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Mohamed AZ, Andersen T, Radovic S, Del Fante P, Kwiatek R, Calhoun V, Bhuta S, Hermens DF, Lagopoulos J, Shan ZY. Objective sleep measures in chronic fatigue syndrome patients: A systematic review and meta-analysis. Sleep Med Rev 2023; 69:101771. [PMID: 36948138 PMCID: PMC10281648 DOI: 10.1016/j.smrv.2023.101771] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/11/2023]
Abstract
Patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) often report disrupted and unrefreshing sleep in association with worsened fatigue symptoms. However, the nature and magnitude of sleep architecture alteration in ME/CFS is not known, with studies using objective sleep measures in ME/CFS generating contradictory results. The current manuscript aimed to review and meta-analyse of case-control studies with objective sleep measures in ME/CSF. A search was conducted in PubMed, Scopus, Medline, Google Scholar, and Psychoinfo databases. After review, 24 studies were included in the meta-analysis, including 20 studies with 801 adults (ME/CFS = 426; controls = 375), and 4 studies with 477 adolescents (ME/CFS = 242; controls = 235), who underwent objective measurement of sleep. Adult ME/CFS patients spend longer time in bed, longer sleep onset latency, longer awake time after sleep onset, reduced sleep efficiency, decreased stage 2 sleep, more Stage 3, and longer rapid eye movement sleep latency. However, adolescent ME/CFS patients had longer time in bed, longer total sleep time, longer sleep onset latency, and reduced sleep efficiency. The meta-analysis results demonstrate that sleep is altered in ME/CFS, with changes seeming to differ between adolescent and adults, and suggesting sympathetic and parasympathetic nervous system alterations in ME/CFS.
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Affiliation(s)
- Abdalla Z Mohamed
- Thompson Institute, University of the Sunshine Coast, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia.
| | - Thu Andersen
- Thompson Institute, University of the Sunshine Coast, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| | - Sanja Radovic
- Thompson Institute, University of the Sunshine Coast, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| | - Peter Del Fante
- Thompson Institute, University of the Sunshine Coast, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| | - Richard Kwiatek
- Thompson Institute, University of the Sunshine Coast, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| | - Vince Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, 55 Park Pl NE, 18th Floor, Atlanta, GA, 30303, USA
| | - Sandeep Bhuta
- Medical Imaging Department, Gold Coast University Hospital, Parklands, QLD, 4215, Australia
| | - Daniel F Hermens
- Thompson Institute, University of the Sunshine Coast, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| | - Jim Lagopoulos
- Thompson Institute, University of the Sunshine Coast, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| | - Zack Y Shan
- Thompson Institute, University of the Sunshine Coast, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
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Wang J, Zhao H, Shi K, Wang M. Treatment of insomnia based on the mechanism of pathophysiology by acupuncture combined with herbal medicine: A review. Medicine (Baltimore) 2023; 102:e33213. [PMID: 36930068 PMCID: PMC10019201 DOI: 10.1097/md.0000000000033213] [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: 01/24/2023] [Accepted: 02/15/2023] [Indexed: 03/18/2023] Open
Abstract
Insomnia is a sleep disorder which severely affects patients mood, quality of life and social functioning, serves as a trigger or risk factor to a variety of diseases such as depression, cardiovascular and cerebrovascular diseases, obesity and diabetes, and even increases the risk of suicide, and has become an increasingly widespread concern worldwide. Considerable research on insomnia has been conducted in modern medicine in recent years and encouraging results have been achieved in the fields of genetics and neurobiology. Unfortunately, however, the pathogenesis of insomnia remains elusive to modern medicine, and pharmacological treatment of insomnia has been regarded as conventional. However, in the course of treatment, pharmacological treatment itself is increasingly being questioned due to potential dependence and drug resistance and is now being replaced by cognitive behavior therapy as the first-line treatment. As an important component of complementary and alternative medicine, traditional Chinese medicine, especially non-pharmacological treatment methods such as acupuncture, is gaining increasing attention worldwide. In this article, we discuss the combination of traditional Chinese medicine, acupuncture, and medicine to treat insomnia based on neurobiology in the context of modern medicine.
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Affiliation(s)
- Jie Wang
- Department of Pain, Datong Hospital of Traditional Chinese Medicine, Shanxi Province, Datong, China
| | - Haishen Zhao
- Department of Rehabilitation, Luchaogang Community Health Service Center, Pudong New District, Shanghai, China
| | - Kejun Shi
- Department of Rehabilitation, Luchaogang Community Health Service Center, Pudong New District, Shanghai, China
| | - Manya Wang
- Department of Rehabilitation, Luchaogang Community Health Service Center, Pudong New District, Shanghai, China
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Yang M, Yang J, Gong M, Luo R, Lin Q, Wang B. Effects of Tai Chi on Sleep Quality as Well as Depression and Anxiety in Insomnia Patients: A Meta-Analysis of Randomized Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3074. [PMID: 36833762 PMCID: PMC9959787 DOI: 10.3390/ijerph20043074] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 02/04/2023] [Indexed: 06/07/2023]
Abstract
To systematically review the effects of Tai chi on sleep quality, depression, and anxiety in patients with insomnia. The electronic databases including PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), WanFang Data, Chinese Biomedical Literature Database (CBM), and VIP Database for Chinese Technical Periodicals (VIP) were retrieved and screened by computer. Randomized controlled trials (RCT) on patients with insomnia who practiced Tai chi were collected, and the RCT risk of bias assessment criteria was used to evaluate the methodological quality of the included studies. The combined effect size was expressed as the weighted mean difference (WMD), with a confidence interval of 95% (CI). Review Manager 5.4 and Stata16.0 were used for heterogeneity analysis and sensitivity analysis. Tai chi reduced the patients' Pittsburgh sleep quality index (PSQI) score (WMD = -1.75, 95% CI: -1.88, -1.62, p < 0.001); Hamilton depression scale (HAMD) score (WMD = -5.08, 95% CI: -5.46, -4.69, p < 0.001), Hamilton anxiety scale (HAMA) score (WMD = -2.18, 95% CI: -2.98, -1.37, p < 0.001), and self-rating anxiety scale (SAS) score (WMD = -7.01, 95% CI: -7.72, -6.29, p < 0.001). Tai chi exercise has a good preventive and ameliorating effect on insomnia, which can relieve patients' depression and anxiety, simultaneously enhancing various functions of the body. However, most of the included studies reported random assignment with some lack of specific descriptions, and the blinding of participants was difficult to achieve due to the nature of exercise, which may cause bias. Therefore, more high-quality, multi-center, and bigger-sample studies need to be included in the future to further verify the results.
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Affiliation(s)
- Min Yang
- School of Physical Education, Yanshan University, Qinhuangdao 066004, China
| | - Jiaqi Yang
- School of Physical Education, Yanshan University, Qinhuangdao 066004, China
| | - Mingjun Gong
- School of Sports Training and Science, Tianjin University of Sport, Tianjin 300211, China
| | - Rui Luo
- School of Sport and Leisure, Sichuan Tourism University, Chengdu 610100, China
| | - Qinqin Lin
- School of Physical Education, Yanshan University, Qinhuangdao 066004, China
| | - Baihui Wang
- School of Physical Education, Yanshan University, Qinhuangdao 066004, China
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Zhou JC, Jiang JB, Guo H, Yang SR, Liu CF, Qu WM, Huang ZL, Ding FF. Trihexyphenidyl increases delta activity in non-rapid eye movement sleep without impairing cognitive function in rodent models. Neuropharmacology 2022; 218:109217. [PMID: 35973600 DOI: 10.1016/j.neuropharm.2022.109217] [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: 02/15/2022] [Revised: 07/18/2022] [Accepted: 08/08/2022] [Indexed: 10/31/2022]
Abstract
Both human and rodent studies suggest the link between non-rapid eye movement (NREM) sleep and cognition. Recent study indicated that selective activation of cholinergic neurons in basal forebrain inhibits electroencephalogram (EEG) delta power and shortens NREM sleep. In the current study, we aimed to test the pharmacological effect of trihexyphenidyl (THP), a selective muscarinic M1 receptor antagonist, on EEG power spectra and sleep with or without the selective activation of basal forebrain cholinergic neurons. THP (1, 2, and 3 mg/kg) was administrated intraperitoneally in natural sleep phase. Basal forebrain cholinergic neurons expressing modified G protein-coupled muscarinic receptors (hM3Dq) were activated by intraperitoneal injection of clozapine-N-oxide in ChAT-IRES-Cre mice. EEG and electromyogram (EMG) signals were recorded in freely moving mice to analyze EEG power spectrum and sleep hypnogram. Y-maze and novel object recognition tests were used for testing cognition. THP 1 mg/kg significantly increased EEG delta power and facilitated NREM sleep in wildtype mice, while THP 3 mg/kg was required in ChAT-IRES-Cre mice treated with clozapine-N-oxide. THP with dosage up to 8 mg/kg did not induce cognitive impairments in wildtype mice. EEG delta power of NREM sleep is often used as an indicator of sleep depth or sleep quality, which tightly link with sleep-dependent cognition. Taken together, the data collected from rodents hinted that, THP could possibly be used as the NREM sleep facilitator in humans.
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Affiliation(s)
- Ji Chuan Zhou
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Institutes of Brain Science, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Jian Bo Jiang
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Institutes of Brain Science, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Han Guo
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Institutes of Brain Science, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Su Rong Yang
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Institutes of Brain Science, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Chun Feng Liu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215000, China
| | - Wei Min Qu
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Institutes of Brain Science, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Zhi Li Huang
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Institutes of Brain Science, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
| | - Feng Fei Ding
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Institutes of Brain Science, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
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Hirsch S, Stephens AR, Crane PB. Fatigue, Depression, Cardiovascular Risk, and Self-Rated Health: Comparing a Community Sample of Adults to Those With a History of Myocardial Infarction. Clin Nurs Res 2021; 31:174-182. [PMID: 34727779 DOI: 10.1177/10547738211055570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This cross-sectional descriptive study was designed to compare fatigue, depression, cardiovascular risk, and self-rated health in community dwelling adults (CDA) without a history of myocardial infarction (MI) compared to adults who had experienced an MI 3 to 7 years ago. A convenience sample (n = 40) of CDA completed: demographic health form, Revised Piper Fatigue Scale, and CES-D. Age-matched controls (n = 40) were randomly selected from the Recurrence of Myocardial Infarction (ROMI) study. Most (N = 80) were White (66%) with a mean age of 58.3 (SD = 11.5; range 21-83). The ROMI group reported more diabetes, hypercholesterolemia, obesity, and hypertension, and had higher fatigue (t(61) = 4.51, p < .001). No differences were noted in depression scores (p = .952). Higher fatigue and depression scores were correlated with poorer self-rated health: r = .544 (p < .001) and r = .295 (p = .008).
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Kang JM, Cho SE, Lee GB, Cho SJ, Park KH, Kim ST, Kang SG. Relationship between the Spectral Power Density of Sleep Electroencephalography and Psychiatric Symptoms in Patients with Breathing-related Sleep Disorder. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2021; 19:521-529. [PMID: 34294621 PMCID: PMC8316670 DOI: 10.9758/cpn.2021.19.3.521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/28/2020] [Accepted: 09/05/2020] [Indexed: 11/18/2022]
Abstract
Objective Patients with breathing-related sleep disorder (BRSD) often complain of psychiatric symptoms such as depression in addition to snoring, excessive sleepiness, and disturbed sleep. However, the relationship between psychiatric symptoms and severity of sleep apnea in BRSD is controversial. We conducted this study to investigate the relationship between psychiatric symptoms and sleep electroencephalography (EEG) findings in BRSD patients using spectral analysis. Methods All participants underwent polysomnography and evaluation using Symptom Checklist-90-Revised (SCL-90-R) scale. We analyzed the absolute spectral power density values of standard EEG frequency bands in the participants (n = 169) with BRSD during the non-rapid eye movement (NREM) sleep period. We performed correlation analysis between the domain scores of SCL-90-R scale and the absolute values of the EEG frequency bands. Results Significant positive correlation was observed between the absolute spectral power density values in the slow oscillation band and the degree of paranoid ideation (r = 0.226, p = 0.028) and depression (r = 0.216, p = 0.044) in SCL-90-R. The multiple linear regression model showed that higher paranoid ideation domain score (B = 0.007, p = 0.020), younger age (B = −0.011, p < 0.001), and female sex (B = 0.213, p = 0.004) were associated with higher slow oscillation power during NREM sleep. Conclusion The results of the present study suggested a relationship between sleep EEG and psychiatric symptoms in patients with BRSD. This relationship needs to be validated with further studies.
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Affiliation(s)
- Jae Myeong Kang
- Department of Psychiatry, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Seo-Eun Cho
- Department of Psychiatry, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Gun Bae Lee
- Gachon Sleep Medicine Center, Gachon University Gil Medical Center, Incheon, Korea
| | - Seong-Jin Cho
- Department of Psychiatry, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Kee Hyung Park
- Department of Neurology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Seon Tae Kim
- Department of Otolaryngology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Seung-Gul Kang
- Department of Psychiatry, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
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Grimaldi D, Reid KJ, Papalambros NA, Braun RI, Malkani RG, Abbott SM, Ong JC, Zee PC. Autonomic dysregulation and sleep homeostasis in insomnia. Sleep 2021; 44:6029088. [PMID: 33295989 DOI: 10.1093/sleep/zsaa274] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 11/24/2020] [Indexed: 11/12/2022] Open
Abstract
STUDY OBJECTIVES Insomnia is common in older adults, and is associated with poor health, including cognitive impairment and cardio-metabolic disease. Although the mechanisms linking insomnia with these comorbidities remain unclear, age-related changes in sleep and autonomic nervous system (ANS) regulation might represent a shared mechanistic pathway. In this study, we assessed the relationship between ANS activity with indices of objective and subjective sleep quality in older adults with insomnia. METHODS Forty-three adults with chronic insomnia and 16 age-matched healthy sleeper controls were studied. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), objective sleep quality by electroencephalogram spectral components derived from polysomnography, and ANS activity by measuring 24-h plasma cortisol and norepinephrine (NE). RESULTS Sleep cycle analysis displayed lower slow oscillatory (SO: 0.5-1.25 Hz) activity in the first cycle in insomnia compared to controls. In insomnia, 24-h cortisol levels were higher and 24-h NE levels were lower than controls. In controls, but not in insomnia, there was a significant interaction between NE level during wake and SO activity levels across the sleep cycles, such that in controls but not in insomnia, NE level during wake was positively associated with the amount of SO activity in the first cycle. In insomnia, lower 24-h NE level and SO activity in the first sleep cycle were associated with poorer subjective sleep quality. CONCLUSION Dysregulation of autonomic activity may be an underlying mechanism that links objective and subjective measures of sleep quality in older adults with insomnia, and potentially contribute to adverse health outcomes.
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Affiliation(s)
- Daniela Grimaldi
- Center for Circadian and Sleep Medicine, Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Kathryn J Reid
- Center for Circadian and Sleep Medicine, Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Nelly A Papalambros
- Center for Circadian and Sleep Medicine, Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Rosemary I Braun
- Biostatistics Division, Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.,Department of Engineering Sciences and Applied Mathematics, Northwestern University, Evanston, IL, USA.,Department of Physics and Astronomy, Northwestern University, Evanston, IL, USA
| | - Roneil G Malkani
- Center for Circadian and Sleep Medicine, Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Sabra M Abbott
- Center for Circadian and Sleep Medicine, Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Jason C Ong
- Center for Circadian and Sleep Medicine, Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Phyllis C Zee
- Center for Circadian and Sleep Medicine, Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
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Maksoud R, Eaton-Fitch N, Matula M, Cabanas H, Staines D, Marshall-Gradisnik S. Systematic Review of Sleep Characteristics in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Healthcare (Basel) 2021; 9:healthcare9050568. [PMID: 34065013 PMCID: PMC8150292 DOI: 10.3390/healthcare9050568] [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: 04/13/2021] [Revised: 05/01/2021] [Accepted: 05/07/2021] [Indexed: 02/04/2023] Open
Abstract
(1) Background—Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a multifaceted illness characterized by profound and persistent fatigue unrelieved by rest along with a range of other debilitating symptoms. Experiences of unrefreshing and disturbed sleep are frequently described by ME/CFS patients. This is the first systematic review assessing sleep characteristics in ME/CFS. The aim of this review is to determine whether there are clinical characteristics of sleep in ME/CFS patients compared to healthy controls using objective measures such as polysomnography and multiple sleep latency testing. (2) Methods—the following databases—Pubmed, Embase, Medline (EBSCO host) and Web of Science, were systematically searched for journal articles published between January 1994 to 19 February 2021. Articles that referred to polysomnography or multiple sleep latency testing and ME/CFS patients were selected, and further refined through use of specific inclusion and exclusion criteria. Quality and bias were measured using the Joanna Briggs Institute checklist. (3) Results—twenty observational studies were included in this review. The studies investigated objective measures of sleep quality in ME/CFS. Subjective measures including perceived sleep quality and other quality of life factors were also described. (4) Conclusions—Many of the parameters measured including slow- wave sleep, apnea- hypopnea index, spectral activity and multiple sleep latency testing were inconsistent across the studies. The available research on sleep quality in ME/CFS was also limited by recruitment decisions, confounding factors, small sample sizes and non-replicated findings. Future well-designed studies are required to understand sleep quality in ME/CFS patients.
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Affiliation(s)
- Rebekah Maksoud
- National Centre for Neuroimmunology and Emerging Diseases (NCNED), Menzies Health Institute Queensland, Griffith University, Gold Coast 4222, Australia; (N.E.-F.); (M.M.); (H.C.); (D.S.); (S.M.-G.)
- Consortium Health International for Myalgic Encephalomyelitis, Griffith University, Gold Coast 4222, Australia
- Correspondence:
| | - Natalie Eaton-Fitch
- National Centre for Neuroimmunology and Emerging Diseases (NCNED), Menzies Health Institute Queensland, Griffith University, Gold Coast 4222, Australia; (N.E.-F.); (M.M.); (H.C.); (D.S.); (S.M.-G.)
- Consortium Health International for Myalgic Encephalomyelitis, Griffith University, Gold Coast 4222, Australia
- School of Medical Science, Griffith University, Gold Coast 4222, Australia
| | - Michael Matula
- National Centre for Neuroimmunology and Emerging Diseases (NCNED), Menzies Health Institute Queensland, Griffith University, Gold Coast 4222, Australia; (N.E.-F.); (M.M.); (H.C.); (D.S.); (S.M.-G.)
- Consortium Health International for Myalgic Encephalomyelitis, Griffith University, Gold Coast 4222, Australia
| | - Hélène Cabanas
- National Centre for Neuroimmunology and Emerging Diseases (NCNED), Menzies Health Institute Queensland, Griffith University, Gold Coast 4222, Australia; (N.E.-F.); (M.M.); (H.C.); (D.S.); (S.M.-G.)
- Consortium Health International for Myalgic Encephalomyelitis, Griffith University, Gold Coast 4222, Australia
| | - Donald Staines
- National Centre for Neuroimmunology and Emerging Diseases (NCNED), Menzies Health Institute Queensland, Griffith University, Gold Coast 4222, Australia; (N.E.-F.); (M.M.); (H.C.); (D.S.); (S.M.-G.)
- Consortium Health International for Myalgic Encephalomyelitis, Griffith University, Gold Coast 4222, Australia
| | - Sonya Marshall-Gradisnik
- National Centre for Neuroimmunology and Emerging Diseases (NCNED), Menzies Health Institute Queensland, Griffith University, Gold Coast 4222, Australia; (N.E.-F.); (M.M.); (H.C.); (D.S.); (S.M.-G.)
- Consortium Health International for Myalgic Encephalomyelitis, Griffith University, Gold Coast 4222, Australia
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Zhao W, Van Someren EJW, Li C, Chen X, Gui W, Tian Y, Liu Y, Lei X. EEG spectral analysis in insomnia disorder: A systematic review and meta-analysis. Sleep Med Rev 2021; 59:101457. [PMID: 33607464 DOI: 10.1016/j.smrv.2021.101457] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 12/07/2020] [Accepted: 12/31/2020] [Indexed: 12/29/2022]
Abstract
Insomnia disorder (ID) has become the second-most common mental disorder. Despite burgeoning evidence for increased high-frequency electroencephalography (EEG) activity and cortical hyperarousal in ID, the detailed spectral features of this disorder during wakefulness and different sleep stages remain unclear. Therefore, we adopted a meta-analytic approach to systematically assess existing evidence on EEG spectral features in ID. Hedges's g was calculated by 148 effect sizes from 24 studies involving 977 participants. Our results demonstrate that, throughout wakefulness and sleep, patients with ID exhibited increased beta band power, although such increases sometimes extended into neighboring frequency bands. Patients with ID also exhibited increased theta and gamma power during wakefulness, as well as increased alpha and sigma power during rapid eye movement (REM) sleep. In addition, ID was associated with decreased delta power and increased theta, alpha, and sigma power during NREM sleep. The EEG measures of absolute and relative power have similar sensitivity in detecting spectral features of ID during wakefulness and REM sleep; however, relative power appeared to be a more sensitive biomarker during NREM sleep. Our study is the first statistics-based review to quantify EEG power spectra across stages of sleep and wakefulness in patients with ID.
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Affiliation(s)
- Wenrui Zhao
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality of Ministry of Education, Chongqing, 400715, China
| | - Eus J W Van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands; Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience Research Institute, Amsterdam UMC, Vrije Universiteit, the Netherlands; Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, Vrije Universiteit Amsterdam, the Netherlands
| | - Chenyu Li
- Sleep Center, Department of Brain Disease, Chongqing Traditional Chinese Medicine Hospital, Chongqing 400021, China
| | - Xinyuan Chen
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality of Ministry of Education, Chongqing, 400715, China
| | - Wenjun Gui
- Key Laboratory of Mental Health, Center on Aging Psychology, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Yu Tian
- Institution of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, 610066, China
| | - Yunrui Liu
- Center for Cognitive and Decision Sciences, Department of Psychology, University of Basel, Basel, Switzerland
| | - Xu Lei
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality of Ministry of Education, Chongqing, 400715, China.
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10
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Schmid SR, Nissen C, Riemann D, Spiegelhalder K, Frase L. Auditorische Stimulation während des Schlafs. SOMNOLOGIE 2020. [DOI: 10.1007/s11818-020-00255-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
ZusammenfassungDie Insomnie, d. h. eine Ein- und/oder Durchschlafstörung, die sich negativ auf die Leistungsfähigkeit und Tagesbefindlichkeit auswirkt, ist eine der häufigsten Erkrankungen in der Allgemeinbevölkerung. Sie wird derzeit meistens pharmakologisch und/oder psychotherapeutisch behandelt, wobei die pharmakologische Behandlung mit Benzodiazepin-Rezeptor-Agonisten zu Abhängigkeit führen kann und die Verfügbarkeit von für die Insomnie-Therapie ausgebildeten Psychotherapeuten momentan nicht in ausreichendem Maße gegeben ist. Durch innovative Behandlungsmethoden könnte hier eine Versorgungslücke effektiv geschlossen werden. Hierzu zählt die auditorische Stimulation, welche vorhandene Sinneskanäle nutzt, um den Schlaf zu beeinflussen. Bisher wurde die auditorische Stimulation vor allem zur Untersuchung von Prozessen der Gedächtniskonsolidierung bei gesunden Probanden angewendet, wobei erfolgreich eine Erhöhung langsamer Oszillationen erreicht wurde, welche vor allem während des Tiefschlafs auftreten. Erste Befunde und sekundäre Outcome-Parameter liefern Hinweise, dass die Potenzierung langsamer Oszillationen durch auditorische Stimulation den Schlaf vertiefen kann, jedoch wurde hierzu bislang keine Studie mit Insomniepatienten durchgeführt. Weitere Forschung bezüglich des Einflusses der Potenzierung langsamer Oszillationen auf die Linderung von Ein- und Durchschlafproblemen bei vorliegender nichtorganischer Insomnie erscheint daher geboten zu sein, um der hohen Beschwerdelast dieser Patientengruppe entgegenzuwirken.
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11
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Van Someren EJW. Brain mechanisms of insomnia: new perspectives on causes and consequences. Physiol Rev 2020; 101:995-1046. [PMID: 32790576 DOI: 10.1152/physrev.00046.2019] [Citation(s) in RCA: 154] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
While insomnia is the second most common mental disorder, progress in our understanding of underlying neurobiological mechanisms has been limited. The present review addresses the definition and prevalence of insomnia and explores its subjective and objective characteristics across the 24-hour day. Subsequently, the review extensively addresses how the vulnerability to develop insomnia is affected by genetic variants, early life stress, major life events, and brain structure and function. Further supported by the clear mental health risks conveyed by insomnia, the integrated findings suggest that the vulnerability to develop insomnia could rather be found in brain circuits regulating emotion and arousal than in circuits involved in circadian and homeostatic sleep regulation. Finally, a testable model is presented. The model proposes that in people with a vulnerability to develop insomnia, the locus coeruleus is more sensitive to-or receives more input from-the salience network and related circuits, even during rapid eye movement sleep, when it should normally be sound asleep. This vulnerability may ignite a downward spiral of insufficient overnight adaptation to distress, resulting in accumulating hyperarousal, which, in turn, impedes restful sleep and moreover increases the risk of other mental health adversity. Sensitized brain circuits are likely to be subjectively experienced as "sleeping with one eye open". The proposed model opens up the possibility for novel intervention studies and animal studies, thus accelerating the ignition of a neuroscience of insomnia, which is direly needed for better treatment.
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Affiliation(s)
- Eus J W Van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands; Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit University Amsterdam, Amsterdam, The Netherlands; and Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
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12
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A Novel Microwave Treatment for Sleep Disorders and Classification of Sleep Stages Using Multi-Scale Entropy. ENTROPY 2020; 22:e22030347. [PMID: 33286121 PMCID: PMC7516818 DOI: 10.3390/e22030347] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/12/2020] [Accepted: 03/16/2020] [Indexed: 12/21/2022]
Abstract
The aim of this study was to develop an integrated system of non-contact sleep stage detection and sleep disorder treatment for health monitoring. Hence, a method of brain activity detection based on microwave scattering technology instead of scalp electroencephalogram was developed to evaluate the sleep stage. First, microwaves at a specific frequency were used to penetrate the functional sites of the brain in patients with sleep disorders to change the firing frequency of the activated areas of the brain and analyze and evaluate statistically the effects on sleep improvement. Then, a wavelet packet algorithm was used to decompose the microwave transmission signal, the refined composite multiscale sample entropy, the refined composite multiscale fluctuation-based dispersion entropy and multivariate multiscale weighted permutation entropy were obtained as features from the wavelet packet coefficient. Finally, the mutual information-principal component analysis feature selection method was used to optimize the feature set and random forest was used to classify and evaluate the sleep stage. The results show that after four times of microwave modulation treatment, sleep efficiency improved continuously, the overall maintenance was above 80%, and the insomnia rate was reduced gradually. The overall classification accuracy of the four sleep stages was 86.4%. The results indicate that the microwaves with a certain frequency can treat sleep disorders and detect abnormal brain activity. Therefore, the microwave scattering method is of great significance in the development of a new brain disease treatment, diagnosis and clinical application system.
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13
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Fatt SJ, Beilharz JE, Joubert M, Wilson C, Lloyd AR, Vollmer-Conna U, Cvejic E. Parasympathetic activity is reduced during slow-wave sleep, but not resting wakefulness, in patients with chronic fatigue syndrome. J Clin Sleep Med 2019; 16:19-28. [PMID: 31957647 DOI: 10.5664/jcsm.8114] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Physiological dearousal characterized by an increase in parasympathetic nervous system activity is important for good-quality sleep. Previous research shows that nocturnal parasympathetic activity (reflected by heart rate variability [HRV]) is diminished in individuals with chronic fatigue syndrome (CFS), suggesting hypervigilant sleep. This study investigated differences in nocturnal autonomic activity across sleep stages and explored the association of parasympathetic activity with sleep quality and self-reported physical and psychological wellbeing in individuals with CFS. METHODS Twenty-four patients with medically diagnosed CFS, and 24 matched healthy control individuals participated. Electroencephalography and HRV were recorded during sleep in participants' homes using a minimally invasive ambulatory device. Questionnaires were used to measure self-reported wellbeing and sleep quality. RESULTS Sleep architecture in patients with CFS differed from that of control participants in slower sleep onset, more awakenings, and a larger proportion of time spent in slow-wave sleep (SWS). Linear mixed-model analyses controlling for age revealed that HRV reflecting parasympathetic activity (normalized high frequency power) was reduced in patients with CFS compared to control participants, particularly during deeper stages of sleep. Poorer self-reported wellbeing and sleep quality was associated with reduced parasympathetic signaling during deeper sleep, but not during wake before sleep, rapid eye movement sleep, or with the proportion of time spent in SWS. CONCLUSIONS Autonomic hypervigilance during the deeper, recuperative stages of sleep is associated with poor quality sleep and self-reported wellbeing. Causal links need to be confirmed but provide potential intervention opportunities for the core symptom of unrefreshing sleep in CFS.
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Affiliation(s)
- Scott J Fatt
- School of Psychiatry, Faculty of Medicine, University of New South Wales Sydney, New South Wales, Australia
| | - Jessica E Beilharz
- School of Psychiatry, Faculty of Medicine, University of New South Wales Sydney, New South Wales, Australia
| | - Michael Joubert
- School of Psychiatry, Faculty of Medicine, University of New South Wales Sydney, New South Wales, Australia
| | - Chloe Wilson
- School of Psychiatry, Faculty of Medicine, University of New South Wales Sydney, New South Wales, Australia
| | - Andrew R Lloyd
- Viral Immunology Systems Program, The Kirby Institute, University of New South Wales Sydney, New South Wales, Australia
| | - Uté Vollmer-Conna
- School of Psychiatry, Faculty of Medicine, University of New South Wales Sydney, New South Wales, Australia
| | - Erin Cvejic
- School of Psychiatry, Faculty of Medicine, University of New South Wales Sydney, New South Wales, Australia.,The University of Sydney, School of Public Health, Faculty of Medicine and Health, New South Wales, Australia
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14
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Mairesse O, Damen V, Newell J, Kornreich C, Verbanck P, Neu D. The Brugmann Fatigue Scale: An Analogue to the Epworth Sleepiness Scale to Measure Behavioral Rest Propensity. Behav Sleep Med 2019; 17:437-458. [PMID: 29065269 DOI: 10.1080/15402002.2017.1395336] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Background: While often confused, fatigue (as opposed to sleepiness) mostly requires rest, not sleep, to recover from. Clinical evaluations of fatigue mainly rely on assessments of symptom intensity, however without taking into account the need to engage in behavioral countermeasures. We therefore developed an 8-item 4-point Likert scale (the Brugmann Fatigue Scale; BFS) sharing a similar conceptual background with the Epworth Sleepiness Scale (ESS), assessing mental and physical fatigue and focusing specifically on rest propensity. Methods: Out of 496 consecutive patients addressed to the sleep unit of an academic hospital, we selected a sample of 295 hypnotic-free subjects (122 females). The present study examines (a) the psychometric properties of the BFS and (b) measurement invariance regarding perceived sleep quality, in parallel with common sleepiness and fatigue scales (ESS and Fatigue Severity Scale; FSS). In addition, (c) correlations of the BFS with clinical scales and polysomnographic variables were explored descriptively. Results: Rasch analyses revealed that the BFS possesses sound psychometric characteristics (rating scale functioning, item fit, dimensionality and measurement invariance) allowing for valid, reliable, linear and unidimensional measurement of mental and physical rest propensity, irrespective of perceived sleep quality, age, or gender. In addition, the BFS was significantly correlated to periodic limb movements during sleep and inversely to REM sleep duration. For both mental and physical subscales, scores above 6 are proposed as cutoff values. Conclusion: In analogy to the ESS, the BFS shows to be a unique and precise instrument assessing symptomatic fatigue with respect to rest propensity.
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Affiliation(s)
- Olivier Mairesse
- a Sleep Laboratory and Unit for Chronobiology U78 , Brugmann University Hospital, Université Libre de Bruxelles (U.L.B.) , Brussels Belgium.,b Department of Experimental and Applied Psychology (EXTO) , Vrije Universiteit Brussel (V.U.B.) , Brussels , Belgium.,c Royal Military Academy , Department LIFE, Vital Signs and Performance (VIPER) , Brussels , Belgium
| | - Vincent Damen
- a Sleep Laboratory and Unit for Chronobiology U78 , Brugmann University Hospital, Université Libre de Bruxelles (U.L.B.) , Brussels Belgium
| | - Johan Newell
- a Sleep Laboratory and Unit for Chronobiology U78 , Brugmann University Hospital, Université Libre de Bruxelles (U.L.B.) , Brussels Belgium
| | - Charles Kornreich
- d Department of Psychiatry , Brugmann University Hospital U.L.B ., Brussels Belgium
| | - Paul Verbanck
- d Department of Psychiatry , Brugmann University Hospital U.L.B ., Brussels Belgium.,e UNI Neuroscience Institute, ULB312 Faculty of Medicine, and ULB388 Faculty of Motor Sciences , Université Libre de Bruxelles (U.L.B.) , Brussels , Belgium
| | - Daniel Neu
- a Sleep Laboratory and Unit for Chronobiology U78 , Brugmann University Hospital, Université Libre de Bruxelles (U.L.B.) , Brussels Belgium.,e UNI Neuroscience Institute, ULB312 Faculty of Medicine, and ULB388 Faculty of Motor Sciences , Université Libre de Bruxelles (U.L.B.) , Brussels , Belgium
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15
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Léger D, Debellemaniere E, Rabat A, Bayon V, Benchenane K, Chennaoui M. Slow-wave sleep: From the cell to the clinic. Sleep Med Rev 2018; 41:113-132. [DOI: 10.1016/j.smrv.2018.01.008] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 01/02/2018] [Accepted: 01/22/2018] [Indexed: 10/18/2022]
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16
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Pattyn N, Van Cutsem J, Dessy E, Mairesse O. Bridging Exercise Science, Cognitive Psychology, and Medical Practice: Is "Cognitive Fatigue" a Remake of "The Emperor's New Clothes"? Front Psychol 2018; 9:1246. [PMID: 30250436 PMCID: PMC6139359 DOI: 10.3389/fpsyg.2018.01246] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 06/28/2018] [Indexed: 12/30/2022] Open
Abstract
Fatigue is such a multifaceted construct it has sprouted specific research fields and experts in domains as different as exercise physiology, cognitive psychology, human factors and engineering, and medical practice. It lacks a consensus definition: it is an experimental concept, a symptom, a risk, a cause (e.g., of performance decrement) and a consequence (e.g., of sleep deprivation). This fragmentation of knowledge leads to slower dissemination of novel insights, and thus to a poorer research. Indeed, what may seem as a novel result in one field, may very well be old news in another, hence leading to this "innovation" being a scientific equivalent to the emperor's new clothes. The current paper aims to describe the common denominator in the different areas of expertise where fatigue is investigated. Indeed, rather than focusing on the differences in semantics and conceptualization, we hope that identifying common concepts may be inductive of easier multidisciplinary research. Considering the vastness of fatigue research in all areas identified as relevant-cognitive science, exercise physiology, and medical practice, this analysis has not the ambition to be an exhaustive review in all domains. We have reviewed the fatigue concepts and research in these areas and report the ones that are used to describe the proposed common model to be further investigated. The most promising common feature to cognitive science, exercise physiology and clinical practice is the notion of "perceived effort." This allows to account for interindividual differences, as well as for the situational variations in fatigue. It is applicable to both mental and physical constructs. It integrates motivational and emotional dimensions. It overcomes current polemics in various research fields, and it does not draw on any semantic ambiguity. We thus suggest a new model of fatigue and performance, whether this performance is mental or physical; and whether it is in a clinical range or relates to optimal functioning.
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Affiliation(s)
- Nathalie Pattyn
- VIPER Research Unit, Royal Military Academy, Brussels, Belgium
- Department of Experimental and Applied Psychology, Vrije Universiteit Brussel, Brussels, Belgium
- Human Physiology Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jeroen Van Cutsem
- Human Physiology Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Endurance Research Group, University of Kent, Chatham, United Kingdom
| | - Emilie Dessy
- VIPER Research Unit, Royal Military Academy, Brussels, Belgium
- Department of Experimental and Applied Psychology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Olivier Mairesse
- VIPER Research Unit, Royal Military Academy, Brussels, Belgium
- Department of Experimental and Applied Psychology, Vrije Universiteit Brussel, Brussels, Belgium
- Sleep Unit, CHU Brugmann, Brussels, Belgium
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17
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Neu D, Mairesse O, Le Bon O. What about sleep homeostasis in insomnia? Comment on the European guideline for the diagnosis and treatment of insomnia. J Sleep Res 2017; 26:701. [PMID: 29047179 DOI: 10.1111/jsr.12625] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Daniel Neu
- Sleep Laboratory and Unit for Chronobiology U78, Brugmann University Hospital, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium.,UNI Neuroscience Institute, ULB312 Faculty of Medicine, and ULB388 Faculty of Motor Sciences, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium.,Center for the Study of Sleep Disorders, Department of Internal Medicine, Edith Cavell Medical Institute, CHIREC, Brussels, Belgium
| | - Olivier Mairesse
- Sleep Laboratory and Unit for Chronobiology U78, Brugmann University Hospital, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium.,Department EXTO, Vrije Universiteit Brussel (V.U.B.), Brussels, Belgium.,Royal Military Academy, Department LIFE, Brussels, Belgium
| | - Olivier Le Bon
- Department of Psychiatry, Centre Hospitalier de Tivoli, U.L.B., La Louvière, Belgium
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18
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Ronai KZ, Szentkiralyi A, Lazar AS, Lazar ZI, Papp I, Gombos F, Zoller R, Czira ME, Lindner AV, Mucsi I, Bodizs R, Molnar MZ, Novak M. Association of symptoms of insomnia and sleep parameters among kidney transplant recipients. J Psychosom Res 2017; 99:95-104. [PMID: 28712436 DOI: 10.1016/j.jpsychores.2017.05.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 05/15/2017] [Accepted: 05/29/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Insomnia complaints are frequent among kidney transplant (kTx) recipients and are associated with fatigue, depression, lower quality of life and increased morbidity. However, it is not known if subjective insomnia symptoms are associated with objective parameters of sleep architecture. Thus, we analyze the association between sleep macrostructure and EEG activity versus insomnia symptoms among kTx recipients. METHODS Participants (n1=100) were selected from prevalent adult transplant recipients (n0=1214) followed at a single institution. Insomnia symptoms were assessed by the Athens Insomnia Scale (AIS) and standard overnight polysomnography was performed. In a subgroup of patients (n2=56) sleep microstructure was also analyzed with power spectral analysis. RESULTS In univariable analysis AIS score was not associated with sleep macrostructure parameters (sleep latency, total sleep time, slow wave sleep, wake after sleep onset), nor with NREM and REM beta or delta activity in sleep microstructure. In multivariable analysis after controlling for covariables AIS score was independently associated with the proportion of slow wave sleep (β=0.263; CI: 0.026-0.500) and REM beta activity (β=0.323; CI=0.041-0.606) (p<0.05 for both associations). CONCLUSIONS Among kTx recipients the severity of insomnia symptoms is independently associated with higher proportion of slow wave sleep and increased beta activity during REM sleep but not with other parameters sleep architecture. The results suggest a potential compensatory sleep protective mechanism and a sign of REM sleep instability associated with insomnia symptoms among this population.
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Affiliation(s)
- Katalin Z Ronai
- Inst. of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Andras Szentkiralyi
- Inst. of Behavioural Sciences, Semmelweis University, Budapest, Hungary; Inst. of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
| | - Alpar S Lazar
- Inst. of Behavioural Sciences, Semmelweis University, Budapest, Hungary; Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Zsolt I Lazar
- Dept. of Physics, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Istvan Papp
- Dept. of Physics, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Ferenc Gombos
- Dept. of General Psychology, Pázmány Péter Catholic University, Budapest, Hungary
| | - Rezso Zoller
- 1st Dept. of Internal Medicine, Semmelweis University, Budapest, Hungary
| | - Maria E Czira
- Inst. of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
| | - Anett V Lindner
- Klinikum Landkreis Erding, Interdisciplinary Pain Center, Erding, Germany
| | - Istvan Mucsi
- Inst. of Behavioural Sciences, Semmelweis University, Budapest, Hungary; Dept. of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Canada
| | - Robert Bodizs
- Inst. of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Miklos Z Molnar
- Dept. Transplantation and Surgery, Semmelweis University, Budapest, Hungary; Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, TN, USA
| | - Marta Novak
- Inst. of Behavioural Sciences, Semmelweis University, Budapest, Hungary; Centre for Mental Health, University Health Network and Dept. of Psychiatry, University of Toronto, Toronto, Canada.
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19
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Milrad SF, Hall DL, Jutagir DR, Lattie EG, Ironson GH, Wohlgemuth W, Nunez MV, Garcia L, Czaja SJ, Perdomo DM, Fletcher MA, Klimas N, Antoni MH. Poor sleep quality is associated with greater circulating pro-inflammatory cytokines and severity and frequency of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) symptoms in women. J Neuroimmunol 2016; 303:43-50. [PMID: 28038892 DOI: 10.1016/j.jneuroim.2016.12.008] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 12/07/2016] [Accepted: 12/12/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Poor sleep quality has been linked to inflammatory processes and worse disease outcomes in the context of many chronic illnesses, but less is known in conditions such as chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). This study examines the relationships between sleep quality, pro-inflammatory cytokines, and CFS/ME symptoms. METHODS Sixty women diagnosed with CFS/ME were assessed using the Pittsburgh Sleep Quality Index (PSQI), Fatigue Symptom Inventory (FSI) and Center for Disease Control and Prevention (CDC)-based CFS/ME symptom questionnaires. Circulating plasma pro-inflammatory cytokine levels were measured by ELISA. Multiple regression analyses examined associations between sleep, cytokines and symptoms, controlling for age, education, and body mass index. RESULTS Poor sleep quality (PSQI global score) was associated with greater pro-inflammatory cytokine levels: interleukin-1β (IL-1β) (β=0.258, p=0.043), IL-6 (β=0.281, p=0.033), and tumor necrosis factor-alpha (TNF-α) (β=0.263, p=0.044). Worse sleep quality related to greater fatigue severity (β=0.395, p=0.003) and fatigue-related interference with daily activities (β=0.464, p<0.001), and more severe and frequent CDC-defined core CFS/ME symptoms (β=0.499, p<0.001, and β=0.556, p<0.001, respectively). CONCLUSIONS Results underscore the importance of managing sleep-related difficulties in this patient population. Further research is needed to identify the etiology of sleep disruptions in CFS/ME and mechanistic factors linking sleep quality to symptom severity and inflammatory processes.
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Affiliation(s)
- Sara F Milrad
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Miami, FL 33133, USA
| | - Daniel L Hall
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, 55 Fruit St., Boston, MA 02114, USA
| | - Devika R Jutagir
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Miami, FL 33133, USA
| | - Emily G Lattie
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N Lake Shore Dr. Suite 1400, Chicago, IL 60611, USA
| | - Gail H Ironson
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Miami, FL 33133, USA
| | - William Wohlgemuth
- Department of Sleep Medicine, Miami Veteran Affairs Hospital, 1201 NW 16th St, Miami, FL 33125, USA
| | - Maria Vera Nunez
- Institute for Neuro Immune Medicine, Nova Southeastern University, 8501 SW 124th Ave #111, Miami, FL 33183, USA
| | - Lina Garcia
- Department of Psychiatry and Behavioral Sciences, University of Miami, 1120 NW 14th St., Miami, FL 33136, USA
| | - Sara J Czaja
- Department of Psychiatry and Behavioral Sciences, University of Miami, 1120 NW 14th St., Miami, FL 33136, USA
| | - Dolores M Perdomo
- Department of Psychiatry and Behavioral Sciences, University of Miami, 1120 NW 14th St., Miami, FL 33136, USA
| | - Mary Ann Fletcher
- Institute for Neuro Immune Medicine, Nova Southeastern University, 8501 SW 124th Ave #111, Miami, FL 33183, USA
| | - Nancy Klimas
- Institute for Neuro Immune Medicine, Nova Southeastern University, 8501 SW 124th Ave #111, Miami, FL 33183, USA
| | - Michael H Antoni
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Miami, FL 33133, USA.
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20
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Frontier studies on fatigue, autonomic nerve dysfunction, and sleep-rhythm disorder. J Physiol Sci 2015; 65:483-98. [PMID: 26420687 PMCID: PMC4621713 DOI: 10.1007/s12576-015-0399-y] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 09/01/2015] [Indexed: 12/30/2022]
Abstract
Fatigue is defined as a condition or phenomenon of decreased ability and efficiency of mental and/or physical activities, caused by excessive mental or physical activities, diseases, or syndromes. It is often accompanied by a peculiar sense of discomfort, a desire to rest, and reduced motivation, referred to as fatigue sensation. Acute fatigue is a normal condition or phenomenon that disappears after a period of rest; in contrast, chronic fatigue, lasting at least 6 months, does not disappear after ordinary rest. Chronic fatigue impairs activities and contributes to various medical conditions, such as cardiovascular disease, epileptic seizures, and death. In addition, many people complain of chronic fatigue. For example, in Japan, more than one third of the general adult population complains of chronic fatigue. It would thus be of great value to clarify the mechanisms underlying chronic fatigue and to develop efficient treatment methods to overcome it. Here, we review data primarily from behavioral, electrophysiological, and neuroimaging experiments related to neural dysfunction as well as autonomic nervous system, sleep, and circadian rhythm disorders in fatigue. These data provide new perspectives on the mechanisms underlying chronic fatigue and on overcoming it.
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