu Y, Shelyag S, Drummond SPA, Ellis JG, Angelova M. A machine learning model for multi-night actigraphic detection of chronic insomnia: development and validation of a pre-screening tool. ROYAL SOCIETY OPEN SCIENCE 2021; 8:202264. [PMID: 34150313 PMCID: PMC8206690 DOI: 10.1098/rsos.202264] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
We propose a novel machine learning-based method for analysing multi-night actigraphy signals to objectively classify and differentiate nocturnal awakenings in individuals with chronic insomnia (CI) and their cohabiting healthy partners. We analysed nocturnal actigraphy signals from 40 cohabiting couples with one partner seeking treatment for insomnia. We extracted 12 time-domain dynamic and nonlinear features from the actigraphy signals to classify nocturnal awakenings in healthy individuals and those with CI. These features were then used to train two machine learning classifiers, random forest (RF) and support vector machine (SVM). An optimization algorithm that incorporated the predicted quality of each night for each individual was used to classify individuals into CI or healthy sleepers. Using the proposed actigraphic signal analysis technique, coupled with a rigorous leave-one-out validation approach, we achieved a classification accuracy of 80% (sensitivity: 76%, specificity: 82%) in classifying CI individuals and their healthy bed partners. The RF classifier (accuracy: 80%) showed a better performance than SVM (accuracy: 75%). Our approach to analysing the multi-night nocturnal actigraphy recordings provides a new method for screening individuals with CI, using wrist-actigraphy devices, facilitating home monitoring.
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Affiliation(s)
- S. Kusmakar
- School of Information Technology, Deakin University, Geelong, Victoria 3125, Australia
| | - C. Karmakar
- School of Information Technology, Deakin University, Geelong, Victoria 3125, Australia
| | - Y. Zhu
- School of Information Technology, Deakin University, Geelong, Victoria 3125, Australia
| | - S. Shelyag
- School of Information Technology, Deakin University, Geelong, Victoria 3125, Australia
| | - S. P. A. Drummond
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - J. G. Ellis
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - M. Angelova
- School of Information Technology, Deakin University, Geelong, Victoria 3125, Australia
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27
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Cheong MJ, Kim S, Kim JS, Lee H, Lyu YS, Lee YR, Jeon B, Kang HW. A systematic literature review and meta-analysis of the clinical effects of aroma inhalation therapy on sleep problems. Medicine (Baltimore) 2021; 100:e24652. [PMID: 33655928 PMCID: PMC7939222 DOI: 10.1097/md.0000000000024652] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 01/10/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND This systematic review investigated the clinical effects of inhalation aromatherapy for the treatment of sleep problems such as insomnia. METHODS Studies on sleep problems and inhalation aromatherapy, published in Korean and international journals, were included in the meta-analysis. Five domestic and international databases, respectively each, were used for the literature search. Keywords included sleep disorder, sleep problems, insomnia, and aroma inhalation, and the related literature was further searched. After the screening, selected articles were assessed for their quality and conducted the risk of bias using RevMan 5.0, a systematic literature review was then conducted. A meta-analysis comparing the averages was conducted on studies that reported numerical values. Additionally, meta-analysis of variance and meta-regression analyses were performed. RESULTS Meta-analysis of the 34 studies using the random-effects model revealed that the use of aromatherapy was highly effective in improving sleep problems such as insomnia, including quantitative and qualitative sleep effects (95% confidence interval [CI], effect sizes = 0.6491). Subgroup analysis revealed that the secondary outcomes including stress, depression, anxiety, and fatigue were significantly effective. The single aroma inhalation method was more effective than the mixed aroma inhalation method. Among the single inhalation methods, the lavender inhalation effect was the greatest. CONCLUSION Inhalation aromatherapy is effective in improving sleep problems such as insomnia. Therefore, it is essential to develop specific guidelines for the efficient inhalation of aromatherapy. ETHICS AND DISSEMINATION Ethical approval is not required because individual patient data are not included. The findings of this systematic review were disseminated through peer-reviewed publications or conference presentations. PROSPERO REGISTRATION NUMBER CRD42020142120.
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Affiliation(s)
- Moon Joo Cheong
- Rare Diseases Integrative Treatment Research Institute, Wonkwang University, Jangheung Integrative Medical Hospital, Anyang-myeon, Jangheung-gun, Jeollanam-do
| | - Sungchul Kim
- Center of Amyotrophic Lateral Sclerosis & Motor Neuron Disease, Wonkwang University Gwangju Medical Hospital, Nam-gu, Gwangju
| | - Jee Su Kim
- Department of Korean Neuropsychiatry Medicine, Wonkwang University, Iksan
| | - Hyeryun Lee
- Department of Korean Neuropsychiatry Medicine, Wonkwang University, Iksan
| | - Yeoung-Su Lyu
- Rare Diseases Integrative Treatment Research Institute, Wonkwang University, Jangheung Integrative Medical Hospital, Anyang-myeon, Jangheung-gun, Jeollanam-do
- Department of Korean Neuropsychiatry Medicine, Wonkwang University, Iksan
| | - Yu Ra Lee
- Rare Diseases Integrative Treatment Research Institute, Wonkwang University, Jangheung Integrative Medical Hospital, Anyang-myeon, Jangheung-gun, Jeollanam-do
| | - Byeonghyeon Jeon
- Rare Diseases Integrative Treatment Research Institute, Wonkwang University, Jangheung Integrative Medical Hospital, Anyang-myeon, Jangheung-gun, Jeollanam-do
| | - Hyung Won Kang
- Department of Korean Neuropsychiatry Medicine, Wonkwang University, Iksan
- Department of Korean Neuropsychiatry Medicine & Inam Neuroscience Research Center, Wonkwang University Sanbon Hospital, Gunpo, Republic of Korea
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28
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Modularized iCBT‑I self-learn training for university staff-prevention and early intervention in the SARS-CoV-2 crisis: A pilot study. SOMNOLOGIE 2021; 25:29-37. [PMID: 33649702 PMCID: PMC7903869 DOI: 10.1007/s11818-021-00301-z] [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] [Accepted: 01/22/2021] [Indexed: 11/08/2022]
Abstract
Background Insomnia is a widespread disease in adults and has a high prevalence rate. As sleep disturbances are a risk factor concerning mental and physical health, prevention and early intervention are necessary. Thus, the aim of this study was to implement a self-learning prevention and early intervention training for university staff members. We adapted an established cognitive behavioral therapy for insomnia (CBT-I) intervention as an online version for use during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) crisis. Methods Development and adaptation procedure of the internet-based CBT‑I (iCBT-I) prevention and early intervention training is described. Sessions and topics are shown in detail. The Online Sleep Prevention and Treatment Acceptance questionnaire (OSTA) and the Online Sleep Prevention and Treatment Feedback questionnaire (OSTF) were used to assess acceptance. Sleep problems of university staff members were assessed using the Pittsburgh Sleep Questionnaire (PSQI). Results The online-adapted version consisted of seven modules. Contents of sessions and topics were implemented based on video clips. Drawings were added to information regarding sleep and sleep hygiene as well as addressing stress and cognitions. In all, 15 individuals participated in this pilot study. The new iCBT‑I self-learning prevention training was well accepted. In addition, participants scored the online version as helpful based on the OSTA. Prior to online training, 89% of the participants reported impaired sleep quality or insomnia symptoms, and 56% had a PSQI score over 10. After training 78% of participants showed reduced sleep problems according to PSQI and 56% reached clinically significant enhancement. In addition, after training 44% were healthy sleepers. Discussion This is the first iCBT‑I prevention and early intervention training for university staff members. The training by participants was very well accepted and they scored the videos as very helpful. Sleep problems decreased after online training. However, further studies with larger samples and more sleep-related assessment strategies, e.g., actigraphy and sleep log, are necessary.
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29
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Sahin L, Cevik OS, Cevik K, Guven C, Taskin E, Kocahan S. Mild regular treadmill exercise ameliorated the detrimental effects of acute sleep deprivation on spatial memory. Brain Res 2021; 1759:147367. [PMID: 33582122 DOI: 10.1016/j.brainres.2021.147367] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 02/04/2021] [Accepted: 02/08/2021] [Indexed: 01/06/2023]
Abstract
Vulnerable areas like the hippocampus are sensitive to insults such as sleep deprivation (SD); they are also susceptible to environmental enrichment. Much evidence is accumulating that chronic sleep deprivation causes alterations in the hippocampus that responsible for spatial memory. However, there is conflicting about the differences between acute and chronic SD results. The purpose of this study was to determine the protective effects of mild treadmill exercise on acute SD rats. Four groups were created as control, exercise, sleep deprivation, exercise + sleep deprivation. Multiple platforms method was used to induce REM sleep deprivation (RD) for 48 h. The exercise was applied fivedaysperweekforfour weeks(5 × 4). For the first and second weeks, the length of the exercise was 15 min in two sessions (5 min interval) followed by 15 min in three, 15 min in four sessions. Morris water maze (MWM) was used as a spatial memory test. Gene level was determined by using the qPCR technique. Malondialdehyde (MDA) content in the hippocampus was measured as an extent of peroxidative damage to lipids by using the ELISA method. 48 h RD impaired long-term spatial memory significantly. Mild, regular treadmill exercise ameliorated the detrimental effects of acute sleep deprivation on memory. There was no significant difference in MDA between groups. Hippocampal gene expression did not show any changes in all groups. Lack of correlation between memory impairment and levels of genes in the hippocampus is likely to be related to the differences in behavioral and genetic mechanisms.
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Affiliation(s)
- Leyla Sahin
- Mersin University, Faculty of Medicine, Physiology, Mersin, Turkey.
| | - Ozge Selin Cevik
- Mersin University, Faculty of Medicine, Physiology, Mersin, Turkey
| | - Kenan Cevik
- Mersin University, Faculty of Medicine, Medical Biology, Mersin, Turkey
| | - Celal Guven
- Ömer Halis Demir University, Faculty of Medicine, Physiology, Niğde, Turkey
| | - Eylem Taskin
- Ömer Halis Demir University, Faculty of Medicine, Physiology, Niğde, Turkey
| | - Sayad Kocahan
- Adıyaman University, Faculty of Medicine, Physiology, Adıyaman, Turkey
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30
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Mo MH. The Development and Application Effects of a Fatigue Self-Care Smartphone Application for Lung Cancer Patients Receiving Chemotherapy. ASIAN ONCOLOGY NURSING 2021. [DOI: 10.5388/aon.2021.21.4.183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Moon-Hee Mo
- Department of Nursing, Yeungnam University College, Daegu, Korea
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31
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Lee S, Gonzalez BD, Small BJ. My job impacts my sleep: signs and symptoms of insomnia among healthcare workers. INDUSTRIAL HEALTH 2021; 59:86-98. [PMID: 33762517 PMCID: PMC8010164 DOI: 10.2486/indhealth.2020-0191] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 11/30/2020] [Indexed: 06/12/2023]
Abstract
Potential insomnia in healthcare workers is a public health concern as it may degrade the quality of patient care. We examined the prevalence of insomnia symptoms in healthcare workers and their perceived need for a sleep intervention. Participants were 62 nurses working full-time at a U.S. hospital. These nurses were asked about background characteristics, perceived stress, sleep concerns, and need for a sleep intervention. They also participated in 14-d ecological momentary assessment (EMA) and actigraphy sleep study. A qualitative analysis showed that the majority (92%) of participants reported at least one sleep concern with insomnia-related concerns being most prevalent (68%). Quantitative analyses indicated that those with insomnia-related concerns had higher perceived stress overall and lower EMA sleep sufficiency and sleep quality. Moreover, participants with insomnia concerns had shorter actigraphy-measured nap duration prior to non-workdays than those without. Nearly all (95%) expressed interest in participating in a sleep intervention; an online format and mindfulness contents were most preferred. Our results suggest a high prevalence of insomnia symptoms and a high interest in a sleep intervention in nurses. Information obtained from this study could be used to deliver a tailored sleep intervention for nurses whose role in public health is essential.
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Affiliation(s)
- Soomi Lee
- School of Aging Studies, University of South Florida, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, USA
| | - Brent J Small
- School of Aging Studies, University of South Florida, USA
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32
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Lee S, Vigoureux TF, Hyer K, Small BJ. Prevalent Insomnia Concerns and Perceived Need for Sleep Intervention Among Direct-Care Workers in Long-Term Care. J Appl Gerontol 2020; 41:274-284. [PMID: 33322992 DOI: 10.1177/0733464820978612] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study examined sleep concerns among direct-care workers in long-term care and their perceived need for a sleep intervention. Thirty-five participants reported their sleep concerns and willingness to participate in a sleep intervention with preferred delivery forms/content. Multiple sleep characteristics were assessed via ecological momentary assessment and actigraphy for 2 weeks. Eighty percent reported at least one sleep concern with insomnia-related concerns being most prevalent. Those with insomnia-related concerns tended to have long sleep onset latency, frequent awakenings, suboptimal (long) sleep duration, and long naps. Most participants (66%) expressed interest in participating in a sleep intervention either online or in group sessions; interest was higher in those with insomnia-related concerns. Mindfulness strategies were most preferred, followed by cognitive-behavioral therapy and sleep hygiene education. The high prevalence of insomnia-related concerns in direct-care workers needs to be addressed for the well-being of these workers and for the quality of geriatric care delivery.
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Affiliation(s)
- Soomi Lee
- University of South Florida, Tampa, USA
| | | | - Kathryn Hyer
- University of South Florida, Tampa, USA.,Florida Policy Exchange Center on Aging, Tampa, USA
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Yu H, Shin OS, Kim S, Park C. Effect of an Inflatable Air Mattress with Variable Rigidity on Sleep Quality. SENSORS 2020; 20:s20185317. [PMID: 32957531 PMCID: PMC7570988 DOI: 10.3390/s20185317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/09/2020] [Accepted: 09/14/2020] [Indexed: 11/19/2022]
Abstract
Several studies, wherein the structure or rigidity of a mattress was varied, have been conducted to improve sleep quality. These studies investigated the effect of variation in the surface characteristics of mattresses on sleep quality. The present study developed a mattress whose rigidity can be varied by controlling the amount of air in its air cells. To investigate the effect of the variable rigidity of the air mattress on sleep quality, participants (Male, Age: 23.9 ± 2.74, BMI: 23.3 ± 1.60) were instructed to sleep on the air mattress under different conditions, and their sleep quality was subjectively and objectively investigated. Subjectively, sleep quality is assessed based on the participants’ evaluations of the depth and length of their sleep. Objectively, sleep is estimated using the sleep stage information obtained by analysing the movements and brain waves of the participants during their sleep. A subjective assessment of the sleep quality demonstrates that the participants’ sleep was worse with the adjustment of the air mattress than that without; however, the objective sleep quality results demonstrates an improvement in the sleep quality when the rigidity of the air mattress is varied based on the participant’s preference. This paper proposes a design for mattresses that can result in more efficient sleep than that provided by traditional mattresses.
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Affiliation(s)
- Hyunsoo Yu
- Department of Computer Engineering, Kwangwoon University, Seoul 01897, Korea;
| | - Oh-Soon Shin
- School of Electronic Engineering, Soongsil University, Seoul 07040, Korea;
| | - Sayup Kim
- Human Convergence R&D Department, Korea Institute of Industrial Technology, Ansan 15588, Korea
- Correspondence: (S.K.); (C.P.)
| | - Cheolsoo Park
- Department of Computer Engineering, Kwangwoon University, Seoul 01897, Korea;
- Correspondence: (S.K.); (C.P.)
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Ivgy-May N, Hajak G, van Osta G, Braat S, Chang Q, Roth T. Efficacy and safety of esmirtazapine in adult outpatients with chronic primary insomnia: a randomized, double-blind placebo-controlled study and open-label extension. J Clin Sleep Med 2020; 16:1455-1467. [PMID: 32351205 DOI: 10.5664/jcsm.8526] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Esmirtazapine (1.5-4.5 mg) has demonstrated short-term sleep-promoting effects in nonelderly outpatients with chronic insomnia. This phase 3, randomized, double-blind study (NCT00631657) and its open-label extension (NCT00750919) investigated efficacy and safety of long-term esmirtazapine treatment in adult outpatients with chronic insomnia. METHODS Participants were randomized to receive esmirtazapine 4.5 mg or placebo for 6 months; those receiving esmirtazapine were then rerandomized to esmirtazapine or placebo for an additional 7 days. Participants could enter the 6-month open-label extension with esmirtazapine 4.5 mg. The primary objective of the double-blind study was to assess long-term efficacy of esmirtazapine vs placebo on self-reported total sleep time. Assessing long-term safety and tolerability were secondary and primary objectives of the double-blind and extension studies, respectively. RESULTS Overall, 457 participants received treatment in the double-blind study (esmirtazapine, n = 342; placebo, n = 115) and 184 participants (prior esmirtazapine, n = 136; prior placebo, n = 48) received esmirtazapine in the extension. In the double-blind study, a 48.7-minute increase in average nightly total sleep time was observed for esmirtazapine vs placebo (95% confidence interval, 35.0-62.5; P < .0001) at months 4-6. There was no evidence of residual effects on next-day alertness or daytime functioning and no evidence of rebound insomnia or withdrawal symptoms upon treatment discontinuation. Esmirtazapine was generally well tolerated; somnolence and weight gain were the most common adverse events. CONCLUSIONS Esmirtazapine improved sleep duration vs placebo over at least 6 months. There was no evidence of next-day residual effects or of withdrawal symptoms or rebound insomnia following abrupt treatment discontinuation. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Name: A 6-Month Efficacy and Safety Study of Org 50081 in Adult Patients With Chronic Primary Insomnia (21106/P05701/MK-8265-002); URL: https://clinicaltrials.gov/ct2/show/NCT00631657; Identifier: NCT00631657; and Registry: ClinicalTrials.gov; Name: Twenty-Six Week Extension Trial of Org 50081 (Esmirtazapine) in Outpatients With Chronic Primary Insomnia (176003/P05721/MK-8265-007); URL: https://clinicaltrials.gov/ct2/show/NCT00750919); Identifier: NCT00750919.
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Affiliation(s)
| | - Goeran Hajak
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Social Foundation Bamberg, Bamberg, Germany
| | | | | | - Qing Chang
- Merck & Co., Inc., Kenilworth, New Jersey
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Woo J, Lee CJ. Sleep-enhancing Effects of Phytoncide Via Behavioral, Electrophysiological, and Molecular Modeling Approaches. Exp Neurobiol 2020; 29:120-129. [PMID: 32408402 PMCID: PMC7237266 DOI: 10.5607/en20013] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/24/2020] [Accepted: 04/27/2020] [Indexed: 12/16/2022] Open
Abstract
Sleep is indispensable for living animals to live and maintain a normal life. Due to the growing number of people suffering from sleep disorders such as insomnia, there have been increasing interests in environmentally friendly therapeutic approaches for sleep disorders to avoid any side effects of pharmacological treatment using synthetic hypnotics. It has been widely accepted that the various beneficial effects of forest, such as relieving stress and anxiety and enhancing immune system function, are caused by plant-derived products, also known as phytoncide. Recently, it has been reported that the sleep-enhancing effects of phytoncide are derived from pine trees such as (-)-α-pinene and 3-carene. These are the major constituents of pine tree that potentiate the inhibitory synaptic responses by acting as a positive modulator for GABAA-BZD receptor. In this review, we discuss the effects of phytoncide on sleep and review the latest approaches of sleep-related behavioral assay, electrophysiological recording, and molecular modeling technique.
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Affiliation(s)
- Junsung Woo
- Center for Cell and Gene Th erapy, Baylor College of Medicine, Houston, TX 77030, USA
| | - C Justin Lee
- Center for Cognition and Sociality, Institute for Basic Science, Daejeon 34126, Korea
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The Relationship between Self-Compassion and Sleep Quality: An Overview of a Seven-Year German Research Program. Behav Sci (Basel) 2020; 10:bs10030064. [PMID: 32155708 PMCID: PMC7139482 DOI: 10.3390/bs10030064] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/01/2020] [Accepted: 03/02/2020] [Indexed: 12/03/2022] Open
Abstract
Poor sleep quality is highly prevalent in modern societies and negatively linked to various health outcomes. While previous research has demonstrated preliminary evidence for self-compassion as a tool for improving sleep quality, this review provides a meta-analysis of respective published and unpublished results of our own research group using German samples. A total of nine studies are included (N = 956 participants), consisting of both correlational and experimental data. Across these studies, there was a medium correlation between self-compassion and subjective sleep quality, r = 0.303, 95% CI (0.244; 0.360). In three experimental studies, a small increase in participants’ self-reported sleep quality emerged, in comparison to control conditions, Hedges’ s g = 0.484, 95% CI (0.148; 0.821). Limitations on study level concern both the small sample sizes and short-term analyses of intervention effects. As a conclusion, this review supports both the correlational and causal relationship between self-compassion and increased subjective sleep quality across diverse operationalizations and samples. Future research should focus on the moderating effects of intervention type, duration of intervention effects, and type of target population.
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Maluck E, Busack I, Besseling J, Masurat F, Turek M, Busch KE, Bringmann H. A wake-active locomotion circuit depolarizes a sleep-active neuron to switch on sleep. PLoS Biol 2020; 18:e3000361. [PMID: 32078631 PMCID: PMC7053779 DOI: 10.1371/journal.pbio.3000361] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 03/03/2020] [Accepted: 01/23/2020] [Indexed: 11/18/2022] Open
Abstract
Sleep-active neurons depolarize during sleep to suppress wakefulness circuits. Wake-active wake-promoting neurons in turn shut down sleep-active neurons, thus forming a bipartite flip-flop switch. However, how sleep is switched on is unclear because it is not known how wakefulness is translated into sleep-active neuron depolarization when the system is set to sleep. Using optogenetics in Caenorhabditis elegans, we solved the presynaptic circuit for depolarization of the sleep-active RIS neuron during developmentally regulated sleep, also known as lethargus. Surprisingly, we found that RIS activation requires neurons that have known roles in wakefulness and locomotion behavior. The RIM interneurons—which are active during and can induce reverse locomotion—play a complex role and can act as inhibitors of RIS when they are strongly depolarized and as activators of RIS when they are modestly depolarized. The PVC command interneurons, which are known to promote forward locomotion during wakefulness, act as major activators of RIS. The properties of these locomotion neurons are modulated during lethargus. The RIMs become less excitable. The PVCs become resistant to inhibition and have an increased capacity to activate RIS. Separate activation of neither the PVCs nor the RIMs appears to be sufficient for sleep induction; instead, our data suggest that they act in concert to activate RIS. Forward and reverse circuit activity is normally mutually exclusive. Our data suggest that RIS may be activated at the transition between forward and reverse locomotion states, perhaps when both forward (PVC) and reverse (including RIM) circuit activity overlap. While RIS is not strongly activated outside of lethargus, altered activity of the locomotion interneurons during lethargus favors strong RIS activation and thus sleep. The control of sleep-active neurons by locomotion circuits suggests that sleep control may have evolved from locomotion control. The flip-flop sleep switch in C. elegans thus requires an additional component, wake-active sleep-promoting neurons that translate wakefulness into the depolarization of a sleep-active neuron when the worm is sleepy. Wake-active sleep-promoting circuits may also be required for sleep state switching in other animals, including in mammals. This study in nematodes shows that to understand sleep state switching, the flip-flop model for sleep regulation needs to be complemented by additional wake-active sleep-promoting neurons that activate sleep-active sleep-promoting neurons to induce sleep.
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Affiliation(s)
- Elisabeth Maluck
- Max Planck Institute for Biophysical Chemistry, Göttingen, Germany
- University of Marburg, Marburg, Germany
| | - Inka Busack
- Max Planck Institute for Biophysical Chemistry, Göttingen, Germany
- University of Marburg, Marburg, Germany
| | - Judith Besseling
- Max Planck Institute for Biophysical Chemistry, Göttingen, Germany
| | | | - Michal Turek
- Max Planck Institute for Biophysical Chemistry, Göttingen, Germany
| | | | - Henrik Bringmann
- Max Planck Institute for Biophysical Chemistry, Göttingen, Germany
- University of Marburg, Marburg, Germany
- * E-mail:
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Bacaro V, Chiabudini M, Buonanno C, De Bartolo P, Riemann D, Mancini F, Baglioni C. Insomnia in the Italian Population During Covid-19 Outbreak: A Snapshot on One Major Risk Factor for Depression and Anxiety. Front Psychiatry 2020; 11:579107. [PMID: 33384625 PMCID: PMC7769843 DOI: 10.3389/fpsyt.2020.579107] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 11/25/2020] [Indexed: 12/27/2022] Open
Abstract
Objectives: One of the largest clusters of Covid-19 infections was observed in Italy. The population was forced to home confinement, exposing individuals to increased risk for insomnia, which is, in turn, associated with depression and anxiety. Through a cross-sectional online survey targeting all Italian adult population (≥18 yrs), insomnia prevalence and its interactions with relevant factors were investigated. Methods: The survey was distributed from 1st April to 4th May 2020. We collected information on insomnia severity, depression, anxiety, sleep hygiene behaviors, dysfunctional beliefs about sleep, circadian preference, emotion regulation, cognitive flexibility, perceived stress, health habits, self-report of mental disorders, and variables related to individual difference in life changes due to the pandemic's outbreak. Results: The final sample comprised 1,989 persons (38.4 ± 12.8 yrs). Prevalence of clinical insomnia was 18.6%. Results from multivariable linear regression showed that insomnia severity was associated with poor sleep hygiene behaviors [β = 0.11, 95% CI (0.07-0.14)]; dysfunctional beliefs about sleep [β = 0.09, 95% CI (0.08-0.11)]; self-reported mental disorder [β = 2.51, 95% CI (1.8-3.1)]; anxiety [β = 0.33, 95% CI (0.25-0.42)]; and depression [β = 0.24, 95% CI (0.16-0.32)] symptoms. Conclusion: An alarming high prevalence of clinical insomnia was observed. Results suggest that clinical attention should be devoted to problems of insomnia in the Italian population with respect to both prevention and treatment.
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Affiliation(s)
- Valeria Bacaro
- Human Sciences Department, University of Rome Guglielmo Marconi, Rome, Italy.,School of Cognitive Psychotherapy, Association of Cognitive Psychology, Rome, Italy
| | - Marco Chiabudini
- School of Cognitive Psychotherapy, Association of Cognitive Psychology, Rome, Italy
| | - Carlo Buonanno
- School of Cognitive Psychotherapy, Association of Cognitive Psychology, Rome, Italy
| | - Paola De Bartolo
- Human Sciences Department, University of Rome Guglielmo Marconi, Rome, Italy.,Lab of Experimental Psychophysiology, IRCCS S. Lucia, Rome, Italy
| | - Dieter Riemann
- Department of Clinical Psychology and Psychophysiology/Sleep, Medicine, Centre for Mental Disorders, University Medical Centre, Freiburg, Germany
| | - Francesco Mancini
- Human Sciences Department, University of Rome Guglielmo Marconi, Rome, Italy.,School of Cognitive Psychotherapy, Association of Cognitive Psychology, Rome, Italy
| | - Chiara Baglioni
- Human Sciences Department, University of Rome Guglielmo Marconi, Rome, Italy.,School of Cognitive Psychotherapy, Association of Cognitive Psychology, Rome, Italy.,Department of Clinical Psychology and Psychophysiology/Sleep, Medicine, Centre for Mental Disorders, University Medical Centre, Freiburg, Germany
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Full KM, Moran K, Carlson J, Godbole S, Natarajan L, Hipp A, Glanz K, Mitchell J, Laden F, James P, Kerr J. Latent profile analysis of accelerometer-measured sleep, physical activity, and sedentary time and differences in health characteristics in adult women. PLoS One 2019; 14:e0218595. [PMID: 31247051 PMCID: PMC6597058 DOI: 10.1371/journal.pone.0218595] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 06/05/2019] [Indexed: 12/21/2022] Open
Abstract
Objectives Independently, physical activity (PA), sedentary behavior (SB), and sleep are related to the development and progression of chronic diseases. Less is known about how rest-activity behaviors cluster within individuals and how rest-activity behavior profiles relate to health. In this study we aimed to investigate if adult women cluster into profiles based on how they accumulate rest-activity behavior (including accelerometer-measured PA, SB, and sleep), and if participant characteristics and health outcomes differ by profile membership. Methods A convenience sample of 372 women (mean age 55.38 + 10.16) were recruited from four US cities. Participants wore ActiGraph GT3X+ accelerometers on the hip and wrist for a week. Total daily minutes in moderate-to-vigorous PA (MVPA) and percentage of wear-time spent in SB was estimated from the hip device. Total sleep time (hours/minutes) and sleep efficiency (% of in bed time asleep) were estimated from the wrist device. Latent profile analysis (LPA) was performed to identify clusters of participants based on accumulation of the four rest-activity variables. Adjusted ANOVAs were conducted to explore differences in demographic characteristics and health outcomes across profiles. Results Rest-activity variables clustered to form five behavior profiles: Moderately Active Poor Sleepers (7%), Highly Actives (9%), Inactives (41%), Moderately Actives (28%), and Actives (15%). The Moderately Active Poor Sleepers (profile 1) had the lowest proportion of whites (35% vs 78–91%, p < .001) and college graduates (28% vs 68–90%, p = .004). Health outcomes did not vary significantly across all rest-activity profiles. Conclusions In this sample, women clustered within daily rest-activity behavior profiles. Identifying 24-hour behavior profiles can inform intervention population targets and innovative behavioral goals of multiple health behavior interventions.
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Affiliation(s)
- Kelsie M. Full
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, United States of America
- Department of Family Medicine & Public Health, University of California San Diego, La Jolla, California, United States of America
- * E-mail:
| | - Kevin Moran
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Jordan Carlson
- Center for Children’s Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, Missouri, United States of America
| | - Suneeta Godbole
- Department of Family Medicine & Public Health, University of California San Diego, La Jolla, California, United States of America
| | - Loki Natarajan
- Department of Family Medicine & Public Health, University of California San Diego, La Jolla, California, United States of America
| | - Aaron Hipp
- Department of Parks, Recreation, and Tourism Management, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Karen Glanz
- Perelman School of Medicine and School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Jonathan Mitchell
- Division of Gastroenterology, Hepatology and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Francine Laden
- Departments of Environmental Health and Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Harvard University, Boston, Massachusetts, United States of America
| | - Peter James
- Departments of Environmental Health and Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Harvard University, Boston, Massachusetts, United States of America
| | - Jacqueline Kerr
- Department of Family Medicine & Public Health, University of California San Diego, La Jolla, California, United States of America
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Bringmann H. Genetic sleep deprivation: using sleep mutants to study sleep functions. EMBO Rep 2019; 20:embr.201846807. [PMID: 30804011 PMCID: PMC6399599 DOI: 10.15252/embr.201846807] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 11/14/2018] [Accepted: 11/23/2018] [Indexed: 01/08/2023] Open
Abstract
Sleep is a fundamental conserved physiological state in animals and humans. It may serve multiple functions, ranging from energy conservation to higher brain operation. Understanding sleep functions and the underlying mechanisms requires the study of sleeplessness and its consequences. The traditional approach to remove sleep is sleep deprivation (SD) by sensory stimulation. However, stimulation-induced SD can be stressful and can cause non-specific side effects. An emerging alternative method is "genetic SD", which removes sleep using genetics or optogenetics. Sleep requires sleep-active neurons and their regulators. Thus, genetic impairment of sleep circuits might lead to more specific and comprehensive sleep loss. Here, I discuss the advantages and limits of genetic SD in key genetic sleep model animals: rodents, zebrafish, fruit flies and roundworms, and how the study of genetic SD alters our view of sleep functions. Genetic SD typically causes less severe phenotypes compared with stimulation-induced SD, suggesting that sensory stimulation-induced SD may have overestimated the role of sleep, calling for a re-investigation of sleep functions.
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Affiliation(s)
- Henrik Bringmann
- Max Planck Institute for Biophysical Chemistry, Göttingen, Germany
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41
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Abstract
PURPOSE OF REVIEW Inflammation has emerged as an important biological process in the development of many age-related diseases that occur at different frequencies in men and women. The aim of this review was to examine the current evidence linking stress and sleep with inflammation with a focus on sex differences. RECENT FINDINGS Psychosocial stress that occurs either acutely or chronically is associated with elevated levels of systemic inflammation. While not as robust, insufficient sleep, particularly sleep disturbances, appears to be associated with higher levels of inflammatory activity as well. In several contexts, associations of stress and insufficient sleep with inflammation appear stronger in women than in men. However, this should be interpreted with caution as few studies test for sex differences. Stress and poor sleep often predict elevations in systemic inflammation. While there is some evidence that these associations are stronger in women, findings are largely mixed and more systematic investigations of sex differences in future studies are warranted.
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Crain TL, Hammer LB, Bodner T, Olson R, Kossek EE, Moen P, Buxton OM. Sustaining sleep: Results from the randomized controlled work, family, and health study. J Occup Health Psychol 2019; 24:180-197. [PMID: 29809024 PMCID: PMC6261705 DOI: 10.1037/ocp0000122] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although calls for intervention designs are numerous within the organizational literature and increasing efforts are being made to conduct rigorous randomized controlled trials, existing studies have rarely evaluated the long-term sustainability of workplace health intervention outcomes, or mechanisms of this process. This is especially the case with regard to objective and subjective sleep outcomes. We hypothesized that a work-family intervention would increase both self-reported and objective actigraphic measures of sleep quantity and sleep quality at 6 and 18 months post-baseline in a sample of information technology workers from a U.S. Fortune 500 company. Significant intervention effects were found on objective actigraphic total sleep time and self-reported sleep insufficiency at the 6- and 18-month follow-up, with no significant decay occurring over time. However, no significant intervention effects were found for objective actigraphic wake after sleep onset or self-reported insomnia symptoms. A significant indirect effect was found for the effect of the intervention on objective actigraphic total sleep time through the proximal intervention target of 6-month control over work schedule and subsequent more distal 12-month family time adequacy. These results highlight the value of long-term occupational health intervention research, while also highlighting the utility of this work-family intervention with respect to some aspects of sleep. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Tori L Crain
- Department of Psychology, Colorado State University
| | - Leslie B Hammer
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University
| | - Todd Bodner
- Department of Psychology, Portland State University
| | - Ryan Olson
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University
| | | | - Phyllis Moen
- Department of Sociology, University of Minnesota
| | - Orfeu M Buxton
- Department of Biobehavioral Health, The Pennsylvania State University
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Gosling JA, Batterham P, Ritterband L, Glozier N, Thorndike F, Griffiths KM, Mackinnon A, Christensen HM. Online insomnia treatment and the reduction of anxiety symptoms as a secondary outcome in a randomised controlled trial: The role of cognitive-behavioural factors. Aust N Z J Psychiatry 2018; 52:1183-1193. [PMID: 29717621 DOI: 10.1177/0004867418772338] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Insomnia and anxiety commonly co-occur, yet the mechanisms underlying this remain unclear. The current paper describes the impact of an Internet-based intervention for insomnia on anxiety, and explores the influence of two cognitive-behavioural constructs - dysfunctional beliefs about sleep and sleep-threat monitoring. METHODS A large-scale, 9-week, two-arm randomised controlled trial ( N = 1149) of community-dwelling Australian adults with insomnia and elevated yet subclinical depression symptoms was conducted, comparing a cognitive behavioural therapy-based online intervention for insomnia (Sleep Healthy Using The Internet) with an attention-matched online control intervention (HealthWatch). Symptoms of anxiety were assessed at pretest, posttest, and 6-month follow-up. Dysfunctional beliefs about sleep and sleep threat monitoring were assessed only at pretest. RESULTS Sleep Healthy Using The Internet led to a greater reduction in anxiety symptoms at both posttest ( t724.27 = -6.77, p < 0.001) and at 6-month follow-up ( t700.67 = -4.27, p < 0.001) than HealthWatch. At posttest and follow-up, this effect was found to moderated by sleep-threat monitoring ( t713.69 = -2.39, p < 0.05 and t694.77 = -2.98, p < 0.01 respectively) but not by dysfunctional beliefs about sleep at either posttest or follow-up ( t717.53 = -0.61, p = 0.55 and t683.79 = 0.22, p = 0.83 respectively). Participants in the Sleep Healthy Using The Internet condition with higher levels of sleep-threat monitoring showed a greater reduction in anxiety than those with lower levels from pretest to posttest, ( t724.27 = -6.77, p < 0.001) and through to 6-month follow-up ( t700.67 = -4.27, p < 0.001). This result remained after controlling for baseline anxiety levels. CONCLUSION The findings suggest that online cognitive behavioral therapy interventions for insomnia are beneficial for reducing anxiety regardless of people's beliefs about their sleep and insomnia, and this is particularly the case for those with high sleep-threat monitoring. This study also provides further evidence for cognitive models of insomnia.
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Affiliation(s)
- John A Gosling
- 1 Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, ACT, Australia
| | - Phil Batterham
- 1 Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, ACT, Australia
| | - Lee Ritterband
- 2 Department of Psychiatry and Neurobehavioral Sciences, Center for Behavioral Health & Technology, University of Virginia School of Medicine, Charlottesville, VA, USA.,3 BeHealth Solutions, Charlottesville, VA, USA
| | - Nick Glozier
- 4 Brain and Mind Research Institute, The University of Sydney, Sydney, NSW, Australia
| | - Frances Thorndike
- 2 Department of Psychiatry and Neurobehavioral Sciences, Center for Behavioral Health & Technology, University of Virginia School of Medicine, Charlottesville, VA, USA.,3 BeHealth Solutions, Charlottesville, VA, USA
| | - Kathleen M Griffiths
- 5 College of Medicine Biology & Environment, The Australian National University, Canberra, ACT, Australia
| | - Andrew Mackinnon
- 6 Black Dog Institute, University of New South Wales, Hospital Road, Randwick, Sydney, NSW, Australia.,7 School of Medicine, University of New South Wales, Randwick, NSW, Australia
| | - Helen M Christensen
- 6 Black Dog Institute, University of New South Wales, Hospital Road, Randwick, Sydney, NSW, Australia.,7 School of Medicine, University of New South Wales, Randwick, NSW, Australia
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Kalmbach DA, Anderson JR, Drake CL. The impact of stress on sleep: Pathogenic sleep reactivity as a vulnerability to insomnia and circadian disorders. J Sleep Res 2018; 27:e12710. [PMID: 29797753 PMCID: PMC7045300 DOI: 10.1111/jsr.12710] [Citation(s) in RCA: 247] [Impact Index Per Article: 41.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 04/12/2018] [Accepted: 04/13/2018] [Indexed: 12/19/2022]
Abstract
Sleep reactivity is the trait-like degree to which stress exposure disrupts sleep, resulting in difficulty falling and staying asleep. Individuals with highly reactive sleep systems experience drastic deterioration of sleep when stressed, whereas those with low sleep reactivity proceed largely unperturbed during stress. Research shows that genetics, familial history of insomnia, female gender and environmental stress influence how the sleep system responds to stress. Further work has identified neurobiological underpinnings for sleep reactivity involving disrupted cortical networks and dysregulation in the autonomic nervous system and hypothalamic-pituitary-adrenal axis. Sleep reactivity is most pathologically and clinically pertinent when in excess, such that high sleep reactivity predicts risk for future insomnia disorder, with early evidence suggesting high sleep reactivity corresponds to severe insomnia phenotypes (sleep onset insomnia and short sleep insomnia). High sleep reactivity is also linked to risk of shift-work disorder, depression and anxiety. Importantly, stress-related worry and rumination may exploit sensitive sleep systems, thereby augmenting the pathogenicity of sleep reactivity. With the development of cost-effective assessment of sleep reactivity, we can now identify individuals at risk of future insomnia, shift-work disorder and mental illness, thus identifying a target population for preventive intervention. Given that insomniacs with high sleep reactivity tend to present with severe insomnia phenotypes, patient sleep reactivity may inform triaging to different levels of treatment. Future research on sleep reactivity is needed to clarify its neurobiology, characterize its long-term prospective associations with insomnia and shift-work disorder phenotypes, and establish its prognostic value for mental illness and other non-sleep disorders.
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Affiliation(s)
- David A. Kalmbach
- Sleep Disorders and Research Center, Henry Ford Hospital, Detroit, Michigan
| | - Jason R. Anderson
- Department of Psychological Sciences, Kent State University, Kent, Ohio
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Cheong MJ, Lee GE, Kang HW, Kim S, Kim HK, Jo HI, Kang Y, Kim JH, Baek HG. Clinical effects of mindfulness meditation and cognitive behavioral therapy standardized for insomnia: A protocol for a systematic review and meta-analysis. Medicine (Baltimore) 2018; 97:e13499. [PMID: 30572449 PMCID: PMC6320014 DOI: 10.1097/md.0000000000013499] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 11/09/2018] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION This systematic review protocol describes the methods that will be used to evaluate the efficacy and safety of mindfulness meditation and cognitive behavioral therapy programs as a psychological intervention for insomnia disorders. METHODS AND ANALYSIS We will search the following 11 electronic databases without language or publication status restrictions: MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, and PsycARTICLES. Furthermore, we will also search 5 Korean-language databases (Oriental Medicine Advanced Searching Integrated System, Korean studies Information Service System, Research Information Service System, Korean Medical Database, and Korea Citation Index). The study selection and data extraction will be performed independently by 2 authors. The study quality assessment and evaluation of the quality of evidence for the main findings will be performed independently by 2 authors using the Cochrane tool for assessing risk of bias and predefined criteria (the Grading of Recommendations Assessment, Development, and Evaluation approach). Data synthesis and analysis will be performed using RevMan Version 5.3. Data will be synthesized by either a fixed effects or random effects model according to a heterogeneity test or the number of studies included in the meta-analysis. If any plan for documenting important protocol amendments changes, the researchers will have a revision agreement and then register the modification in the International Prospective Register of Systematic Reviews (PROSPERO). ETHICS AND DISSEMINATION Ethical approval will not be required because individual patient data are not included and because this protocol is for a systematic review. The findings of this systematic review will be disseminated through conference presentations.PROSPERO registration number: CRD42018111217.
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Affiliation(s)
| | - Go-Eun Lee
- Department of Oriental Rehabilitation Medicine, Korean National Rehabilitation, Seoul
| | - Hyung Won Kang
- Department of Korean Neuropsychiatry Medicine & Inam Neuroscience Research Center, Wonkwang University Sanbon Hospital, Gunpo
| | - Sooim Kim
- Department of Clinical Counseling Psychology, CHA University
| | - Hye Kyung Kim
- Department of Counseling Psychology, Hankuk University of Foreign Studies, Seoul
| | - Han-ik Jo
- Education Graduate of Hanyang University
| | | | - Jae-Hyo Kim
- Department of Meridian & Acupoint, College of Korean Medicine
| | - Hyeon-Gi Baek
- The Institute of Mind Humanities, Wonkwang University, Iksan, Republic of Korea
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Wagenseil B, Garcia C, Suvorov AV, Fietze I, Penzel T. The effect of cranial electrotherapy stimulation on sleep in healthy women. Physiol Meas 2018; 39:114007. [PMID: 30475746 DOI: 10.1088/1361-6579/aaeafa] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Cranial electrotherapy stimulation (CES) is considered to be a potential treatment for insomnia. Women are more likely to suffer from insomnia than men. Therefore we studied the effect of CES on sleep efficiency in young healthy women. METHODS A randomized, controlled clinical study was conducted on 40 women (age 18-35 years) without sleep disorders. Each subject underwent two nights of polysomnography in a sleep center. During the second night, we applied CES with a commercial device (Alpha-Stim 100) using either active or sham stimulation (double-blinded). Sleep was evaluated with respect to differences between the active and sham modes. Sleep electroencephalogram (EEG) analysis was applied to determine frequency changes. RESULTS In our study we found no evidence of any direct influence of the Alpha-Stim 100 on sleep. After application of CES, we determined no significant differences between the active group and the control group (sham). Using EEG spectral analysis there was evidence of a frequency-lowering influence on the low-α frequency band (8-10 Hz). CONCLUSIONS At most we may assume a reproducible effect on the α frequency measured in the EEG for application of CES with current levels >100 µA and presumably also with frequencies >0.5 Hz, with application directly at the cranium. We found no influence on sleep parameters. The effect on the low-α band evidenced in quantitative EEG analysis would require further investigation in a study with sufficient effect size. SIGNIFICANCE This is the first study to investigate the effects of CES with polysomnography during and after therapy. Our study contributes to the few controlled trials that have been conducted to study CES and its effects on the EEG α band. Highlights • This is the first study to investigate the effects of the Alpha-Stim in polysomnography during and subsequent to therapy. • In a quantitative electroencephalogram analysis we studied the data obtained for systematic changes. • To minimize placebo effects in patients with sleep disorders, we conducted the tests on subjects without such disorders.
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Affiliation(s)
- Boris Wagenseil
- Interdisciplinary Sleep Medicine Center, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany. Institute of Biomedical Problems (IMBP), Moscow, Germany
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Firat H, Yuceege M, Kiran S, Akgun M, Demir AU, Aksu M, Ardic S, Karadeniz D, Ucar ZZ, Sevim S, Itil O, Yilmaz H. Absenteeism and Delay to Work Due to Sleep Disorders in the Turkish Adult Population: A Questionnaire-Based National Survey. Workplace Health Saf 2018; 67:27-35. [PMID: 30223724 DOI: 10.1177/2165079918785392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Sleep problems may have negative effects on work-life balance, overall health, and safety. We aimed to investigate the association between sleep disorders and absenteeism and delay to work (being late or tardy) among the working adult population. The study was conducted by using data from a large survey of working adults who participated in the Turkish Adult Population Epidemiology of Sleep Study (TAPES) managed by Turkish Sleep Medicine Society (TSMS). Secondary analyses was employed to examine absenteeism and delay to work and their associations with sleep problems, including sleepiness by Epworth Sleepiness Scale (ESS), parasomnias, sleep apnea (by Berlin Questionnaire), sleep quality (by Pittsburgh Sleep Quality Index), and restless leg. History of any absenteeism and delay to work was observed in 276 (18%) and 443 (29%) out of 1,533 working adults, respectively. In the multivariate analyses, absenteeism was associated with younger age, female gender and poor sleep quality, while delay to work was associated with younger age, poor sleep quality, parasomnia, and sleepiness. In the presence of absenteeism and delay to work, sleep disorders including sleepiness, poor sleep quality, and parasomnia should be considered. Such evaluation may improve worker well-being and provide some additional benefits in terms of increasing productivity and lowering work-related costs.
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Affiliation(s)
- Hikmet Firat
- 1 Diskapi Yildirim Beyazit Education & Research Hospital
| | - Melike Yuceege
- 1 Diskapi Yildirim Beyazit Education & Research Hospital
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EEG-Based Automatic Sleep Staging Using Ontology and Weighting Feature Analysis. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2018; 2018:6534041. [PMID: 30254690 PMCID: PMC6142786 DOI: 10.1155/2018/6534041] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 06/26/2018] [Accepted: 07/02/2018] [Indexed: 01/08/2023]
Abstract
Sleep staging is considered as an effective indicator for auxiliary diagnosis of sleep diseases and related psychiatric diseases, so it attracts a lot of attention from sleep researchers. Nevertheless, sleep staging based on visual inspection of tradition is subjective, time-consuming, and error-prone due to the large bulk of data which have to be processed. Therefore, automatic sleep staging is essential in order to solve these problems. In this article, an electroencephalogram- (EEG-) based scheme that is able to automatically classify sleep stages is proposed. Firstly, EEG data are preprocessed to remove artifacts, extract features, and normalization. Secondly, the normalized features and other context information are stored using an ontology-based model (OBM). Thirdly, an improved method of self-adaptive correlation analysis is designed to select the most effective EEG features. Based on these EEG features and weighting features analysis, the improved random forest (RF) is considered as the classifier to achieve the classification of sleep stages. To investigate the classification ability of the proposed method, several sets of experiments are designed and conducted to classify the sleep stages into two, three, four, and five states. The accuracy of five-state classification is 89.37%, which is improved compared to the accuracy using unimproved RF (84.37%) or previously reported classifiers. In addition, a set of controlled experiments is executed to verify the effect of the number of sleep segments (epochs) on the classification, and the results demonstrate that the proposed scheme is less affected by the sleep segments.
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Kalmbach DA, Cuamatzi-Castelan AS, Tonnu CV, Tran KM, Anderson JR, Roth T, Drake CL. Hyperarousal and sleep reactivity in insomnia: current insights. Nat Sci Sleep 2018; 10:193-201. [PMID: 30046255 PMCID: PMC6054324 DOI: 10.2147/nss.s138823] [Citation(s) in RCA: 173] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Hyperarousal is a key component in all modern etiological models of insomnia disorder. Overall patterns in the literature suggest that over-active neurobiological and psychological systems contribute to difficulty sleeping. Even so, mixed results regarding the specific mechanisms linking hyperarousal to sleep disturbance limit current etiological conceptualizations. Similar basal arousal profiles between individuals with high vs low risk for insomnia in the absence of stress exposure suggest that dysregulated stress "response" rather than general hyperarousal may be a more pertinent marker of risk. In this report, we discuss evidence for hyperarousal in insomnia and explore the role of sleep reactivity. A trait characteristic, sleep reactivity is the degree to which stress disrupts sleep, manifesting as difficulty falling and staying asleep. Premorbid sleep reactivity has been shown to identify individuals at risk for future insomnia disorder, such as highly reactive sleepers (whose sleep systems are sensitive to stress) who are at elevated disease risk. Research points to genetics, family history of insomnia, gender, and environmental stress as factors that influence sleep reactivity. Importantly, stress-related cognitive-emotional reactivity (e.g., rumination, worry) may exploit the vulnerability of a highly reactive sleep system. We propose that sleep reactivity and cognitive-emotional reactivity may share a bidirectional relationship, conferring an insalubrious environment for sleep in response to stress. Future research on sleep reactivity is needed to identify its neurobiology, characterize its relationship with cognitive-emotional reactivity, and explore the potential clinical utility of sleep reactivity in treatment planning.
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Affiliation(s)
- David A Kalmbach
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USA,
| | | | - Christine V Tonnu
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USA,
| | - Kieulinh Michelle Tran
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USA,
| | - Jason R Anderson
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Thomas Roth
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USA,
| | - Christopher L Drake
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USA,
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Klingaman EA, Brownlow JA, Boland EM, Mosti C, Gehrman PR. Prevalence, predictors and correlates of insomnia in US army soldiers. J Sleep Res 2018; 27:e12612. [PMID: 29024363 PMCID: PMC5895531 DOI: 10.1111/jsr.12612] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 08/22/2017] [Indexed: 12/31/2022]
Abstract
The objective of this study was to investigate the rates, predictors and correlates of insomnia in a national sample of US Army soldiers. Data were gathered from the cross-sectional survey responses of the All-Army Study, of the Army Study to Assess Risk and Resilience in Service members. Participants were a representative sample of 21 499 US Army soldiers who responded to the All-Army Study self-administered questionnaire between 2011 and 2013. Insomnia was defined by selected DSM-5 criteria using the Brief Insomnia Questionnaire. The results highlight significant functional difficulties associated with insomnia among US soldiers, as well as insights into predictors of insomnia specific to this population. Insomnia was present in 22.76% of the sample. Predictors of insomnia status in logistic regression included greater number of current mental health disorders, less perceived open lines of communication with leadership, less unit member support and less education. Insomnia had global, negative associations with health, social functioning, support, morale, work performance and Army career intentions. The results provide the strongest evidence to-date that insomnia is common in a military population, and is associated with a wide array of negative factors in the domains of health, military readiness and intentions to remain in military careers.
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Affiliation(s)
- Elizabeth A Klingaman
- US Department of Veterans Affairs Capitol Healthcare Network (VISN 5), Mental Illness Research, Education, and Clinical Center (MIRECC) and Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Janeese A Brownlow
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Cpl. Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
| | - Elaine M Boland
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Cpl. Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
| | - Caterina Mosti
- Department of Psychology, Drexel University, Philadelphia, PA, USA
- Department of Psychiatry, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Philip R Gehrman
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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