1
|
Huang T. Low Delta Wave Activity During Sleep Promotes Cardiovascular Disease Risk: What's Next? J Am Coll Cardiol 2024; 83:1685-1687. [PMID: 38658107 DOI: 10.1016/j.jacc.2024.03.358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 04/26/2024]
Affiliation(s)
- Tianyi Huang
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA.
| |
Collapse
|
2
|
Seaver C, Bowers C, Beidel D, Holt L, Ramakrishnan S. A game-based learning approach to sleep hygiene education: a pilot investigation. Front Digit Health 2024; 6:1334840. [PMID: 38680214 PMCID: PMC11045930 DOI: 10.3389/fdgth.2024.1334840] [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: 11/07/2023] [Accepted: 03/22/2024] [Indexed: 05/01/2024] Open
Abstract
Introduction Sleep hygiene education (SHE) consists of environmental and behavioral practices primarily intended to reduce sleep problems. Currently considered ineffective as a stand-alone treatment, the manner in which the education is typically delivered may be ineffective for the acquisition of new knowledge. The purpose of this study was to determine if a more engaging teaching medium may improve the efficacy of sleep hygiene education. This study examined the use of game-based learning to teach SHE to individuals with sleep problems. Methods 35 participants played the SHE games for 30 days. Differences in pre- and post-state anxiety and sleep quality measures were examined. Results Participants had significant improvements in sleep quality and state anxiety after using the app for 30 days, although scores for the majority of patients remained elevated. Discussion This pilot investigation provides initial evidence for the efficacy of a game-based approach to SHE.
Collapse
Affiliation(s)
- Christine Seaver
- UCF RESTORES, University of Central Florida, Orlando, FL, United States
| | - Clint Bowers
- UCF RESTORES, University of Central Florida, Orlando, FL, United States
| | - Deborah Beidel
- UCF RESTORES, University of Central Florida, Orlando, FL, United States
| | - Lisa Holt
- BlueHalo, Rockville, MD, United States
| | | |
Collapse
|
3
|
Callow DD, Zipunnikov V, Spira AP, Wanigatunga SK, Pettigrew C, Albert M, Soldan A. Actigraphy Estimated Sleep Moderates the Relationship between Physical Activity and Cognition in Older Adults. Ment Health Phys Act 2024; 26:100573. [PMID: 38264712 PMCID: PMC10803079 DOI: 10.1016/j.mhpa.2023.100573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
Background and Aims Physical inactivity and poor sleep are common in older adults and may interact to contribute to age- and disease-related cognitive decline. However, prior work regarding the associations among physical activity, and cognition in older adults is primarily limited to subjective questionnaires that are susceptible to inaccuracies and recall bias. Therefore, this study examined whether objectively measured physical activity and sleep characteristics, each estimated using actigraphy, are independently or interactively associated with cognitive performance. Methods The study included 157 older adults free of dementia (136 cognitively unimpaired; 21 MCI; M age = 71.7) from the BIOCARD cohort. Results Using multiple linear regression, cognition was regressed on estimated total volume of physical activity (TVPA), sleep efficiency (SE), wake after sleep onset (WASO), and total sleep time (TST) (adjusted for age, sex, education, diagnosis, vascular risk factors, and Apolipoprotein E (APOE)-e4 genetic status). Models were also run for domain-specific cognitive composite scores. TVPA and SE each were positively associated with a global cognitive composite score. TVPA was positively associated with executive function and language composites, and SE was positively related to executive function, visuospatial, and language composites. Importantly, a TVPA by SE interaction (p = 0.015) suggested that adults with the poorest SE experienced the greatest benefit from physical activity in relation to global cognition. The other sleep metrics were unrelated to cognitive performance. Conclusion These results suggest that TVPA and SE may synergistically benefit cognition in older adults.
Collapse
Affiliation(s)
- Daniel D Callow
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Vadim Zipunnikov
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Adam P Spira
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
| | - Sarah K Wanigatunga
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Corinne Pettigrew
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Marilyn Albert
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Anja Soldan
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD
| |
Collapse
|
4
|
Wei R, Ganglberger W, Sun H, Hadar P, Gollub R, Pieper S, Billot B, Au R, Eugenio Iglesias J, Cash SS, Kim S, Shin C, Westover MB, Joseph Thomas R. Linking brain structure, cognition, and sleep: insights from clinical data. Sleep 2024; 47:zsad294. [PMID: 37950486 PMCID: PMC10851868 DOI: 10.1093/sleep/zsad294] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/13/2023] [Indexed: 11/12/2023] Open
Abstract
STUDY OBJECTIVES To use relatively noisy routinely collected clinical data (brain magnetic resonance imaging (MRI) data, clinical polysomnography (PSG) recordings, and neuropsychological testing), to investigate hypothesis-driven and data-driven relationships between brain physiology, structure, and cognition. METHODS We analyzed data from patients with clinical PSG, brain MRI, and neuropsychological evaluations. SynthSeg, a neural network-based tool, provided high-quality segmentations despite noise. A priori hypotheses explored associations between brain function (measured by PSG) and brain structure (measured by MRI). Associations with cognitive scores and dementia status were studied. An exploratory data-driven approach investigated age-structure-physiology-cognition links. RESULTS Six hundred and twenty-three patients with sleep PSG and brain MRI data were included in this study; 160 with cognitive evaluations. Three hundred and forty-two participants (55%) were female, and age interquartile range was 52 to 69 years. Thirty-six individuals were diagnosed with dementia, 71 with mild cognitive impairment, and 326 with major depression. One hundred and fifteen individuals were evaluated for insomnia and 138 participants had an apnea-hypopnea index equal to or greater than 15. Total PSG delta power correlated positively with frontal lobe/thalamic volumes, and sleep spindle density with thalamic volume. rapid eye movement (REM) duration and amygdala volume were positively associated with cognition. Patients with dementia showed significant differences in five brain structure volumes. REM duration, spindle, and slow-oscillation features had strong associations with cognition and brain structure volumes. PSG and MRI features in combination predicted chronological age (R2 = 0.67) and cognition (R2 = 0.40). CONCLUSIONS Routine clinical data holds extended value in understanding and even clinically using brain-sleep-cognition relationships.
Collapse
Affiliation(s)
- Ruoqi Wei
- Division of Pulmonary Critical Care & Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Wolfgang Ganglberger
- McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Sleep and Health Zurich, University of Zurich, Zurich, Switzerland
| | - Haoqi Sun
- McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Peter N Hadar
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Randy L Gollub
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
| | | | - Benjamin Billot
- Computer Science and Artificial Intelligence Lab, MIT, Boston, MA, USA
| | - Rhoda Au
- Anatomy& Neurobiology, Neurology, Medicine and Epidemiology, Boston University Chobanian & Avedisian School of Medicine and School of Public Health, Boston University, Boston, MA, USA
| | - Juan Eugenio Iglesias
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
- Isomics, Inc. Cambridge, MA, USA
- Center for Medical Image Computing, University College London, London, UK
| | - Sydney S Cash
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Soriul Kim
- Institute of Human Genomic Study, College of Medicine, Kore University, Seoul, Republic of Korea
| | - Chol Shin
- Institute of Human Genomic Study, College of Medicine, Kore University, Seoul, Republic of Korea
- Biomedical Research Center, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - M Brandon Westover
- McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Robert Joseph Thomas
- Division of Pulmonary Critical Care & Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
| |
Collapse
|
5
|
Hariri M, Shamshirgaran SM, Aminisani N, Abasi H, Gholami A. Is poor sleep quality associated with lipid profile in elderly population? Finding from Iranian Longitudinal Study on Ageing. Ir J Med Sci 2024; 193:123-129. [PMID: 37400651 DOI: 10.1007/s11845-023-03449-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/23/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND Abnormal lipid profile as one of reversible cardiovascular disease risk factors might be affected by poor sleep quality. AIM This study aimed to assess the association between poor sleep quality and serum concentration of lipid profile in Iranian elderly population. METHODS The study was performed on a representative sample of 3452 Iranian older people (≥60 years) who contributed in the Iranian Longitudinal Study on Ageing (IRLSA). Sleep quality was measured through the validated Persian version of Pittsburgh Sleep Quality Index (PSQI). Fasting blood samples were collected from the participants to measure plasma levels lipid profile. We used multiple linear regression model to evaluate the independent association of poor sleep quality with lipid profile. RESULTS The mean age of participants was 68.0±6.7 years and 52.5% of them were male. In total, 52.4% of study population reported poor sleep quality (PSQI>5). Mean serum concentration of triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) was 143.2±74.2 mg/dl, 195.6±43.2 mg/dl, 112.9±31.0 mg/dl, and 57.3±12.4 mg/dl, respectively. Poor sleep quality was significantly associated with serum levels of TG (β=17.85; P=0.006), LDL-C (β=5.45; P=0.039) and HDL-C (β=-2.13; P=0.039) after adjusting for studied covariates. CONCLUSION Our study illustrates that poor sleep quality is a risk factor for poorer lipid profile. Therefore, early behavioral or pharmacological interventions that improve sleep quality are necessary to modify lipid profile in elderly population.
Collapse
Affiliation(s)
- Mitra Hariri
- Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
- Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Seyed Morteza Shamshirgaran
- Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Nayyereh Aminisani
- Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Hamid Abasi
- Public Health Department, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Ali Gholami
- Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran.
- Department of Epidemiology and Biostatistics, School of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran.
| |
Collapse
|
6
|
Madaeva IM, Titova EV, Berdina ON, Sholokhov LF, Kolesnikov SI, Kolesnikova LI. [Changes the level of differentiating growth factor - GDF 15 in patients with sleep apnea syndrome after aPAP-therapy: pilot study]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:118-124. [PMID: 38934676 DOI: 10.17116/jnevro2024124052118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
OBJECTIVE Comparative assessment of the level of differentiating growth factor 15 (GDF 15 ) against the background of a 6-month course of respiratory support in the mode of automatic positive pressure in the airways therapy (aPAP therapy) in patients with obstructive sleep apnea syndrome (OSA). MATERIAL AND METHODS 59 men participated in the study, the average age was 51.9±2.4 years. The main group (MG1) consisted of 30 patients with a verified diagnosis of moderate OSA. 29 men of comparable age and body weight made up the control group (CG) without an objectively confirmed diagnosis of OSA. After the stage of introduction into the study, the type of respiratory support with individual pressure settings was selected for patients with MG1. After 6 months of aPAP therapy with high compliance (at least 85%), the same patients who made up MG2 after treatment underwent repeated polysomnography (PSG) and the GDF 15 content was evaluated. Methods: questionnaire, examination, polysomnography, enzyme immunoassay of blood serum to determine the content of GDF 15. RESULTS A 6-month course of aPAP therapy with a high degree of compliance significantly improved the sleep structure and breathing pattern: the representation of NREM 3 increased from 79.2±15.6 to 102.6±21.6 minutes and the REM phase from 56.9± 13.6 to 115.6±26.8. Episodes of apnea were eliminated - apnea-hypopnea index decreased from 21.1 [17.3; 39.1] to 2.5 [1.8; 4.6] and the average values of SaO2 increased from 85.9% to 91.5%. At the same time, a statistically significant excess of GDF 15 was revealed in MG1 - 20.4 [14.16; 31.71] and MG2 - 17.2 [13.63; 24.44]) in comparison with CG - 13.65 [10.7; 17.09]. Despite the lack of statistical significance, a change in the level of GDF 15 was revealed in the form of a decrease in its concentration after a 6-month course of aPAP therapy. CONCLUSION A 6-month course of aPAP therapy made it possible to eliminate intermittent nocturnal hypoxia and improve sleep structure in patients with OSA, as well as reduce the content of GDF 15 protein in blood serum in patients with OSA. However, the tendency to decrease the content of this protein, despite the lack of statistical reliability, confirms the effectiveness of OSA therapy and the possibility of preventing early and pathological aging from the standpoint of somnology and molecular biogerontology.
Collapse
Affiliation(s)
- I M Madaeva
- Scientific Centre for Family Health and Human Reproduction Problems, Irkutsk, Russia
| | - E V Titova
- Scientific Centre for Family Health and Human Reproduction Problems, Irkutsk, Russia
| | - O N Berdina
- Scientific Centre for Family Health and Human Reproduction Problems, Irkutsk, Russia
| | - L F Sholokhov
- Scientific Centre for Family Health and Human Reproduction Problems, Irkutsk, Russia
| | - S I Kolesnikov
- Scientific Centre for Family Health and Human Reproduction Problems, Irkutsk, Russia
| | - L I Kolesnikova
- Scientific Centre for Family Health and Human Reproduction Problems, Irkutsk, Russia
| |
Collapse
|
7
|
Chen JH. Racial and Ethnic Trajectories of Sleep Disturbances: Variations by Age and Cohort. J Gerontol A Biol Sci Med Sci 2023; 78:1897-1907. [PMID: 36702761 DOI: 10.1093/gerona/glad031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The racial and ethnic differences in trajectories of sleep disturbances in later life are crucial for addressing health disparities, but are not well understood. This study examines (a) how trajectories of sleep disturbances vary by race and ethnicity and birth cohort and (b) whether social and health risk factors explain such variations. METHODS The study uses longitudinal data from the 2002-2018 Health and Retirement Study (N = 21 963) and the multilevel growth curve model to assess trajectories of sleep disturbances and their variations across 6 cohorts of White, Black, and Hispanic older adults. Sleep disturbances are measured using a modified Jenkins Sleep Scale. RESULTS Without controls, sleep disturbances increased with aging for all racial and ethnic groups, but more rapidly among minorities, particularly younger cohorts of Hispanic older adults. When controlling for social and health risks, sleep disturbances did not change with aging for Whites and Blacks and increased for younger cohorts of Hispanics. Cohort effects were observed among White older adults, with higher sleep disturbances in younger cohorts. Importantly, the racial and ethnic disparities in age and cohort effects were not fully explained by social and health risks. Of the symptoms, the most salient racial and ethnic disparities were found in "waking up at night" and "not feeling rested." CONCLUSIONS Findings reveal several differences by race and ethnicity and birth cohort in trajectories of sleep disturbances. Efforts should be made to improve sleep health for older adults as they age, especially for younger cohorts of Blacks and Hispanics.
Collapse
Affiliation(s)
- Jen-Hao Chen
- Department of Sociology & Department of Psychology, National Chengchi University, Taipei, Taiwan
| |
Collapse
|
8
|
Safak ED, Celik F, Mazicioglu MM, Akin S, Manav TY, Kesim S, Ozturk A. The relationship between oral health and sleep quality in community-dwelling older adults. Niger J Clin Pract 2023; 26:1449-1455. [PMID: 37929520 DOI: 10.4103/njcp.njcp_756_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
Introduction The assessment of the sleep status of older adults and its relationship to oral health can help determine their well-being and quality of life. In accordance with this purpose, we aimed to evaluate the relationship between oral health and sleep quality in community-dwelling older adults in an urban area. Materials and Methods The data of this study were taken from the Kayseri Elderly Health Study. The study group was administered a questionnaire form and the Pittsburgh Sleep Quality Index. A specialist dentist examined the oral health conditions (dentures use; caries; deficient, filled, natural teeth numbers; periodontal health) using the Community Periodontal Index and the Oral Health Impact Profile-14 (OHIP-14-TR). Results One hundred forty (38.1%) of the study group were female, and 227 (61.9%) were male. When evaluated in terms of oral hygiene, there was a statistically significant difference between those with good sleep quality and poor sleep quality in terms of mechanical interventions such as using toothpaste and an inter-dental brush, and also, OHIP-14-TR was significant. In the binary logistic regression analysis, OHIP-14-TR was found to be a significant risk factor, reflecting only the subjective interpretation of the older adults in terms of oral health-related quality of life (odds ratio: 1.069, 95.0% confidence interval: 1.043-1.096). Conclusion This is the first epidemiologic study to examine the relationship between oral health status and sleep quality, in which many oral health indicators are evaluated together in Turkish community-dwelling older adults. OHIP-14-TR may be a useful tool to employ in sleep disorder clinics for older people.
Collapse
Affiliation(s)
- E Deniz Safak
- Department of Family Medicine, Erciyes University School of Medicine, Kayseri, Turkey
| | - F Celik
- Biruni University School of Dentistry, İstanbul, Turkey
| | - M M Mazicioglu
- Department of Family Medicine, Erciyes University School of Medicine, Kayseri, Turkey
| | - S Akin
- Department of Internal Medicine, Division of Geriatrics, Erciyes University School of Medicine, Kayseri, Turkey
| | - T Y Manav
- Kahramanmaraş Sütçü İmam University School of Dentistry, Kahramanmaraş, Turkey
| | - S Kesim
- Beykent University School of Dentistry, İstanbul, Turkey
| | - A Ozturk
- Department of Biostatistics, Erciyes University School of Medicine, Kayseri, Turkey
| |
Collapse
|
9
|
Rouhi S, Topcu J, Egorova-Brumley N, Jordan AS. The impact of sleep disturbance on pain perception: A systematic review examining the moderating effect of sex and age. Sleep Med Rev 2023; 71:101835. [PMID: 37586144 DOI: 10.1016/j.smrv.2023.101835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 07/27/2023] [Accepted: 08/06/2023] [Indexed: 08/18/2023]
Abstract
Females have increased pain sensitivity and are more vulnerable to chronic pain conditions. Sleep disturbances are comorbid with chronic pain and exacerbate pain symptoms. Different types of sleep disturbance affect pain perception distinctly, but it is not clear if these effects are equal in men and women. This systematic review investigated potential differences in how sleep disturbance affects pain in males and females. We searched EBSCO, MEDLINE, Psych INFO, Science Direct, and Web of Science from January 2001 to November 2022 and found 38 studies with 978 participants. Separate random-effects models were used to estimate the pooled effect sizes based on standardized mean differences (SMDs) of experimental sleep disturbance paradigms on various pain outcomes. Sex moderated the effect of sleep disturbance on pain facilitation (SMD = 0.13; 95%CI: 0.004 to 0.022; p=.009) and pain inhibition (SMD = 0.033; 95%CI: 0.011 to 0.054; p=.005), with increased facilitation and decreased inhibition in females, but the opposite effect in males. Further, age moderated the effects of total sleep deprivation (SMD = -0.194; 95%CI -0.328 to -0.060; p=.008) on pain sensitivity and fragmented sleep (SMD = -0.110; 95%CI: 0.148 to -0.072; p<.001) on pain threshold. While the moderating effect of sex and age on the sleep-pain relationship was small, these factors need to be considered in future sleep-pain research.
Collapse
|
10
|
Lin S, Gong Q, Wang J, Gao H, Hong J, Guo Y, Zhang Y, Jiang D. The association between sleep duration and risk of myopia in Chinese school-aged children: a cross-sectional study. Sleep Breath 2023; 27:2041-2047. [PMID: 36797552 DOI: 10.1007/s11325-023-02794-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 01/31/2023] [Accepted: 02/06/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND Myopia is one of the most commonly diagnosed refractive disorders worldwide. Identifying risk factors for myopia at an early age may help to characterize children who would benefit most from individualized lifestyle advice and early interventions. The influence of sleep duration on myopia risk remains controversial and thus needs to be evaluated. METHODS A population-based cross-sectional study of Chinese school-aged children was conducted. Information on sleep duration was derived. The association between sleep duration and myopia risk was investigated by logistic regression analysis. RESULTS Myopia prevalence among 9530 Chinese school-aged children was 75.4% and decreased from 84.9%, 76.5%, 65.8%, to 61.3% along with the extension of sleep duration. Univariate logistic regression found longer sleep duration of 8-9 h (OR = 0.58, 95% CI: 0.51-0.66), 9-10 h (OR = 0.34, 95% CI: 0.30-0.39), and ≥ 10 h (OR = 0.28, 95% CI: 0.24-0.33) were protective factors for myopia in all participants (P for trend < 0.001). In the multivariate analyses, sleep duration was inversely associated with the risk of myopia, and a dose-effect relationship was observed when the analysis was split by age category. CONCLUSIONS Long sleep duration was associated with decreased risk of myopia in Chinese school-aged children.
Collapse
Affiliation(s)
- Shujuan Lin
- School of Basic Medical Science, Putian University, Putian, China
- Key Laboratory of Translational Tumor Medicine in Fujian Province, Putian University, Putian, China
| | - Qinghai Gong
- Ningbo Municipal Center for Disease Control and Prevention, Yongfeng Road 237, Haishu District, Ningbo, 315010, China
| | - Jinghui Wang
- Ningbo Municipal Center for Disease Control and Prevention, Yongfeng Road 237, Haishu District, Ningbo, 315010, China
| | - Hua Gao
- Ningbo Municipal Center for Disease Control and Prevention, Yongfeng Road 237, Haishu District, Ningbo, 315010, China
| | - Jia Hong
- Ningbo Municipal Center for Disease Control and Prevention, Yongfeng Road 237, Haishu District, Ningbo, 315010, China
| | - Yanbo Guo
- Ningbo Municipal Center for Disease Control and Prevention, Yongfeng Road 237, Haishu District, Ningbo, 315010, China
| | - Yan Zhang
- Ningbo Municipal Center for Disease Control and Prevention, Yongfeng Road 237, Haishu District, Ningbo, 315010, China.
| | - Danjie Jiang
- Ningbo Municipal Center for Disease Control and Prevention, Yongfeng Road 237, Haishu District, Ningbo, 315010, China.
| |
Collapse
|
11
|
Ranjan A, Biswas S, Mallick BN. Rapid eye movement sleep loss associated cytomorphometric changes and neurodegeneration. Sleep Med 2023; 110:25-34. [PMID: 37524037 DOI: 10.1016/j.sleep.2023.07.022] [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: 02/20/2023] [Revised: 07/10/2023] [Accepted: 07/22/2023] [Indexed: 08/02/2023]
Abstract
Rapid eye movement sleep (REMS) is essential for leading normal healthy living at least in higher-order mammals, including humans. In this review, we briefly survey the available literature for evidence linking cytomorphometric changes in the brain due to loss of REMS. As a mechanism of action, we add evidence that REMS loss elevates noradrenaline (NA) levels in the brain, which affects neuronal cytomorphology. These changes may be a compensatory mechanism as the changes return to normal after the subjects recover from the loss of REMS or if during REMS deprivation, the subjects are treated with NA-adrenoceptor antagonist prazosin (PRZ). We had proposed earlier that one of the fundamental functions of REMS is to maintain the level of NA in the brain. We elaborate on this idea to propose that if REMS loss continues without recovery, the sustained level of NA breaks down neurophysiologically active compensatory mechanism/s starting with changes in the neuronal cytomorphology, followed by their degeneration, leading to acute and chronic pathological conditions. Identification of neuronal cytomorphological changes could prove to be of significance for predicting future neuronal (brain) damage as well as an indicator for REMS health. Although current brain imaging techniques may not enable us to visualize changes in neuronal cytomorphology, given the rapid technological progress including use of artificial intelligence, we are optimistic that it may be a reality soon. Finally, we propose that maintenance of optimum REMS must be considered a criterion for leading a healthy life.
Collapse
Affiliation(s)
- Amit Ranjan
- Department of Zoology, Mahatma Gandhi Central University, Motihari, East Champaran, Bihar, 845401, India.
| | - Sudipta Biswas
- Math, Science, Engineering Department, South Mountain Community College, 7050 S 24th St, Phoenix, AZ, 85042, USA
| | - Birendra Nath Mallick
- Amity Institute of Neuropsychology & Neurosciences, Amity University Campus, Sector 125, Gautam Budh Nagar, Noida, 201313, Uttar Pradesh, India
| |
Collapse
|
12
|
Sheehan CM, Garcia MA, Chiu CT, Cantu PA. Racial and Ethnic Differences in Sleep Duration Life Expectancies among Men and Women in Mid-to-Late Life. Res Aging 2023; 45:620-629. [PMID: 36548945 DOI: 10.1177/01640275221146478] [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: 12/24/2022]
Abstract
This analysis documents U.S. racial/ethnic and gender differences in life expectancies with different self-reported sleep durations among adults aged 50 and older. We used self-reported sleep duration and linked mortality information from the 2004-2015 National Health Interview Survey (n = 145,015) to calculate Sullivan Method Lifetables for life expectancies with different self-reported sleep duration states: short (≤6 hours), optimal (seven to 8 hours), and long (≥9 hours) sleep duration per-day by race/ethnicity and gender. Non-Hispanic Black men (35.8%, 95% CI: 34.8%-36.8%) and women (36.5%, 95% CI: 35.7%-37.1%) exhibited the highest proportion of years lived with short sleep duration followed by Hispanic men (31.1%, 95% CI: 29.9%-32.3%) and women (34.1%, 95% CI: 33.1%-35.1%) and Non-Hispanic White men (25.8%, 95% CI: 25.4%-26.2%) and women (27.4%, 95% CI: 27.0%-27.7%). These results highlight how race/ethnic inequality in sleep duration and life expectancy are intertwined among older adults in the U.S.
Collapse
Affiliation(s)
- Connor M Sheehan
- School of Social and Family Dynamics, Arizona State University, Tempe, AZ, USA
| | - Marc A Garcia
- Department of Sociology, Aging Studies Institute, Center for Aging and Policy Studies, Lerner Center for Public Health Promotion, Syracuse University, Syracuse, New York, USA
| | - Chi-Tsun Chiu
- Institute of European and American Studies, Academia Sinica, Taipei, Taiwan
| | - Phillip A Cantu
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA
| |
Collapse
|
13
|
Tegegne TK, Islam SMS, Maddison R. Longitudinal patterns of lifestyle risk behaviours among UK adults with established cardiovascular disease: a latent transition analysis. Front Cardiovasc Med 2023; 10:1116905. [PMID: 37731520 PMCID: PMC10507625 DOI: 10.3389/fcvm.2023.1116905] [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: 01/18/2023] [Accepted: 08/21/2023] [Indexed: 09/22/2023] Open
Abstract
Background People with cardiovascular disease (CVD) need to engage in healthy lifestyle behaviours. However, there is a gap in identifying longitudinal patterns of change in lifestyle behaviours among people with CVD. This study aimed to identify clustering of lifestyle risk behaviours and their 4 ± year changes among UK adults with CVD, and to determine the associated factors. Methods We used the UK Biobank data collected at two time points (2006-2010/baseline data = T0 and 2014+/third visit data = T4). Six key lifestyle risk behaviours were assessed: smoking, high alcohol intake, poor fruit and vegetable consumption, physical inactivity, poor sleep balance (<7 or >8 h/night) and prolonged sitting. A random intercept latent transition analysis was performed to identify patterns of lifestyle risk behaviours at T0 and their changes from T0 to T4. Results We included 5,304 participants with CVD whose data on lifestyle risk behaviours were collected at two-time points. Alcohol intake and current smoking were 75.7% and 5.4% at baseline, respectively, and 67.4% and 3.0% at follow-up. Three latent classes emerged: Latent class (LC) 1-"high alcohol intake, poor sleep balance and poor fruit and vegetable intake", LC2-"high alcohol intake and poor fruit and vegetable intake", and LC3-"high alcohol intake". Most adults remained in the same LC over the 4 + years (range: 83.9%-100.0%). After 4 + years, 3.5% from LC3 and 10.4% from LC2 at baseline moved into LC1. The odds of transitioning to LC2 relative to staying in LC1 and LC3 were 2.22 and 4.13 times higher for males than for females, respectively. A single-year increase in participants' age was associated with a 1.16 times increase in the odds of moving to LC1 relative to staying in LC2. Conclusion People with CVD did not show improvement in lifestyle risk behaviours, and interventions targeting multiple lifestyle risk behaviours are needed to improve CVD.
Collapse
Affiliation(s)
- Teketo Kassaw Tegegne
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | | | | |
Collapse
|
14
|
Bai D, Ho MC, Mathunjwa BM, Hsu YL. Deriving Multiple-Layer Information from a Motion-Sensing Mattress for Precision Care. SENSORS (BASEL, SWITZERLAND) 2023; 23:1736. [PMID: 36772776 PMCID: PMC9919926 DOI: 10.3390/s23031736] [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: 11/25/2022] [Revised: 01/26/2023] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
Bed is often the personal care unit in hospitals, nursing homes, and individuals' homes. Rich care-related information can be derived from the sensing data from bed. Patient fall is a significant issue in hospitals, many of which are related to getting in and/or out of bed. To prevent bed falls, a motion-sensing mattress was developed for bed-exit detection. A machine learning algorithm deployed on the chip in the control box of the mattress identified the in-bed postures based on the on/off pressure pattern of 30 sensing areas to capture the users' bed-exit intention. This study aimed to explore how sleep-related data derived from the on/off status of 30 sensing areas of this motion-sensing mattress can be used for multiple layers of precision care information, including wellbeing status on the dashboard and big data analysis for living pattern clustering. This study describes how multiple layers of personalized care-related information are further derived from the motion-sensing mattress, including real-time in-bed/off-bed status, daily records, sleep quality, prolonged pressure areas, and long-term living patterns. Twenty-four mattresses and the smart mattress care system (SMCS) were installed in a dementia nursing home in Taiwan for a field trial. Residents' on-bed/off-bed data were collected for 12 weeks from August to October 2021. The SMCS was developed to display care-related information via an integrated dashboard as well as sending reminders to caregivers when detecting events such as bed exits and changes in patients' sleep and living patterns. The ultimate goal is to support caregivers with precision care, reduce their care burden, and increase the quality of care. At the end of the field trial, we interviewed four caregivers for their subjective opinions about whether and how the SMCS helped their work. The caregivers' main responses included that the SMCS helped caregivers notice the abnormal situation for people with dementia, communicate with family members of the residents, confirm medication adjustments, and whether the standard care procedure was appropriately conducted. Future studies are suggested to focus on integrated care strategy recommendations based on users' personalized sleep-related data.
Collapse
Affiliation(s)
- Dorothy Bai
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei 110, Taiwan
| | - Mu-Chieh Ho
- Gerontechnology Research Center, Yuan Ze University, Taoyuan 320, Taiwan
| | | | - Yeh-Liang Hsu
- Gerontechnology Research Center, Yuan Ze University, Taoyuan 320, Taiwan
| |
Collapse
|
15
|
Wen CCY, Cherian D, Schenker MT, Jordan AS. Fatigue and Sleep in Airline Cabin Crew: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2652. [PMID: 36768014 PMCID: PMC9916232 DOI: 10.3390/ijerph20032652] [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: 12/04/2022] [Revised: 01/23/2023] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
Airline cabin crew operate in dynamic work environments that are continuously changing, from unpredictable shift work hours to travelling through multiple time zones. These likely impact cabin crews' overall health and may affect their performance on safety-related tasks. Research on this population has been limited; therefore, the aim was to summarise the relevant literature regarding fatigue, sleepiness and mental health of cabin crew. This review followed the PRISMA-ScR guidelines and conducted a systematic search utilising five databases. The initial search identified 1223 studies, and through vigorous screening processes, 27 studies were selected for this review. Over half of the selected studies focused on international or long-haul flights, and a large proportion of the sample participants were women. Findings suggested a high prevalence of fatigue and sleepiness as well as unsatisfactory sleep quality with elevated susceptibility to sleep disorders. Factors identified with health outcomes were associated with flight operations (e.g., rosters) and individual differences (e.g., age and coping strategies). Regarding mental health, cabin crews are potentially at a greater risk for depression and anxiety compared to the general public. This review draws attention to the importance of using a standardised approach, such as validated measures for fair and consistent inferences.
Collapse
Affiliation(s)
- Candice C. Y. Wen
- John Trinder Sleep Laboratory, Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC 3010, Australia
| | - Darsh Cherian
- John Trinder Sleep Laboratory, Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC 3010, Australia
| | - Maya T. Schenker
- John Trinder Sleep Laboratory, Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC 3010, Australia
| | - Amy S. Jordan
- John Trinder Sleep Laboratory, Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC 3010, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, VIC 3084, Australia
| |
Collapse
|
16
|
Corbo I, Forte G, Favieri F, Casagrande M. Poor Sleep Quality in Aging: The Association with Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20031661. [PMID: 36767029 PMCID: PMC9914898 DOI: 10.3390/ijerph20031661] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/13/2023] [Accepted: 01/14/2023] [Indexed: 05/13/2023]
Abstract
Sleep disturbances are common in the elderly. A primary sleep disorder can result from the physiological decline of aging; however, secondary sleep problems result from various causes involving physical and mental health. Since little is known about the relationships between sleep quality and mental health in aging, the present study aims to understand how different aspects generally associated with sleep (e.g., psychological and physiological factors, and sleep medication) may predict poor sleep quality in different stages of the lifespan. Therefore, we conducted several analyses (ANOVAs, Pearson correlations, and linear regressions) to test the hypotheses of the study. Accordingly, from a pool of 180 participants (elderly, middle-aged, and young adults), 143 individuals with poor sleep quality were selected. Different predictive patterns in the three groups emerged. Specifically, the use of sleep medication associated with worse sleep conditions is predicted by poor sleep quality in the elderly and by depression in young adults. In contrast, worsening sleep quality is predicted by depression in middle-aged adults. Previous studies focused on the transitions from good to poor sleep quality, while this is the first study to have examined the features of poor sleep quality in aging, highlighting different sleep patterns across the lifespan. This evidence should be considered from a preventive perspective.
Collapse
Affiliation(s)
- Ilaria Corbo
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy
- Correspondence: (I.C.); (M.C.)
| | - Giuseppe Forte
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, 00185 Rome, Italy
- Body and Action Laboratory, IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy
| | - Francesca Favieri
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy
- Body and Action Laboratory, IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy
| | - Maria Casagrande
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, 00185 Rome, Italy
- Correspondence: (I.C.); (M.C.)
| |
Collapse
|
17
|
Chan WS, McCrae CS, Ng ASY. Is Cognitive Behavioral Therapy for Insomnia Effective for Improving Sleep Duration in Individuals with Insomnia? A Meta-Analysis of Randomized Controlled Trials. Ann Behav Med 2022; 57:428-441. [DOI: 10.1093/abm/kaac061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Abstract
Background
Accumulating evidence suggests that sleep duration is a critical determinant of physical and mental health. Half of the individuals with chronic insomnia report less than optimal sleep duration. Cognitive behavioral therapy for insomnia (CBT-I) is an effective treatment for reducing sleep difficulties in individuals with chronic insomnia. However, its effectiveness for increasing sleep duration is less well-established and a synthesis of these findings is lacking.
Purpose
To provide a synthesis of findings from randomized controlled trials (RCTs) on the effect of CBT-I on subjective and objective total sleep time (TST).
Methods
A systematic search was performed on articles published from 2004 to 05/30/2021. A total of 43 RCTs were included in the meta-analysis. Publication biases were examined. Meta-regressions were conducted to examine if any sample or treatment characteristics moderated the effect sizes across trials.
Results
We found a small average effect of CBT-I on diary-assessed TST at post-treatment, equivalent to an approximately 30-min increase. Age significantly moderated the effects of CBT-I on diary-measured and polysomnography-measured TST; older ages were associated with smaller effect sizes. Contrarily, a negative, medium effect size was found for actigraphy-assessed TST, equivalent to an approximately 30-min decrease. Publication biases were found for diary data at follow-up assessments suggesting that positive findings were favored.
Conclusions
CBT-I resulted in improvements in TST measured by sleep diaries and polysomnography (in adults). These improvements were not corroborated by actigraphy findings. Theoretical and clinical implications were discussed.
Collapse
Affiliation(s)
- Wai Sze Chan
- Department of Psychology, The University of Hong Kong , Hong Kong , China
| | | | - Albe Sin-Ying Ng
- Department of Psychology, The University of Hong Kong , Hong Kong , China
| |
Collapse
|
18
|
Yan Y, Zhang H, Kang M, Lan L, Wang Z, Lin Y. Experimental study of the negative effects of raised bedroom temperature and reduced ventilation on the sleep quality of elderly subjects. INDOOR AIR 2022; 32:e13159. [PMID: 36437666 DOI: 10.1111/ina.13159] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/14/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
This study investigated the effects of air temperature and ventilation on the sleep quality of elderly subjects and elucidated the mechanisms involved. Sixteen subjects aged over 65 years old were exposed to four conditions in a 2 × 2 design: air temperatures of 27°C and 30°C (with a ceiling fan in operation at 30°C) and two ventilation conditions (with and without mechanical ventilation) in experimental bedrooms. Their electroencephalogram, electrooculogram, chin electromyogram, electrocardiogram, respiration, oxygen saturation, and wrist skin temperature were measured continuously during sleep. Saliva samples were collected, and blood pressure was measured both before and after sleep. The results showed that at the temperature of 30°C, the total sleep time, sleep efficiency, and duration of REM sleep of the elderly decreased by 26.3 min, 5.5%, and 5.3 min, respectively, and time awake increased by 27.0 min, in comparison with 27°C, indicating that the sleep quality of the elderly is very vulnerable to heat exposure. Even a small heat load led to an overactive sympathetic nervous system and increased wrist skin temperature, which reduced sleep quality. Improving the ventilation increased the duration of deep sleep and REM sleep by 10.3 min and 3.7 min, respectively. Higher pollutant concentrations affected the respiration and autonomous nervous systems to reduce sleep quality. The benefits of improved thermal environment and ventilation on sleep quality were found to be additive. Good ventilation and the avoidance of raised temperatures in the bedroom are thus both important for the sleep quality of the elderly.
Collapse
Affiliation(s)
- Yan Yan
- Department of Architecture, School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Haodong Zhang
- Department of Architecture, School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Mengyuan Kang
- Department of Architecture, School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Li Lan
- Department of Architecture, School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Zhentao Wang
- School of medicine affiliated Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yanbin Lin
- School of medicine affiliated Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
19
|
Associations of testosterone and cortisol concentrations with sleep quality in Japanese male workers. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2022; 12:100158. [PMID: 36148025 PMCID: PMC9485038 DOI: 10.1016/j.cpnec.2022.100158] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 11/29/2022] Open
Abstract
Low testosterone concentrations are associated with disrupted sleep, and high levels of cortisol, which is elevated in response to stress, lead to insomnia. This study aimed to investigate the associations of testosterone and cortisol concentrations with sleep quality and to examine potential interactions between them in Japanese working men. This study was a cross-sectional design, and testosterone and cortisol concentrations in blood were the exposure variables and sleep parameters were the outcome variables. The Japanese version of the Pittsburgh Sleep Quality Index was used to measure sleep quality, and it included the total duration of sleep, time in bed (TIB), and sleep efficacy. We included 178 men (mean age = 49.1 years, standard deviation = 9.0) who completed all components in the questionnaire related to sleep and provided blood samples. Testosterone and cortisol concentrations were negatively associated with TIB (standardized beta = −0.15 and −0.24, p < 0.05, respectively), while only testosterone concentrations were positively associated with sleep efficacy (standardized beta = 0.15, p < 0.05). An interaction effect of testosterone and cortisol was significant for TIB and sleep efficacy (standardized beta for interaction term = 0.40, p < 0.001 and −0.22, p = 0.012, respectively). When stratified by cortisol concentrations, the associations between testosterone concentrations and sleep parameters were modified. Our findings suggest that associations between testosterone concentrations and sleep parameters are stronger at low cortisol concentrations, but not at high cortisol concentrations. High cortisol concentrations may diminish associations between low testosterone concentrations and diminished sleep efficacy. Testosterone and cortisol levels were negatively associated with hours in bed. Testosterone concentrations were positively associated with sleep efficacy. Cortisol levels modified the associations between testosterone and sleep efficacy. Testosterone strongly associated with sleep efficacy in low cortisol levels. Cortisol levels may inhibit associations between testosterone and sleep efficacy.
Collapse
|
20
|
Effect of Docosahexaenoic Acid and Eicosapentaenoic Acid Supplementation on Sleep Quality in Healthy Subjects: A Randomized, Double-Blinded, Placebo-Controlled Trial. Nutrients 2022; 14:nu14194136. [PMID: 36235788 PMCID: PMC9573173 DOI: 10.3390/nu14194136] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 11/17/2022] Open
Abstract
Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA)-omega-3 fatty acids with various functions-influence sleep in children and young adults. However, only limited studies on their effects on sleep in middle- and old-aged adults have been reported. Therefore, we investigated the effects of DHA and EPA on sleep quality in subjects aged ≥ 45 years. We performed a randomized, placebo-controlled, double-blinded, parallel-grouped study, in which we randomly assigned 66 healthy Japanese males and females. Each individual received six 480 mg capsules containing 576 mg DHA and 284 mg EPA per day (DHA/EPA group, n = 33), or corn oil (placebo group, n = 33), for 12 weeks. Before and after the intervention, the Oguri-Shirakawa-Azumi sleep inventory MA version (OSA-MA) and the sleep state test were conducted. In the DHA/EPA group, factor III (frequent dreaming) scores among the OSA-MA scores were significantly improved compared to the placebo group. Additionally, sleep state tests revealed that sleep efficiency improved in the DHA/EPA group. To our knowledge, this study is the first to report that DHA/EPA improves sleep quality in middle- and old-aged individuals, even at doses lower than those administered in previous studies.
Collapse
|
21
|
Muhammad T, Gharge S, Meher T. The associations of BMI, chronic conditions and lifestyle factors with insomnia symptoms among older adults in India. PLoS One 2022; 17:e0274684. [PMID: 36108066 PMCID: PMC9477301 DOI: 10.1371/journal.pone.0274684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 09/02/2022] [Indexed: 11/26/2022] Open
Abstract
Background The aim of the study was to estimate the prevalence of insomnia symptoms and to examine the associations of body mass index (BMI), chronic diseases, and lifestyle factors with self-reported insomnia symptoms among older people in India. Methods We conducted a cross-sectional study using data from the baseline wave of the Longitudinal Ageing Study in India (LASI) that was collected during 2017–18. A sample of 31,358 older adults aged 60 and above was included in the analyses. Descriptive statistics and bivariate and multivariable analyses were performed to obtain the results. Results In this study, insomnia symptoms were reported by around 36 percent of older adults aged 60 and above. After controlling for socio-demographic factors, insomnia symptoms were positively associated with the risk of being underweight [AOR: 1.289, CI: 1.211–1.372] and negatively associated with obesity/overweight [AOR: 0.928, CI: 0.872–0.990] as compared to older adults with normal BMI. The odds of insomnia symptoms were higher among those who reported the following chronic conditions, i.e., hypertension [AOR:1.356, CI:1.278–1.438], diabetes [AOR:1.160, CI:1.074–1.254], chronic lung diseases [AOR:1.485, CI:1.351–1.632], bone-related diseases [AOR:1.561, CI:1.458–1.670] and any psychiatric disorders [AOR:1.761, CI:1.495–2.074]. In addition, older adults who were physically active [AOR: 0.850, CI:0.804–0.900] were less likely to report insomnia symptoms. Conclusions The study suggests a high prevalence of insomnia symptoms among the older population in India. Early identification of the signs of insomnia in older population is crucial, as is timely treatment for any kind of sleep problems. In addition, nutrition-based interventions and individual disease-specific management programs may help minimize the stressful situations in later life and develop a good night’s sleep for the older population.
Collapse
Affiliation(s)
- T. Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, Maharashtra, India
- * E-mail: ,
| | - Shivani Gharge
- Department of Bio-Statistics & Epidemiology, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Trupti Meher
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, Maharashtra, India
| |
Collapse
|
22
|
Casagrande M, Forte G, Favieri F, Corbo I. Sleep Quality and Aging: A Systematic Review on Healthy Older People, Mild Cognitive Impairment and Alzheimer’s Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148457. [PMID: 35886309 PMCID: PMC9325170 DOI: 10.3390/ijerph19148457] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/27/2022] [Accepted: 07/07/2022] [Indexed: 02/01/2023]
Abstract
Aging is characterized by changes in the structure and quality of sleep. When the alterations in sleep become substantial, they can generate or accelerate cognitive decline, even in the absence of overt pathology. In fact, impaired sleep represents one of the earliest symptoms of Alzheimer’s disease (AD). This systematic review aimed to analyze the studies on sleep quality in aging, also considering mild cognitive impairment (MCI) and AD. The review process was conducted according to the PRISMA statement. A total of 71 studies were included, and the whole sample had a mean age that ranged from 58.3 to 93.7 years (62.8–93.7 healthy participants and 61.8–86.7 pathological populations). Of these selected studies, 33 adopt subjective measurements, 31 adopt objective measures, and 10 studies used both. Pathological aging showed a worse impoverishment of sleep than older adults, in both subjective and objective measurements. The most common aspect compromised in AD and MCI were REM sleep, sleep efficiency, sleep latency, and sleep duration. These results underline that sleep alterations are associated with cognitive impairment. In conclusion, the frequency and severity of sleep disturbance appear to follow the evolution of cognitive impairment. The overall results of objective measures seem more consistent than those highlighted by subjective measurements.
Collapse
Affiliation(s)
- Maria Casagrande
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, 00185 Roma, Italy;
- Correspondence: (M.C.); (I.C.)
| | - Giuseppe Forte
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, 00185 Roma, Italy;
- Body and Action Laboratory, IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy;
| | - Francesca Favieri
- Body and Action Laboratory, IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy;
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Roma, Italy
| | - Ilaria Corbo
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Roma, Italy
- Correspondence: (M.C.); (I.C.)
| |
Collapse
|
23
|
Abstract
Sleep is a key determinant of healthy and cognitive aging. Sleep patterns change with aging, independent of other factors, and include advanced sleep timing, shortened nocturnal sleep duration, increased frequency of daytime naps, increased number of nocturnal awakenings and time spent awake during the night, and decreased slow-wave sleep. The sleep-related hormone secretion changes with aging. Most changes seem to occur between young and middle adulthood; sleep parameters remain largely unchanged among healthy older adults. The circadian system and sleep homeostatic mechanisms become less robust with normal aging. The causes of sleep disturbances in older adults are multifactorial.
Collapse
Affiliation(s)
- Junxin Li
- School of Nursing, Johns Hopkins University, 525 North Wolfe Street, Baltimore, MD 21205, USA.
| | - Michael V Vitiello
- Center for Sleep and Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, 3624 Market Street, Philadelphia, PA 19104, USA
| | - Nalaka S Gooneratne
- Department of Psychiatry and Behavioral Sciences, University of Washington, Box 356560, Seattle, WA 98195-6560, USA
| |
Collapse
|
24
|
Kuhathasan N, Minuzzi L, MacKillop J, Frey BN. An investigation of cannabis use for insomnia in depression and anxiety in a naturalistic sample. BMC Psychiatry 2022; 22:303. [PMID: 35484520 PMCID: PMC9052466 DOI: 10.1186/s12888-022-03948-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 04/21/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Little is known about cannabis use for insomnia in individuals with depression, anxiety, and comorbid depression and anxiety. To develop a better understanding of distinct profiles of cannabis use for insomnia management, a retrospective cohort study was conducted on a large naturalistic sample. METHODS Data were collected using the medicinal cannabis tracking app, Strainprint®, which allows users to monitor and track cannabis use for therapeutic purposes. The current study examined users managing insomnia symptoms in depression (n = 100), anxiety (n = 463), and comorbid depression and anxiety (n = 114), for a total of 8476 recorded sessions. Inferential analyses used linear mixed effects modeling to examine self-perceived improvement across demographic variables and cannabis product variables. RESULTS Overall, cannabis was perceived to be efficacious across all groups, regardless of age and gender. Dried flower and oral oil were reported as the most used and most efficacious product forms. In the depression group, all strains were perceived to be efficacious and comparisons between strains revealed indica-dominant (Mdiff = 1.81, 95% CI 1.26-2.36, Padj < .001), indica hybrid (Mdiff = 1.34, 95% CI 0.46-2.22, Padj = .045), and sativa-dominant (Mdiff = 1.83, 95% CI 0.68-2.99, Padj = .028) strains were significantly more efficacious than CBD-dominant strains. In anxiety and comorbid conditions, all strain categories were perceived to be efficacious with no significant differences between strains. CONCLUSIONS In terms of perceptions, individuals with depression, anxiety, and both conditions who use cannabis for insomnia report significant improvements in symptom severity after cannabis use. The current study highlights the need for placebo-controlled trials investigating symptom improvement and the safety of cannabinoids for sleep in individuals with mood and anxiety disorders.
Collapse
Affiliation(s)
- Nirushi Kuhathasan
- grid.416721.70000 0001 0742 7355Mood Disorders Program and Women’s Health Concerns Clinic, St. Joseph’s Healthcare Hamilton, 100 West 5th Street, Hamilton, ON L8N 3K7 Canada ,grid.25073.330000 0004 1936 8227Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, 100 West 5th Street, Hamilton, ON L8N 3K7 Canada
| | - Luciano Minuzzi
- grid.416721.70000 0001 0742 7355Mood Disorders Program and Women’s Health Concerns Clinic, St. Joseph’s Healthcare Hamilton, 100 West 5th Street, Hamilton, ON L8N 3K7 Canada ,grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th Street, Hamilton, ON L8N 3K7 Canada
| | - James MacKillop
- grid.25073.330000 0004 1936 8227Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, 100 West 5th Street, Hamilton, ON L8N 3K7 Canada ,grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th Street, Hamilton, ON L8N 3K7 Canada ,grid.25073.330000 0004 1936 8227Peter Boris Centre for Addictions Research, McMaster University/St. Joseph’s Healthcare Hamilton, 100 West 5th Street, Hamilton, ON L8N 3K7 Canada
| | - Benicio N. Frey
- grid.416721.70000 0001 0742 7355Mood Disorders Program and Women’s Health Concerns Clinic, St. Joseph’s Healthcare Hamilton, 100 West 5th Street, Hamilton, ON L8N 3K7 Canada ,grid.25073.330000 0004 1936 8227Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, 100 West 5th Street, Hamilton, ON L8N 3K7 Canada ,grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th Street, Hamilton, ON L8N 3K7 Canada
| |
Collapse
|
25
|
Lustenberger C, Ferster ML, Huwiler S, Brogli L, Werth E, Huber R, Karlen W. Auditory deep sleep stimulation in older adults at home: a randomized crossover trial. COMMUNICATIONS MEDICINE 2022; 2:30. [PMID: 35603302 PMCID: PMC9053232 DOI: 10.1038/s43856-022-00096-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 03/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background Auditory stimulation has emerged as a promising tool to enhance non-invasively sleep slow waves, deep sleep brain oscillations that are tightly linked to sleep restoration and are diminished with age. While auditory stimulation showed a beneficial effect in lab-based studies, it remains unclear whether this stimulation approach could translate to real-life settings. Methods We present a fully remote, randomized, cross-over trial in healthy adults aged 62-78 years (clinicaltrials.gov: NCT03420677). We assessed slow wave activity as the primary outcome and sleep architecture and daily functions, e.g., vigilance and mood as secondary outcomes, after a two-week mobile auditory slow wave stimulation period and a two-week Sham period, interleaved with a two-week washout period. Participants were randomized in terms of which intervention condition will take place first using a blocked design to guarantee balance. Participants and experimenters performing the assessments were blinded to the condition. Results Out of 33 enrolled and screened participants, we report data of 16 participants that received identical intervention. We demonstrate a robust and significant enhancement of slow wave activity on the group-level based on two different auditory stimulation approaches with minor effects on sleep architecture and daily functions. We further highlight the existence of pronounced inter- and intra-individual differences in the slow wave response to auditory stimulation and establish predictions thereof. Conclusions While slow wave enhancement in healthy older adults is possible in fully remote settings, pronounced inter-individual differences in the response to auditory stimulation exist. Novel personalization solutions are needed to address these differences and our findings will guide future designs to effectively deliver auditory sleep stimulations using wearable technology.
Collapse
Affiliation(s)
- Caroline Lustenberger
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Neuroscience Center Zurich (ZNZ), University of Zurich and ETH Zurich, Zurich, Switzerland
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
| | - M. Laura Ferster
- Mobile Health Systems Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Stephanie Huwiler
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Luzius Brogli
- Mobile Health Systems Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Institute of Biomedical Engineering, Universität Ulm, Ulm, Germany
| | - Esther Werth
- Neuroscience Center Zurich (ZNZ), University of Zurich and ETH Zurich, Zurich, Switzerland
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
- Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Reto Huber
- Neuroscience Center Zurich (ZNZ), University of Zurich and ETH Zurich, Zurich, Switzerland
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
- Child Development Centre, University Children’s Hospital, University of Zurich, Zurich, Switzerland
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Walter Karlen
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
- Mobile Health Systems Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Institute of Biomedical Engineering, Universität Ulm, Ulm, Germany
| |
Collapse
|
26
|
Ferster ML, Da Poian G, Menachery K, Schreiner SJ, Lustenberger C, Maric A, Huber R, Baumann CR, Karlen W. Benchmarking real-time algorithms for in-phase auditory stimulation of low amplitude slow waves with wearable EEG devices during sleep. IEEE Trans Biomed Eng 2022; 69:2916-2925. [PMID: 35259094 DOI: 10.1109/tbme.2022.3157468] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Auditory stimulation of EEG slow waves (SW) during non-rapid eye movement (NREM) sleep has shown to improve cognitive function when it is delivered at the up-phase of SW. SW enhancement is particularly desirable in subjects with low-amplitude SW such as older adults or patients suffering from neurodegeneration such as Parkinson disease (PD). However, existing algorithms to estimate the up-phase suffer from a poor phase accuracy at low EEG amplitudes and when SW frequencies are not constant. We introduce two novel algorithms for real-time EEG phase estimation on autonomous wearable devices. The algorithms were based on a phase-locked loop (PLL) and, for the first time, a phase vocoder (PV). We compared these phase tracking algorithms with a simple amplitude threshold approach. The optimized algorithms were benchmarked for phase accuracy, the capacity to estimate phase at SW amplitudes between 20 and 60 V, and SW frequencies above 1 Hz on 324 recordings from healthy older adults and PD patients. Furthermore, the algorithms were implemented on a wearable device and the computational efficiency and the performance was evaluated on simulated sleep EEG, as well as prospectively during a recording with a PD patient. All three algorithms delivered more than 70% of the stimulation triggers during the SW up-phase. The PV showed the highest capacity on targeting low-amplitude SW and SW with frequencies above 1 Hz. The testing on real-time hardware revealed that both PV and PLL have marginal impact on microcontroller load, while the efficiency of the PV was 4% lower than the PLL. Active auditory stimulation did not influence the phase tracking. This work demonstrated that phase-accurate auditory stimulation can be delivered during home-based sleep interventions with a wearable device also in populations with low-amplitude SW.
Collapse
|
27
|
Huang WC, Lin CY, Togo F, Lai TF, Hsueh MC, Liao Y, Park H, Kumagai S. Nonlinear associations between sleep patterns and sarcopenia risks in older adults. J Clin Sleep Med 2022; 18:731-738. [PMID: 34608860 PMCID: PMC8883095 DOI: 10.5664/jcsm.9698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Despite considering it as a common geriatric condition, sarcopenia is linked to various behavioral factors that may be changeable. As sleep is one of the important routines in physiological homeostasis, further investigating the underlying relationships of sleep behavior with sarcopenia is urgently needed. We examined the association between sleep parameters (ie, sleep duration, bedtime, wake time, or midsleep time) and sarcopenia risks in older adults, in the total sample and age group subsamples. METHODS A total of 1,068 older adults in Taiwan were included. Data on bedtime, wake time, and sleep duration were collected through telephone interview. Midsleep time was calculated by the midpoint of bedtime and wake time. Sarcopenia was screened by the SARC-F questionnaire composed of 5 questions (the strength, assistance in walking, rising from a chair, climbing stairs, and falls) as well as higher scores was related to greater risks. Generalized additive models were conducted to examine the nonlinear relationships between sleep parameters and sarcopenia risks. RESULTS The covariate-adjusted analysis showed that a reverse J-shaped relationship for sleep duration and sarcopenia risk (P < .001) and a significant association for wake time and the SARC-F score (P = .009) in total sample, with considering age-related interaction. No associations were found in the other sleep parameters (bedtime and midsleep time) and sarcopenia in older adults. Similar associations were observed between wake time and the SARC-F score across age groups, while diverse associations of sleep duration with the SARC-F score were found in different age groups. CONCLUSIONS The sleep pattern is significantly associated with sarcopenia risks in aging adults. Improving inappropriate sleep behaviors in older adults is suggested to prevent a decline in muscle function and promote healthy aging. CITATION Huang W-C, Lin C-Y, Togo F, et al. Nonlinear associations between sleep patterns and sarcopenia risks in older adults. J Clin Sleep Med. 2022;18(3):731-738.
Collapse
Affiliation(s)
- Wan-Chi Huang
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Chien-Yu Lin
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Fumiharu Togo
- Educational Physiology Laboratory, Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Ting-Fu Lai
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Ming-Chun Hsueh
- Graduate Institute of Sport Pedagogy, University of Taipei, Taipei, Taiwan
| | - Yung Liao
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan,Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan,Address correspondence to: Yung Liao, PhD, Department of Health Promotion and Health Education, National Taiwan Normal University, 162, Heping East Road Section 1, Taipei 106, Taiwan; ; and Hyuntae Park, PhD, Department of Health Care Science, Dong-A University, 37, 550-Gil Nakdongdaero, Saha, Busan 604-714, Korea;
| | - Hyuntae Park
- Department of Health Care Science, Dong-A University, Busan, Korea,Address correspondence to: Yung Liao, PhD, Department of Health Promotion and Health Education, National Taiwan Normal University, 162, Heping East Road Section 1, Taipei 106, Taiwan; ; and Hyuntae Park, PhD, Department of Health Care Science, Dong-A University, 37, 550-Gil Nakdongdaero, Saha, Busan 604-714, Korea;
| | - Shuzo Kumagai
- Kumagai Institute of Health Policy, Fukuoka, Japan,Institute of Convergence Bio-Health, Dong-A University, Busan, Korea
| |
Collapse
|
28
|
Lok R, Chawra D, Hon F, Ha M, Kaplan KA, Zeitzer JM. Objective underpinnings of self-reported sleep quality in middle-aged and older adults: the importance of N2 and wakefulness. Biol Psychol 2022; 170:108290. [PMID: 35192907 PMCID: PMC9038649 DOI: 10.1016/j.biopsycho.2022.108290] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 12/16/2022]
Abstract
STUDY OBJECTIVES The measurable aspects of brain function (polysomnography, PSG) that are correlated with sleep satisfaction are poorly understood. Using recent developments in automated sleep scoring, which remove the within- and between-rater error associated with human scoring, we examine whether PSG measures are associated with sleep satisfaction. DESIGN AND SETTING A single night of PSG data was compared to contemporaneously collected measures of sleep satisfaction with Random Forest regressions. Whole and partial night PSG data were scored using a novel machine learning algorithm. PARTICIPANTS Community-dwelling adults (N = 3165) who participated in the Sleep Heart Health Study. INTERVENTIONS None. MEASUREMENTS AND RESULTS Models explained 30% of sleep depth and 27% of sleep restfulness, with a similar top four predictors: minutes of N2 sleep, sleep efficiency, age, and minutes of wake after sleep onset (WASO). With increasing self-reported sleep quality, there was a progressive increase in N2 and decrease in WASO of similar magnitude, without systematic changes in N1, N3 or REM sleep. In comparing those with the best and worst self-reported sleep satisfaction, there was a range of approximately 30 min more N2, 30 min less WASO, an improvement of sleep efficiency of 7-8%, and an age span of 3-5 years. Examination of sleep most proximal to morning awakening revealed no greater explanatory power than the whole-night data set. CONCLUSIONS Higher N2 and concomitant lower wake is associated with improved sleep satisfaction. Interventions that specifically target these may be suitable for improving the self-reported sleep experience.
Collapse
Affiliation(s)
- Renske Lok
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Dwijen Chawra
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Flora Hon
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA; College of Literature, Science, and The Arts, University of Michigan, Ann Arbor, MI 48109, USA
| | - Michelle Ha
- Department of Mathematics and Statistics, San Jose State University, San Jose, CA 95112, USA
| | - Katherine A Kaplan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Jamie M Zeitzer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA; Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA 94304, USA.
| |
Collapse
|
29
|
Hai Y, Xue Y, Wang YH. Does Long-Term Shift Work Increase the Risk of Dementia? A Systematic Review and Meta-Analysis. Am J Alzheimers Dis Other Demen 2022; 37:15333175221141535. [PMID: 36419317 PMCID: PMC10581141 DOI: 10.1177/15333175221141535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Background: Shift work is associated with impaired sleep quality and disrupted circadian rhythms, but the way in which it increases the risk of dementia remains controversial. We conducted a systematic review and meta-analysis to assess the integrated risk of dementia with shift work. Methods: Searching in PubMed, Cochrane Library, and the Web of Science databases, the relative risks of dementia with shift work were extracted from 12 included studies with 3975 dementia cases from 84 492 participants. The subgroup analysis was stratified by age, gender, sample size, dementia cases, shift schedule, occupation, and follow-up time. Heterogeneity analysis and publication bias analysis were conducted for quality control. Results: The pooled risk ratios (RRs) of dementia with shift work were 1.15 (95%CI = 1.02-1.30). The subgroup analysis found that continuous evening shifts reversibly reduced the risk, but continuous night shifts remarkedly increased the risk of dementia. In addition, a larger cohort and longer follow-up significantly increased the risk of dementia with shift work. Conclusion: Shift work shows mild increases in the risk of dementia using meta-analysis.
Collapse
Affiliation(s)
- Yang Hai
- College of International Education, Harbin Medical University, China
| | - Ying Xue
- Department of Geriatrics, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yu-hong Wang
- Department of Geriatrics, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| |
Collapse
|
30
|
Yao F, Ma J, Qin P, Tu X, Li X, Tang X. Age and Sex Differences in the Association of Sleep Duration and Overweight/Obesity among Chinese Participants Age above 45 Years: A Cohort Study. J Nutr Health Aging 2022; 26:714-722. [PMID: 35842762 DOI: 10.1007/s12603-022-1823-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES We aimed to evaluate the association between sleep duration and obesity and estimate the attributable risk of sleep in the China Health and Retirement Longitudinal Study surveys (CHARLS). METHODS A total of 9061 adults aged 45 years above from CHARLS (2011-2015) were included. The main outcome of this study was incident overweight/obesity specific to general and abdominal obesity. Overweight/obesity was defined as BMI ≥ 23.0 (kg/m2) and BMI≥27.5 (kg/m2), respectively. Abdominal obesity was defined as waist circumference ≥90 cm for men and ≥80 cm for women. Self-reported sleep durations were obtained using a structured questionnaire. We assessed hazard ratios (HRs) and 95% confidence intervals (CIs) as well as the population attributable fraction (PAF) for associations between sleep duration and obesity. RESULTS 986 and 606 participants were identified as overweight and general obesity respectively, 1253 experienced abdominal obesity events. In multivariable-adjusted models, participants with daytime sleep of 0-30 minutes and more than 30 minutes associated with 30% (HR: 0.70, 95% CI: 0.56-0.87) and 35% (HR: 0.65, 95% CI: 0.55-0.78) decreased incident overweight risk respectively compared to those having no daytime sleep, this association also found among females and middle-aged, not males or elderly. Similarly, 0-30 minutes (HR: 0.68, 95% CI: 0.48-0.96) and more than 30 minutes of daytime sleep (HR: 0.73, 95% CI: 0.59-0.91) were associated with a reduced risk of abdominal obesity, similar results also found among females and middle-aged. Compared with 7-9 hours of nocturnal sleep, people who slept 5-7 hours had a reduced risk of overweight (HR: 0.59, 95% CI=0.47-0.74),but not found in subgroups. The hazard role of long nocturnal sleep for abdominal obesity was only found among elderly (HR: 2.33, 95% CI=1.35-4.04) and males (HR: 2.24, 95% CI=1.17-4.29). Compared with moderate total sleepers (7-9hours/day), participants with short total sleep duration exhibited an elevated risk of overweight (HR: 1.13, 95% CI=1.00-1.28), this also found among middle-aged. The PAF for inadequate total sleep duration (<7 hours/day) was 10.77% for overweight individuals. CONCLUSIONS Insufficient sleep duration was associated with an elevated risk of overweight only detected among middle-aged not elderly and other subgroups specific by age. The risks for abdominal obesity were increased for males and middle-aged with long nocturnal sleep. Daytime sleep may significantly reduce the risk of overweight and abdominal obesity in female and middle-aged individuals. The link between sleep duration and obesity requires further study.
Collapse
Affiliation(s)
- F Yao
- Xiangyu Tang, Gastroenterology department, Qianhai shekou free trade zone hospital, Shenzhen city, Guangdong province, 518067, China,
| | | | | | | | | | | |
Collapse
|
31
|
Thomas KG, Bradley H, Chen A, Lipinska G. Trauma survivors with disrupted sleep generate less specific and less emotional autobiographical memories. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
|
32
|
Parker JL, Melaku YA, D'Rozario AL, Wittert GA, Martin SA, Catcheside PG, Lechat B, Teare AJ, Adams RJ, Appleton SL, Vakulin A. The association between obstructive sleep apnea and sleep spindles in middle-aged and older men: A community-based cohort study. Sleep 2021; 45:6446158. [PMID: 34850237 DOI: 10.1093/sleep/zsab282] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/01/2021] [Indexed: 01/25/2023] Open
Abstract
STUDY OBJECTIVES Sleep spindles show morphological changes in obstructive sleep apnea (OSA). However, previous small studies have limited generalisability, leaving associations between OSA severity measures and spindle metrics uncertain. This study examined cross-sectional associations between OSA severity measures and spindle metrics among a large population-based sample of men. METHODS Community-dwelling men with no previous OSA diagnosis underwent home-based polysomnography. All-night EEG (F4-M1) recordings were processed for artefacts and spindle events identified using previously validated algorithms. Spindle metrics of interest included frequency (Hz), amplitude (µV 2), overall density (11-16 Hz), slow density (11-13 Hz), and fast density (13-16 Hz) (number/minute). Multivariable linear regression models controlling for demographic, biomedical, and behavioural confounders were used to examine cross-sectional associations between OSA severity measures and spindle metrics. RESULTS In adjusted analyses, higher apnea-hypopnea index (AHI/h, as a continuous variable) and percentage total sleep time with oxygen saturation <90% (TST90) were associated with decreased slow spindle density (AHI, B= -0.003, p=0.032; TST90, B= -0.004, p=0.047) but increased frequency (AHI, B=0.002, p=0.009; TST90, B=0.002, p=0.043). Higher TST90 was also associated with greater spindle amplitude (N2 sleep, B=0.04, p=0.011; N3 sleep, B=0.11, p<0.001). Furthermore, higher arousal index was associated with greater spindle amplitude during N2 sleep (B=0.31, p<0.001) but decreased overall density (B= -1.27, p=0.030) and fast density (B= -4.36, p=0.028) during N3 sleep. CONCLUSIONS Among this large population-based sample of men, OSA severity measures were independently associated with spindle abnormalities. Further population studies are needed to determine associations between spindle metrics and functional outcomes.
Collapse
Affiliation(s)
- Jesse L Parker
- Flinders Health and Medical Research Institute, Adelaide Institute for Sleep Health, Flinders University, Adelaide, South Australia, Australia
| | - Yohannes Adama Melaku
- Flinders Health and Medical Research Institute, Adelaide Institute for Sleep Health, Flinders University, Adelaide, South Australia, Australia
| | - Angela L D'Rozario
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia.,The University of Sydney, Faculty of Science, School of Psychology, Sydney, New South Wales, Australia
| | - Gary A Wittert
- Freemasons Centre for Male Health and Wellbeing, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia.,South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Sean A Martin
- Freemasons Centre for Male Health and Wellbeing, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia.,South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Peter G Catcheside
- Flinders Health and Medical Research Institute, Adelaide Institute for Sleep Health, Flinders University, Adelaide, South Australia, Australia
| | - Bastien Lechat
- Flinders Health and Medical Research Institute, Adelaide Institute for Sleep Health, Flinders University, Adelaide, South Australia, Australia
| | - Alison J Teare
- Flinders Health and Medical Research Institute, Adelaide Institute for Sleep Health, Flinders University, Adelaide, South Australia, Australia
| | - Robert J Adams
- Flinders Health and Medical Research Institute, Adelaide Institute for Sleep Health, Flinders University, Adelaide, South Australia, Australia.,Respiratory and Sleep Services, Southern Adelaide Local Health Network, Bedford Park, Adelaide, South Australia, Australia.,South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Sarah L Appleton
- Flinders Health and Medical Research Institute, Adelaide Institute for Sleep Health, Flinders University, Adelaide, South Australia, Australia.,South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Andrew Vakulin
- Flinders Health and Medical Research Institute, Adelaide Institute for Sleep Health, Flinders University, Adelaide, South Australia, Australia.,CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
33
|
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.
Collapse
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
| |
Collapse
|
34
|
Hajipour M, Soltani M, Safari-Faramani R, Khazaei S, Etemad K, Rahmani S, Valadbeigi T, Yaghoobi H, Rezaeian S. Maternal Sleep and Related Pregnancy Outcomes: A Multicenter Cross-Sectional Study in 11 Provinces of Iran. J Family Reprod Health 2021; 15:53-60. [PMID: 34429737 PMCID: PMC8346736 DOI: 10.18502/jfrh.v15i1.6078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: Sleep disturbance during pregnancy is one of the most common maternal complaints. Not only does it play a crucial role in a mother’s life, but also it comes with a multitude number of complications. This study aimed at assessing the association between sleep disturbance in pregnancy and maternal and child outcomes. Materials and methods: This was a multicenter cross-sectional study, conducted on pregnant women across 11 provinces in Iran in 2018. Sleep disturbance as a composite variable was defined using the principal component analysis based on five questions. Abortion, anemia in the first and third trimester, gestational diabetes, gestational age, glucose tolerance test (GTT), fasting blood sugar (FBS), mode of delivery, low birth weight and stillbirth were defined as study outcomes. Results: Totally, 3675 pregnant women enrolled in the study. Most of the participants (84.5%) reported that their sleep duration is less than 8 hours per day. The prevalence of sleep disturbance was 20.7% (95% CI: 19.1, 22.3). After adjusting for maternal age, education, job, place of residency and physical violence, sleep disturbance would increase the odds of abortion (p=0.009), anemia in both first (p=0.001) and third (p=0.003) trimester, gestational age (p=0.049), abnormal FBS (p=0.015) and cesarean section (p<0.001). Conclusion: Regarding the effect of sleep quality on maternal outcomes, planning and implementing a suitable intervention in the context of primary health care is necessary. Increasing the awareness of mothers, health workers and medical personnel about the suitable quality and quantity of sleep during pregnancy is of great importance.
Collapse
Affiliation(s)
- Mahmoud Hajipour
- Research Center Office, Epidemiology Department, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Soltani
- Razi Clinical Research Development Unit (RCRDU), Birjand University of Medical Sciences (BUMS), Birjand, Iran
| | - Roya Safari-Faramani
- Research Center for Environmental Determinants of Health, Health Institute, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Salman Khazaei
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Koorosh Etemad
- Department of Epidemiology, Environmental and Occupational Hazards Control Research Center, Faculty of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sharmin Rahmani
- Student Research Committee, Research Center for Environmental Determinants of Health, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Tannaz Valadbeigi
- Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Halime Yaghoobi
- Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Shahab Rezaeian
- Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| |
Collapse
|
35
|
Aluzaite K, Wu H, Hyslop B, Young J, Schultz M, Brockway B. Perceived versus objective sleep quality in long-stay hospitalised older adults-a mixed methods study. Age Ageing 2021; 50:955-962. [PMID: 33527984 DOI: 10.1093/ageing/afaa292] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Hospital inpatients experience substantial sleep problems that have been linked with worse health outcomes, poor quality of life and the post-hospital syndrome. However, little is known about assessing sleep issues in older hospitalised patients. OBJECTIVE To conduct an in-depth investigation on hospitalised older adults' sleep challenges and methods of sleep assessment. DESIGN Cross-sectional observational study. SETTING Public hospital inpatient unit. SUBJECTS Long-stay hospitalised older adults. METHODS Data were collected using validated sleep questionnaires, actigraphy devices and qualitative interviews. Quantitative data were analysed with descriptive statistics, multiple logistic regression and Cohen's Kappa. Qualitative data were analysed with qualitative content analysis; findings compared to the quantitative assessments. RESULTS We collected data on 33 older long-stay hospital inpatients, who were mean (SD) 80.2(7.4) years old, 57.6% female and were hospitalised following stroke, medical illness and orthopaedic fracture. Mean (SD) total sleep time and actigraphic sleep efficiency were 480.6(73.6) minutes and 81.5(11.2)%, respectively. About, 57.6% were poor sleepers (Pittsburgh Sleep Quality Index [PSQI]) and 30.8% had indicators of clinical depression/low quality of life (WHO-5 well-being index). Three main themes were identified: "sleep assessment"; "factors that affect sleep"; "expectations of sleep". Bad sleepers were more likely to feel a lack of control over their sleep, while good sleepers spoke about the ability to adjust and accept their circumstances. CONCLUSIONS We found high levels of sleep problems and identified substantial discrepancies between the validated sleep questionnaire and qualitative response data. Our findings indicate that standard assessment tools, such as PSQI, may not be suitable to assess sleep in hospitalised older adults and call for further investigations to build more appropriate methods. Further exploring psychological factors and expectations could potentially lead to novel interventions to improve sleep in this setting.
Collapse
Affiliation(s)
- Kristina Aluzaite
- Department of Medicine, Dunedin School of Medicine, University of Otago, New Zealand
| | - Harry Wu
- Department of Medicine, Dunedin School of Medicine, University of Otago, New Zealand
| | - Brent Hyslop
- Department of Medicine, Dunedin School of Medicine, University of Otago, New Zealand
| | - Jessica Young
- Preventative and Social Medicine, Dunedin School of Medicine, University of Otago, New Zealand
| | - Michael Schultz
- Department of Medicine, Dunedin School of Medicine, University of Otago, New Zealand
| | - Ben Brockway
- Department of Medicine, Dunedin School of Medicine, University of Otago, New Zealand
| |
Collapse
|
36
|
Ong HS, Lim CS, Png ALC, Kong JW, Peh ALH. Chronobiology and the case for sleep health interventions in the community. Singapore Med J 2021; 62:220-224. [PMID: 34409473 PMCID: PMC8801860 DOI: 10.11622/smedj.2021058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Our sleep-wake cycle is determined by the interaction between our homeostatic sleep drive and circadian rhythm. Each of us has a personalised biological rhythm or chronotype that determines the optimal time to fall asleep and wake up. Chronic sleep deprivation has been linked to the development of several physical and mental health disorders, as well as accidents and occupational errors. Around the world, growing recognition of the importance of sleep has led to the adoption of practices that promote sleep health. Given that Singaporeans were consistently found to be one of the most sleep-deprived populations in the world, we believe that there is an urgent need to pursue the introduction of community-based sleep health interventions here. This includes sleep education and promotion of sleep hygiene, adopting practices to reduce social jetlag and improve sleep health, and enhancing screening and treatment of sleep disorders.
Collapse
Affiliation(s)
- Hatta Santoso Ong
- Department of Psychological Medicine, Changi General Hospital, Singapore
- Department of Sleep Medicine, Surgery and Science, Changi General Hospital, Singapore
| | - Chau Sian Lim
- Department of Psychological Medicine, Changi General Hospital, Singapore
- Department of Sleep Medicine, Surgery and Science, Changi General Hospital, Singapore
| | - Ai-Li Constance Png
- Department of Sleep Medicine, Surgery and Science, Changi General Hospital, Singapore
- Department of Clinical Psychology, Changi General Hospital, Singapore
| | - Jing Wen Kong
- Hougang Polyclinic, National Healthcare Group Polyclinics, Singapore
| | | |
Collapse
|
37
|
Jonasdottir SS, Minor K, Lehmann S. Gender differences in nighttime sleep patterns and variability across the adult lifespan: a global-scale wearables study. Sleep 2021; 44:5901589. [PMID: 32886772 DOI: 10.1093/sleep/zsaa169] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 08/04/2020] [Indexed: 12/15/2022] Open
Abstract
STUDY OBJECTIVES Previous research on sleep patterns across the lifespan have largely been limited to self-report measures and constrained to certain geographic regions. Using a global sleep dataset of in situ observations from wearable activity trackers, we examine how sleep duration, timing, misalignment, and variability develop with age and vary by gender and BMI for nonshift workers. METHODS We analyze 11.14 million nights from 69,650 adult nonshift workers aged 19-67 from 47 countries. We use mixed effects models to examine age-related trends in naturalistic sleep patterns and assess gender and BMI differences in these trends while controlling for user and country-level variation. RESULTS Our results confirm that sleep duration decreases, the prevalence of nighttime awakenings increases, while sleep onset and offset advance to become earlier with age. Although men tend to sleep less than women across the lifespan, nighttime awakenings are more prevalent for women, with the greatest disparity found from early to middle adulthood, a life stage associated with child-rearing. Sleep onset and duration variability are nearly fixed across the lifespan with higher values on weekends than weekdays. Sleep offset variability declines relatively rapidly through early adulthood until age 35-39, then plateaus on weekdays, but continues to decrease on weekends. The weekend-weekday contrast in sleep patterns changes as people age with small to negligible differences between genders. CONCLUSIONS A massive dataset generated by pervasive consumer wearable devices confirms age-related changes in sleep and affirms that there are both persistent and life-stage dependent differences in sleep patterns between genders.
Collapse
Affiliation(s)
- Sigga Svala Jonasdottir
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Lyngby, Denmark
| | - Kelton Minor
- Copenhagen Center for Social Data Science, University of Copenhagen, Copenhagen, Denmark
| | - Sune Lehmann
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Lyngby, Denmark.,Copenhagen Center for Social Data Science, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
38
|
Hermesdorf M, Szentkirályi A, Teismann H, Teismann I, Young P, Berger K. Sleep characteristics, cognitive performance, and gray matter volume: findings from the BiDirect Study. Sleep 2021; 44:5919359. [PMID: 33029624 DOI: 10.1093/sleep/zsaa209] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/24/2020] [Indexed: 11/15/2022] Open
Abstract
STUDY OBJECTIVES Sleep is essential for restorative metabolic changes and its physiological correlates can be examined using overnight polysomnography. However, the association between physiological sleep characteristics and brain structure is not well understood. We aimed to investigate gray matter volume and cognitive performance related to physiological sleep characteristics. METHODS Polysomnographic recordings from 190 community-dwelling participants were analyzed with a principal component analysis in order to identify and aggregate shared variance into principal components. The relationship between aggregated sleep components and gray matter volume was then analyzed using voxel-based morphometry. In addition, we explored how cognitive flexibility, selective attention, and semantic fluency were related to aggregated sleep components and gray matter volume. RESULTS Three principal components were identified from the polysomnographic recordings. The first component, primarily described by apnea events and cortical arousal, was significantly associated with lower gray matter volume in the left frontal pole. This apnea-related component was furthermore associated with lower cognitive flexibility and lower selective attention. CONCLUSIONS Sleep disrupted by cortical arousal and breathing disturbances is paralleled by lower gray matter volume in the frontal pole, a proposed hub for the integration of cognitive processes. The observed effects provide new insights on the interplay between disrupted sleep, particularly breathing disturbances and arousal, and the brain.
Collapse
Affiliation(s)
- Marco Hermesdorf
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - András Szentkirályi
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Henning Teismann
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Inga Teismann
- Department for Stroke and Respiratory Medicine, Alexianer Misericordia GmbH, Münster, Germany
| | - Peter Young
- Department of Neurology, Medical Park Bad Feilnbach, Bad Feilnbach, Germany
| | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| |
Collapse
|
39
|
Sheehan C, Iida M. Spousal Educational Attainment and Sleep Duration Among American Older Adults. J Gerontol B Psychol Sci Soc Sci 2021; 76:1015-1026. [PMID: 33249460 DOI: 10.1093/geronb/gbaa206] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Sleep has consistently been shown to have a dyadic nature among married older adults; however, less is known about the influence of a spouses' social characteristics on one's own sleep. Focusing on older adults, we examined the association between one's spouses' educational attainment and one's own sleep duration. METHOD We used the 2004-2018 National Health Interview Survey (NHIS) to analyze heterosexual married adults aged 50-84 (N = 89,180). Respondents reported typical sleep duration in a 24-hr period, which was categorized as short (≤6 hr), normal (7-8 hr), or long (≥9 hr). We fit multinomial logistic regression models predicting these categories of sleep duration and accounted for demographic, household socioeconomic characteristics, and health/health behaviors. Using interaction terms, we tested if the association varied by the respondent's gender and educational attainment. RESULTS Older adults married to spouses with college or more education had significantly lower relative risk of short sleep than those whose spouses had some college, high school, or less than high school education, net of the covariates including their own education. The benefit of higher levels of spousal education was significantly more protective against short sleep for women and more highly educated older adults. DISCUSSION Older adults married to spouses with high levels of education reported more favorable sleep durations, but this benefit was significantly stronger for women and the highly educated which has important implications for their aging. These findings suggest that social inequality may condition the dyadic nature of sleep for heterosexual married older adults.
Collapse
Affiliation(s)
- Connor Sheehan
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe
| | - Masumi Iida
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe
| |
Collapse
|
40
|
Hermans LWA, van Gilst MM, Regis M, van den Heuvel LCE, Langen H, van Mierlo P, Krijn R, Hoondert B, Maass H, van Dijk JP, Leufkens TRM, Overeem S. Modeling sleep onset misperception in insomnia. Sleep 2021; 43:5721963. [PMID: 32016410 DOI: 10.1093/sleep/zsaa014] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 12/06/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To extend and validate a previously suggested model of the influence of uninterrupted sleep bouts on sleep onset misperception in a large independent data set. METHODS Polysomnograms and sleep diaries of 139 insomnia patients and 92 controls were included. We modeled subjective sleep onset as the start of the first uninterrupted sleep fragment longer than Ls minutes, where parameter Ls reflects the minimum length of a sleep fragment required to be perceived as sleep. We compared the so-defined sleep onset latency (SOL) for various values of Ls. Model parameters were compared between groups, and across insomnia subgroups with respect to sleep onset misperception, medication use, age, and sex. Next, we extended the model to incorporate the length of wake fragments. Model performance was assessed by calculating root mean square errors (RMSEs) of the difference between estimated and perceived SOL. RESULTS Participants with insomnia needed a median of 34 minutes of undisturbed sleep to perceive sleep onset, while healthy controls needed 22 minutes (Mann-Whitney U = 4426, p < 0.001). Similar statistically significant differences were found between sleep onset misperceivers and non-misperceivers (median 40 vs. 20 minutes, Mann-Whitney U = 984.5, p < 0.001). Model outcomes were similar across other subgroups. Extended models including wake bout lengths resulted in only marginal improvements of model outcome. CONCLUSIONS Patients with insomnia, particularly sleep misperceivers, need larger continuous sleep bouts to perceive sleep onset. The modeling approach yields a parameter for which we coin the term Sleep Fragment Perception Index, providing a useful measure to further characterize sleep state misperception.
Collapse
Affiliation(s)
- Lieke W A Hermans
- Department of Electrical Engineering, Eindhoven University of Technology, De Zaale, Eindhoven, The Netherlands
| | - Merel M van Gilst
- Department of Electrical Engineering, Eindhoven University of Technology, De Zaale, Eindhoven, The Netherlands.,Center for Sleep Medicine, Kempenhaeghe Foundation, Heeze, Noord Brabant, The Netherlands
| | - Marta Regis
- Department of Mathematics and Computer Science, Eindhoven University of Technology, De Zaale, Eindhoven, The Netherlands
| | | | - Hanneke Langen
- Center for Sleep Medicine, Kempenhaeghe Foundation, Heeze, Noord Brabant, The Netherlands
| | - Petra van Mierlo
- Center for Sleep Medicine, Kempenhaeghe Foundation, Heeze, Noord Brabant, The Netherlands
| | - Roy Krijn
- Center for Sleep Medicine, Kempenhaeghe Foundation, Heeze, Noord Brabant, The Netherlands
| | - Bertram Hoondert
- Center for Sleep Medicine, Kempenhaeghe Foundation, Heeze, Noord Brabant, The Netherlands
| | | | - Johannes P van Dijk
- Department of Electrical Engineering, Eindhoven University of Technology, De Zaale, Eindhoven, The Netherlands.,Center for Sleep Medicine, Kempenhaeghe Foundation, Heeze, Noord Brabant, The Netherlands.,Department of Orthodontics, University of Ulm, Ulm, Germany
| | - Tim R M Leufkens
- Philips Research, Eindhoven, The Netherlands.,Department of Industrial Design, Eindhoven University of Technology, De Zaale, Eindhoven, The Netherlands
| | - Sebastiaan Overeem
- Department of Electrical Engineering, Eindhoven University of Technology, De Zaale, Eindhoven, The Netherlands.,Center for Sleep Medicine, Kempenhaeghe Foundation, Heeze, Noord Brabant, The Netherlands.,Department of Industrial Design, Eindhoven University of Technology, De Zaale, Eindhoven, The Netherlands
| |
Collapse
|
41
|
Silveira SL, Cederberg KLJ, Jeng B, Sikes EM, Sandroff BM, Jones CD, Motl RW. Symptom clusters and quality of life in persons with multiple sclerosis across the lifespan. Qual Life Res 2021; 30:1061-1071. [PMID: 33155152 PMCID: PMC8005422 DOI: 10.1007/s11136-020-02689-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 01/30/2023]
Abstract
PURPOSE To describe symptom clusters based on severity of co-occurring symptoms among adults with multiple sclerosis (MS) by age groups and to further examine symptom clusters as a correlate of quality of life (QOL) by age groups. METHODS This cross-sectional study enrolled persons with MS between 20 and 79 years of age who completed measures of fatigue, depression, anxiety, sleep quality, and QOL using the 36-Item Short Form Health Survey. Bivariate correlation and partial correlation analyses examined associations among symptoms, QOL, and MS characteristics. K-means cluster analyses determined symptom clusters among the full sample and pre-determined age groups (i.e., 20-39, 40-59, and 60-79). One-way ANOVAs examined differences in QOL among clusters for the overall sample and by age groups. RESULTS Among the overall sample of 205 participants, symptoms were significantly correlated with QOL and three distinct clusters were identified and differentiated by the magnitude of symptom experience (i.e., mild, moderate, and severe). Results were consistent among young and middle-aged adults; however, among older adults two severe sleep problem clusters were identified that were distinguished by moderate versus severe fatigue, depression, and anxiety. ANOVAs among the overall sample indicated that the three symptom clusters varied significantly for both physical component scores, F(2, 202) = 12.03, p < .001, η2 = .10, and mental component scores, F(2, 202) = 137.92, p < .001, η2 = .58; severe symptom cluster was associated with worse QOL. Patterns in the age subgroup ANOVAs were consistent. CONCLUSIONS Given the strong association between severity of symptom clusters and QOL, approaches for targeting co-occurring symptoms are critically needed.
Collapse
Affiliation(s)
- Stephanie L Silveira
- Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL, 35209, USA.
| | - Katie L J Cederberg
- Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL, 35209, USA
| | - Brenda Jeng
- Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL, 35209, USA
| | - E Morghen Sikes
- Department of Occupational Therapy, Shenandoah University, Winchester, VA, USA
| | - Brian M Sandroff
- Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL, 35209, USA
| | - Catherine D Jones
- Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL, 35209, USA
| | - Robert W Motl
- Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL, 35209, USA
| |
Collapse
|
42
|
Saber M, Murphy SM, Cho Y, Lifshitz J, Rowe RK. Experimental diffuse brain injury and a model of Alzheimer's disease exhibit disease-specific changes in sleep and incongruous peripheral inflammation. J Neurosci Res 2021; 99:1136-1160. [PMID: 33319441 PMCID: PMC7897258 DOI: 10.1002/jnr.24771] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 11/18/2020] [Accepted: 11/24/2020] [Indexed: 01/09/2023]
Abstract
Elderly populations (≥65 years old) have the highest risk of developing Alzheimer's disease (AD) and/or obtaining a traumatic brain injury (TBI). Using translational mouse models, we investigated sleep disturbances and inflammation associated with normal aging, TBI and aging, and AD. We hypothesized that aging results in marked changes in sleep compared with adult mice, and that TBI and aging would result in sleep and inflammation levels similar to AD mice. We used female 16-month-old wild-type (WT Aged) and 3xTg-AD mice, as well as a 2-month-old reference group (WT Adult), to evaluate sleep changes. WT Aged mice received diffuse TBI by midline fluid percussion, and blood was collected from both WT Aged (pre- and post-TBI) and 3xTg-AD mice to evaluate inflammation. Cognitive behavior was tested, and tissue was collected for histology. Bayesian generalized additive and mixed-effects models were used for analyses. Both normal aging and AD led to increases in sleep compared with adult mice. WT Aged mice with TBI slept substantially more, with fragmented shorter bouts, than they did pre-TBI and compared with AD mice. However, differences between WT Aged and 3xTg-AD mice in immune cell populations and plasma cytokine levels were incongruous, cognitive deficits were similar, and cumulative sleep was not predictive of inflammation or behavior for either group. Our results suggest that in similarly aged individuals, TBI immediately induces more profound sleep alterations than in AD, although both diseases likely include cognitive impairments. Unique pathological sleep pathways may exist in elderly individuals who incur TBI compared with similarly aged individuals who have AD, which may warrant disease-specific treatments in clinical settings.
Collapse
Affiliation(s)
- Maha Saber
- BARROW Neurological Institute at Phoenix Children’s Hospital, Phoenix, AZ
- Department of Child Health, University of Arizona College of Medicine – Phoenix, Phoenix, AZ
| | - Sean M. Murphy
- Department of Child Health, University of Arizona College of Medicine – Phoenix, Phoenix, AZ
| | - Yerin Cho
- BARROW Neurological Institute at Phoenix Children’s Hospital, Phoenix, AZ
- Department of Child Health, University of Arizona College of Medicine – Phoenix, Phoenix, AZ
| | - Jonathan Lifshitz
- BARROW Neurological Institute at Phoenix Children’s Hospital, Phoenix, AZ
- Department of Child Health, University of Arizona College of Medicine – Phoenix, Phoenix, AZ
- Phoenix Veteran Affairs Health Care System, Phoenix, AZ
| | - Rachel K. Rowe
- BARROW Neurological Institute at Phoenix Children’s Hospital, Phoenix, AZ
- Department of Child Health, University of Arizona College of Medicine – Phoenix, Phoenix, AZ
- Phoenix Veteran Affairs Health Care System, Phoenix, AZ
| |
Collapse
|
43
|
Montaruli A, Castelli L, Mulè A, Scurati R, Esposito F, Galasso L, Roveda E. Biological Rhythm and Chronotype: New Perspectives in Health. Biomolecules 2021; 11:biom11040487. [PMID: 33804974 PMCID: PMC8063933 DOI: 10.3390/biom11040487] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/03/2021] [Accepted: 03/16/2021] [Indexed: 12/11/2022] Open
Abstract
The circadian rhythm plays a fundamental role in regulating biological functions, including sleep–wake preference, body temperature, hormonal secretion, food intake, and cognitive and physical performance. Alterations in circadian rhythm can lead to chronic disease and impaired sleep. The circadian rhythmicity in human beings is represented by a complex phenotype. Indeed, over a 24-h period, a person’s preferred time to be more active or to sleep can be expressed in the concept of morningness–eveningness. Three chronotypes are distinguished: Morning, Neither, and Evening-types. Interindividual differences in chronotypes need to be considered to reduce the negative effects of circadian disruptions on health. In the present review, we examine the bi-directional influences of the rest–activity circadian rhythm and sleep–wake cycle in chronic pathologies and disorders. We analyze the concept and the main characteristics of the three chronotypes.
Collapse
Affiliation(s)
- Angela Montaruli
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
- IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20161 Milan, Italy
| | - Lucia Castelli
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
| | - Antonino Mulè
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
| | - Raffaele Scurati
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
| | - Fabio Esposito
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
- IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20161 Milan, Italy
| | - Letizia Galasso
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
- Correspondence: ; Tel.: +2-5031-4656
| | - Eliana Roveda
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
- IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20161 Milan, Italy
| |
Collapse
|
44
|
Wooten SV, Mittag U, Alvero Cruz JR, Stray-Gundersen S, Hoffmann F, Michély S, Möstl S, Sies W, Mulder E, Rauschendorfer P, Chilibeck PD, Rittweger J, Tanaka H. Life Satisfaction, Positive Affect, and Sleep Impairment in Masters Athletes: Modulation by Age, Sex, and Exercise Type. Front Physiol 2021; 12:634433. [PMID: 33746775 PMCID: PMC7970109 DOI: 10.3389/fphys.2021.634433] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 01/22/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction The masters athlete has been proposed as a model of successful aging. Research studies investigating psychological outlook in older athletes have primarily addressed negative affects including depression, anxiety, and stress. The impact of lifelong exercise on positive affect and life satisfaction as well as sleep impairment that could impact on these psychological states is largely unknown. Methods A series of questionnaires (general life satisfaction, positive affect, and sleep-related impairment) were administered to 240 masters athletes participating in the World Masters Athletics Championships. Total raw scores were converted into T scores for comparison with the general population. Meaningful difference was defined by the PROMIS® as one-half standard deviation from the centering sample. Results Meaningful differences were observed for improved general life satisfaction and reduced sleep impairment for all masters athletes. Positive affect did not reach the meaningful difference threshold. No significant sex differences were found for any of the questionnaires (all p > 0.05). Similarly, no significant differences were found between endurance, sprint, and strength/power sports for general life satisfaction (p = 0.18), positive affect (p = 0.46), and sleep impairment (p = 0.77). In general, life satisfaction increased with age (r = 0.15, p = 0.02), and sleep impairment trended towards reduction with age (r = −0.13, p = 0.05). Positive affect demonstrated no correlation with age (r = 0.09, p = 0.18). Conclusion This study demonstrates that the lifestyles of masters athletes contribute to improved general life satisfaction and reduced sleep impairment but not improved positive affect. The beneficial effects were observed irrespective of age, gender, and sporting types.
Collapse
Affiliation(s)
- Savannah V Wooten
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, United States
| | - Uwe Mittag
- German Aerospace Center, Institute of Aerospace Medicine, Cologne, Germany
| | - José Ramón Alvero Cruz
- Department of Human Physiology and Sports Physical Education, University of Málaga, Málaga, Spain
| | - Sten Stray-Gundersen
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, United States
| | - Fabian Hoffmann
- German Aerospace Center, Institute of Aerospace Medicine, Cologne, Germany.,Department of Cardiology, University Hospital Cologne, Cologne, Germany
| | - Sarah Michély
- German Aerospace Center, Institute of Aerospace Medicine, Cologne, Germany
| | - Stefan Möstl
- German Aerospace Center, Institute of Aerospace Medicine, Cologne, Germany
| | - Wolfram Sies
- German Aerospace Center, Institute of Aerospace Medicine, Cologne, Germany
| | - Edwin Mulder
- German Aerospace Center, Institute of Aerospace Medicine, Cologne, Germany
| | | | - Philip D Chilibeck
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Jörn Rittweger
- German Aerospace Center, Institute of Aerospace Medicine, Cologne, Germany.,Department of Pediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany
| | - Hirofumi Tanaka
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, United States
| |
Collapse
|
45
|
Loneliness and social isolation is associated with sleep problems among older community dwelling women and men with complex needs. Sci Rep 2021; 11:4877. [PMID: 33649402 PMCID: PMC7921547 DOI: 10.1038/s41598-021-83778-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 01/14/2021] [Indexed: 11/18/2022] Open
Abstract
Sleep problems, loneliness and social isolation often increase with age, significantly impacting older adults’ health and wellbeing. Yet general population health empirical evidence is surprisingly scant. Using the largest national database to date, cross-sectional and longitudinal analyses was undertaken on 140,423 assessments from 95,045 (women: 61.0%) community living older adults aged ≥ 65 years having standardised home care assessments between 1 July 2012 and 31 May 2018 to establish the prevalence and relationships between insufficient sleep, excessive sleep, loneliness and social isolation. At first assessment, insufficient sleep (women: 12.4%, men: 12.7%) was more commonly reported than excessive sleep (women: 4.7%, men: 7.6%). Overall, 23.6% of women and 18.9% of men reported feeling lonely, while 53.8% women and 33.8% men were living alone. In adjusted longitudinal analyses, those who were lonely and socially isolated were more likely to experience insufficient sleep. Respondents with excessive sleep were more likely to live with others. Both loneliness and social isolation contributed to insufficient sleep, synergistically. Loneliness, social isolation and health-concerns may affect the restorative properties of sleep over and above the effects of ageing. Further research is warranted.
Collapse
|
46
|
Gencarelli A, Sorrell A, Everhart CM, Zurlinden T, Everhart DE. Behavioral and exercise interventions for sleep dysfunction in the elderly: a brief review and future directions. Sleep Breath 2021; 25:2111-2118. [PMID: 33630239 PMCID: PMC7905198 DOI: 10.1007/s11325-021-02329-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/26/2021] [Accepted: 02/19/2021] [Indexed: 11/28/2022]
Abstract
Purpose The impact of sleep-related changes and disorders in the geriatric populations are of utmost concern due to health consequences and increased risk of injury as well as injuring others as a result of poor sleep. The purpose of this paper is to provide a brief review of the current state of the literature with regard to sleep, aging, common non-pharmacological interventions, and the potential use of exercise in combination with behavioral interventions. Methods Initially, this manuscript focuses on a brief (nonsystematic) review of sleep parameters and physiology that are associated with the aging process. Subsequently, information regarding sleep disorders in the elderly in general, and insomnia in particular are discussed. Last, a brief review of current recommended interventions is provided. Results The current major nonpharmacological interventions are described including Cognitive Behavioral Therapy for Insomnia (CBT-I). The potential use of exercise as a safe intervention for poor sleep is discussed. Finally, a call is made for increased research that examines the combination of traditional behavioral interventions with exercise.
Collapse
Affiliation(s)
- Amy Gencarelli
- Department of Psychology, East Carolina University, Greenville, NC, 27858, USA
| | - Anne Sorrell
- Department of Psychology, East Carolina University, Greenville, NC, 27858, USA
| | | | - Taylor Zurlinden
- Department of Psychology, East Carolina University, Greenville, NC, 27858, USA
| | - D Erik Everhart
- Department of Psychology, East Carolina University, Greenville, NC, 27858, USA.
| |
Collapse
|
47
|
Cai ZJ. Hypothalamic aging and hormones. VITAMINS AND HORMONES 2021; 115:15-37. [PMID: 33706947 DOI: 10.1016/bs.vh.2020.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
It is the heterogeneous changes of hypothalamic functions that determine the chronological sequence of aging in mammals. Recently, it was hypothesized by Cai the decrease in slow-wave sleep (SWS) resulting from skin aging as responsible for the degeneration of hypothalamic suprachiasmatic nucleus (SCN). It was soon hypothesized by the European people in television that the increase in body fat as responsible for the degeneration of male preoptic sexually dimorphic nucleus (SDN-POA), via the aromatase converting testosterone to estradiol as proposed by Cohen. It is the hypothalamic paraventricular nucleus (PVN) that remains unchanged in neuron number during aging for psychological stress. In this chapter, it is briefly reviewed more manifestations of hypothalamic related mammalian aging processes, including (1) the aging of ovary by lipid, estradiol and hypothalamus; (2) the aging of muscle, stomach, intestine, thymus, and the later aging of brain, regulated by growth hormone/insulin-like growth factor 1(GH/IGF1); (3) the cardiovascular hypertension from PVN activation, the bone and other peripheral aging by psychological stress, and that of kidney by vasopressin. It is classified these aging processes by the primary regulation from one of the three hypothalamic nuclei, although still necessary to investigate and supplement their secondary regulation by the hypothalamic nuclei in future. It is the hypothalamic structural changes that shift the functional balance among these three hypothalamic systems toward aging.
Collapse
Affiliation(s)
- Zi-Jian Cai
- CaiFortune Consulting, Suzhou, Jiangsu, PR China.
| |
Collapse
|
48
|
Singh S, Jadhav S, Subramanyam A, Raut N. A study of quality of sleep, quality of life, and cognition in elderly: Healthy control, depressed and with mild neurocognitive disorder. JOURNAL OF GERIATRIC MENTAL HEALTH 2021. [DOI: 10.4103/jgmh.jgmh_35_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
49
|
Woods HJ, Li MF, Patel UA, Lascelles BDX, Samson DR, Gruen ME. A functional linear modeling approach to sleep-wake cycles in dogs. Sci Rep 2020; 10:22233. [PMID: 33335259 PMCID: PMC7747556 DOI: 10.1038/s41598-020-79274-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 12/07/2020] [Indexed: 11/09/2022] Open
Abstract
The study of companion (pet) dogs is an area of great translational potential, as they share a risk for many conditions that afflict humans. Among these are conditions that affect sleep, including chronic pain and cognitive dysfunction. Significant advancements have occurred in the ability to study sleep in dogs, including development of non-invasive polysomnography; however, basic understanding of dog sleep patterns remains poorly characterized. The purpose of this study was to establish baseline sleep-wake cycle and activity patterns using actigraphy and functional linear modeling (FLM), for healthy, adult companion dogs. Forty-two dogs were enrolled and wore activity monitors for 14 days. FLM demonstrated a bimodal pattern of activity with significant effects of sex, body mass, and age; the effect of age was particularly evident during the times of peak activity. This study demonstrated that FLM can be used to describe normal sleep-wake cycles of healthy adult dogs and the effects of physiologic traits on these patterns of activity. This foundation makes it possible to characterize deviations from normal patterns, including those associated with chronic pain and cognitive dysfunction syndrome. This can improve detection of these conditions in dogs, benefitting them and their potential as models for human disease.
Collapse
Affiliation(s)
- Hope J Woods
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Ming Fei Li
- Department of Anthropology, University of Toronto, Toronto, ON, Canada
| | - Ujas A Patel
- Department of Anthropology, University of Toronto Mississauga, Mississauga, ON, Canada
| | - B Duncan X Lascelles
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.,Translational Research in Pain (TRiP) Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.,Comparative Pain Research and Education Centre, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.,Comparative Medicine Institute, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27612, USA.,Thurston Arthritis Centre, UNC School of Medicine, Chapel Hill, NC, USA.,Department of Anaesthesiology, Center for Translational Pain Research, Duke University, Durham, NC, USA
| | - David R Samson
- Department of Anthropology, University of Toronto Mississauga, Mississauga, ON, Canada
| | - Margaret E Gruen
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA. .,Comparative Pain Research and Education Centre, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA. .,Comparative Medicine Institute, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27612, USA.
| |
Collapse
|
50
|
The core circadian component, Bmal1, is maintained in the pineal gland of old killifish brain. iScience 2020; 24:101905. [PMID: 33385110 PMCID: PMC7770606 DOI: 10.1016/j.isci.2020.101905] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 10/05/2020] [Accepted: 12/03/2020] [Indexed: 11/20/2022] Open
Abstract
Circadian rhythm is altered during aging, although the underlying molecular mechanisms remain largely unknown. Here, we used the turquoise killifish as a short-lived vertebrate model to examine the effects of aging on the major circadian network comprising the four mammalian clock protein homologs, Bmal1, Clockb, Cry1b, and Per3, which are highly conserved in the killifish with 50%–85% amino acid sequence identity to their human counterparts. The amplitude of circadian rhythm was smaller in old fish (14 weeks) than in young fish (6 weeks). In old fish brain, the Bmal1 protein level was significantly downregulated. However, the Bmal1 interaction with Clockb and chromatin binding of Bmal1 to its downstream target promoters were retained. Furthermore, Bmal1 was relatively well maintained in the pineal gland compared with other regions of the old fish brain. The results suggest that the circadian clock system in the killifish becomes spatially confined to the pineal gland upon aging. The amplitude of free-running circadian rhythms decreases during aging in killifish Core clock genes are highly conserved in the turquoise killifish genome Bmal1 protein expression decreases in whole brain tissue with aging Bmal1 expression is relatively well maintained in the pineal gland with aging
Collapse
|