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Reynolds AM, Spaeth AM, Hale L, Williamson AA, LeBourgeois MK, Wong SD, Hartstein LE, Levenson JC, Kwon M, Hart CN, Greer A, Richardson CE, Gradisar M, Clementi MA, Simon SL, Reuter-Yuill LM, Picchietti DL, Wild S, Tarokh L, Sexton-Radek K, Malow BA, Lenker KP, Calhoun SL, Johnson DA, Lewin D, Carskadon MA. Pediatric sleep: current knowledge, gaps, and opportunities for the future. Sleep 2023; 46:zsad060. [PMID: 36881684 PMCID: PMC10334737 DOI: 10.1093/sleep/zsad060] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/19/2023] [Indexed: 03/09/2023] Open
Abstract
This White Paper addresses the current gaps in knowledge, as well as opportunities for future studies in pediatric sleep. The Sleep Research Society's Pipeline Development Committee assembled a panel of experts tasked to provide information to those interested in learning more about the field of pediatric sleep, including trainees. We cover the scope of pediatric sleep, including epidemiological studies and the development of sleep and circadian rhythms in early childhood and adolescence. Additionally, we discuss current knowledge of insufficient sleep and circadian disruption, addressing the neuropsychological impact (affective functioning) and cardiometabolic consequences. A significant portion of this White Paper explores pediatric sleep disorders (including circadian rhythm disorders, insomnia, restless leg and periodic limb movement disorder, narcolepsy, and sleep apnea), as well as sleep and neurodevelopment disorders (e.g. autism and attention deficit hyperactivity disorder). Finally, we end with a discussion on sleep and public health policy. Although we have made strides in our knowledge of pediatric sleep, it is imperative that we address the gaps to the best of our knowledge and the pitfalls of our methodologies. For example, more work needs to be done to assess pediatric sleep using objective methodologies (i.e. actigraphy and polysomnography), to explore sleep disparities, to improve accessibility to evidence-based treatments, and to identify potential risks and protective markers of disorders in children. Expanding trainee exposure to pediatric sleep and elucidating future directions for study will significantly improve the future of the field.
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Affiliation(s)
| | - Andrea M Spaeth
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ, USA
| | - Lauren Hale
- Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Ariel A Williamson
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Monique K LeBourgeois
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Sachi D Wong
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Lauren E Hartstein
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Jessica C Levenson
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Misol Kwon
- Division of Sleep Medicine, University of Pennsylvania Perelman School of Medicine, PA, USA
| | - Chantelle N Hart
- The Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, USA
- The Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Ashley Greer
- The Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Cele E Richardson
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | | | - Michelle A Clementi
- Clinical Sciences, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Stacey L Simon
- Clinical Sciences, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lilith M Reuter-Yuill
- Comprehensive Speech and Therapy Center, Western Michigan University, Kalamazoo, MI, USA
| | - Daniel L Picchietti
- University of Illinois School of Medicine, Carle Illinois College of Medicine, Carle Foundation Hospital, and University of Illinois School of Medicine, Urbana, IL, USA
| | - Salome Wild
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Leila Tarokh
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | | | - Beth A Malow
- Departments of Neurology and Pediatrics, Burry Chair in Cognitive Childhood Development, Vanderbilt University Medical Center, Nashville, TN, USA
- Sleep Disorders Division, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kristina P Lenker
- Department of Psychiatry and Behavioral Health, Penn State Health Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA, USA
| | - Susan L Calhoun
- Department of Psychiatry and Behavioral Health, Penn State Health Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA, USA
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Daniel Lewin
- Department of Pulmonary and Sleep Medicine, Children’s National Hospital, Washington, DC, USA
| | - Mary A Carskadon
- Bradley Hospital Sleep Lab, Warren Alpert Medical School, Brown University, Providence, RI, USA
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Huang Y, Lou H, Song Y, Cui L, Li R, Gao G, Lou X, Hao C, Wang X. The association between various dimensions of sleep parameters and mental health: A large cross-sectional study of 13554 Chinese students. J Psychosom Res 2023; 170:111356. [PMID: 37178473 DOI: 10.1016/j.jpsychores.2023.111356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 04/04/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVES We aimed to investigate the association between multiple sleep variables and mental health among Chinese students aged 9-22. METHOD We stratified the included 13,554 students by educational levels. Sleep parameters contained sleep duration on school days and weekends, napping time, chronotype and social jetlag (SJL), which were calculated via questionnaires. Individual psychological well-being and distress were assessed by Warwick-Edinburgh mental Well-being scale and the Kessler Psychological Distress Scale 10 respectively. The multiple linear and binary logistic regression were applied to analyze the association of sleep with mental health. RESULTS Short sleep on school days showed significantly positive association with psychological problems. While among senior high school students, we found reverse result that sleeping less might negatively associated with more severe distress (7-8 h: aOR = 0.67, 95% CI: 0.46, 0.97). The association of sleep duration with mental health was attenuated a lot on weekends. The chronotype was significantly related with mental health in primary and junior high school: intermediate chronotype (vs late chronotype) was associated with greater wellbeing (β = 1.03, 95% CI: 0.09, 1.96; β = 1.89, 95% CI: 0.81, 2.97) and less distress (aOR = 0.78, 95% CI: 0.60, 1.00; aOR = 0.73, 95% CI: 0.58, 0.91). The relationship between SJL, napping duration and psychological health problems were also observed in some educational levels. CONCLUSION Sleep deprivation on school days, late chronotype and SJL were positively associated with worse mental health in our study, which differed among various educational stages.
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Affiliation(s)
- Ye Huang
- Department of Children, Adolescents and Women Health, College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou 450001, Henan, PR China; Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Hao Lou
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, PR China
| | - Yalin Song
- Department of Children, Adolescents and Women Health, College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou 450001, Henan, PR China
| | - Lina Cui
- Luohe Central Hospital, Luohe 462300, Henan, PR China
| | - Ran Li
- Zhengzhou Station for Students' Health, Zhengzhou 450007, Henan, PR China
| | - Genli Gao
- The Education Department of Henan Province, Zhengzhou 450018, Henan, PR China
| | - Xiaomin Lou
- Department of Children, Adolescents and Women Health, College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou 450001, Henan, PR China
| | - Changfu Hao
- Department of Children, Adolescents and Women Health, College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou 450001, Henan, PR China
| | - Xian Wang
- Department of Children, Adolescents and Women Health, College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou 450001, Henan, PR China.
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Oh CE, Lim HJ, Park J, Moon E, Park JK. Relationship of Circadian Rhythm in Behavioral Characteristics and Lipid Peroxidation of Brain Tissues in Mice. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2022; 20:649-661. [PMID: 36263640 PMCID: PMC9606440 DOI: 10.9758/cpn.2022.20.4.649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/07/2021] [Accepted: 08/11/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVE This study aimed to explore the relationship among several indices of circadian rhythms and lipid peroxidation of brain tissue in mice. METHODS After entrainment of 4-week-old mice, one group was disrupted their circadian rhythms for three days and the other group for seven days (n = 10, respectively). After a recovery period, the Y-maze test, the elevated plus maze test, the tail suspension test, and the forced swimming test were conducted. To assess lipid peroxidation in brain tissue, thiobarbituric acid reactive substances were measured in the cortex, hippocampus, and cerebellum. RESULTS When circadian rhythms were disrupted and adapted back to their original rhythm, the recovery time of the 7-day disruption group (median 3.35 days) was significiantly faster than one of the 3-day disruption group (median 4.87 days). In the group with a 7-day disruption, mice that had recovered their rhythms early had higher malondialdehyde levels in their hippocampus compared to those with delayed recovery. The entrainment of circadian rhythms was negatively correlated with the malondialdehyde level of brain tissue. The behavioral test results showed no differences depending on the disruption durations or recovery patterns of circadian rhythms. CONCLUSION These results suggest that disruption types, recovery patterns, and the entrainment of circadian rhythms are likely to affect oxidative stress in adolescents or young adult mice. Future study is needed to confirm and specify these results on the effects of circadian rhythms on oxidative stress and age-dependent effects.
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Affiliation(s)
- Chi Eun Oh
- Department of Pediatrics, Kosin University College of Medicine, Busan, Korea,Address for correspondence: Ji Kyoung Park Department of Pediatrics, Busan Paik Hospital, Inje University College of Medicine, 75 Bokji-ro, Busanjin-gu, Busan 47392, Korea, E-mail: , ORCID: https://orcid.org/0000-0002-8241-2302, Eunsoo Moon, E-mail: , ORCID ID: https://orcid.org/0000-0002-8863-3413, This manuscript is based on Chi Eun Oh’s doctoral thesis
| | - Hyun Ju Lim
- Department of Psychiatry and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jeounghyun Park
- Department of Psychiatry and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Eunsoo Moon
- Department of Psychiatry and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea,Department of Psychiatry, Pusan National University School of Medicine, Yangsan, Korea,Address for correspondence: Ji Kyoung Park Department of Pediatrics, Busan Paik Hospital, Inje University College of Medicine, 75 Bokji-ro, Busanjin-gu, Busan 47392, Korea, E-mail: , ORCID: https://orcid.org/0000-0002-8241-2302, Eunsoo Moon, E-mail: , ORCID ID: https://orcid.org/0000-0002-8863-3413, This manuscript is based on Chi Eun Oh’s doctoral thesis
| | - Ji Kyoung Park
- Department of Pediatrics, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea,Address for correspondence: Ji Kyoung Park Department of Pediatrics, Busan Paik Hospital, Inje University College of Medicine, 75 Bokji-ro, Busanjin-gu, Busan 47392, Korea, E-mail: , ORCID: https://orcid.org/0000-0002-8241-2302, Eunsoo Moon, E-mail: , ORCID ID: https://orcid.org/0000-0002-8863-3413, This manuscript is based on Chi Eun Oh’s doctoral thesis
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Francisco AP, Tonon AC, Amando GR, Hidalgo MP. Self-perceived rhythmicity in affective and cognitive functions is related to psychiatric symptoms in adolescents. Chronobiol Int 2022; 40:103-113. [PMID: 36377323 DOI: 10.1080/07420528.2022.2147078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The objective of this study was to evaluate the relationship between self-perceived rhythms measured using the Mood Rhythm Instrument for adolescents (MRhI-Y) and depressive and psychiatric symptoms measured with the Children's Depressive Instrument (CDI) and the Strengths and Difficulties Questionnaire (SDQ). In this study, 186 adolescents were recruited in Rio Grande do Sul, Brazil. We performed a Spearman correlation analysis to evaluate the relationships between quantitative variables. All variables that had a statistically significant correlation were included in ANOVA multiple regression models. The dependent variables in the multiple regression analyses were CDI score and total and emotional scores on the SDQ. We found that only Cognitive self-perceived rhythmicity contributed significantly to the first multiple regression with CDI as the outcome variable. The second regression with SDQ Emotional score as the outcome variable showed that female sex, age, and self-perceived affective rhythmicity contributed significantly to the model. The third regression with SDQ total score as the outcome variable showed that chronotype, self-perceived cognitive symptoms, and affective rhythmicity contributed significantly to the model. In conclusion, we found that lower self-perceived rhythmicity in cognitive factors and higher self-perceived rhythmicity in affective factors were related to presence and intensity of psychiatric and depressive symptoms.
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Affiliation(s)
- Ana Paula Francisco
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento – Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Andre Comiran Tonon
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento – Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Guilherme Rodriguez Amando
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento – Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Paz Hidalgo
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento – Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Persistence of Anxiety/Depression Symptoms in Early Adolescence: A Prospective Study of Daily Life Stress, Rumination, and Daytime Sleepiness in a Genetically Informative Cohort. Twin Res Hum Genet 2022; 25:115-128. [PMID: 35856184 DOI: 10.1017/thg.2022.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In this prospective study of mental health, we examine the influence of three interrelated traits - perceived stress, rumination, and daytime sleepiness - and their association with symptoms of anxiety and depression in early adolescence. Given the known associations between these traits, an important objective is to determine the extent to which they may independently predict anxiety/depression symptoms. Twin pairs from the Queensland Twin Adolescent Brain (QTAB) project were assessed on two occasions (N = 211 pairs aged 9-14 years at baseline and 152 pairs aged 10-16 years at follow-up). Linear regression models and quantitative genetic modeling were used to analyze the data. Prospectively, perceived stress, rumination, and daytime sleepiness accounted for 8-11% of the variation in later anxiety/depression; familial influences contributed strongly to these associations. However, only perceived stress significantly predicted change in anxiety/depression, accounting for 3% of variance at follow-up after adjusting for anxiety/depression at baseline, although it did not do so independently of rumination and daytime sleepiness. Bidirectional effects were found between all traits over time. These findings suggest an underlying architecture that is shared, to some degree, by all traits, while the literature points to hypothalamic-pituitary-adrenal (HPA) axis and/or circadian systems as potential sources of overlapping influence and possible avenues for intervention.
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Francisco AP, Cunha AMD, Tonon AC, Scop M, Mathur S, Caropreso L, Frey BN, Hidalgo MP. Adaptation and validation of the Mood Rhythm Instrument for use in Brazilian adolescents. BRAZILIAN JOURNAL OF PSYCHIATRY 2022; 44:264-270. [PMID: 35081211 PMCID: PMC9169486 DOI: 10.1590/1516-4446-2021-2092] [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: 02/23/2021] [Accepted: 09/05/2021] [Indexed: 12/03/2022]
Abstract
Objective: Adapt and validate the Mood Rhythm Instrument (MRhI), a self-reported questionnaire that assesses self-perceived rhythmicity of mood-related symptoms in adults, into a version that assesses and evaluates perceived mood-related symptoms in adolescents (MRhI-Y). Methods: Adaptation of the Brazilian Portuguese version of the MRhI for an adolescent population followed three steps: review by consultants, analysis by experts, and pilot testing through a visual analogue scale (VAS). The final questionnaire (MRhI-Y) was applied to 171 adolescents aged 12-17 years. Internal consistency was calculated using Cronbach’s alpha and McDonald’s omega. The psychometric properties of the MRhI-Y were evaluated using exploratory factor analysis (EFA). Results: The MRhI-Y was designed to use wording more appropriate for adolescents than that of the MRhI. Expert agreement about item quality ranged between 82 and 100%. Adolescents’ VAS ratings indicated good comprehension of the items. Cronbach’s alpha and McDonalds’ omega coefficients were 0.71 and 0.74. The EFA resulted in a three-factor solution (affective, cognitive, and somatic). Younger adolescents (ages 12 to 13) reported lower rhythmicity scores than older groups (ages 14 to 15 and 16 to 17), even controlling for chronotype. Conclusions: The Brazilian Portuguese version of the MRhI-Y presented adequate comprehension by adolescents and good internal consistency. The MRhI-Y is a promising tool to improve our understanding of the underlying characteristics of mood fluctuation in adolescence.
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Affiliation(s)
- Ana Paula Francisco
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; UFRGS, Brazil
| | - Ana Maria Delgado Cunha
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; UFRGS, Brazil
| | - Andre Comiran Tonon
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; UFRGS, Brazil
| | - Marina Scop
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; UFRGS, Brazil
| | | | - Luisa Caropreso
- McMaster University, Canada; Mood Disorders Program, Women's Health Concerns Clinic, St. Joseph’s Healthcare, Canada
| | - Benicio Noronha Frey
- McMaster University, Canada; Mood Disorders Program, Women's Health Concerns Clinic, St. Joseph’s Healthcare, Canada
| | - Maria Paz Hidalgo
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; UFRGS, Brazil
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The potential role of clock genes in children attention-deficit/hyperactivity disorder. Sleep Med 2020; 71:18-27. [PMID: 32460137 DOI: 10.1016/j.sleep.2020.02.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/16/2020] [Accepted: 02/20/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Attention deficit/ hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder and is thought to be associated with circadian system. METHODS We performed a pathway-based study to test individual single nucleotide polymorphisms (SNPs) and the overall evidence of genetic polymorphisms involved in the circadian pathway in association with children ADHD susceptibility among a Chinese population. A community-based case-control study was conducted among Chinese children, and 168 ADHD patients and 233 controls were recruited using a combination diagnosis based on the diagnostic and statistical manual of mental disorders iv (DSM-IV) ADHD rating scale, Swanson, Nolan, and Pelham rating scale (SNAP-IV) rating scale, and semi-structured clinical interview. RESULTS The results of single-loci analyses identified that PER1 rs2518023 and ARNTL2 rs2306074 were nominally association with ADHD susceptibility (P < 0.05). Next, we applied multifactor dimensionality reduction (MDR), and classification and regression tree (CART) analyses to explore high-order gene-gene interactions among the functional SNPs to ADHD risks. The results indicated that interactions among the PER1 rs2518023, ARNTL2 rs2306074 and NR1D1 rs939347 were associated with the risk of ADHD in children. Individuals carrying the combination genotypes of the PER1 rs2518023 GG or GT, ARNTL2 rs2306074 TC or TT and NR1D1 rs939347 GA or AA displayed a significantly higher risk for ADHD than who carry the PER1 rs2518023 TT and CRY2 rs2292910 CA/CC genotypes (adjusted OR = 4.37, 95% CI = 2.16-8.85, P < 0.001). CONCLUSIONS These findings revealed the importance of genetic variations related to the circadian clock system to the susceptibility of children ADHD.
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Association of health literacy and sleep problems with mental health of Chinese students in combined junior and senior high school. PLoS One 2019; 14:e0217685. [PMID: 31173621 PMCID: PMC6555521 DOI: 10.1371/journal.pone.0217685] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 05/17/2019] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES The aim of this study was to examine the association between health literacy (HL) and sleep problems with mental health of Chinese students in combined junior and senior high school. METHODS A cross-sectional study was conducted among seven hundred and seventy-five students from a combined junior and senior high school in Shenyang on December 16, 2016. HL, sleep problems, anxiety symptoms and depressive symptoms were measured by self-reported validated instruments. Multiple logistic regression models were used to examine the association of HL and sleep problems with mental health problems. RESULTS The prevalence of anxiety symptoms and depressive symptoms was 24.6% and 45.2%, respectively. Low HL was significantly associated with anxiety symptoms (OR = 2.457, 95%CI: 1.493-4.045) and depressive symptoms (OR = 5.164, 95%CI: 3.233-8.250). Sleep problems were significantly positively correlated with anxiety symptoms (OR = 4.237, 95%CI: 2.831-6.341) and depressive symptoms (OR = 3.170, 95%CI: 2.084-4.823). The students who had sleep problems with low HL had the highest risks of anxiety symptoms (OR = 11.440, 95%CI: 5.564-23.520) and depressive symptoms (OR = 19.470, 95%CI: 8.143-46.558). CONCLUSION Our findings suggest that Chinese students in combined junior and senior high school who had sleep problems with low HL are at risk of exhibiting anxiety symptoms and depressive symptoms. Intervention programs of mental health problems should enhance HL level and improve sleep quality.
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Davis DW, Feygin Y, Creel L, Williams PG, Lohr WD, Jones VF, Le J, Pasquenza N, Ghosal S, Jawad K, Yan X, Liu G, McKinley S. Longitudinal Trends in the Diagnosis of Attention-Deficit/Hyperactivity Disorder and Stimulant Use in Preschool Children on Medicaid. J Pediatr 2019; 207:185-191.e1. [PMID: 30545564 DOI: 10.1016/j.jpeds.2018.10.062] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 08/31/2018] [Accepted: 10/26/2018] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To describe trends in the diagnosis of attention-deficit/hyperactivity disorder (ADHD) and prescribing of stimulants in preschool-age children receiving Medicaid and to identify factors associated with the receipt of psychosocial care. STUDY DESIGN Data were extracted from 2012-2016 Kentucky Medicaid claims for children aged <6 years. ADHD was identified using International Classification of Diseases, Tenth Revision codes F90.0, F90.1, F90.2, F90.8, and F90.9. Psychosocial therapy was defined as having at least 1 relevant Current Procedural Terminology code in a claim within the year. A generalized linear model with a logit link and binomial distribution was used to assess factors associated with receipt of psychosocial treatment in 2016. RESULTS More than 2500 (1.24%) preschool-aged children receiving Medicaid had a diagnosis of ADHD in 2016, with 988 (38.2%) of those receiving a stimulant medication. Children in foster care were diagnosed with and/or treated for ADHD 4 times more often than other Medicaid recipients. Of the 1091 preschoolers receiving stimulants, 99 (9%) did not have a diagnosis of ADHD. There were no significant differences in diagnoses by race/ethnicity, but children reported to be black, Hispanic, or other race/ethnicity received stimulants at a lower rate than white children. Positive predictors for receiving psychosocial therapy in 2016 included having the diagnosis but not receiving a stimulant, having at least 1 prescription written by a psychiatrist, having comorbidities, and age. The use of stimulants in children aged <6 years declined from 0.9% in 2012 to 0.5% in 2016. CONCLUSIONS Promising trends demonstrate a decreasing use of stimulants in preschoolers; however, continued vigilance is needed to promote the optimal use of psychosocial interventions.
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Affiliation(s)
- Deborah Winders Davis
- University of Louisville School of Medicine; Department of Pediatrics, Child & Adolescent Research Design & Support Unit, Louisville, KY, USA.
| | - Yana Feygin
- University of Louisville School of Medicine; Department of Pediatrics, Child & Adolescent Research Design & Support Unit, Louisville, KY, USA
| | - Liza Creel
- University of Louisville School of Medicine; Department of Pediatrics, Child & Adolescent Research Design & Support Unit, Louisville, KY, USA; University of Louisville School of Public Health and Information Sciences, Health Management & Systems Science, Louisville, KY, USA
| | - P Gail Williams
- University of Louisville School of Medicine, Department of Pediatrics, Weisskopf Child Evaluation Center, Louisville, KY, USA
| | - W David Lohr
- University of Louisville School of Medicine; Department of Pediatrics, Child & Adolescent Research Design & Support Unit, Louisville, KY, USA; University of Louisville School of Medicine, Department of Pediatrics, Division of Child & Adolescent Psychiatry & Psychology, Louisville, KY, USA
| | - V Faye Jones
- University of Louisville School of Medicine, Department of Pediatrics, Division of General Pediatrics, Louisville, KY, USA
| | - Jennifer Le
- University of Louisville School of Medicine, Department of Pediatrics, Division of Child & Adolescent Psychiatry & Psychology, Louisville, KY, USA
| | - Natalie Pasquenza
- University of Louisville School of Medicine; Department of Pediatrics, Child & Adolescent Research Design & Support Unit, Louisville, KY, USA
| | - Soutik Ghosal
- University of Louisville School of Medicine; Department of Pediatrics, Child & Adolescent Research Design & Support Unit, Louisville, KY, USA; University of Louisville School of Public Health and Information Sciences, Bioinformatics and Biostatistics, Louisville, KY, USA
| | - Kahir Jawad
- University of Louisville School of Medicine; Department of Pediatrics, Child & Adolescent Research Design & Support Unit, Louisville, KY, USA
| | - Xiaofang Yan
- University of Louisville School of Medicine; Department of Pediatrics, Child & Adolescent Research Design & Support Unit, Louisville, KY, USA; University of Louisville School of Public Health and Information Sciences, Bioinformatics and Biostatistics, Louisville, KY, USA
| | - Gil Liu
- University of Louisville School of Medicine, Department of Pediatrics, Division of General Pediatrics, Louisville, KY, USA; Kentucky Department of Medicaid Services, Frankfort, KY, USA
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Palagini L, Domschke K, Benedetti F, Foster RG, Wulff K, Riemann D. Developmental pathways towards mood disorders in adult life: Is there a role for sleep disturbances? J Affect Disord 2019; 243:121-132. [PMID: 30243192 DOI: 10.1016/j.jad.2018.09.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 08/01/2018] [Accepted: 09/09/2018] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Mood disorders are among the most prevalent and serious mental disorders and rank high among to the leading global burdens of disease. The developmental psychopathology framework can offer a life course perspective on them thus providing a basis for early prevention and intervention. Sleep disturbances, are considered risk factors for mood disorders across childhood, adolescence and adulthood. Assuming that sleep disturbances may play a pivotal role in the pathogenesis of mood disorders from a life course point of view, we reviewed the data on developmental pathways towards mood disorders in adult life in relation to sleep disturbances. METHOD From February 2017, a systematic search was conducted in PubMed, PsycINFO and Embase electronic databases for literature on developmental pathways to mood disorders in adult life in relation to sleep disturbances and to 1) pre-natal stress, 2) early brain developmental processes, and 3) temperaments, character and attachment style. RESULTS Eleven, 54 and 15 articles were respectively selected. CONCLUSIONS Experimental and clinical studies revealed that exposure to prenatal/early life stress results in sleep disturbances such as poor sleep and altered circadian regulation phases and may predict or even precipitate mood disorders in adulthood. Chronic sleep disruption may interfere with neuronal plasticity, connectivity and the developing brain thus contributing to the development of mood disorders. In addition sleep and circadian dysregulations have been shown to be related to those temperaments, character and attachment styles which are considered precursors of mood disorders. Sleep and circadian behaviours may serve as early targets regarding mood disorders.
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Affiliation(s)
- Laura Palagini
- Department of Clinical Experimental Medicine, Psychiatric Unit, University of Pisa, Italy.
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Francesco Benedetti
- Psychiatry and Clinical Psychobiology, Scientific Institute Ospedale San Raffaele, Via Stamira d'Ancona 20, 20127 Milano, Italy
| | - Russell G Foster
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neuroscience at the University of Oxford, UK
| | - Katharina Wulff
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neuroscience at the University of Oxford, UK
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
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Agostini A, Lushington K, Dorrian J. The relationships between bullying, sleep, and health in a large adolescent sample. Sleep Biol Rhythms 2018. [DOI: 10.1007/s41105-018-0197-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Boksa P, Joober R. Who should be "controls" in studies on the neurobiology of psychiatric disorders? J Psychiatry Neurosci 2018; 43. [PMID: 30125246 PMCID: PMC6158024 DOI: 10.1503/jpn.180128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Patricia Boksa
- From the Douglas Mental Health University Institute, Dept. of Psychiatry, McGill University, Montreal, Que., Canada
| | - Ridha Joober
- From the Douglas Mental Health University Institute, Dept. of Psychiatry, McGill University, Montreal, Que., Canada
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Blake MJ, Trinder JA, Allen NB. Mechanisms underlying the association between insomnia, anxiety, and depression in adolescence: Implications for behavioral sleep interventions. Clin Psychol Rev 2018; 63:25-40. [PMID: 29879564 DOI: 10.1016/j.cpr.2018.05.006] [Citation(s) in RCA: 207] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 05/05/2018] [Accepted: 05/26/2018] [Indexed: 11/27/2022]
Abstract
There is robust evidence of an association between insomnia, anxiety, and depression in adolescence. The aim of this review is to describe and synthesize potential mechanisms underlying this association and explore implications for the design of adolescent behavioral sleep interventions. Specifically, we examine whether insomnia symptoms are a mechanism for the development of internalizing symptoms in adolescence and whether sleep interventions are an effective treatment for both insomnia and internalizing symptoms in adolescence because they target the shared mechanisms underlying these disorders. Research using different methodologies points to the role of sequential, parallel, and interacting mechanisms. In this paper, we review a wide range of relevant biological (i.e., polymorphisms and dysregulation in serotonin, dopamine, and circadian clock genes; alterations in corticolimbic and mesolimbic brain circuits; cortisol reactivity to stress; inflammatory cytokine dysregulation; biased memory consolidation; changes in sleep architecture), psychological (i.e., cognitive inflexibility, interpretational biases, judgment biases, negative attribution styles, worry, rumination, biased attention to threat, dysfunctional beliefs and attitudes about sleep, misperception of sleep deficit), and social mechanisms (i.e., reduced and impaired social interactions, unhelpful parenting behaviors, family stress) and propose an integrative multilevel model of how these phenomena may interact to increase vulnerability to both insomnia and internalizing disorders. Several 'biopsychosocial' mechanisms hold promise as viable treatment targets for adolescent behavioral sleep interventions, which may reduce both insomnia and internalizing symptoms.
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Affiliation(s)
- Matthew J Blake
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Vic 3010, Australia.
| | - John A Trinder
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Vic 3010, Australia.
| | - Nicholas B Allen
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Vic 3010, Australia; Department of Psychology, University of Oregon, Eugene, OR 97403-1227, USA.
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Semplonius T, Willoughby T. Psychosocial Adjustment Throughout University: A Longitudinal Investigation of the Roles of Sleep Quality and Emotion Dysregulation. J Youth Adolesc 2018; 47:1267-1278. [PMID: 29476457 DOI: 10.1007/s10964-018-0826-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 02/08/2018] [Indexed: 10/18/2022]
Abstract
Sleep problems and emotion dysregulation are associated with depressive symptoms and alcohol use but little research has examined the long-term associations and the direction of effects between these factors. We examined these relationships with 1132 undergraduates (70.5% female) over 5 years. Sleep problems and emotion dysregulation, sleep problems and depressive symptoms, and emotion dysregulation and depressive symptoms were all related bidirectionally. Tests of indirect effects indicated that sleep problems predicted depressive symptoms over time (and vice versa) via emotion dysregulation and emotion dysregulation predicted depressive symptoms over time (and vice versa) via sleep problems. The results highlight the need to assess direction of effects, given that many factors that are typically seen as "predictors" also can be framed as "outcomes".
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Affiliation(s)
- Thalia Semplonius
- Department of Psychology, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada.
| | - Teena Willoughby
- Department of Psychology, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada
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Morales-Lara D, De-la-Peña C, Murillo-Rodríguez E. Dad's Snoring May Have Left Molecular Scars in Your DNA: the Emerging Role of Epigenetics in Sleep Disorders. Mol Neurobiol 2017; 55:2713-2724. [PMID: 28155201 DOI: 10.1007/s12035-017-0409-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 01/13/2017] [Indexed: 12/16/2022]
Abstract
The sleep-wake cycle is a biological phenomena under the orchestration of neurophysiological, neurochemical, neuroanatomical, and genetical mechanisms. Moreover, homeostatic and circadian processes participate in the regulation of sleep across the light-dark period. Further complexity of the understanding of the genesis of sleep engages disturbances which have been characterized and classified in a variety of sleep-wake cycle disorders. The most prominent sleep alterations include insomnia as well as excessive daytime sleepiness. On the other side, several human diseases have been linked with direct changes in DNA, such as chromatin configuration, genomic imprinting, DNA methylation, histone modifications (acetylation, methylation, ubiquitylation or sumoylation, etc.), and activating RNA molecules that are transcribed from DNA but not translated into proteins. Epigenetic theories primarily emphasize the interaction between the environment and gene expression. According to these approaches, the environment to which mammals are exposed has a significant role in determining the epigenetic modifications occurring in chromosomes that ultimately would influence not only development but also the descendants' physiology and behavior. Thus, what makes epigenetics intriguing is that, unlike genetic variation, modifications in DNA are altered directly by the environment and, in some cases, these epigenetic changes may be inherited by future generations. Thus, it is likely that epigenetic phenomena might contribute to the homeostatic and/or circadian control of sleep and, possibly, have an undescribed link with sleep disorders. An exciting new horizon of research is arising between sleep and epigenetics since it represents the relevance of the study of how the genome learns from its experiences and modulates behavior, including sleep.
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Affiliation(s)
- Daniela Morales-Lara
- Laboratorio de Neurociencias Moleculares e Integrativas, Escuela de Medicina, División Ciencias de la Salud, Universidad Anáhuac Mayab, Carretera Mérida-Progreso Km. 15.5, A.P. 96 Cordemex, C.P. 97310, Mérida, Yucatán, Mexico.,Grupo de Investigación en Envejecimiento, División Ciencias de la Salud, Universidad Anáhuac Mayab, Mérida, Yucatán, Mexico.,Intercontinental Neuroscience Research Group, Mérida, Yucatán, Mexico
| | - Clelia De-la-Peña
- Unidad de Biotecnología, Centro de Investigación Científica de Yucatán, A.C, Mérida, Yucatán, Mexico
| | - Eric Murillo-Rodríguez
- Laboratorio de Neurociencias Moleculares e Integrativas, Escuela de Medicina, División Ciencias de la Salud, Universidad Anáhuac Mayab, Carretera Mérida-Progreso Km. 15.5, A.P. 96 Cordemex, C.P. 97310, Mérida, Yucatán, Mexico. .,Grupo de Investigación en Envejecimiento, División Ciencias de la Salud, Universidad Anáhuac Mayab, Mérida, Yucatán, Mexico. .,Intercontinental Neuroscience Research Group, Mérida, Yucatán, Mexico. .,Grupo de Investigación Desarrollos Tecnológicos para la Salud, División de Ingeniería y Ciencias Exactas, Universidad Anáhuac Mayab, Mérida, Yucatán, Mexico.
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Attention-Deficit/Hyperactivity Disorder: Focus upon Aberrant N-Methyl-D-Aspartate Receptors Systems. Curr Top Behav Neurosci 2015; 29:295-311. [PMID: 26718589 DOI: 10.1007/7854_2015_415] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) pathophysiology persists in an obscure manner with complex interactions between symptoms, staging, interventions, genes, and environments. Only on the basis of increasing incidence of the disorder, the need for understanding is greater than ever. The notion of an imbalance between central inhibitory/excitatory neurotransmitters is considered to exert an essential role. In this chapter, we first review how the default mode network functions and dysfunction in individuals diagnosed with ADHD. We also present and briefly review some of the animal models used to examine the neurobiological aspects of ADHD. There is much evidence indicating that compounds/interventions that antagonize/block glutamic acid receptors and/or block the glutamate signal during the "brain growth spurt" or in the adult animal may induce functional and biomarker deficits. Additionally, we present evidence suggesting that animals treated with glutamate blockers at the period of the "brain growth spurt" fail to perform the exploratory activity, observed invariably with control mice, that is associated with introduction to a novel environment (the test cages). Later, when the control animals show less locomotor and rearing activity, i.e., interest in the test cages, the MK-801, ketamine and ethanol treated mice showed successively greater levels of locomotion and rearing (interest), i.e., they fail to "habituate" effectively, implying a cognitive dysfunction. These disturbances of glutamate signaling during a critical period of brain development may contribute to the ADHD pathophysiology. As a final addition, we have briefly identified new research venues in the interaction between ADHD, molecular studies, and personality research.
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