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Koutsonida M, Psyhogiou M, Aretouli E, Tsilidis KK. Sleep Quality and Cognitive Abilities in the Greek Cohort of Epirus Health Study. Nat Sci Sleep 2024; 16:33-42. [PMID: 38249621 PMCID: PMC10800107 DOI: 10.2147/nss.s436519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/03/2024] [Indexed: 01/23/2024] Open
Abstract
Purpose Sleep is essential to all human body functions as well as brain functions. Inadequate sleep quantity and poor sleep quality have been shown to directly affect cognitive functioning and especially memory. The primary aim of the present study was to investigate the association of sleep quality with cognitive abilities cross-sectionally in a middle-aged Greek population and secondarily to examine this association prospectively in a smaller group of these participants. Patients and Methods A total of 2112 healthy adults aged 25-70 years (mean: 46.7±11.5) from the Epirus Health Study cohort were included in the analysis and 312 of them participated in secondary prospective analysis. Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI) scale and cognition was assessed in primary cross-sectional analyses with three neuropsychological tests, namely the Verbal Fluency test, the Logical Memory test and the Trail Making test, and in secondary prospective analyses with online versions of Posner cueing task, an emotional recognition task, the Corsi block-tapping task and the Stroop task. Statistical analysis was performed using multivariable linear regression models adjusted for age, sex, education, body mass index and alcohol consumption. Results Attention/processing speed was the only cognitive domain associated cross-sectionally with PSQI score. Specifically, participants with better self-reported sleep quality performed faster on the Trail Making Test - Part A (β= 0.272 seconds, 95% CI 0.052, 0.493). Conclusion Further studies are needed to clarify the association of sleep quality with cognition, especially in middle-aged people that are still in productive working years.
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Affiliation(s)
- Myrto Koutsonida
- Department of Hygiene and Epidemiology, University of Ioannina, School of Medicine, Ioannina, Greece
| | - Maria Psyhogiou
- Interdisciplinary Department 10B, General Hospital “Evaggelismos”, Athens, Greece
| | - Eleni Aretouli
- Department of Psychology, School of Social Sciences, University of Ioannina, Ioannina, Greece
| | - Konstantinos K Tsilidis
- Department of Hygiene and Epidemiology, University of Ioannina, School of Medicine, Ioannina, Greece
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
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Yan W, Hou D, Li Z, Tang W, Han X, Tang Y. Reduced left hippocampal perfusion is associated with insomnia in patients with cerebral small vessel disease. CNS Spectr 2023; 28:702-709. [PMID: 37095715 DOI: 10.1017/s1092852923002250] [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] [Indexed: 04/26/2023]
Abstract
OBJECTIVES Insomnia was associated with cerebral structural changes and Alzheimer's disease. However, associations among cerebral perfusion, insomnia with cerebral small vessel disease (CSVD), and cognitive performance were little investigated. METHODS This cross-sectional study included 89 patients with CSVDs and white matter hyperintensities (WMHs). They were dichotomized into the normal sleep and poor sleep group, according to Pittsburgh sleep quality index (PSQI). Baseline characteristics, cognitive performance, and cerebral blood flow (CBF) were measured and compared between the two groups. The association or correlation between cerebral perfusion, cognition, and insomnia was analyzed using binary logistic regression. RESULTS Our study found that declined MoCA score (P = .0317) was more prevalent in those with poor sleep. There was a statistical difference in the recall (P = .0342) of MMSE, the delayed recall (P = .0289) of MoCA between the two groups. Logistic regression analysis showed educational background (P < .001) and insomnia severity index (ISI) score (P = .039) were independently correlated with MoCA scores. Arterial spin labeling demonstrated that left hippocampal gray matter perfusion was significantly reduced (P = .0384) in the group with poor sleep. And, negative correlation was found between left hippocampal perfusion and PSQI scores. CONCLUSIONS In the patients with CSVDs, insomnia severity was associated with cognitive decline. Left hippocampal gray matter perfusion was correlated with PSQI scores in CSVDs.
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Affiliation(s)
- Wei Yan
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Duanlu Hou
- Department of Neurology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China
| | - Zhixin Li
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Weijun Tang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiang Han
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yuping Tang
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
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Ai JY, Kuan G, Juang LYT, Lee CH, Kueh YC, Chu IH, Geng XL, Chang YK. Effects of Multi-Component Exercise on Sleep Quality in Middle-Aged Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15472. [PMID: 36497548 PMCID: PMC9737228 DOI: 10.3390/ijerph192315472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/28/2022] [Accepted: 11/10/2022] [Indexed: 06/17/2023]
Abstract
Sleep is a crucial factor in healthy aging. However, most middle-aged adults experience high levels of sleep disorders. While previous findings have suggested exercise training could benefit the quality of sleep, the effects of multi-component exercise on sleep quality are less examined. Accordingly, the current study aimed to assess the effectiveness of a multi-component exercise program on the quality of sleep among middle-aged adults. Twenty-four middle-aged adults were randomly assigned either to a multi-component exercise (MCE) group or a control group. The participants in the MCE group attended a 90-min session per week for 12 weeks. The control group was instructed to maintain their daily routine for 12 weeks. The primary outcome was the sleep quality evaluated by the Pittsburgh Sleep Quality Index (PSQI). The secondary outcome was physical fitness, including muscular strength and endurance, balance, and flexibility. Regarding sleep quality, the global mean score (p = 028), sleep disturbances (p = 011), and sleep efficiency (p = 035) of the PSQI scores were significantly reduced in the MCE group after the 12-week intervention. Regarding physical fitness, the flexibility of the MCE group improved significantly after the intervention (p = 028), yet, no significant change was observed in the control group. Additionally, the muscular strength of the control group declined significantly after the 12-week period (p = 034). Our results revealed the effectiveness of the MCE intervention in improving sleep quality and physical fitness in middle-aged adults. Further studies using larger sample sizes, objective measures of sleep quality, different types of exercise training, as well as different populations, are warranted to extend our current findings.
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Affiliation(s)
- Jing-Yi Ai
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei 106209, Taiwan
| | - Garry Kuan
- Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Linda Ya-Ting Juang
- Lifestyles of Health and Sustainability Executive Master of Business Administration, National Taiwan Normal University, Taipei 106209, Taiwan
| | - Ching-Hsiu Lee
- Lifestyles of Health and Sustainability Executive Master of Business Administration, National Taiwan Normal University, Taipei 106209, Taiwan
| | - Yee-Cheng Kueh
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - I-Hua Chu
- Department of Sports Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
- College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Xiao-Ling Geng
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei 106209, Taiwan
- Department of Wushu, Hong Kong Sports Institute, Hong Kong 999077, China
| | - Yu-Kai Chang
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei 106209, Taiwan
- Institute for Research Excellence in Learning Science, National Taiwan Normal University, Taipei 106209, Taiwan
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Malcom DR. The Power of Sleep to Transform Learning and Knowledge Retention. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2022; 86:8915. [PMID: 34716139 PMCID: PMC10159460 DOI: 10.5688/ajpe8915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 10/19/2021] [Indexed: 05/06/2023]
Affiliation(s)
- Daniel R Malcom
- Sullivan University, College of Pharmacy and Health Sciences, Louisville, Kentucky
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Zhang W, Liu Y, Yu J, Li D, Jia Y, Zhang Q, Gao Y, Wan Z, Wei W. Exercise improves sleep quality in older adults: a protocol for a systematic review and meta-analysis. BMJ Open 2022; 12:e047555. [PMID: 35105610 PMCID: PMC8804655 DOI: 10.1136/bmjopen-2020-047555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 01/07/2022] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Sleep disturbance is a common problem among the elderly and is associated with physical and mental health. Exercise has been reported as an alternative therapeutic strategy for people with sleep disturbances. However, this topic has not been systematically reviewed for older adults. This study was conducted to provide a protocol to systematically evaluate the effects of exercise on sleep quality in the elderly. METHODS AND ANALYSIS An electronic search of the PubMed, Embase and Cochrane Library databases will be performed with no language restrictions, and data extraction will be performed by two independent reviewers. The reviewers will discuss and resolve any differences, and a third reviewer will be consulted in cases of uncertainty. Randomised controlled trials will be selected. The primary outcome will be an objective measurement of sleep quality (eg, polysomnography). The secondary outcomes will be self-reported sleep quality (using the Pittsburgh Sleep Quality Index scale), and adverse events (such as falls and fractures). RevMan V.5.3.5 and Stata V.16.0 software will be used for meta-analysis. If the heterogeneity tests show slight or no statistical heterogeneity, the fixed effects model will be used; in other cases, the random effect model will be used for data synthesis. ETHICS AND DISSEMINATION The protocol does not require ethical approval. The findings will be disseminated in peer-reviewed publications and journals. PROSPERO REGISTRATION NUMBER CRD42021287980.
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Affiliation(s)
- Wei Zhang
- Department of Emergency Medicine, Disaster Medical Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- School of Nursing, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Institute of Disaster Medicine, Sichuan University, Chengdu, People's Republic of China
- Nursing Key Laboratory of Sichuan Province, Chengdu, People's Republic of China
| | - Yi Liu
- Department of Emergency Medicine, Disaster Medical Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- School of Nursing, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Institute of Disaster Medicine, Sichuan University, Chengdu, People's Republic of China
- Nursing Key Laboratory of Sichuan Province, Chengdu, People's Republic of China
| | - Jing Yu
- School of Nursing, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Institute of Disaster Medicine, Sichuan University, Chengdu, People's Republic of China
- Nursing Key Laboratory of Sichuan Province, Chengdu, People's Republic of China
| | - Dongze Li
- Department of Emergency Medicine, Disaster Medical Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yu Jia
- Department of Emergency Medicine, Disaster Medical Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Qin Zhang
- Department of Emergency Medicine, Disaster Medical Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- School of Nursing, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Institute of Disaster Medicine, Sichuan University, Chengdu, People's Republic of China
- Nursing Key Laboratory of Sichuan Province, Chengdu, People's Republic of China
| | - Yongli Gao
- Department of Emergency Medicine, Disaster Medical Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- School of Nursing, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Institute of Disaster Medicine, Sichuan University, Chengdu, People's Republic of China
- Nursing Key Laboratory of Sichuan Province, Chengdu, People's Republic of China
| | - Zhi Wan
- Department of Emergency Medicine, Disaster Medical Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Wei Wei
- Department of Emergency Medicine, Disaster Medical Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
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Sleep Disturbances in Patients with Persistent Delusions: Prevalence, Clinical Associations, and Therapeutic Strategies. Clocks Sleep 2020; 2:399-415. [PMID: 33118525 PMCID: PMC7711969 DOI: 10.3390/clockssleep2040030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/12/2020] [Accepted: 10/12/2020] [Indexed: 11/17/2022] Open
Abstract
Sleep disturbances accompany almost all mental illnesses, either because sound sleep and mental well-being share similar requisites, or because mental problems lead to sleep problems, or vice versa. The aim of this narrative review was to examine sleep in patients with delusions, particularly in those diagnosed with delusional disorder. We did this in sequence, first for psychiatric illness in general, then for psychotic illnesses where delusions are prevalent symptoms, and then for delusional disorder. The review also looked at the effect on sleep parameters of individual symptoms commonly seen in delusional disorder (paranoia, cognitive distortions, suicidal thoughts) and searched the evidence base for indications of antipsychotic drug effects on sleep. It subsequently evaluated the influence of sleep therapies on psychotic symptoms, particularly delusions. The review’s findings are clinically important. Delusional symptoms and sleep quality influence one another reciprocally. Effective treatment of sleep problems is of potential benefit to patients with persistent delusions, but may be difficult to implement in the absence of an established therapeutic relationship and an appropriate pharmacologic regimen. As one symptom can aggravate another, comorbidities in patients with serious mental illness all need to be treated, a task that requires close liaison among medical specialties.
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