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Siddiqi UA, Patel A, Jang Y, Cruz J, Combs P, Casida JM. Nighttime sleep and daytime sleepiness patterns among left ventricular assist device patients. J Artif Organs 2024; 27:172-176. [PMID: 37389676 DOI: 10.1007/s10047-023-01410-2] [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: 02/08/2023] [Accepted: 06/07/2023] [Indexed: 07/01/2023]
Abstract
Despite the high prevalence of sleep disturbance in the heart failure population, information about its consequence on daytime function in patients with left-ventricular assist devices (LVADs) is limited. This study examined the nighttime and daytime sleep patterns and changes from pre-implant to 6 months post-implant. This study included 32 LVAD patients. Demographics, nighttime and daytime sleep variables were collected pre-implant and at 1, 3, and 6 months post-implant. Wrist actigraphy and self-report questionnaires measured objective and subjective sleep, respectively. Objective nighttime sleep data were sleep efficiency (SE), sleep latency (SL), total sleep time (TST), wake after sleep onset (WASO), and sleep fragmentation (SF). Objective daytime sleep data were nap times. Self-reported Subjective Sleep Quality Scale (SSQS) and Stanford Sleepiness Scale (SSS) were subjective measures. Increased SF and WASO scores and decreased TST and SE scores were found pre-LVAD implant, indicative of poor sleep quality. TST, SE, naptime and SSQS scores were higher at 3 and 6 months post-implant compared to baseline. Decreases in TST and SF scores were observed at 3 and 6 months post-implant along with increases in SSS scores. Increasing SSS scores and decreasing overall scores from pre- and up to 6 months post-implant suggest improvement in daytime function. This study provides information on sleep-daytime function in the LVAD patient population. Improvements in daytime sleepiness do not imply "good" sleep quality, consistent with the extant knowledge in LVAD literature. Future investigations should elucidate the mechanism by which sleep-daytime function influences quality of life.
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Affiliation(s)
- Umar A Siddiqi
- Section of Cardiac Surgery, University of Chicago Medicine, Chicago, IL, USA.
| | - Aashka Patel
- Section of Cardiac Surgery, University of Chicago Medicine, Chicago, IL, USA
| | - Yena Jang
- Section of Cardiac Surgery, University of Chicago Medicine, Chicago, IL, USA
| | - Jennifer Cruz
- Section of Cardiac Surgery, University of Chicago Medicine, Chicago, IL, USA
| | - Pamela Combs
- Section of Cardiac Surgery, University of Chicago Medicine, Chicago, IL, USA
| | - Jesus M Casida
- School of Nursing, University of Arkansas-Fayetteville, Fayetteville, AR, USA
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Arnison T, Evans B, Schrooten MGS, Persson J, Palermo TM. Adolescent Girls' Musculoskeletal Pain is More Affected by Insomnia Than Boys, and Through Different Psychological Pathways. THE JOURNAL OF PAIN 2024:104571. [PMID: 38763259 DOI: 10.1016/j.jpain.2024.104571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 05/21/2024]
Abstract
Prior research has established that insomnia is predictive of pain in adolescents and that psychological mechanisms have a crucial role in this relationship. Adolescent girls report more insomnia and pain than boys, yet little is known of gender differences in how insomnia influences pain. This study assessed gender differences in levels and trajectories of insomnia and pain during adolescence, and whether rumination and negative mood mediated the effect of insomnia on pain. Longitudinal survey data measured on 5 annual occasions (Nbaseline = 2,767) were analyzed in a multigroup longitudinal serial mediation model. A final model was generated with insomnia as the predictor, rumination and depressed mood as mediators, pain as the outcome, and gender as the grouping variable. The results showed that insomnia predicted pain in adolescents, with an effect 3.5 times larger in girls than boys. Depressed mood was the main mediator in boys. In girls, rumination was the only significant mediator. There were significant gender differences in the effects of insomnia on rumination and pain, and in the effects of rumination on depressed mood and pain, with stronger effects in girls. These results highlight that girls and boys should be considered separately when studying the relationship between insomnia and pain. PERSPECTIVE: Levels of insomnia and pain are progressively higher in adolescent girls than boys, across adolescence. The predictive strength of insomnia symptoms for future pain is 3.5 times greater in girls, with distinct gender-specific underlying pathways: rumination partially mediates this effect in girls, while depressed mood does so in boys.
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Affiliation(s)
- Tor Arnison
- Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Örebro County, Sweden; School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Örebro County, Sweden.
| | - Brittany Evans
- School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Örebro County, Sweden
| | - Martien G S Schrooten
- School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Örebro County, Sweden
| | - Jonas Persson
- School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Örebro County, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Stockholm County, Sweden
| | - Tonya M Palermo
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington; Department of Anesthesiology, Pediatrics & Psychiatry, University of Washington School of Medicine, Seattle, Washington
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Bidwell LC, Sznitman SR, Martin-Willett R, Hitchcock LH. Daily associations with cannabis use and sleep quality in anxious cannabis users. Behav Sleep Med 2024; 22:150-167. [PMID: 37255232 PMCID: PMC10687319 DOI: 10.1080/15402002.2023.2217969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Cannabis is increasingly used to self-treat anxiety and related sleep problems, without clear evidence of either supporting or refuting its anxiolytic or sleep aid effects. In addition, different forms of cannabis and primary cannabinoids ∆9-tetrahydrocannabinol (THC) and cannabidiol (CBD) have differing pharmacological effects. METHODS Thirty days of daily data on sleep quality and cannabis use were collected in individuals who use cannabis for mild-to-moderate anxiety (n = 347; 36% male, 64% female; mean age = 33 years). Participants self-reported both the form (flower or edible) and the ratio of THC to CBD in the cannabis used during the observation period. RESULTS Individuals who reported cannabis use on a particular day also reported better sleep quality the following night. Moderation analyses showed that better perceived sleep after cannabis use days was stronger for respondents with higher baseline affective symptoms. Further, respondents who used cannabis edibles with high CBD concentration reported the highest perceived quality of sleep. CONCLUSIONS Among individuals with affective symptoms, naturalistic use of cannabis was associated with better sleep quality, particularly for those using edible and CBD dominant products.
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Affiliation(s)
- L C Bidwell
- Institute of Cognitive Science, University of Colorado Boulder, Boulder, CO, USA
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - S R Sznitman
- School of Public Health, University of Haifa Faculty of Social Welfare and Health Sciences, Haifa, Israel
| | - R Martin-Willett
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - L H Hitchcock
- Institute of Cognitive Science, University of Colorado Boulder, Boulder, CO, USA
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Milane T, Hansen C, Correno MB, Chardon M, Barbieri FA, Bianchini E, Vuillerme N. Comparison of sleep characteristics between Parkinson's disease with and without freezing of gait: A systematic review. Sleep Med 2024; 114:24-41. [PMID: 38150950 DOI: 10.1016/j.sleep.2023.11.021] [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: 05/25/2023] [Revised: 08/03/2023] [Accepted: 11/15/2023] [Indexed: 12/29/2023]
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder characterized by a range of motor and non-motor symptoms. Among the motor complaints, freezing of gait (FOG) is a common and disabling phenomenon that episodically hinders patients' ability to produce efficient steps. Concurrently, sleep disorders are prevalent in PD and significantly impact the quality of life of affected individuals. Numerous studies have suggested a bidirectional relationship between FOG and sleep disorders. Therefore, our objective was to systematically review the literature and compare sleep outcomes in PD patients with FOG (PD + FOG) and those without FOG (PD-FOG). By conducting a comprehensive search of the PubMed and Web of Science databases, we identified 20 eligible studies for inclusion in our analysis. Our review revealed that compared to PD-FOG, PD + FOG patients exhibited more severe symptoms of rapid eye movement sleep behavior disorder in nine studies, increased daytime sleepiness in eight studies, decreased sleep quality in four studies, and more frequent and severe sleep disturbances in four studies. These findings indicate that PD + FOG patients generally experience worse sleep quality, higher levels of daytime sleepiness, and more disruptive sleep disturbances compared to those without FOG (PD-FOG). The association between sleep disturbances and FOG highlights the importance of evaluating and monitoring these symptoms in PD patients and open the possibility for future studies to assess the impact of managing sleep disturbances on the severity and occurrence of FOG, and vice versa.
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Affiliation(s)
- Tracy Milane
- AGEIS, Université Grenoble Alpes, 38000, Grenoble, France; Department of Neurology, UKSH Campus Kiel, Kiel University, Arnold-Heller-Str. 3, Haus D, 24105, Kiel, Germany
| | - Clint Hansen
- AGEIS, Université Grenoble Alpes, 38000, Grenoble, France; Department of Neurology, UKSH Campus Kiel, Kiel University, Arnold-Heller-Str. 3, Haus D, 24105, Kiel, Germany.
| | - Mathias Baptiste Correno
- AGEIS, Université Grenoble Alpes, 38000, Grenoble, France; Department of Neurology, UKSH Campus Kiel, Kiel University, Arnold-Heller-Str. 3, Haus D, 24105, Kiel, Germany
| | - Matthias Chardon
- AGEIS, Université Grenoble Alpes, 38000, Grenoble, France; São Paulo State University (Unesp), School of Sciences, Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), Bauru, Brazil
| | - Fabio A Barbieri
- São Paulo State University (Unesp), School of Sciences, Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), Bauru, Brazil
| | - Edoardo Bianchini
- AGEIS, Université Grenoble Alpes, 38000, Grenoble, France; Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189, Rome, Italy
| | - Nicolas Vuillerme
- AGEIS, Université Grenoble Alpes, 38000, Grenoble, France; LabCom Telecom4Health, Orange Labs & Université Grenoble Alpes, CNRS, Inria, Grenoble INP-UGA, 38000, Grenoble, France; Institut Universitaire de France, 75005, Paris, France.
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Santi D, Debbi V, Costantino F, Spaggiari G, Simoni M, Greco C, Casarini L. Microbiota Composition and Probiotics Supplementations on Sleep Quality-A Systematic Review and Meta-Analysis. Clocks Sleep 2023; 5:770-792. [PMID: 38131749 PMCID: PMC10742335 DOI: 10.3390/clockssleep5040050] [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: 11/13/2023] [Revised: 11/29/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
The gut microbiota (GM) plays a crucial role in human health. The bidirectional interaction between GM and the central nervous system may occur via the microbiota-gut-brain axis, possibly regulating the sleep/wake cycle. Recent reports highlight associations between intestinal dysbiosis and sleep disorders, suggesting that probiotics could ameliorate this condition. However, data are poor and inconsistent. The aim of this quantitative metanalytic study is to assess the GM composition in sleep disturbances and evaluate probiotics' effectiveness for managing sleep disorders. A systematic review was carried out until July 2022 in online databases, limiting the literature research to human studies and English language articles. No significant GM diversity between patients with sleep disturbances versus healthy controls was found, revealed by α-diversity, while β-diversity is missing due to lack of proper reporting. However, probiotics supplementation significantly reduced the self-assessed parameter of sleep quality and disturbances Pittsburgh Sleep Quality Index (PSQI) score compared with the placebo. No difference in the Epworth Sleepiness Scale (ESS) score was found. While available data suggest that GM diversity is not related to sleep disturbances, probiotics administration strongly improves sleep quality as a subjective perception. However, heterogeneity of data reporting in the scientific literature should be considered as a limitation.
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Affiliation(s)
- Daniele Santi
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy; (D.S.); (V.D.); (M.S.); (L.C.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
- Unit of Andrology and Sexual Medicine of the Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
| | - Valentina Debbi
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy; (D.S.); (V.D.); (M.S.); (L.C.)
| | - Francesco Costantino
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy; (D.S.); (V.D.); (M.S.); (L.C.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
| | - Giorgia Spaggiari
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
- Unit of Andrology and Sexual Medicine of the Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
| | - Manuela Simoni
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy; (D.S.); (V.D.); (M.S.); (L.C.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
- Unit of Andrology and Sexual Medicine of the Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
- Center for Genomic Research, University of Modena and Reggio Emilia, 41126 Modena, Italy
| | - Carla Greco
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy; (D.S.); (V.D.); (M.S.); (L.C.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
| | - Livio Casarini
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy; (D.S.); (V.D.); (M.S.); (L.C.)
- Center for Genomic Research, University of Modena and Reggio Emilia, 41126 Modena, Italy
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Meng J, Zheng C, Wang H, Välimäki M, Wang M. Non-pharmacological interventions for improving sleep in people living with HIV: a systematic narrative review. Front Neurol 2023; 14:1017896. [PMID: 38125837 PMCID: PMC10732507 DOI: 10.3389/fneur.2023.1017896] [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: 09/06/2022] [Accepted: 10/27/2023] [Indexed: 12/23/2023] Open
Abstract
Background Sleep disturbances are common in people living with Human Immunodeficiency Virus (HIV) and may lead to poor adherence to antiretroviral therapy and worsen HIV symptom severity. Due to the side effects of pharmacotherapy for sleep disturbances, there is more room for non-pharmacological interventions, but knowledge of how these non-pharmacological interventions have been used to improve sleep in people living with HIV (PLWH) is still missing. Objective To investigate the content of non-pharmacological interventions, sleep measurements, and the impact of these interventions on improving sleep in PLWH. Methods Following PRISMA guidelines, we conducted a systematic search on PubMed, EMBASE, Cochrane Central Registry of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, Web of Science, China National Knowledge Infrastructure, Wanfang Data, and China Biology Medicine disc. Non-pharmacological interventions for improving sleep in PLWH were included, and study quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklists. We performed a narrative approach to synthesize the data to better understand the details and complexity of the interventions. Results Fifteen experimental studies in three categories for improving sleep in PLWH were included finally, including psychological interventions (components of cognitive-behavioral therapy for insomnia or mindfulness-based cognitive therapy, n = 6), physical interventions (auricular plaster therapy, acupuncture, and exercise, n = 8), and elemental interventions (speed of processing training with transcranial direct current stimulation, n = 1). Wrist actigraphy, sleep diary, and self-reported scales were used to measure sleep. Psychological interventions and physical interventions were found to have short-term effects on HIV-related sleep disturbances. Conclusions Psychological and physical interventions of non-pharmacological interventions can potentially improve sleep in PLWH, and the combination of patient-reported outcomes and actigraphy devices can help measure sleep comprehensively. Future non-pharmacological interventions need to follow protocols with evidence-based dosing, contents, and measures to ensure their sustainable and significant effects.
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Affiliation(s)
- Jingjing Meng
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
| | - Chunyuan Zheng
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
| | - Honghong Wang
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
- Xiangya Center for Evidence-Based Practice & Healthcare Innovation: A Joanna Briggs Institute Affiliated Group, Xiangya Nursing School, Central South University, Changsha, Hunan, China
| | - Maritta Välimäki
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
- Xiangya Center for Evidence-Based Practice & Healthcare Innovation: A Joanna Briggs Institute Affiliated Group, Xiangya Nursing School, Central South University, Changsha, Hunan, China
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Min Wang
- The Institute of HIV/AIDS, The First Hospital of Changsha, Hunan, China
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Bastain T, Naya C, Yang T, Vigil M, Chen C, Chavez T, Toledo-Corral C, Farzan S, Habre R, Lerner D, Lurvey N, Grubbs B, Dunton G, Breton C, Eckel S. Poor Sleep Quality Increases Gestational Weight Gain Rate in Pregnant People: Findings from the MADRES Study. RESEARCH SQUARE 2023:rs.3.rs-2944456. [PMID: 37841879 PMCID: PMC10571604 DOI: 10.21203/rs.3.rs-2944456/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Background Poor sleep quality is associated with weight gain in non-pregnant populations, but evidence in pregnant people is lacking. Our study examined the association between early-to-mid pregnancy sleep quality and weekly gestational weight gain (GWG) rate during mid-to-late pregnancy by pre-pregnancy body mass index (BMI). Method Participants were 316 pregnant participants from the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) study. During early-to-mid pregnancy, participants reported their sleep quality which was used to construct four categories: very poor, poor, good, and very good. Linear growth curve models examined the association between early-to-mid pregnancy sleep quality and weekly rate of GWG (kg/week) during mid-to-late pregnancy (> 20 weeks gestation), with a three-way cross-level interaction between gestational age, sleep quality, and pre-pregnancy BMI category. Models adjusted for ethnicity by birthplace, hypertensive disorders, perceived stress score, and physical activity level. Results Overall, poorer early-to-mid pregnancy sleep quality was associated with increased weekly weight gain during mid-to-late pregnancy. For example, amongst normal weight participants, mid-to-late pregnancy weight gain was, on average, 0.39 kg (95% CI: 0.29, 0.48) per week for those with very good sleep quality, 0.53 kg (95% CI: 0.44, 0.61) per week for those with poor sleep quality, and 0.54 kg (95% CI: 0.46, 0.62) per week for those with very poor sleep quality during early-to-mid pregnancy. This difference in GWG rate was statistically significantly comparing very good to poor sleep (0.14 kg/week, 95% CI: 0.01, 0.26) and very good to very poor sleep (0.15kg/week, 85% CI: 0.02, 0.27). This association between sleep quality and GWG rate did not statistically differ by pre-pregnancy BMI. Conclusion Our study found very poor early-to-mid pregnancy sleep quality was associated with higher mid-to-late pregnancy GWG rate. Incorporating pregnancy-specific sleep recommendations into routine obstetric care may be a critical next step in promoting healthy GWG.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Carrie Breton
- Keck School of Medicine, University of Southern California
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Mohamed AZ, Andersen T, Radovic S, Del Fante P, Kwiatek R, Calhoun V, Bhuta S, Hermens DF, Lagopoulos J, Shan ZY. Objective sleep measures in chronic fatigue syndrome patients: A systematic review and meta-analysis. Sleep Med Rev 2023; 69:101771. [PMID: 36948138 PMCID: PMC10281648 DOI: 10.1016/j.smrv.2023.101771] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/11/2023]
Abstract
Patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) often report disrupted and unrefreshing sleep in association with worsened fatigue symptoms. However, the nature and magnitude of sleep architecture alteration in ME/CFS is not known, with studies using objective sleep measures in ME/CFS generating contradictory results. The current manuscript aimed to review and meta-analyse of case-control studies with objective sleep measures in ME/CSF. A search was conducted in PubMed, Scopus, Medline, Google Scholar, and Psychoinfo databases. After review, 24 studies were included in the meta-analysis, including 20 studies with 801 adults (ME/CFS = 426; controls = 375), and 4 studies with 477 adolescents (ME/CFS = 242; controls = 235), who underwent objective measurement of sleep. Adult ME/CFS patients spend longer time in bed, longer sleep onset latency, longer awake time after sleep onset, reduced sleep efficiency, decreased stage 2 sleep, more Stage 3, and longer rapid eye movement sleep latency. However, adolescent ME/CFS patients had longer time in bed, longer total sleep time, longer sleep onset latency, and reduced sleep efficiency. The meta-analysis results demonstrate that sleep is altered in ME/CFS, with changes seeming to differ between adolescent and adults, and suggesting sympathetic and parasympathetic nervous system alterations in ME/CFS.
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Affiliation(s)
- Abdalla Z Mohamed
- Thompson Institute, University of the Sunshine Coast, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia.
| | - Thu Andersen
- Thompson Institute, University of the Sunshine Coast, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| | - Sanja Radovic
- Thompson Institute, University of the Sunshine Coast, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| | - Peter Del Fante
- Thompson Institute, University of the Sunshine Coast, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| | - Richard Kwiatek
- Thompson Institute, University of the Sunshine Coast, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| | - Vince Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, 55 Park Pl NE, 18th Floor, Atlanta, GA, 30303, USA
| | - Sandeep Bhuta
- Medical Imaging Department, Gold Coast University Hospital, Parklands, QLD, 4215, Australia
| | - Daniel F Hermens
- Thompson Institute, University of the Sunshine Coast, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| | - Jim Lagopoulos
- Thompson Institute, University of the Sunshine Coast, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| | - Zack Y Shan
- Thompson Institute, University of the Sunshine Coast, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
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Rocha RB, Bomtempo FF, Nager GB, Cenci GI, Telles JPM. Dual orexin receptor antagonists for the treatment of insomnia: systematic review and network meta-analysis. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:475-483. [PMID: 37257468 DOI: 10.1055/s-0043-1768667] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Several randomized clinical trials (RCTs) have shown that dual orexin receptor antagonists (DORAs) are effective in the treatment of chronic insomnia. However, the superiority of one particular DORA over the others remains unclear. OBJECTIVE To perform a network meta-analysis to evaluate the efficacy of different DORAs in patients with chronic insomnia. METHODS The Medline, Embase, and Cochrane Central databases were searched for RCTs that compared DORA with placebo in patients ≥ 18 years of age with a diagnosis of insomnia disorder. We pooled outcomes for wake time after sleep onset (WASO), latency to persistent sleep (LPS), total sleep time (TST), and adverse events (AEs). RESULTS We included 10 RCTs with 7,806 patients, 4,849 of whom received DORAs as the intervention. Overall, we found that DORAs were associated with the improvement of all analyzed efficacy outcomes. Concerning TST, an apparent dose-dependent pattern was noticed, with higher doses relating to a longer TST. Lemborexant 10mg provided the largest reduction in WASO (at month 1) in minutes (standardized mean difference [SMD] = -25.40; 95% confidence interval [95%CI] = -40.02--10.78), followed by suvorexant 20/15mg (SMD = -25.29; 95%CI = -36.42--14.15), which also appeared to provide the largest decrease in long-term WASO (SMD = -23.70; 95%CI = -35.89--11.51). The most frequent AEs were somnolence, nasopharyngitis, and headache, with rates of up to 14.8%. CONCLUSION Our results suggest that DORAs are associated with greater efficacy when compared with placebo in the treatment of insomnia, a complex 24-hour sleep disorder. Additionally, dosing might play an important role in the management of chronic insomnia.
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Affiliation(s)
| | | | - Gabriela Borges Nager
- Universidade Federal do Estado do Rio de Janeiro, Faculdade de Medicina, Rio de Janeiro RJ, Brazil
| | | | - João Paulo Mota Telles
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil
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10
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Solelhac G, Berger M, Strippoli MPF, Marchi NA, Stephan A, Petit JM, Bayon V, Imler T, Haba-Rubio J, Raffray T, Vollenweider P, Marques-Vidal P, Waeber G, Léger D, Siclari F, Geoffroy PA, Preisig M, Heinzer R. Objective polysomnography-based sleep features and major depressive disorder subtypes in the general population. Psychiatry Res 2023; 324:115213. [PMID: 37098299 DOI: 10.1016/j.psychres.2023.115213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 04/27/2023]
Abstract
Insomnia and its opposite hypersomnia are part of the diagnostic criteria for major depressive disorder (MDD). However, no study has investigated whether the postulated sleep alterations in clinical subtypes of MDD are reflected in polysomnography (PSG)-derived objective sleep measures. The objective of this study was to establish associations between the melancholic, atypical and unspecified subtypes of MDD and objective PSG-based sleep features. This cross-sectional analysis included 1820 community-dwelling individuals who underwent PSG and a semi-structured psychiatric interview to elicit diagnostic criteria for MDD and its subtypes. Adjusted robust linear regression was used to assess associations between MDD subtypes and PSG-derived objective sleep measures. Current melancholic MDD was significantly associated with decreased absolute delta power and sleep efficiency and with increased wake after sleep onset. Remitted unspecified MDD was significantly associated with increased rapid eye movements density. No other significant associations were identified. Our findings reflect that some PSG-based sleep features differed in MDD subtypes compared with no MDD. The largest number of significant differences were observed for current melancholic MDD, whereas only rapid eye movements density could represent a risk factor for MDD as it was the only sleep measure that was also associated with MDD in remitted participants.
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Affiliation(s)
- Geoffroy Solelhac
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland.
| | - Mathieu Berger
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland.
| | - Marie-Pierre F Strippoli
- Center for research in Psychiatric Epidemiology and Psychopathology (CEPP), Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland.
| | - Nicola Andrea Marchi
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland.
| | - Aurélie Stephan
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Jean-Marie Petit
- Center for Psychiatric Neuroscience (CNP), Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
| | - Virginie Bayon
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland.
| | - Théo Imler
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Jose Haba-Rubio
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland; Florimont Sleep Center, Lausanne, Switzerland.
| | - Tifenn Raffray
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland; Florimont Sleep Center, Lausanne, Switzerland.
| | - Peter Vollenweider
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
| | - Gerard Waeber
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
| | - Damien Léger
- Université Paris Cité, VIFASOM, AP-HP, Hôtel-Dieu, Centre du Sommeil et de la Vigilance, Paris, France.
| | - Francesca Siclari
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland; The Sense Innovation and Research Center, Lausanne and Sion, Switzerland; Department of Clinical Neurosciences Lausanne University Hospital (CHUV), Lausanne, Switzerland; Netherlands Institute for Neuroscience, Amsterdam, Netherlands.
| | - Pierre A Geoffroy
- GHU Paris - Psychiatry & Neurosciences, Paris, France; Université de Paris, NeuroDiderot, Inserm, Paris, France; Département de Psychiatrie et d'Addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, Paris, France
| | - Martin Preisig
- Center for research in Psychiatric Epidemiology and Psychopathology (CEPP), Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland.
| | - Raphaël Heinzer
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland.
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Chen Y, Zhou E, Wang Y, Wu Y, Xu G, Chen L. The past, present, and future of sleep quality assessment and monitoring. Brain Res 2023; 1810:148333. [PMID: 36931581 DOI: 10.1016/j.brainres.2023.148333] [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: 01/05/2023] [Revised: 03/09/2023] [Accepted: 03/12/2023] [Indexed: 03/17/2023]
Abstract
Sleep quality is considered to be an individual's self-satisfaction with all aspects of the sleep experience. Good sleep not only improves a person's physical, mental and daily functional health, but also improves the quality-of-life level to some extent. In contrast, chronic sleep deprivation can increase the risk of diseases such as cardiovascular diseases, metabolic dysfunction and cognitive and emotional dysfunction, and can even lead to increased mortality. The scientific evaluation and monitoring of sleep quality is an important prerequisite for safeguarding and promoting the physiological health of the body. Therefore, we have compiled and reviewed the existing methods and emerging technologies commonly used for subjective and objective evaluation and monitoring of sleep quality, and found that subjective sleep evaluation is suitable for clinical screening and large-scale studies, while objective evaluation results are more intuitive and scientific, and in the comprehensive evaluation of sleep, if we want to get more scientific monitoring results, we should combine subjective and objective monitoring and dynamic monitoring.
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Affiliation(s)
- Yanyan Chen
- School of Physical Education, Jianghan University, Wuhan Hubei, 430056, China
| | - Enyuan Zhou
- School of Physical Education, Jianghan University, Wuhan Hubei, 430056, China
| | - Yu Wang
- School of Physical Education, Jianghan University, Wuhan Hubei, 430056, China
| | - Yuxiang Wu
- School of Physical Education, Jianghan University, Wuhan Hubei, 430056, China
| | - Guodong Xu
- School of Physical Education, Jianghan University, Wuhan Hubei, 430056, China
| | - Lin Chen
- School of Physical Education, Jianghan University, Wuhan Hubei, 430056, China.
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12
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Park JH, Park H, Bae S, Kang J. Associations between the Timing and Nutritional Characteristics of Bedtime Meals and Sleep Quality for Nurses after a Rotating Night Shift: A Cross-Sectional Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1489. [PMID: 36674243 PMCID: PMC9859258 DOI: 10.3390/ijerph20021489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 06/17/2023]
Abstract
The purpose of this study was to investigate the associations of the timing and nutritional characteristics of bedtime meals with sleep quality in nurses after rotating night shifts. In total, 128 nurses from a university hospital in South Korea participated in this cross-sectional study. Data were collected on the first night of two or three consecutive routine night shifts. Participants recorded all food eaten before going to bed after work. An accelerometer was used to objectively measure sleep quality, and subjective sleep quality was assessed by self-report using the Korean version of the Verran and Snyder-Halpern Sleep Scale. The associations of timing and nutritional characteristics of bedtime meals with sleep quality after night shifts were analyzed using multivariate linear regression. A short time interval between meals and sleep was associated with longer objectively measured total sleep time (β = -0.37, p = 0.002), and the proportion of protein in meals was associated with better objectively measured sleep efficiency (β = 0.31, p = 0.007). The shorter the time interval, the better the subjective sleep quality (β = -0.23, p = 0.048), and high-calorie meals were positively associated with subjective sleep quality (β = 0.23, p = 0.043). Based on our findings, we encourage nurses to have protein-rich meals after night shifts and reduce the delay between meals and sleep. Although high-calorie meals were shown to have a positive effect on subjective sleep quality, it is necessary to confirm this effect through additional research.
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Affiliation(s)
- Jung Hoon Park
- Neurological Intensive Care Unit, Dong-A University Medical Center, Busan 49201, Republic of Korea
| | - Hyuntae Park
- Department of Health Sciences, Graduate School, Dong-A University, Busan 49315, Republic of Korea
| | - Seongryu Bae
- Department of Health Sciences, Graduate School, Dong-A University, Busan 49315, Republic of Korea
| | - Jiyeon Kang
- College of Nursing, Dong-A University, Busan 49201, Republic of Korea
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13
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Kadier K, Qin L, Ainiwaer A, Rehemuding R, Dilixiati D, Du YY, Maimaiti H, Ma X, Ma YT. Association of sleep-related disorders with cardiovascular disease among adults in the United States: A cross-sectional study based on national health and nutrition examination survey 2005–2008. Front Cardiovasc Med 2022; 9:954238. [PMID: 35990939 PMCID: PMC9386143 DOI: 10.3389/fcvm.2022.954238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/14/2022] [Indexed: 11/25/2022] Open
Abstract
Background and objective The association between sleep-related disorders and cardiovascular diseases (CVDs) remains controversial and lacks epidemiological evidence in the general population. We investigated whether sleep-related disorders are related to CVDs in a large, nationally representative, diverse sample of American adults. Materials and methods Data were collected from the National Health and Nutrition Examination Survey (NHANES) 2005–2008. Logistic regression was performed to explore associations of sleep-related disorders with the prevalence of total and specific CVDs. Stratified subgroup analysis was performed to exclude interactions between variables and sleep-related disorders. Non-linearity was explored using restricted cubic splines. Results In total, 7,850 participants aged over 20 years were included. After controlling for confounders, multivariate regression analysis showed that sleep problems were associated increases in risk of 75% for CVD (OR: 1.75; 95% CI 1.41, 2.16), 128% for congestive heart failure (CHF) (OR: 2.28; 95% CI 1.69, 3.09), 44% for coronary heart disease (CHD) (OR: 1.44; 95% CI 1.12, 1.85), 96% for angina pectoris (AP) (OR: 1.96; 95% CI 1.40, 2.74), 105% for heart attack (OR: 2.05; 95% CI 1.67, 2.53) and 78% for stroke (OR: 1.78; 95% CI 1.32, 2.40). Daytime sleepiness was associated increases in risk of 54% for CVD (OR: 1.54; 95% CI 1.25, 1.89), 73% for CHF (OR: 1.73; 95% CI 1.22, 2.46), 53% for AP (OR: 1.53; 95% CI 1.12, 2.10), 51% for heart attack (OR: 1.51; 95% CI 1.18, 1.95), and 60% for stroke (OR: 1.60; 95% CI 1.09, 2.36). Participants with insufficient sleep had a 1.42-fold higher likelihood of CVD (OR: 1.42; 95% CI 1.13, 1.78) and a 1.59-fold higher likelihood of heart attack (OR: 1.59; 95% CI 1.19, 2.13) than participants with adequate sleep. Prolonged sleep-onset latency was associated with an increased risk of CVD (OR: 1.59; 95% CI 1.17, 2.15), CHF (OR: 2.08; 95% CI 1.33, 3.23) and heart attack (OR: 1.76; 95% CI 1.29, 2.41). Short sleep-onset latency was associated with a 36% reduction in stroke risk (OR: 0.64; 95% CI 0.45, 0.90). The association of sleep problems with CVD risk was more pronounced in the group younger than 60 years (p for interaction = 0.019), and the relationship between short sleep-onset latency and total CVD differed by sex (p for interaction = 0.049). Additionally, restricted cubic splines confirmed a linear relationship between sleep-onset latency time and CVD (p for non-linearity = 0.839) and a non-linear relationship between sleep duration and CVD (p for non-linearity <0.001). Conclusion According to a limited NHANES sample used to examine sleep-related disorders and CVD, total and specific CVDs could be associated with certain sleep-related disorders. Additionally, our study uniquely indicates that CVD risk should be considered in participants younger than 60 years with sleep problems, and shortened sleep-onset latency may be a CVD protective factor in females.
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Affiliation(s)
- Kaisaierjiang Kadier
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China
| | - Lian Qin
- Department of Emergency Medicine, First Affiliated Hospital of Medical College, Shihezi University, Shihezi, China
| | - Aikeliyaer Ainiwaer
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China
| | - Rena Rehemuding
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China
| | - Diliyaer Dilixiati
- Clinical Medical College, First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China
| | - Yi-Ying Du
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China
| | - Halimulati Maimaiti
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China
| | - Xiang Ma
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China
- *Correspondence: Xiang Ma,
| | - Yi-Tong Ma
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China
- Yi-Tong Ma,
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14
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Kell PA, Huber FA, Street EN, Shadlow JO, Rhudy JL. Sleep Problems Mediate the Relationship Between Psychosocial Stress and Pain Facilitation in Native Americans: A Structural Equation Modeling Analysis from the Oklahoma Study of Native American Pain Risk. Ann Behav Med 2022; 56:1116-1130. [PMID: 35775809 PMCID: PMC9924047 DOI: 10.1093/abm/kaac034] [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: 11/14/2022] Open
Abstract
BACKGROUND Native Americans (NAs) are more likely to experience chronic pain than non-Hispanic Whites (NHWs); however, the proximate causes predisposing NAs to chronic pain remain elusive. Likely due to centuries of adversity, discrimination, and marginalization, NAs report greater psychological stress than NHWs, which may place them at risk for sleep problems, a well-established risk factor for chronic pain onset. PURPOSE This study examined the effects of psychological stress and sleep problems on subjective and physiological measures of pain processing in NAs and NHWs. METHODS Structural equation modeling was used to determine whether ethnicity (NA or NHW) was associated with psychological stress or sleep problems and whether these variables were related to conditioned pain modulation of pain perception (CPM-pain) and the nociceptive flexion reflex (CPM-NFR), temporal summation of pain (TS-pain) and NFR (TS-NFR), and pain tolerance in a sample of 302 (153 NAs) pain-free participants. RESULTS NAs experienced more psychological stress (Estimate = 0.027, p = .009) and sleep problems (Estimate = 1.375, p = .015) than NHWs. When controlling for age, sex, physical activity, BMI, and general health, NA ethnicity was no longer related to greater sleep problems. Psychological stress was also related to sleep problems (Estimate = 30.173, p = <.001) and psychological stress promoted sleep problems in NAs (indirect effect = 0.802, p = .014). In turn, sleep problems were associated with greater TS-pain (Estimate = 0.714, p = .004), but not other pain measures. CONCLUSIONS Sleep problems may contribute to chronic pain risk by facilitating pain perception without affecting facilitation of spinal neurons or endogenous inhibition of nociceptive processes. Since psychological stress promoted pain facilitation via enhanced sleep problems, efforts to reduce psychological stress and sleep problems among NAs may improve health outcomes.
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Affiliation(s)
- Parker A Kell
- Department of Psychology, The University of Tulsa, Tulsa, OK, USA
| | | | - Erin N Street
- Department of Psychology, The University of Tulsa, Tulsa, OK, USA
| | - Joanna O Shadlow
- Department of Psychology, The University of Tulsa, Tulsa, OK, USA
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15
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Spaggiari G, Romeo M, Casarini L, Granata ARM, Simoni M, Santi D. Human fertility and sleep disturbances: A narrative review. Sleep Med 2022; 98:13-25. [PMID: 35772248 DOI: 10.1016/j.sleep.2022.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 06/06/2022] [Accepted: 06/10/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Many factors may be hidden behind the global fertility decline observed in Western countries. Alongside the progressively increased age of infertile couples, environmental and behavioural factors, including non-optimal lifestyle habits, should be considered. Among these, sleep disorders have been suggested to be linked to human fertility. METHODS This is a narrative review, describing first sleep physiology, its disturbances, and the tools able to quantify sleep dysfunction. Then, we consider all available studies aimed at investigating the connection between sleep disorders and human fertility, providing a comprehensive view on this topic. RESULTS Forty-two studies investigating the relationship between sleep habits and human reproduction were included. All the published evidence was grouped according to the aspect of human fertility considered, i.e. i) female reproductive functions, ii) male reproductive functions, iii) natural conception and iv) assisted reproduction. For each of the sub-groups considered, the connection between sleep dysregulation and human fertility was classified according to specific sleep characteristics, such as sleep duration, quality, and habits. In addition, possible physio-pathological mechanisms proposed to support the link between sleep and fertility were summarized. CONCLUSION This review summarizes the most relevant findings about the intricate and still largely unknown network of molecular pathways involved in the regulation of circadian homeostasis, to which sleep contributes, essential for reproductive physiology. Thus, many mechanisms seem correlate sleep disorders to reproductive health, such as adrenal activation, circadian dysregulation, and genetic influences. This review highlights the need to properly designed trials on the topic.
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Affiliation(s)
- Giorgia Spaggiari
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy
| | - Marilina Romeo
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Livio Casarini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Antonio R M Granata
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy
| | - Manuela Simoni
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Daniele Santi
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
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16
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Mousavi Z, Tran ML, Borelli JL, Dent AL, Kuhlman KR. The moderating role of gender in the association between quality of social relationships and sleep. J Behav Med 2022; 45:378-390. [PMID: 35150370 PMCID: PMC9160110 DOI: 10.1007/s10865-022-00286-6] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/04/2022] [Indexed: 11/27/2022]
Abstract
To determine whether the association between perceived social support or strain in close relationships and sleep outcomes varies by gender. Participants were selected from the Biomarker projects of either the MIDUS II or MIDUS Refresher study if they were in a married-or married-like relationship and shared a bed with their partner (N = 989). A subsample also participated in a seven-day sleep study (n = 282). Perceived social support and strain from partner, family, and friends were examined by self-report questionnaires. We used the Pittsburgh Sleep Quality Index, sleep daily diary, and actigraphy to measure both subjective and objective sleep. Social support and strain were both associated with sleep outcomes. Specifically, higher social support was associated with fewer daily reports of light sleep and feeling more rested in the morning, while higher social strain was associated with higher clinical sleep disturbance. For women, but not men, social support was significantly associated with lower daily sleep disturbance while perceived social strain was significantly associated with higher daily sleep disturbance, lighter sleep, feeling less rested in the morning, lower sleep efficiency, and longer sleep onset latency. Mainly among women, social support and strain are associated with an important transdiagnostic health outcome-sleep-which may have implications for a wide range of health disparities. Interpersonal stressors may increase health risks differently for women compared to men and one mechanism that may link social relationships to long-term health outcomes is sleep.
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Affiliation(s)
- Zahra Mousavi
- Department of Psychological Science, School of Social Ecology, University of California, 4201 Social and Behavioral Sciences Gateway, Irvine, CA, 92697, USA.
| | - Mai-Lan Tran
- Department of Psychological Science, School of Social Ecology, University of California, 4201 Social and Behavioral Sciences Gateway, Irvine, CA, 92697, USA
| | - Jessica L Borelli
- Department of Psychological Science, School of Social Ecology, University of California, 4201 Social and Behavioral Sciences Gateway, Irvine, CA, 92697, USA
| | - Amy L Dent
- Department of Psychological Science, School of Social Ecology, University of California, 4201 Social and Behavioral Sciences Gateway, Irvine, CA, 92697, USA
| | - Kate R Kuhlman
- Department of Psychological Science, School of Social Ecology, University of California, 4201 Social and Behavioral Sciences Gateway, Irvine, CA, 92697, USA
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, USA
- Institute for Interdisciplinary Salivary Bioscience, School of Social Ecology, University of California, Irvine, USA
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17
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Valenzuela PL, Santos-Lozano A, Torres-Barrán A, Morales JS, Castillo-García A, Ruilope LM, Ríos-Insua D, Ordovás JM, Lucia A. Poor self-reported sleep is associated with risk factors for cardiovascular disease: A cross-sectional analysis in half a million adults. Eur J Clin Invest 2022; 52:e13738. [PMID: 34958676 DOI: 10.1111/eci.13738] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/23/2021] [Accepted: 12/25/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sleep is known to affect cardiovascular health, but some controversy exists on the independent association between different sleep characteristics (duration, restfulness, difficulties falling asleep) and specific risk factors for cardiovascular disease (CVD). We aimed to assess the association between self-reported sleep characteristics and the likelihood of major CVD risk factors. METHODS Totally, 521,364 Spanish workers (32% female, 44 ± 9 years [18-64]) insured by an occupational risk prevention company participated in this nationwide cross-sectional study. Participants' sleep was considered 'poor' if they reported having ≥1 of the following conditions: excessively short (<6 h/d) or long (>9 h/d) sleep, unrestful sleep, or difficulties to fall asleep. We assessed the independent association between aforementioned sleep characteristics and the prevalence of hypertension, diabetes, hypercholesterolaemia, obesity and physical inactivity. RESULTS Poor sleep (reported by 33% of participants) was associated with a higher likelihood of presenting all CVD risk factors individually, particularly physical inactivity (which prevalence was ~3-fold higher in the poor sleep group compared with participants reporting no sleep abnormality). In separate analyses, all the different sleep characteristics were associated with the likelihood of ≥2 CVD risk factors. Participants with optimal sleep, normal sleep duration, no difficulties falling sleep and restful sleep showed a lower total CVD risk score than their peers with poor sleep, short sleep duration, difficulties falling sleep and unrestful sleep, respectively (all p < .001). CONCLUSIONS Poor sleep was associated with a higher likelihood of presenting major CVD risk factors. These findings might support the importance of monitoring and improving sleep patterns for primary CVD prevention.
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Affiliation(s)
- Pedro L Valenzuela
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain.,Physical Activity and Health Research Group ('PaHerg'), Research Institute of the Hospital, 12 de Octubre ('imas12'), Madrid, Spain
| | - Alejandro Santos-Lozano
- Physical Activity and Health Research Group ('PaHerg'), Research Institute of the Hospital, 12 de Octubre ('imas12'), Madrid, Spain.,i+HeALTH, European University Miguel de Cervantes, Valladolid, Spain
| | - Alberto Torres-Barrán
- Institute of Mathematical Sciences (ICMAT-CSIC), Madrid, Spain.,Komorebi AI Technologies, Madrid, Spain
| | - Javier S Morales
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Cadiz, Spain
| | | | - Luis M Ruilope
- Hypertension Unit and Cardiorenal Translational Laboratory, Research Institute of the Hospital, 12 de Octubre (imas12), Madrid, Spain
| | | | - José M Ordovás
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts, USA
| | - Alejandro Lucia
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain.,Physical Activity and Health Research Group ('PaHerg'), Research Institute of the Hospital, 12 de Octubre ('imas12'), Madrid, Spain
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18
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Ma H, Yan J, Sun W, Jiang M, Zhang Y. Melatonin Treatment for Sleep Disorders in Parkinson's Disease: A Meta-Analysis and Systematic Review. Front Aging Neurosci 2022; 14:784314. [PMID: 35185525 PMCID: PMC8855052 DOI: 10.3389/fnagi.2022.784314] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/11/2022] [Indexed: 12/19/2022] Open
Abstract
Objective The efficacy of melatonin on sleep disorders in Parkinson's disease (PD) is still unclear. The purpose of this study was to investigate the efficacy of melatonin on sleep disorders in PD by summarizing evidence from randomized clinical trials (RCTs). Methods PubMed, Cochrane Library, EMBASE, and Web of Science databases were searched for studies published before 20 August 2021. Results were analyzed using Review Manager 5.2 software. We used Trial Sequential Analysis (TSA) software to avoid false-positive results caused by random errors. Results We included 7 studies in this systematic review and meta-analysis. The results of the meta-analysis showed that compared with placebo, the subjective sleep quality of patients with PD significantly improved after melatonin treatment (MD = −2.19, 95% CI: −3.53 to −0.86, P = 0.001). In the systematic review, we qualitatively analyzed the efficacy of melatonin on the objective sleep quality of patients with PD, and the results showed that melatonin exerted a positive effect with good safety and tolerability. However, there was no significant improvement in excessive daytime sleepiness assessed by the Epworth Sleepiness Scale (ESS). Conclusion We found that melatonin can significantly improve the subjective and objective sleep quality of patients with PD with good safety and tolerability. Melatonin could be considered an effective treatment for insomnia in patients with PD.
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Affiliation(s)
- Hongxia Ma
- Key Laboratory of Neuromolecular Biology, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Junqiang Yan
- Key Laboratory of Neuromolecular Biology, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
- Department of Neurology, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
- *Correspondence: Junqiang Yan
| | - Wenjie Sun
- Key Laboratory of Neuromolecular Biology, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Menghan Jiang
- Key Laboratory of Neuromolecular Biology, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Yongjiang Zhang
- Key Laboratory of Neuromolecular Biology, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
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19
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Zamani E, Akbari M, Mohammadkhani S, Riskind JH, Drake CL, Palagini L. The Relationship of Neuroticism with Sleep Quality: The Mediating Role of Emotional, Cognitive and Metacognitive Factors. Behav Sleep Med 2022; 20:74-89. [PMID: 33618569 DOI: 10.1080/15402002.2021.1888730] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Poor sleep quality is associated with a broad range of psychopathology and is a common problem among college students. This study aimed to investigate the mediating role of metacognitive beliefs related to sleep, emotion regulation and a negative cognitive style related to anxiety (looming cognitive style) in the relation between neuroticism and reported sleep quality. PARTICIPANTS Participants were 343 undergraduates from three universities in Tehran (56.3% females, Mean age = 22.01 ± 2.74 years). METHOD Data were gathered with a questionnaire packet that included the Pittsburgh Sleep Quality Index (PSQI), Metacognitions Questionnaire-Insomnia (MCQ-I), Emotion Regulation Questionnaire (ERQ), Looming Maladaptive Style Questionnaire (LMSQ) and Neuroticism subscale of NEO-PI-R. RESULTS Structural equation modeling analyses supported a proposed model (R2 = 37%) which proposed that neuroticism both directly and indirectly linked to reported sleep quality through metacognitions related to sleep, cognitive reappraisal and looming cognitive style (χ2 = 1194.87, p < .001; CFI = 0.93, NFI = 0.90, RMSEA = 0.065, GFI = 0.92, SRMR = 0.069, IFI = 0.93). CONCLUSIONS The results provide evidence for the impact of neuroticism on reported sleep quality through metacognitive, cognitive and emotional factors. The result suggest that special attention should be paid to these factors in the treatment and psychopathology of sleep quality.
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Affiliation(s)
- Elahe Zamani
- Department of Clinical Psychology, Kharazmi University, Tehran, Iran
| | - Mehdi Akbari
- Department of Clinical Psychology, Faculty of Psychology and Education, Kharazmi University, Tehran, Iran
| | | | - John H Riskind
- Department of Psychology, George Mason University, Fairfax, Virginia
| | - Christopher L Drake
- Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, Michigan
| | - Laura Palagini
- Department of Clinical Experimental Medicine, Psychiatric Unit, University of Pisa, Pisa, Italy
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20
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Cleland J, Gates LJ, Waiter GD, Ho VB, Schuwirth L, Durning S. Even a little sleepiness influences neural activation and clinical reasoning in novices. Health Sci Rep 2021; 4:e406. [PMID: 34761123 PMCID: PMC8566838 DOI: 10.1002/hsr2.406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 08/23/2021] [Accepted: 08/26/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND AND AIMS Sleepiness influences alertness and cognitive functioning and impacts many aspects of medical care, including clinical reasoning. However, dual processing theory suggests that sleepiness will impact clinical reasoning differently in different individual, depending on their level of experience with the given condition. Our aim, therefore, was to examine the association between clinical reasoning, neuroanatomical activation, and sleepiness in senior medical students. METHODS Our methodology replicated an earlier study but with novices rather than board-certified physicians. Eighteen final-year medical students answered validated multiple-choice questions (MCQs) during an fMRI scan. Each MCQ was projected in three phases: reading, answering, and reflection (modified think aloud). Echo-planar imaging (EPI) scans gave a time series that reflected blood oxygenation level dependent (BOLD) signal in each location (voxel) within the brain. Sleep data were collected via self-report (Epworth Sleepiness Scale) and actigraphy. These data were correlated with answer accuracy using Pearson correlation. RESULTS Analysis revealed an increased BOLD signal in the right dorsomedial prefrontal cortex (P < .05) during reflection (Phase 3) associated with increased self-reported sleepiness (ESS) immediately before scanning. Covariate analysis also revealed that increased BOLD signal in the right supramarginal gyrus (P < .05) when reflecting (Phase 3) was associated with increased correct answer response time. Both patterns indicate effortful analytic (System 2) reasoning. CONCLUSION Our findings that novices use System 2 thinking for clinical reasoning and even a little (perceived) sleepiness influences their clinical reasoning ability to suggest that the parameters for safe working may be different for novices (eg, junior doctors) and experienced physicians.
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Affiliation(s)
- Jennifer Cleland
- Lee Kong Chian School of Medicine, Nanyang Technological UniversitySingaporeSingapore
| | - Laura J. Gates
- Institute of Education for Medical and Dental Sciences, University of AberdeenAberdeenUK
| | - Gordon D. Waiter
- Aberdeen Biomedical Imaging Centre, University of AberdeenAberdeenUK
| | - Vincent B. Ho
- Department of Radiology and Radiological SciencesUniformed Services University of the Health SciencesBethesdaMarylandUSA
| | - Lambert Schuwirth
- College of Medicine and Public Health, Flinders UniversityAdelaideAustralia
| | - Steven Durning
- Department of MedicineUniformed Services University of the Health SciencesBethesdaMarylandUSA
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21
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Validity and reliability of the Turkish version of single-item Sleep Quality Scale in healthy adults. Sleep Med 2021; 88:197-203. [PMID: 34785424 DOI: 10.1016/j.sleep.2021.10.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 10/17/2021] [Accepted: 10/25/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The Single Item Sleep Quality Scale (SQS) is a self-reported outcome measure to assess sleep quality. SQS can be used when there is limited time or sleep impairments need to be identified quickly. This study aimed to investigate the validity, including concurrent criterion, convergent, divergent, and known-groups, and test-retest reliability of the SQS in a sample of the Turkish population. METHODS Turkish translation and cross-cultural adaptation of SQS were conducted. Two hundred and thirty-eight healthy adults aged 18-65 years were included in the study. The validity of the SQS was investigated using the Pittsburgh Sleep Quality Index (PSQI). The data were collected online. The retest-retest reliability was investigated in a subsample of 40 people after 7-14 days. RESULTS The SQS significantly correlated with item 6 (sleep quality) on PSQI and PSQI global score (rs = -0.73, -0.61, respectively). Although, it had a small correlation with total sleep time (rs = 0.28), awakenings (rs = -0.21) and habitual sleep efficiency (rs = -0.24). 8 of 11 predetermined hypotheses (73%) for convergent validity and 10 of 12 predetermined hypotheses for divergent validity (83%) were confirmed to test the construct validity. Test-retest reliability was found high (ICC = 0.82 (95%CI: 0.66 to 0.91)). SQS score of the sleep disorders group, which was determined according to the PSQI global score, was significantly lower. CONCLUSIONS The results revealed that SQS is a valid and reliable instrument and can be used to evaluate sleep quality in healthy Turkish adults.
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22
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Sella E, Miola L, Toffalini E, Borella E. The relationship between sleep quality and quality of life in aging: a systematic review and meta-analysis. Health Psychol Rev 2021; 17:169-191. [PMID: 34459704 DOI: 10.1080/17437199.2021.1974309] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This study examined the available literature concerning the association between sleep quality and quality of life (QoL) in autonomous older people with no sleep disorders. A systematic review and meta-analysis were conducted on studies identified in the PsycInfo, PubMed and Scopus databases that examined the associations between QoL and sleep quality in older adults. Our systematic literature search identified 23 studies concerning a total of 21,092 participants (range of mean ages: 58-79 years). The results showed that self-reported sleep quality, but not objective sleep quality, correlated positively with QoL with a moderate effect size (for self-reported sleep quality, the overall estimate of the average effect size was a Pearson's r = .28 [95% CI: .34, .23]; for objective sleep quality, it was r = .01 [.12, -.09]). This also applied to the main domains of QoL concerning physical and psychological health, social relationships and environmental aspects (the estimated average effect sizes ranged from Pearson's r = .13 to r = .35). These findings highlight the influence of sleep quality, and particularly of self-reported sleep quality, on QoL (as a whole and in its specific domains) in older adults with normal aging and no insomnia. This influence should therefore be investigated systematically when examining QoL.
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Affiliation(s)
- Enrico Sella
- Department of General Psychology, University of Padova, Padova, Italy
| | - Laura Miola
- Department of General Psychology, University of Padova, Padova, Italy
| | - Enrico Toffalini
- Department of General Psychology, University of Padova, Padova, Italy
| | - Erika Borella
- Department of General Psychology, University of Padova, Padova, Italy
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23
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Cain-Shields LR, Johnson DA, Glover L, Sims M. A Longitudinal Evaluation of Goal-Striving Stress and Sleep Duration Among African Americans in the Jackson Heart Study. Psychosom Med 2021; 83:932-937. [PMID: 34334729 PMCID: PMC8976697 DOI: 10.1097/psy.0000000000000993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The purposes of this study were to assess the association between changes in goal-striving stress (GSS) and changes in sleep duration in African Americans (AAs) and to determine if the association varies by sex, age, and/or educational attainment. METHODS We completed a longitudinal analysis using examination 1 (2000-2004, n = 5306) and examination 3 (2009-2013, n = 3819) data from the Jackson Heart Study, with a final sample of 3500. Changes in GSS and changes in sleep duration were calculated by subtracting examination 1 GSS from examination 3 GSS. Mean differences (β [standard error]) between changes in GSS and changes in sleep duration were assessed using linear regression models that adjusted for length of follow-up, sociodemographics, health behaviors/risk factors, and stressors. RESULTS In the fully adjusted models, the increase in GSS from examination 1 to examination 3 was associated with a decrease in sleep duration (in minutes) from examination 1 to examination 3 in the overall cohort (β = -7.72 [2.44], p < .002), in high school graduates (β = -21.23 [5.63], p < .001), and in college graduates (β = -7.57 [3.75], p = .044) but not in those with less than a high school education (β = 1.49 [8.35], p = .86) or those who attended college but did not graduate (β = 0.44 [4.94], p = .93). CONCLUSIONS Changes in GSS were inversely associated with changes in sleep duration over a mean period of 8 years in AA subgroups. Interventions that reduce stress related to goal striving should be considered to help improve sleep health in AAs.
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Affiliation(s)
- Loretta R Cain-Shields
- From the Department of Data Science, John D Bower School of Population Health (Cain-Shields), University of Mississippi Medical Center, Jackson, Mississippi; Department of Epidemiology, Rollins School of Public Health (Johnson), Emory University, Atlanta, Georgia; Department of Epidemiology, Gillings School of Global Public Health (Glover), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and Department of Medicine, School of Medicine (Sims), University of Mississippi Medical Center, Jackson, Mississippi
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24
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Topriceanu C, Tillin T, Chaturvedi N, Joshi R, Garfield V. The association between plasma metabolites and sleep quality in the Southall and Brent Revisited (SABRE) Study: A cross-sectional analysis. J Sleep Res 2021; 30:e13245. [PMID: 33283399 PMCID: PMC8365718 DOI: 10.1111/jsr.13245] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/10/2020] [Accepted: 11/10/2020] [Indexed: 01/17/2023]
Abstract
We examined the association between plasma metabolites and abnormal sleep patterns using data from the Southall and Brent REvisited (SABRE) cohort. Nuclear magnetic resonance spectroscopy provided 146 circulating plasma metabolites. Sleep questionnaires identified the presence or absence of: difficulty falling asleep, early morning waking, waking up tired, and snoring. Metabolites were compared between the sleep quality categories using the t test, and then filtered using a false discovery rate of 0.05. Generalised linear models with logit-link assessed the associations between filtered metabolites and sleep phenotypes. Adjustment was made for important demographic and health-related covariates. In all, 2,718 participants were included in the analysis. After correcting for multiple testing, three metabolites remained for difficulty falling asleep, 59 for snoring, and none for early morning waking and waking up tired. After adjusting for sex, age, ethnicity and years of education, 1 standard deviation increase in serum histidine and valine associated with lower odds of difficulty falling asleep by 0.89-0.90 (95% confidence intervals [CIs] 0.80-0.99). Branched-chain and aromatic amino acids (odds ratios [ORs] 1.19-1.25, 95% CIs 1.09-1.36) were positively associated with snoring. Total cholesterol in low-density lipoprotein (OR 0.90, 95% CI 0.83-0.97) and high-density lipoprotein (OR 0.88, 95% CI 0.81-0.95) associated with lower odds of snoring. In the fully adjusted model, most associations persisted. To conclude, histidine and valine associated with lower odds of difficulty falling asleep, while docosahexaenoic acid and cholesterol in low-density lipoprotein and high-density lipoprotein subfractions associated with lower odds of snoring. Identified metabolites could provide guidance on the metabolic pathways associated with adverse sleep quality.
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Affiliation(s)
| | - Therese Tillin
- Department of Population Science and Experimental MedicineInstitute of Cardiovascular ScienceUniversity College LondonLondonUK
- MRC Unit for Lifelong Health and AgeingUniversity College LondonLondonUK
| | - Nishi Chaturvedi
- Department of Population Science and Experimental MedicineInstitute of Cardiovascular ScienceUniversity College LondonLondonUK
- MRC Unit for Lifelong Health and AgeingUniversity College LondonLondonUK
| | - Roshni Joshi
- Department of Population Science and Experimental MedicineInstitute of Cardiovascular ScienceUniversity College LondonLondonUK
| | - Victoria Garfield
- Department of Population Science and Experimental MedicineInstitute of Cardiovascular ScienceUniversity College LondonLondonUK
- MRC Unit for Lifelong Health and AgeingUniversity College LondonLondonUK
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25
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Harrison EI, Roth RH, Lobo JM, Kang H, Logan J, Patel SR, Kapur VK, Kwon Y. Sleep time and efficiency in patients undergoing laboratory-based polysomnography. J Clin Sleep Med 2021; 17:1591-1598. [PMID: 33739259 PMCID: PMC8656908 DOI: 10.5664/jcsm.9252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
STUDY OBJECTIVES Sleep quality in patients studied with laboratory-based polysomnography may differ from sleep quality in patients studied at home but remains clinically relevant and important to describe. We assessed objective sleep quality and explored factors associated with poor sleep in patients undergoing laboratory-based polysomnography. METHODS We reviewed diagnostic polysomnography studies from a 10-year period at a single sleep center. Total sleep time (TST) and sleep efficiency (SE) were assessed as markers of sleep quality. Poor sleep was defined as TST ≤ 4 hours or SE ≤ 50%. Multivariable analysis was performed to determine associations between objective sleep quality as an outcome and multiple candidate predictors including age, sex, race, body mass index, comorbidities, severity of obstructive sleep apnea, and central nervous system medications. RESULTS Among 4957 patients (age 53 ± 15 years), average TST and median SE were 5.8 hours and 79%, respectively. There were 556 (11%) and 406 (8%) patients who had poor sleep based on TST and SE, respectively. In multivariable analysis, those who were older (per 10 years: 1.48 [1.34, 1.63]), male (1.38 [1.14,1.68]), and had severe obstructive sleep apnea (1.76 [1.28, 2.43]) were more likely to have short sleep. Antidepressant use was associated with lower odds of short sleep (0.77 [0.59,1.00]). Older age (per 10 years: 1.48 [1.34, 1.62]), male sex (1.34 [1.07,1.68]), and severe obstructive sleep apnea (2.16 [1.47, 3.21]) were associated with higher odds of poor SE. CONCLUSIONS We describe TST and SE from a single sleep center cohort. Multiple demographic characteristics were associated with poor objective sleep in patients during laboratory-based polysomnography. CITATION Harrison EI, Roth RH, Lobo JM, et al. Sleep time and efficiency in patients undergoing laboratory-based polysomnography. J Clin Sleep Med. 2021;17(8):1591-1598.
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Affiliation(s)
- Elizabeth I. Harrison
- Division of Child Neurology, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Robert H. Roth
- School of Medicine, University of Virginia, Charlottesville, Virginia
| | - Jennifer M. Lobo
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia
| | - Hyojung Kang
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Jeongok Logan
- Division of Child Neurology, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sanjay R. Patel
- Division of Child Neurology, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Vishesh K. Kapur
- Division of Child Neurology, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Younghoon Kwon
- Division of Child Neurology, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania,Address correspondence to: Younghoon Kwon, MD, MS, Department of Medicine, University of Washington, Box 359748, 325 9th Avenue, Seattle, WA 98104;
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26
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Climent-Sanz C, Valenzuela-Pascual F, Martínez-Navarro O, Blanco-Blanco J, Rubí-Carnacea F, García-Martínez E, Soler-González J, Barallat-Gimeno E, Gea-Sánchez M. Cognitive behavioral therapy for insomnia (CBT-i) in patients with fibromyalgia: a systematic review and meta-analysis. Disabil Rehabil 2021; 44:5770-5783. [PMID: 34297651 DOI: 10.1080/09638288.2021.1954706] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE We aimed to evaluate the effectiveness of CBT-i in patients with fibromyalgia in comparison with other non-pharmacological treatments. METHODS Randomized controlled trials assessing the effects of CBT-i in adults with fibromyalgia, published in English or Spanish, were eligible. Electronic searches were performed using PubMed, Scopus, The Cochrane Library, WebOfKnowledge and Psicodoc databases in March 2021. The main outcome measures were sleep efficiency and sleep quality. Secondary outcomes included pain, depression, and anxiety. RESULTS Of 226 studies reviewed, five were included in the meta-analysis. CBT-i compared with non-pharmacological treatments showed no significant improvements in sleep efficiency (p = 0.05; standardized mean difference (SMD) [95% CI] 0.31 [-0.00 to 0.61]). CBT-i showed significant improvements in sleep quality (p = 0.009; SMD [95% CI] - 0.53 [-0.93 to -0.13]), pain (p = 0.002; SMD [95% CI] - 0.41 [-0.67 to -0.16]), anxiety (p = 0.001; SMD [95% CI] - 0.46 [-0.74 to 0.18]) and depression (p = 0.02; SMD [95% CI] - 0.33 [-0.61 to -0.05]), compared to non-pharmacological treatments. Effect sizes ranged from small to moderate. CONCLUSIONS CBT-i was associated with a significant improvement in sleep quality, pain, anxiety, and depression, although these results are retrieved from very few studies with only very low to low quality evidence. Trial registration: The review protocol was registered with PROSPERO (Record ID = CRD42016030161).IMPLICATIONS FOR REHABILITATIONCBT-i has been proven to improve sleep quality, pain, anxiety and depression, although with small effect sizes.Implementing hybrid CBT for pain and sleep or combining CBT and mindfulness may improve symptoms in people diagnosed with FM.This meta-analysis results highlight the need to enhance sleep management skills among people suffering from this health condition.
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Affiliation(s)
- Carolina Climent-Sanz
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Grup d'Estudis Societat, Salut, Educació i Cultura, University of Lleida, Lleida, Spain.,Grup de Recerca de Cures en Salut, IRBLleida (Lleida Institute for Biomedical Research Dr. Pifarré Foundation), Lleida, Spain
| | - Fran Valenzuela-Pascual
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Grup d'Estudis Societat, Salut, Educació i Cultura, University of Lleida, Lleida, Spain.,Grup de Recerca de Cures en Salut, IRBLleida (Lleida Institute for Biomedical Research Dr. Pifarré Foundation), Lleida, Spain
| | | | - Joan Blanco-Blanco
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Grup d'Estudis Societat, Salut, Educació i Cultura, University of Lleida, Lleida, Spain.,Grup de Recerca de Cures en Salut, IRBLleida (Lleida Institute for Biomedical Research Dr. Pifarré Foundation), Lleida, Spain
| | - Francesc Rubí-Carnacea
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Grup d'Estudis Societat, Salut, Educació i Cultura, University of Lleida, Lleida, Spain.,Grup de Recerca de Cures en Salut, IRBLleida (Lleida Institute for Biomedical Research Dr. Pifarré Foundation), Lleida, Spain
| | - Ester García-Martínez
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Grup de Recerca de Cures en Salut, IRBLleida (Lleida Institute for Biomedical Research Dr. Pifarré Foundation), Lleida, Spain
| | - Jorge Soler-González
- Grup d'Estudis Societat, Salut, Educació i Cultura, University of Lleida, Lleida, Spain.,Faculty of Medicine, University of Lleida, Lleida, Spain.,Catalan Health Institute, Lleida, Spain
| | - Eva Barallat-Gimeno
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Grup d'Estudis Societat, Salut, Educació i Cultura, University of Lleida, Lleida, Spain.,Grup de Recerca de Cures en Salut, IRBLleida (Lleida Institute for Biomedical Research Dr. Pifarré Foundation), Lleida, Spain
| | - Montserrat Gea-Sánchez
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Grup d'Estudis Societat, Salut, Educació i Cultura, University of Lleida, Lleida, Spain.,Grup de Recerca de Cures en Salut, IRBLleida (Lleida Institute for Biomedical Research Dr. Pifarré Foundation), Lleida, Spain
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27
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Cravo AS, Shephard A, Shea T. Efficacy of Triprolidine in the Treatment of Temporary Sleep Disturbance. J Clin Pharmacol 2021; 61:1156-1164. [PMID: 33768603 DOI: 10.1002/jcph.1861] [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: 12/18/2020] [Accepted: 03/19/2021] [Indexed: 11/06/2022]
Abstract
Triprolidine, a first-generation antihistamine for allergic rhinitis, has a shorter half-life and fewer persistent effects relative to other antihistamines and may be useful in the treatment of temporary sleep disturbance. Patients aged ≥18 years old were randomized 1:1:1 to receive either triprolidine 2.5 mg (n = 65), triprolidine 5 mg (n = 66), or placebo (n = 67) on 3 consecutive nights. Sleep disturbance index was monitored via wrist actimeter. Subjective measures were assessed via diary card. Triprolidine 2.5 mg had a significantly lower sleep disturbance index versus placebo on night 1 (P = .02); however, when adjusted for outliers, sleep disturbance index did not significantly differ between either dose of triprolidine versus placebo on night 1. Adjusted sleep disturbance index was significantly lower with triprolidine 2.5 and 5 mg versus placebo on night 3 (P = .0017 and P = .011, respectively) and for the mean of all 3 nights (P = .01 and P = .015, respectively). Sleep latency was significantly improved for triprolidine 2.5 mg versus placebo on nights 2 and 3 and for the mean of all 3 nights and for triprolidine 5 mg versus placebo for the mean of all 3 nights. Subjective measures showed those on both doses of triprolidine felt more refreshed on awakening versus placebo for the mean of all 3 nights, with no increase in daytime sleepiness. The frequency of adverse events was similar across groups. The optimum dose of triprolidine for treatment of temporary sleep disturbance was 2.5 mg. There were improvements in both objective and subjective measures of sleep quality versus placebo, with no safety concerns raised.
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Affiliation(s)
- Ana Santos Cravo
- Global Medical Affairs Senior Advisor (Respiratory), Reckitt Benckiser Healthcare Ltd, Slough, UK
| | - Adrian Shephard
- Global Marketing Director, Reckitt Benckiser Healthcare Ltd, Slough, UK
| | - Tim Shea
- Senior Medical Scientist (Respiratory), Reckitt Benckiser Inc., Parsippany, New Jersey, USA
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28
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Ho LYW, Lai CKY, Ng SSM. Contribution of sleep quality to fatigue following a stroke: a cross-sectional study. BMC Neurol 2021; 21:151. [PMID: 33827471 PMCID: PMC8028229 DOI: 10.1186/s12883-021-02174-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 03/25/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The prevalence of fatigue and sleep disturbances is high in stroke populations. Sleep quality can be targeted by interventions to alleviate fatigue following a stroke. This study aimed to determine the prevalence of fatigue and poor sleep quality, and to quantify the contribution of sleep quality to fatigue following a stroke, in chronic (≥1 year) stroke survivors. METHODS A cross-sectional design was adopted. A total of 112 stroke survivors (mean age ± standard deviation [year], 64.18 ± 5.77) at 6.08 ± 4.80 years post-stroke completed this study. All participants were assessed using the Fatigue Assessment Scale, the Pittsburgh Sleep Quality Index, the Visual Analogue Scale-Pain, the Fugl-Meyer Assessment of the upper and lower extremities, the 5-Time Sit-To-Stand Test, the Epworth Sleepiness Scale, the Frenchay Activities Index, the Life-Space Assessment, the Community Integration Measure, and the Multidimensional Scale of Perceived Social Support. Pearson and partial correlation coefficients were used to examine the correlation between fatigue and other variables. A multiple linear regression (the forced entry method) was performed to quantify the independent contribution of sleep quality to prediction of fatigue. RESULTS Of the 112 participants, 52.7% reported experiencing fatigue and 64.3% reported poor sleep quality. Sleep quality could independently account for 5.9% of the variance in fatigue scores after a stroke. CONCLUSIONS There is a high prevalence of fatigue and poor sleep quality in Chinese stroke survivors. Sleep quality is an independent predictor of fatigue in those living in the community who have survived a stroke for a year or longer.
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Affiliation(s)
- Lily Yuen Wah Ho
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon Hong Kong SAR
| | - Claudia Kam Yuk Lai
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon Hong Kong SAR
| | - Shamay Sheung Mei Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon Hong Kong SAR
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Matenchuk BA, Davenport MH. The influence of sleep quality on weight retention in the postpartum period. Appl Physiol Nutr Metab 2021; 46:77-85. [DOI: 10.1139/apnm-2019-0896] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Poor sleep in the postpartum is often treated as an unavoidable consequence of childbirth. This study aims to compare objective and subjective measures of sleep, explore the relationship between sleep and postpartum weight retention (PPWR), and investigate factors that may contribute to sleep quality in the postpartum period. In this cross-sectional cohort, PPWR, sleep quality (Pittsburgh Sleep Quality Index (PSQI)), and objective sleep and physical activity (accelerometry) were assessed in 109 women 0–52 weeks postpartum. Anthropometric and demographic data were collected. Gestational weight gain (GWG) was classified as inadequate, appropriate, or excessive according to Institute of Medicine guidelines. Average GWG (33.7 lbs) and PPWR (5.39 lbs) were not different between “good” (PSQI < 6) and “bad” (PSQI ≥ 6) sleepers. Following adjustment, mothers with excessive GWG who were “bad” sleepers had 5.26 higher odds of PPWR ≥ 10 lbs compared with all other combinations of GWG and PSQI. PSQI was not correlated with total sleep time (accelerometer-derived). Light activity and moderate-to-vigorous physical activity (MVPA) were associated with reduced odds of being a “bad” sleeper. The influence of GWG on PPWR was modified by postpartum sleep quality. Both light activity and meeting the MVPA guidelines in the postpartum were associated with higher sleep quality. Novelty Subjectively rated poor sleep may represent the number of awakenings and wake after sleep onset in postpartum women. Poor postpartum sleep quality increases excessive postpartum weight retention in women with excessive GWG. Women doing light-to-vigorous physical activity in the postpartum are less likely to experience poor sleep quality.
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30
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Bean HR, Stafford L, Little R, Diggens J, Ftanou M, Alexander M, Francis PA, Bei B, Wiley JF. Light-enhanced cognitive behavioural therapy for sleep and fatigue: study protocol for a randomised controlled trial during chemotherapy for breast cancer. Trials 2020; 21:295. [PMID: 32216832 PMCID: PMC7099834 DOI: 10.1186/s13063-020-4196-4] [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: 05/22/2019] [Accepted: 02/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Women with breast cancer experience a significantly higher prevalence of sleep disturbance and insomnia than the general population. The experience of persistent sleep disturbance places these women at a higher risk of psychological and physical morbidity and a reduced quality of life. Treatment for sleep in this population is not part of routine care and is often managed inadequately. This randomised controlled trial will examine the combined effects of cognitive behavioural therapy (CBT) and bright light therapy (BLT) on the symptoms of insomnia, fatigue and mental health. METHOD/DESIGN Women diagnosed with breast cancer who receive intravenous chemotherapy treatment at a quaternary referral metropolitan cancer centre in Melbourne, Australia, will be recruited. Recruitment will occur after diagnosis and prior to completion of chemotherapy. Eligible women will be randomised to the combined CBT and BLT intervention (CBT+) or relaxation audio-enhanced treatment as usual (TAU+). The CBT+ group will receive one face-to-face session on sleep strategies, one subsequent telephone call, and seven email packages containing CBT-based information and strategies. CBT+ participants will also wear Luminette® light glasses for 20 min each morning for the 6-week duration of the intervention. Women in TAU+ will receive two relaxation audio tracks via email. Outcomes will be measured at multiple points throughout the 6 weeks. Primary outcomes will be symptoms of insomnia and sleep efficiency, measured using the Insomnia Severity Index and a self-reported sleep diary. Secondary outcomes include objective measures of sleep assessed using the ActiGraph wGT3X-BT, and sleep-related complaints, fatigue and mental health, all assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS). Data will also be collected on potential treatment moderators and mechanisms and adherence to treatment. There will be 3-month follow-up measurements of insomnia symptoms, fatigue, sleep-related impairment, sleep disturbance, depression and anxiety. DISCUSSION This is the first randomised controlled trial to combine CBT and BLT for the treatment of sleep disturbance in women with breast cancer. This novel design addresses the multiple causal factors for sleep complaints in this population. Results from this trial will advance knowledge in this field and may have important clinical implications for how best to treat sleep disturbance and insomnia in this population. If effective, the largely email-based format of the intervention would allow for relatively easy translation. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12618001255279. Retrospectively registered on 25 July 2018.
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Affiliation(s)
- Helena R Bean
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Lesley Stafford
- Centre for Women's Mental Health, Royal Women's Hospital, Melbourne, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Ruth Little
- Centre for Women's Mental Health, Royal Women's Hospital, Melbourne, Australia
| | | | - Maria Ftanou
- Peter MacCallum Cancer Centre, Melbourne, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Marliese Alexander
- Pharmacy Department, Peter MacCallum Cancer Centre, Melbourne, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| | | | - Bei Bei
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Joshua F Wiley
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia.
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31
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Zavecz Z, Nagy T, Galkó A, Nemeth D, Janacsek K. The relationship between subjective sleep quality and cognitive performance in healthy young adults: Evidence from three empirical studies. Sci Rep 2020; 10:4855. [PMID: 32184462 PMCID: PMC7078271 DOI: 10.1038/s41598-020-61627-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 02/17/2020] [Indexed: 01/11/2023] Open
Abstract
The role of subjective sleep quality in cognitive performance has gained increasing attention in recent decades. In this paper, our aim was to test the relationship between subjective sleep quality and a wide range of cognitive functions in a healthy young adult sample combined across three studies. Sleep quality was assessed by the Pittsburgh Sleep Quality Index, the Athens Insomnia Scale, and a sleep diary to capture general subjective sleep quality, and the Groningen Sleep Quality Scale to capture prior night’s sleep quality. Within cognitive functions, we tested working memory, executive functions, and several sub-processes of procedural learning. To provide more reliable results, we included robust frequentist as well as Bayesian statistical analyses. Unequivocally across all analyses, we showed that there is no association between subjective sleep quality and cognitive performance in the domains of working memory, executive functions and procedural learning in healthy young adults. Our paper can contribute to a deeper understanding of subjective sleep quality and its measures, and we discuss various factors that may affect whether associations can be observed between subjective sleep quality and cognitive performance.
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Affiliation(s)
- Zsófia Zavecz
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Institute of Cognitive Neuroscience and Psychology, Hungarian Academy of Sciences, Budapest, Hungary
| | - Tamás Nagy
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Adrienn Galkó
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Dezso Nemeth
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary. .,Institute of Cognitive Neuroscience and Psychology, Hungarian Academy of Sciences, Budapest, Hungary. .,Lyon Neuroscience Research Center (CRNL), INSERM, CNRS, Université Claude Bernard Lyon 1, Lyon, France.
| | - Karolina Janacsek
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary. .,Institute of Cognitive Neuroscience and Psychology, Hungarian Academy of Sciences, Budapest, Hungary. .,School of Human Sciences, Faculty of Education, Health and Human Sciences, University of Greenwich, London, United Kingdom.
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32
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Zavecz Z, Nagy T, Galkó A, Nemeth D, Janacsek K. The relationship between subjective sleep quality and cognitive performance in healthy young adults: Evidence from three empirical studies. Sci Rep 2020; 10:4855. [PMID: 32184462 DOI: 10.1101/328369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 02/17/2020] [Indexed: 05/23/2023] Open
Abstract
The role of subjective sleep quality in cognitive performance has gained increasing attention in recent decades. In this paper, our aim was to test the relationship between subjective sleep quality and a wide range of cognitive functions in a healthy young adult sample combined across three studies. Sleep quality was assessed by the Pittsburgh Sleep Quality Index, the Athens Insomnia Scale, and a sleep diary to capture general subjective sleep quality, and the Groningen Sleep Quality Scale to capture prior night's sleep quality. Within cognitive functions, we tested working memory, executive functions, and several sub-processes of procedural learning. To provide more reliable results, we included robust frequentist as well as Bayesian statistical analyses. Unequivocally across all analyses, we showed that there is no association between subjective sleep quality and cognitive performance in the domains of working memory, executive functions and procedural learning in healthy young adults. Our paper can contribute to a deeper understanding of subjective sleep quality and its measures, and we discuss various factors that may affect whether associations can be observed between subjective sleep quality and cognitive performance.
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Affiliation(s)
- Zsófia Zavecz
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Institute of Cognitive Neuroscience and Psychology, Hungarian Academy of Sciences, Budapest, Hungary
| | - Tamás Nagy
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Adrienn Galkó
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Dezso Nemeth
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
- Institute of Cognitive Neuroscience and Psychology, Hungarian Academy of Sciences, Budapest, Hungary.
- Lyon Neuroscience Research Center (CRNL), INSERM, CNRS, Université Claude Bernard Lyon 1, Lyon, France.
| | - Karolina Janacsek
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
- Institute of Cognitive Neuroscience and Psychology, Hungarian Academy of Sciences, Budapest, Hungary.
- School of Human Sciences, Faculty of Education, Health and Human Sciences, University of Greenwich, London, United Kingdom.
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33
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Costemale-Lacoste JF, Asmar KE, Rigal A, Martin S, Kader Ait Tayeb AE, Colle R, Becquemont L, Fève B, Corruble E. Severe insomnia is associated with metabolic syndrome in women over 50 years with major depression treated in psychiatry settings: a METADAP report. J Affect Disord 2020; 264:513-518. [PMID: 32056777 DOI: 10.1016/j.jad.2019.11.084] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/02/2019] [Accepted: 11/12/2019] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Major depression is associated with metabolic syndrome and cardiovascular risk. We have previously shown that severe insomnia, a core symptom of major depression episode (MDE), is associated with hypertriglyceridemia, a component of metabolic syndrome, in women but not in men with major depression. Since insomnia is related to cardiovascular morbidity in the general population and major depression also, our objective was to assess the link between insomnia and metabolic syndrome, a marker syndrome of cardiovascular risk, during MDE, in women and in men. METHODS In 624 patients with a current MDE cohort, both insomnia and metabolic syndrome were assessed in women and men. Insomnia was rated from 0 to 6 based on the HDRS corresponding items, severe insomnia being defined by a total insomnia score ≥4. RESULTS severe insomnia was associated with metabolic syndrome in women but not in men. In multivariate logistic regressions, these results in women were independent from age, educational level, major depressive disorder duration and current smoking. These results were only significant in women aged ≥50 years, a cut-off age for menopausal status but not in women under 50 years. CONCLUSION Women aged ≥50 years with a severe insomnia during MDE have an increased risk of metabolic syndrome. Severe insomnia may be a clinical marker of metabolic risk in this population. They should be particularly monitored for metabolic syndrome and may benefit from sleep recommendations and cardiovascular prevention.
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Affiliation(s)
- Jean-François Costemale-Lacoste
- Institut National de la Santé et de la Recherche Médicale UMR-1178, CESP, Équipe « Dépression » Le Kremlin Bicêtre, F-94276, France; Univ Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France
| | - Khalil El Asmar
- Institut National de la Santé et de la Recherche Médicale UMR-1178, CESP, Équipe « Dépression » Le Kremlin Bicêtre, F-94276, France; Univ Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France; Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, PO Box 11-0236, Beirut, 1107 2020, Lebanon
| | - Adrien Rigal
- Institut National de la Santé et de la Recherche Médicale UMR-1178, CESP, Équipe « dépression » Le Kremlin Bicêtre, F-94276, France; Univ Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, F-94275, France; Service Hospitalo-Universitaire de Psychiatrie, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-94275, France
| | - Séverine Martin
- Institut National de la Santé et de la Recherche Médicale UMR-1178, CESP, Équipe « dépression » Le Kremlin Bicêtre, F-94276, France; Univ Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, F-94275, France; Service Hospitalo-Universitaire de Psychiatrie, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-94275, France
| | - Abd El Kader Ait Tayeb
- Institut National de la Santé et de la Recherche Médicale UMR-1178, CESP, Équipe « dépression » Le Kremlin Bicêtre, F-94276, France; Univ Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, F-94275, France; Service Hospitalo-Universitaire de Psychiatrie, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-94275, France
| | - Romain Colle
- Institut National de la Santé et de la Recherche Médicale UMR-1178, CESP, Équipe « dépression » Le Kremlin Bicêtre, F-94276, France; Univ Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, F-94275, France; Service Hospitalo-Universitaire de Psychiatrie, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-94275, France
| | - Laurent Becquemont
- Institut National de la Santé et de la Recherche Médicale UMR-1178, CESP, Le Kremlin Bicêtre, F-94276, France; Univ Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, F-94275, France; Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-94275, France
| | - Bruno Fève
- Sorbonne Université-Inserm, UMR S_938, Centre de Recherche Saint-Antoine, Institut Hospitalo-Universitaire ICAN, F-75012, Paris, France; Service d'Endocrinologie, Hôpital Saint-Antoine, Assistance Publique Hôpitaux de Paris, F-75012, Paris, France
| | - Emmanuelle Corruble
- Institut National de la Santé et de la Recherche Médicale UMR-1178, CESP, Équipe « dépression » Le Kremlin Bicêtre, F-94276, France; Univ Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre, F-94276, France; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, F-94275, France; Service Hospitalo-Universitaire de Psychiatrie, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-94275, France.
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Clarke A, Ladha C, Wright A, Pattinson K. Losartan may attenuate altitude-related sleep disturbance. BMJ Mil Health 2020; 167:424-428. [PMID: 32086272 DOI: 10.1136/jramc-2019-001308] [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: 08/12/2019] [Revised: 11/12/2019] [Accepted: 11/15/2019] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Sleep disturbance is common at high altitude and likely driven by an exaggerated peripheral chemoreceptor response which leads to apnoeic episodes and arousal. We hypothesised that this heightened response is in part mediated through angiotensin II receptors in the carotid body. To examine this link, we studied the effect of angiotensin II receptor blocker on sleep disturbance. METHODS Twenty participants paired by age, gender and ACE phenotype ascended to the Whymper Hut (5000 m) on Chimborazo in the Ecuadorean Andes as part of a double-blinded randomised placebo-controlled study of physiological mechanisms. Subjects were randomised to either losartan 100 mg daily or placebo. The primary outcome of sleep efficiency was measured using wrist-mounted actigraphs. One pair was excluded from analysis after descending before the end of the study due to acute mountain sickness. RESULTS There was a significantly different response to altitude between the two groups (F=3.274, p=0.029), as a decline in sleep efficiency in the placebo group (F=10.259, p<0.001) was not replicated in the angiotensin II receptor blocker group (F=0.459, p=0.713). CONCLUSION The absence of any significant sleep disturbance in the intervention group suggests that peripheral chemoreceptor hypersensitivity is largely mediated by angiotensin II receptor activation. However, further research is needed to confirm our findings and to study the potential mechanisms of action.
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Affiliation(s)
- Alexander Clarke
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, Tyne and Wear, UK
| | - C Ladha
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, Tyne and Wear, UK
| | - A Wright
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, Birmingham, UK
| | - K Pattinson
- Nuffield Department of Clinical Neurosciences, Oxford University, Oxford, Oxfordshire, UK
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Vanderlinden J, Boen F, van Uffelen JGZ. Effects of physical activity programs on sleep outcomes in older adults: a systematic review. Int J Behav Nutr Phys Act 2020; 17:11. [PMID: 32024532 PMCID: PMC7003368 DOI: 10.1186/s12966-020-0913-3] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 01/12/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND One in two older adults report sleep problems, which not only cause fatigue, but also negatively affect general functioning, activities of daily living, and physical and mental health. Although it is known that physical activity is positively associated with sleep in older adults, the effects of physical activity programs on sleep in older adults has not been reviewed. The aim of this systematic review was to systematically review the effects of physical activity programs on sleep in generally healthy older adults aged 60+ years. METHODS Searches were performed in PubMed, Embase, Web of Science, SPORTDiscus, PEDro and CINAHL. The methodological quality of the included studies was rated using the 'Quality Assessment Tool for Quantitative Studies'. Only studies of moderate and strong quality were included. This review was registered in PROSPERO (CRD42018094007). RESULTS Fourteen studies met the inclusion criteria (six randomised controlled trials and eight pretest-posttest studies). Of these studies, five were moderate and nine were strong quality studies. Mean age of study samples ranged from 64 to 76 years. Exercise programs included various activities aimed at improving mobility, endurance and strength. Intervention duration ranged from 2 weeks to 12 months. Eleven studies used subjective measures of sleep, two used objective measures and one used both. Sixteen different sleep outcomes were reported. All but one study, found at least one significant improvement on sleep outcomes. No significantly detrimental effects were reported. Effect sizes, calculated in ten studies, ranged from 0,34-1,55 and were substantial (≥0,8) in four studies. CONCLUSIONS This systematic review suggests that exercise programs positively affect various aspects of sleep in generally healthy older adults. More specifically, moderate intensity exercise programs, with a frequency of three times per week and a duration of 12 weeks up to 6 months, showed the highest number of significant improvements in different sleep outcomes in older adults. Furthermore, programs that offered single exercise types, such as Baduanjin, Tai chi and the silver yoga program, or a combination of exercises showed the highest proportion of significant versus reported effects on sleep outcomes.
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Affiliation(s)
- J Vanderlinden
- Department of Movement Sciences, KU Leuven, B-3000, Leuven, Belgium.
- Department of Health Care, Odisee University College, Brussels, Belgium.
| | - F Boen
- Department of Movement Sciences, KU Leuven, B-3000, Leuven, Belgium
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Zhang H, Li Y, Li M, Chen X. Retracted: A randomized controlled trial of mindfulness-based stress reduction for insomnia secondary to cervical cancer: Effects on sleep. Cancer Rep (Hoboken) 2019; 2:e1190. [PMID: 32721075 PMCID: PMC7941563 DOI: 10.1002/cnr2.1190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 03/29/2019] [Accepted: 04/09/2019] [Indexed: 11/06/2022] Open
Abstract
Retraction: 'A randomized controlled trial of mindfulness-based stress reduction for insomnia secondary to cervical cancer: Effects on sleep' DOI https://doi.org/10.1002/cnr2.1190 by Huashuang Zhang, Yang Li, Mingming Li, Xiaowen Chen. The above article, published online on 29 May 2019 in Wiley Online Library (http://onlinelibrary.wiley.com), has been retracted by agreement between the authors, Huashuang Zhang, Yang Li, Mingming Li, Xiaowen Chen, the journal Editor in Chief Nidhi Bansal, and John Wiley and Sons Ltd. The retraction has been agreed because of an honest error discovered by the authors in the data presented in Table 4 that impacts the overall conclusions of the article.
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Affiliation(s)
- Huashuang Zhang
- College of NursingWuchang University of TechnologyWuhanChina
| | - Yang Li
- Department of Oncology, The Third Hospital of WuhanWuhanChina
| | - Mingming Li
- College of NursingWuchang University of TechnologyWuhanChina
| | - Xiaowen Chen
- College of NursingWuchang University of TechnologyWuhanChina
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Zhang H, Li Y, Li M, Chen X. A randomized controlled trial of mindfulness-based stress reduction for insomnia secondary to cervical cancer: Sleep effects. Appl Nurs Res 2019; 48:52-57. [DOI: 10.1016/j.apnr.2019.05.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 05/27/2019] [Indexed: 10/26/2022]
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38
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Zagalaz-Anula N, Hita-Contreras F, Martínez-Amat A, Cruz-Díaz D, Aibar-Almazán A, Barranco-Zafra RJ, Lomas-Vega R. The associations between menopausal symptoms and sleep quality in Spanish postmenopausal women. Climacteric 2019; 22:511-517. [PMID: 31079508 DOI: 10.1080/13697137.2019.1609439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: Around the menopause, sleep disturbances frequently occur or worsen and are associated with decreased health quality and physical and psychological problems. The aim of this study was to analyze sleep quality and its association with the impact of menopausal symptoms in Spanish postmenopausal women. Methods: A total of 278 postmenopausal women (age 60.95 ± 8.01 years) participated in this cross-sectional study. The Medical Outcomes Study Sleep Scale (MOS-SS) and the Menopause Rating Scale (MRS) were used to analyze sleep quality and severity of menopausal symptoms, respectively. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale. Results: The linear regression showed that a greater impact of menopausal symptoms (MRS total score) was associated with worse scores regarding sleep adequacy (p < 0.001, R2 = 0.056), snoring (p = 0.020, R2 = 0.036), awaken short of breath (p < 0.001, R2 = 0.089), and quantity of sleep (p < 0.001, R2 = 0.075) domains. Anxiety (p < 0.001) and worse somatic symptoms (p = 0.001) were related to greater sleep disturbances (R2 = 0.164). We also found relationships of heightened psychological symptoms (p < 0.001) and low physical activity level (p = 0.003) with increased daytime somnolence (R2 = 0.064). Finally, higher MRS total score and anxiety levels were associated with worse sleep quality assessed by MOS-SS Sleep Problems Index I (R2 = 0.179, p < 0.001 and p = 0.001, respectively) and Sleep Problems Index II (R2 = 0.146, p < 0.001 and p = 0.011, respectively). Conclusions: Anxiety and severity of menopausal symptoms were associated with poorer sleep quality. Furthermore, low physical activity level and worse psychological symptoms in menopause were predictors for increased somnolence. Therefore, screening for these factors in postmenopausal women is important, since they may be susceptible for intervention.
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Affiliation(s)
- N Zagalaz-Anula
- Faculty of Health Sciences, Department of Health Sciences, University of Jaén , Jaén , Spain
| | - F Hita-Contreras
- Faculty of Health Sciences, Department of Health Sciences, University of Jaén , Jaén , Spain
| | - A Martínez-Amat
- Faculty of Health Sciences, Department of Health Sciences, University of Jaén , Jaén , Spain
| | - D Cruz-Díaz
- Faculty of Health Sciences, Department of Health Sciences, University of Jaén , Jaén , Spain
| | - A Aibar-Almazán
- Faculty of Health Sciences, Department of Health Sciences, University of Jaén , Jaén , Spain
| | - R J Barranco-Zafra
- Faculty of Health Sciences, Department of Health Sciences, University of Jaén , Jaén , Spain
| | - R Lomas-Vega
- Faculty of Health Sciences, Department of Health Sciences, University of Jaén , Jaén , Spain
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Hackett KL, Davies K, Tarn J, Bragg R, Hargreaves B, Miyamoto S, McMeekin P, Mitchell S, Bowman S, Price EJ, Pease C, Emery P, Andrews J, Lanyon P, Hunter J, Gupta M, Bombardieri M, Sutcliffe N, Pitzalis C, McLaren J, Cooper A, Regan M, Giles I, Isenberg D, Vadivelu S, Coady D, Dasgupta B, McHugh N, Young-Min S, Moots R, Gendi N, Akil M, Griffiths B, Lendrem DW, Ng WF. Pain and depression are associated with both physical and mental fatigue independently of comorbidities and medications in primary Sjögren's syndrome. RMD Open 2019; 5:e000885. [PMID: 31168409 PMCID: PMC6525628 DOI: 10.1136/rmdopen-2018-000885] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 03/20/2019] [Accepted: 03/27/2019] [Indexed: 01/01/2023] Open
Abstract
Objectives To report on fatigue in patients from the United Kingdom primary Sjögren's syndrome (pSS) registry identifying factors associated with fatigue and robust to assignable causes such as comorbidities and medications associated with drowsiness. Methods From our cohort (n = 608), we identified those with comorbidities associated with fatigue, and those taking medications associated with drowsiness. We constructed dummy variables, permitting the contribution of these potentially assignable causes of fatigue to be assessed. Using multiple regression analysis, we modelled the relationship between Profile of Fatigue and Discomfort physical and mental fatigue scores and potentially related variables. Results Pain, depression and daytime sleepiness scores were closely associated with both physical and mental fatigue (all p ≤ 0.0001). In addition, dryness was strongly associated with physical fatigue (p ≤ 0.0001). These effects were observed even after adjustment for comorbidities associated with fatigue or medications associated with drowsiness. Conclusions These findings support further research and clinical interventions targeting pain, dryness, depression and sleep to improve fatigue in patients with pSS.This finding is robust to both the effect of other comorbidities associated with fatigue and medications associated with drowsiness.
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Affiliation(s)
- Kate L Hackett
- Department of Life & Health Sciences, Northumbria University Department of Public Health and Wellbeing, Newcastle upon Tyne, UK
| | - Kristen Davies
- Musculoskeletal Research Group, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK
| | - Jessica Tarn
- Musculoskeletal Research Group, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK
| | - Rebecca Bragg
- Musculoskeletal Research Group, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK
| | - Ben Hargreaves
- Musculoskeletal Research Group, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK
| | - Samira Miyamoto
- Musculoskeletal Research Group, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK
- Departamento de Educação Integrada em Saúde, Universidade Federal do Espirito Santo, Vitoria, Brazil
| | - Peter McMeekin
- Department of Life & Health Sciences, Northumbria University Department of Public Health and Wellbeing, Newcastle upon Tyne, UK
| | - Sheryl Mitchell
- Musculoskeletal Services, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Simon Bowman
- Rheumatology Research Group, University of Birmingham, Birmingham, UK
| | - Elizabeth J Price
- Rheumatology, Great Western Hospitals NHS Foundation Trust, Swindon, UK
| | - Colin Pease
- Rheumatology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Paul Emery
- Rheumatology, University of Leeds, Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, UK
- Musculoskeletal, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK
| | - Jacqueline Andrews
- Musculoskeletal, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK
| | - Peter Lanyon
- Rheumatology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | | | - Michele Bombardieri
- Experimental Medicine and Rheumatology, Queen Mary University of London, London, UK
| | - Nurhan Sutcliffe
- Barts Health NHS Trust, London, UK
- Rheumatology, Barts and The London School of Medicine and Dentistry, London, UK
| | - Costantino Pitzalis
- Experimental Medicine and Rheumatology, William Harvey Research Institute Experimental Medicine and Musculoskeletal Sciences, London, UK
| | | | | | | | - Ian Giles
- Centre for Rheumatology, University College London, London, UK
| | - David Isenberg
- Centre for Rheumatology, University College London, London, UK
| | | | - David Coady
- City Hospitals Sunderland NHS Foundation Trust, Sunderland, UK
| | - Bhaskar Dasgupta
- Department of Rheumatology, Southend University Hospital NHS Foundation Trust, Westcliff-on-Sea, UK
| | - Neil McHugh
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
| | | | - Robert Moots
- Rheumatology, Aintree University Hospitals, Liverpool, UK
| | - Nagui Gendi
- Department of Rheumatology, Basildon Hospital, Basildon, UK
| | - Mohammed Akil
- Department of Rheumatology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Bridget Griffiths
- Musculoskeletal Services, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Dennis W Lendrem
- Musculoskeletal Research Group, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK
- Musculoskeletal Ageing, NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne, UK
| | - Wan-Fai Ng
- Musculoskeletal Ageing, NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne, UK
- Musculoskeletal Research Group, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK
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40
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Küüsmaa-Schildt M, Liukkonen J, Vuong MK, Nyman K, Häkkinen K, Häkkinen A. Effects of morning vs. evening combined strength and endurance training on physical performance, sleep and well-being. Chronobiol Int 2019; 36:811-825. [PMID: 30950283 DOI: 10.1080/07420528.2019.1592184] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The aim of the present study was to examine how combined strength and endurance training in the morning and evening influences the adaptations in strength and endurance performance, perception of time management, psychological well-being and sleep. The combined training period lasted for 24 weeks and the participants were divided into the morning training (MG, n = 18), evening training (EG, n = 24) and control groups (CG, n = 10). Isometric leg press force (iLP), maximal oxygen consumption (VO2max), sleep behavior, fatigue, time management, motivation, self-esteem and health-related quality of life (HRQoL) were assessed. Morning to evening difference in iLP was observed in both MG and EG at Pre and Post, with higher force values in the evening, but not for VO2max. iLP force increased significantly in EG in the morning (p < 0.001) and evening (p = 0.010). VO2max increased in MG and EG both in the morning (both p < 0.001) and in the evening (MG: p < 0.001; EG: p = 0.003). Participants of the present study slept 7-8 h per night and the self-reported sleep duration, get-up time and the average time to go to bed were similar between the groups and did not change from Pre to Post. From HRQoL dimensions, the score for bodily pain decreased in MG (p = 0.029) and significant between-group differences were observed for Pre-Post changes in MG and EG (p = 0.001) as well as between MG and CG (p < 0.001). In vitality, a significant between-group difference was observed for Pre to Post changes in MG and EG (p = 0.014). Perception of time management decreased in EG (p = 0.042) but stayed unchanged for MG and CG. For the intrinsic motivation to participate, significant between-group differences were observed for MG and EG (p = 0.033) and between MG and CG (p = 0.032) for Pre to Post changes. Self-esteem improved in MG (p = 0.029) and EG (p = 0.024). The present combined strength and endurance training program performed in the morning and in the evening led to similar improvements in strength and endurance performance. Training in the morning or in the evening did not disrupt the already good sleep behavior and it was able to further increase the self-esteem. Although training in the morning hours may leave more time for free time activities or social life (i.e. family and friends) compared to the evening training, it might be more challenging to stay motivated to participate in prolonged training programs in the morning hours.
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Affiliation(s)
- M Küüsmaa-Schildt
- a Neuromuscular Research Center, Biology of Physical Activity, Faculty of Sport and Health Sciences , University of Jyväskylä , Jyväskylä , Finland
| | - J Liukkonen
- b Behavioral Sciences, Faculty of Sport and Health Sciences , University of Jyväskylä , Jyväskylä , Finland d
| | - M K Vuong
- a Neuromuscular Research Center, Biology of Physical Activity, Faculty of Sport and Health Sciences , University of Jyväskylä , Jyväskylä , Finland
| | - K Nyman
- c Department of Cardiology , Central Hospital of Central Finland , Jyväskylä , Finland
| | - K Häkkinen
- a Neuromuscular Research Center, Biology of Physical Activity, Faculty of Sport and Health Sciences , University of Jyväskylä , Jyväskylä , Finland
| | - A Häkkinen
- c Department of Cardiology , Central Hospital of Central Finland , Jyväskylä , Finland.,d Health Sciences, Faculty of Sport and Health Sciences , University of Jyväskylä , Jyväs , Finland
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41
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Snyder E, Cai B, DeMuro C, Morrison MF, Ball W. A New Single-Item Sleep Quality Scale: Results of Psychometric Evaluation in Patients With Chronic Primary Insomnia and Depression. J Clin Sleep Med 2018; 14:1849-1857. [PMID: 30373688 DOI: 10.5664/jcsm.7478] [Citation(s) in RCA: 155] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 06/05/2018] [Indexed: 12/19/2022]
Abstract
STUDY OBJECTIVES A single-item sleep quality scale (SQS) was developed as a simple and practical sleep quality assessment and psychometrically evaluated. METHODS SQS measurement characteristics were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and morning questionnaire-insomnia (MQI) according to prespecified analysis plans in separate clinical studies of patients with insomnia and depression. Patients with insomnia (n = 70) received 4 weeks' usual care with an FDA-approved hypnotic agent; patients with depression (n = 651) received 8 weeks' active or experimental therapy. RESULTS Concurrent criterion validity (correlation with measures of a similar construct) was demonstrated by strong (inverse) correlations between the SQS and MQI (week 1 Pearson correlation -.76) and PSQI (week 8 Goodman-Kruskal correlation -.92) sleep quality items in populations with insomnia and depression, respectively. In patients with depression, stronger correlations between the SQS and PSQI core sleep quality components versus other items supported convergent/divergent construct validity (similarity/dissimilarity to related/unrelated measures). Known-groups validity was evidenced by decreasing mean SQS scores across those who sleep normally, those borderline to having sleep problems, and those with problems sleeping. Test-retest reliability (intraclass correlation coefficient) was .62 during a 4-week period of sleep stability in patients with insomnia and .74 in stable patients with depression (1 week). Effect sizes (standardized response means) for change from baseline were 1.32 (week 1) and .67 (week 8) in populations with insomnia and depression, respectively. Mean SQS changes from baseline to week 8 convergently decreased across groups of patients with depression categorized by level of PSQI sleep quality improvement. CONCLUSIONS The SQS possesses favorable measurement characteristics relative to lengthier or more frequently administered sleep questionnaires in patients with insomnia and depression. CLINICAL TRIAL REGISTRATION Registry: ClincalTrials.gov, Title: Treatment of Patients With Major Depressive Disorder With MK0869, Identifier: NCT00034983, URL: https://clinicaltrials.gov/ct2/show/NCT00034983.
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Affiliation(s)
| | - Bing Cai
- Merck & Co., Inc., Kenilworth, New Jersey
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42
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Åslund L, Arnberg F, Kanstrup M, Lekander M. Cognitive and Behavioral Interventions to Improve Sleep in School-Age Children and Adolescents: A Systematic Review and Meta-Analysis. J Clin Sleep Med 2018; 14:1937-1947. [PMID: 30373682 DOI: 10.5664/jcsm.7498] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 08/23/2018] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Sleep problems are common in children and adolescents and can aggravate comorbid disorders. This meta-analysis examined the effect of cognitive and behavioral sleep interventions (with four or more treatment sessions) from randomized controlled trials on school-age children and adolescents. METHODS In a systematic literature search, six randomized controlled trials were identified (n = 528; mean age = 14.6 years; female = 63%) that reported total sleep time (TST), sleep onset latency (SOL), wake after sleep onset, and daytime sleepiness from ratings and actigraphy. RESULTS After intervention, no effect was seen on self-reported TST, but when measured with actigraphy, an effect favoring the intervention group was observed (+11.47 minutes, P = .05). SOL decreased in the intervention group compared to the control group after intervention as measured by both sleep diaries (-9.31 minutes, P = .007) and actigraphy (-19.48 minutes, P < .0001). Effect sizes ranged from small to large. No effect was found for wake after sleep onset or daytime sleepiness. Short-term (4 to 8 weeks) follow-up data from four studies indicated maintained positive effects on SOL: sleep diaries -15.85 minutes (P = .01) and actigraphy -23.67 minutes (P < .0001). At follow-up, the effects on wake after sleep onset from ratings (-14.41 minutes, P = .001) and actigraphy (-7.54 minutes, P = .01) were significant, favoring the intervention group (moderate to large effect sizes). No effect on TST was indicated. CONCLUSIONS Cognitive and behavioral sleep interventions are indicated to improve sleep in school-age children and adolescents. However, because treatment protocols were heterogeneous and risk of bias high, results should be interpreted with caution. Large and rigorous trials are needed.
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Affiliation(s)
- Lie Åslund
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Filip Arnberg
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Marie Kanstrup
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Functional Area Medical Psychology, Functional Unit Behavior Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Mats Lekander
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Stress Research Institute, Stockholm University, Stockholm, Sweden
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43
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Maskevich S, Jumabhoy R, Dao PDM, Stout JC, Drummond SPA. Pilot Validation of Ambulatory Activity Monitors for Sleep Measurement in Huntington's Disease Gene Carriers. J Huntingtons Dis 2018; 6:249-253. [PMID: 28968241 DOI: 10.3233/jhd-170251] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sleep disturbance occurs early in Huntington's disease (HD). Consumer- and research-grade activity monitors may enable routine assessment of sleep disturbances in HD. We compared Actiwatch Spectrum Pro, Jawbone UP2 and Fitbit One to the gold standard, polysomnography, in four late presymptomatic and three early HD participants. Compared to polysomnography, all ambulatory monitors overestimated total sleep time by >60 minutes and sleep efficiency by ∼15%. Thus, for assessment of specific sleep parameters in HD, none of the activity monitors are sufficiently accurate to replace polysomnography, although they may be sufficient for estimating overall sleep-wake patterns. Larger sample replication is required.
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Affiliation(s)
- Svetlana Maskevich
- School of Psychological Sciences, Monash University, Melbourne, Australia.,Monash Institute of Cognitive and Clinical Neurosciences, Melbourne, Australia
| | - Ria Jumabhoy
- School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Pierre D M Dao
- School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Julie C Stout
- School of Psychological Sciences, Monash University, Melbourne, Australia.,Monash Institute of Cognitive and Clinical Neurosciences, Melbourne, Australia
| | - Sean P A Drummond
- School of Psychological Sciences, Monash University, Melbourne, Australia.,Monash Institute of Cognitive and Clinical Neurosciences, Melbourne, Australia
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44
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Hong KB, Park Y, Suh HJ. Two combined amino acids promote sleep activity in caffeine-induced sleepless model systems. Nutr Res Pract 2018; 12:208-214. [PMID: 29854326 PMCID: PMC5974066 DOI: 10.4162/nrp.2018.12.3.208] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/08/2018] [Accepted: 03/13/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND/OBJECTIVES The aim of this study was to evaluate the biological and sleep-promoting effects of combined γ-aminobutyric acid (GABA) and 5-hydroxytryptophan (5-HTP) using caffeine-induced sleepless fruit flies, ICR mice, and Sprague-Dawley rats. MATERIALS/METHODS Video-tracking analysis was applied to investigate behavioral changes of Drosophila melanogaster. Pentobarbital-induced sleep test and electroencephalogram (EEG) patterns were used for analysis of sleep latency, duration, and quantity and quality of sleep in vertebrate models. RESULTS Administration of combined GABA/5-HTP could significantly reverse the caffeine induced total distance of flies (P < 0.001). Also, individually administered and combined GABA/5-HTP significantly increased the total sleeping time in the caffeine-induced sleepless ICR mice (P < 0.001). In the caffeine-induced sleepless SD-rats, combined GABA/5-HTP showed significant differences in sleep quality between individual amino acid administrations (P < 0.05). CONCLUSIONS Taken together, we identified inhibitory effects of combined GABA/5-HTP in locomotor activity, sleep quantity and quality in caffeine-induced sleepless models, indicating that combined GABA/5-HTP may be effective in patients with insomnia by providing sufficient sleep.
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Affiliation(s)
- Ki-Bae Hong
- Department of Biological Sciences and Environmental Sciences Program, Southern Illinois University-Edwardsville, Edwardsville, IL 62026, United States
| | - Yooheon Park
- Dongguk University Research Institute of Biotechnology and Medical Converged Science, Dongguk University, Gyeonggi 10325, Korea
| | - Hyung Joo Suh
- Department of Public Health Sciences, Korea University, 145 Anam-ro, Sungbuk-gu, Seoul 02841, Korea
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45
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Meng Q, Li R, Hou F, Zhang Q. Effects of chlorpromazine on sleep quality, clinical and emotional measures among patients with schizophrenia. Clin Neurol Neurosurg 2018; 165:134-138. [DOI: 10.1016/j.clineuro.2018.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 12/14/2017] [Accepted: 01/09/2018] [Indexed: 10/18/2022]
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46
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Denis D, French CC, Schneider MN, Gregory AM. Subjective sleep-related variables in those who have and have not experienced sleep paralysis. J Sleep Res 2017; 27:e12650. [DOI: 10.1111/jsr.12650] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 11/13/2017] [Indexed: 02/02/2023]
Affiliation(s)
- Dan Denis
- Department of Psychiatry; Beth Israel Deaconess Medical Center; Harvard Medical School; Boston MA USA
| | | | | | - Alice M. Gregory
- Department of Psychology, Goldsmiths; University of London; London UK
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47
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Josev EK, Jackson ML, Bei B, Trinder J, Harvey A, Clarke C, Snodgrass K, Scheinberg A, Knight SJ. Sleep Quality in Adolescents With Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME). J Clin Sleep Med 2017; 13:1057-1066. [PMID: 28760189 PMCID: PMC5566461 DOI: 10.5664/jcsm.6722] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 06/12/2017] [Accepted: 06/14/2017] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Little is known about the type and severity of sleep disturbances in the pediatric chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) population, compared with healthy adolescents. Using a range of objective and subjective measures, the aim of this study was to investigate sleep quality, the relationship between objective and subjective measures of sleep quality, and their associations with anxiety in adolescents with CFS/ME compared with healthy controls. METHODS Twenty-one adolescents with CFS/ME aged 13 to 18 years (mean age 15.57 ± 1.40), and 145 healthy adolescents aged 13 to 18 years (mean age 16.2 ± 1.00) wore actigraphy watches continuously for 2 weeks to collect a number of objective sleep variables. The Pittsburgh Sleep Quality Index was used to obtain a subjective measure of sleep quality. Anxiety was measured by the Spence Children's Anxiety scale. RESULTS On average over the 2-week period, adolescents with CFS/ME were found to have (1) significantly longer objective sleep onset latency, time in bed, total sleep time, and a later rise time (all P < .005), and (2) significantly poorer subjective sleep quality (P < .001), compared with healthy adolescents. The CFS/ME patient group displayed higher levels of anxiety (P < .05), and in both groups, higher levels of anxiety were significantly related to poorer subjective sleep quality (P < .001). CONCLUSIONS This study provides objective and subjective evidence of sleep disturbance in adolescents with CFS/ME compared with healthy adolescent controls.
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Affiliation(s)
- Elisha K Josev
- Clinical Sciences, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Melinda L Jackson
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
- School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology, Melbourne, Australia
| | - Bei Bei
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia
- Centre for Women's Mental Health, Department of Psychiatry, University of Melbourne, Royal Women's Hospital, Melbourne, Australia
| | - John Trinder
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Adrienne Harvey
- Clinical Sciences, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia
- Developmental Medicine, Royal Children's Hospital, Melbourne, Australia
| | - Cathriona Clarke
- Clinical Sciences, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Kelli Snodgrass
- Clinical Sciences, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Adam Scheinberg
- Clinical Sciences, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia
- Victorian Paediatric Rehabilitation Service, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, Monash University, Melbourne, Australia
| | - Sarah J Knight
- Clinical Sciences, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia
- Victorian Paediatric Rehabilitation Service, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
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48
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Kim M, Kim JE, Lee HY, Kim AR, Park HJ, Kwon OJ, Kim BK, Cho JH, Kim JH. Electroacupuncture for treating insomnia in patients with cancer: a study protocol for a randomised pilot clinical trial. BMJ Open 2017; 7:e016269. [PMID: 28801421 PMCID: PMC5629657 DOI: 10.1136/bmjopen-2017-016269] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Although insomnia is one of the most prevalent and disturbing symptoms among patients with cancer, it has not been properly managed. Electroacupuncture (EA) has received attention as a promising intervention for insomnia, and a few previous studies have reported that this intervention may be beneficial for treating insomnia in patients with cancer. The aim of this pilot study is to explore the feasibility and preliminary effectiveness of EA on the sleep disturbance of patients with cancer with insomnia using a subjective method, patient-reported questionnaires and an objective tool, actigraphy, to measure the quality of sleep. METHODS AND ANALYSIS This is a study protocol for a randomised, three-arm, multicentre, pilot clinical trial. A total of 45 patients with cancer who have continuous insomnia related to cancer treatment or cancer itself will be randomly allocated to an EA group, sham EA group or usual care group in equal proportions. The EA group will receive 10 sessions of EA treatment over 4 weeks. The sham EA group will receive sham EA at non-acupoints using non-penetrating Streitberger acupuncture needles with mock EA. The usual care group will not receive EA treatment. All participants will be provided a brochure on the management of sleep disorders regardless of their group assignment. The primary outcome measure is the mean change in the insomnia severity index from the baseline to week 5. Information related to sleep quality will also be obtained through the Pittsburgh Sleep Quality Index, a sleep diary and actigraphy. Participants will complete the trial by visiting the research centre at week 9 for follow-up assessment. ETHICS AND DISSEMINATION This study protocol was approved by the institutional review boards of each research centre. Written informed consent will be obtained from all participants. The result of this study will be published in peer-reviewed journals or presented at academic conferences. TRIAL REGISTRATION NUMBER KCT0002162; Pre-results.
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Affiliation(s)
- Mikyung Kim
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Jung-Eun Kim
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Hye-Yoon Lee
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Ae-Ran Kim
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Hyo-Ju Park
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - O-Jin Kwon
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Bo-Kyung Kim
- Department of Neuropsychiatry, College of Oriental Medicine, Dong-eui University, Busan, Republic of Korea
| | - Jung Hyo Cho
- Department of Internal Medicine, College of Traditional Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Joo-Hee Kim
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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49
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Hamida STB, Glos M, Penzel T, Ahmed B. How many sleep stages do we need for an efficient automatic insomnia diagnosis? ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2016:2431-2434. [PMID: 28268816 DOI: 10.1109/embc.2016.7591221] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Tools used by clinicians to diagnose and treat insomnia typically include sleep diaries and questionnaires. Overnight polysomnography (PSG) recordings are used when the initial diagnosis is uncertain due to the presence of other sleep disorders or when the treatment, either behavioral or pharmacologic, is unsuccessful. However, the analysis and the scoring of PSG data are time-consuming. To simplify the diagnosis process, in this paper we have proposed an efficient insomnia detection algorithm based on a central single electroencephalographic (EEG) channel (C3) using only deep sleep. We also analyzed several spectral and statistical EEG features of good sleeper controls and subjects suffering from insomnia in different sleep stages to identify the features that offered the best discrimination between the two groups. Our proposed algorithm was evaluated using EEG recordings from 19 patients diagnosed with primary insomnia (11 females, 8 males) and 16 matched control subjects (11 females, 5 males). The sensitivity of our algorithm is 92%, the specificity is 89.9%, the Cohen's kappa is 0.81 and the agreement is 91%, indicating the effectiveness of our proposed method.
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50
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Dashti HS, Zuurbier LA, de Jonge E, Voortman T, Jacques PF, Lamon-Fava S, Scheer FAJL, Kiefte-De Jong JC, Hofman A, Ordovás JM, Franco OH, Tiemeier H. Actigraphic sleep fragmentation, efficiency and duration associate with dietary intake in the Rotterdam Study. J Sleep Res 2016; 25:404-11. [PMID: 26857552 DOI: 10.1111/jsr.12397] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 01/09/2016] [Indexed: 12/13/2022]
Abstract
Short self-reported sleep duration is associated with dietary intake and this association may partly mediate the link between short sleep and metabolic abnormalities. Subjective sleep measures, however, may be inaccurate and biased. The objective of this study was to evaluate the associations between actigraphic measures of sleep fragmentation, efficiency and duration and energy and macronutrient intakes. We used data from a subgroup of 439 participants of the population-based cohort, Rotterdam Study. Sleep was assessed using 7-day actigraphy and sleep diaries, and dietary data with a validated food frequency questionnaire. We assessed the associations of actigraphic sleep parameters with dietary intake using multivariable linear regression models. Higher sleep fragmentation was associated with 4.19 g lower carbohydrate intake per standard deviation of fragmentation {β [95% confidence interval (CI) = -4.19 (-8.0, -0.3)]; P = 0.03}. Each additional percentage increase in sleep efficiency was associated with 11.1 kcal lower energy intake [β (95% CI) = -11.1 (-20.6, -1.7); P = 0.02]. Furthermore, very short sleep duration (<5.5 h) was associated with 218.1 kcal higher energy intake [β (95% CI = 218.06 (33.3, 402.8), P = 0.02], relative to the reference group (≥6.5 to <7.5 h). We observed associations between higher sleep fragmentation with lower carbohydrate intake, and both lower sleep efficiency and very short sleep duration (<5 h) with higher energy intake. The association between sleep and higher energy intake could mediate, in part, the link between short sleep or sleep fragmentation index and metabolic abnormalities.
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Affiliation(s)
- Hassan S Dashti
- Nutrition and Genomics Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.,Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands
| | - Lisette A Zuurbier
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands
| | - Ester de Jonge
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands.,Department of Internal Medicine, Erasmus MC-University Medical Center, Rotterdam, the Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands
| | - Paul F Jacques
- Nutritional Epidemiology Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Stefania Lamon-Fava
- Cardiovascular Nutrition Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Frank A J L Scheer
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Jessica C Kiefte-De Jong
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands.,Global Public Health, Leiden University College, The Hague, the Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands
| | - José M Ordovás
- Nutrition and Genomics Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.,Department of Epidemiology, Centro Nacional Investigaciones Cardiovasculares (CNIC), Madrid, Spain.,Instituto Madrileño de Estudios Avanzados en Alimentación (IMDEA-FOOD), Madrid, Spain
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands
| | - Henning Tiemeier
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands.,Department of Psychiatry, Erasmus MC-University Medical Center, Rotterdam, the Netherlands
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