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Wenzel C, Liebig T, Swoboda A, Smolareck R, Schlagheck ML, Walzik D, Groll A, Goulding RP, Zimmer P. Machine learning predicts peak oxygen uptake and peak power output for customizing cardiopulmonary exercise testing using non-exercise features. Eur J Appl Physiol 2024:10.1007/s00421-024-05543-x. [PMID: 38958720 DOI: 10.1007/s00421-024-05543-x] [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: 03/28/2024] [Accepted: 06/22/2024] [Indexed: 07/04/2024]
Abstract
PURPOSE Cardiopulmonary exercise testing (CPET) is considered the gold standard for assessing cardiorespiratory fitness. To ensure consistent performance of each test, it is necessary to adapt the power increase of the test protocol to the physical characteristics of each individual. This study aimed to use machine learning models to determine individualized ramp protocols based on non-exercise features. We hypothesized that machine learning models will predict peak oxygen uptake ( V ˙ O2peak) and peak power output (PPO) more accurately than conventional multiple linear regression (MLR). METHODS The cross-sectional study was conducted with 274 (♀168, ♂106) participants who performed CPET on a cycle ergometer. Machine learning models and multiple linear regression were used to predict V ˙ O2peak and PPO using non-exercise features. The accuracy of the models was compared using criteria such as root mean square error (RMSE). Shapley additive explanation (SHAP) was applied to determine the feature importance. RESULTS The most accurate machine learning model was the random forest (RMSE: 6.52 ml/kg/min [95% CI 5.21-8.17]) for V ˙ O2peak prediction and the gradient boosting regression (RMSE: 43watts [95% CI 35-52]) for PPO prediction. Compared to the MLR, the machine learning models reduced the RMSE by up to 28% and 22% for prediction of V ˙ O2peak and PPO, respectively. Furthermore, SHAP ranked body composition data such as skeletal muscle mass and extracellular water as the most impactful features. CONCLUSION Machine learning models predict V ˙ O2peak and PPO more accurately than MLR and can be used to individualize CPET protocols. Features that provide information about the participant's body composition contribute most to the improvement of these predictions. TRIAL REGISTRATION NUMBER DRKS00031401 (6 March 2023, retrospectively registered).
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Affiliation(s)
- Charlotte Wenzel
- Institute for Sport and Sport Science, Performance and Health (Sports Medicine), TU Dortmund University, Dortmund, Germany
| | - Thomas Liebig
- Institute for Computer Science, Department of Artificial Intelligence, TU Dortmund University, Dortmund, Germany
| | - Adrian Swoboda
- Institute for Training Optimization for Sport and Health, iQ Athletik, Frankfurt am Main, Germany
| | - Rika Smolareck
- Institute for Sport and Sport Science, Performance and Health (Sports Medicine), TU Dortmund University, Dortmund, Germany
| | - Marit L Schlagheck
- Institute for Sport and Sport Science, Performance and Health (Sports Medicine), TU Dortmund University, Dortmund, Germany
| | - David Walzik
- Institute for Sport and Sport Science, Performance and Health (Sports Medicine), TU Dortmund University, Dortmund, Germany
| | - Andreas Groll
- Department of Statistics, Statistical Methods for Big Data, TU Dortmund University, Dortmund, Germany
| | - Richie P Goulding
- Faculty of Behavioral and Movement Sciences, Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Philipp Zimmer
- Institute for Sport and Sport Science, Performance and Health (Sports Medicine), TU Dortmund University, Dortmund, Germany.
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Ji W, Nightingale TE, Zhao F, Fritz NE, Phillips AA, Sisto SA, Nash MS, Badr MS, Wecht JM, Mateika JH, Panza GS. The Clinical Relevance of Autonomic Dysfunction, Cerebral Hemodynamics, and Sleep Interactions in Individuals Living With SCI. Arch Phys Med Rehabil 2024; 105:166-176. [PMID: 37625532 DOI: 10.1016/j.apmr.2023.08.006] [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: 05/31/2023] [Revised: 07/25/2023] [Accepted: 08/06/2023] [Indexed: 08/27/2023]
Abstract
A myriad of physiological impairments is seen in individuals after a spinal cord injury (SCI). These include altered autonomic function, cerebral hemodynamics, and sleep. These physiological systems are interconnected and likely insidiously interact leading to secondary complications. These impairments negatively influence quality of life. A comprehensive review of these systems, and their interplay, may improve clinical treatment and the rehabilitation plan of individuals living with SCI. Thus, these physiological measures should receive more clinical consideration. This special communication introduces the under investigated autonomic dysfunction, cerebral hemodynamics, and sleep disorders in people with SCI to stakeholders involved in SCI rehabilitation. We also discuss the linkage between autonomic dysfunction, cerebral hemodynamics, and sleep disorders and some secondary outcomes are discussed. Recent evidence is synthesized to make clinical recommendations on the assessment and potential management of important autonomic, cerebral hemodynamics, and sleep-related dysfunction in people with SCI. Finally, a few recommendations for clinicians and researchers are provided.
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Affiliation(s)
- Wenjie Ji
- Department of Rehabilitation Science, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY
| | - Tom E Nightingale
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK; Centre for Trauma Science Research, University of Birmingham, Birmingham, UK; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
| | - Fei Zhao
- Department of Health Care Sciences, Program of Occupational Therapy, Wayne State University, Detroit, MI; John D. Dingell VA Medical Center, Research and Development, Detroit, MI
| | - Nora E Fritz
- Department of Health Care Sciences, Program of Physical Therapy, Detroit, MI; Department of Neurology, Wayne State University, Detroit, MI
| | - Aaron A Phillips
- Department of Physiology and Pharmacology, Cardiac Sciences, Clinical Neurosciences, Biomedical Engineering, Libin Cardiovascular institute, Hotchkiss Brain Institute, Cumming School of Medicine, Calgary, AB, Canada; RESTORE.network, University of Calgary, Calgary, AB, Canad
| | - Sue Ann Sisto
- Department of Rehabilitation Science, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY
| | - Mark S Nash
- Department of Neurological Surgery, Physical Medicine & Rehabilitation Physical Therapy, Miami, FL; Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL
| | - M Safwan Badr
- John D. Dingell VA Medical Center, Research and Development, Detroit, MI; Departments of Physiology and Internal Medicine, Wayne State University, Detroit, MI
| | - Jill M Wecht
- James J Peters VA Medical Center, Department of Spinal Cord Injury Research, Bronx, NY; Icahn School of Medicine Mount Sinai, Departments of Rehabilitation and Human Performance, and Medicine Performance, and Medicine, New York, NY
| | - Jason H Mateika
- John D. Dingell VA Medical Center, Research and Development, Detroit, MI; Departments of Physiology and Internal Medicine, Wayne State University, Detroit, MI
| | - Gino S Panza
- Department of Health Care Sciences, Program of Occupational Therapy, Wayne State University, Detroit, MI; John D. Dingell VA Medical Center, Research and Development, Detroit, MI.
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LaGoy AD, Conkright WR, Proessl F, Sinnott AM, Beckner ME, Jabloner L, Eagle SR, Sekel NM, Roma PG, Dretsch MN, Flanagan SD, Mi Q, Nindl BC, Germain A, Connaboy C, Ferrarelli F. Less daytime sleepiness and slow wave activity during sleep predict better physical readiness in military personnel. Sleep Health 2023; 9:93-99. [PMID: 36503874 DOI: 10.1016/j.sleh.2022.10.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 10/13/2022] [Accepted: 10/30/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Military personnel must maintain physical performance despite exposure to operational stressors such as sleep loss, caloric restriction and high cognitive load. Habitual sleep and specific sleep features are positively associated with fitness and may contribute to physical performance in operational settings. Further, by affecting muscle recovery, sleep may contribute to the ability to maintain performance across multiple days of exposure to operational stressors. OBJECTIVES We examined the role of individual differences in baseline sleep on baseline physical performance and on change in physical performance throughout exposure to simulated military operational stress (SMOS). METHODS Military personnel (36 male, 9 female, 26.3 ± 5.3 years) completed a 5-day SMOS protocol during which they completed a tactical mobility test daily. Sleep questionnaires were administered at intake and sleep was monitored each night with polysomnography. Lasso regressions were used to identify meaningful predictors of physical performance at baseline and of change in physical performance across SMOS. RESULTS Better aerobic fitness, lower daytime sleepiness (Epworth Sleepiness Scale), and lower absolute slow wave activity (0.5-4 Hz) predicted better physical performance at baseline (66.1% of variance explained), but did not relate to changes in performance. CONCLUSIONS Collectively, higher daytime sleepiness and slow wave activity may reflect more chronic exposure to insufficient sleep and higher baseline sleep drive, which in turn led to compromised physical performance. The findings suggest that low self-report sleepiness and low objective slow wave activity may reflect two quantifiable markers of healthy sleep behaviors that have implications for operational performance.
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Affiliation(s)
- Alice D LaGoy
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - William R Conkright
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Felix Proessl
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Aaron M Sinnott
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Meaghan E Beckner
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Leslie Jabloner
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Shawn R Eagle
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Nicole M Sekel
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Peter G Roma
- Behavioral Health & Performance Laboratory, Biomedical Research and Environmental Sciences Division, Human Health and Performance Directorate, NASA Johnson Space Center/KBR, Houston, Texas, USA
| | - Michael N Dretsch
- U.S. Army Medical Research Directorate-West, Walter Reed Army Institute of Research, Joint Base Lewis-McChord, Washington, USA
| | - Shawn D Flanagan
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Qi Mi
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Bradley C Nindl
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Anne Germain
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Christopher Connaboy
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Fabio Ferrarelli
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
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Castelli L, Walzik D, Joisten N, Watson M, Montaruli A, Oberste M, Roveda E, Zimmer P. Effect of sleep and fatigue on cardiovascular performance in young, healthy subjects. Physiol Behav 2022; 256:113963. [PMID: 36108801 DOI: 10.1016/j.physbeh.2022.113963] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/23/2022] [Accepted: 09/10/2022] [Indexed: 11/19/2022]
Abstract
Physical performance could be negatively affected by sleep deficiency and fatigue. The present study assesses the role of sleep quality, fatigue and motivation on cardiovascular performance (VO2peak, Wmax, and HRmax) in a sample of active young subjects. The current study is a cross-sectional design. Ninety-six university students (males 54.2%; 21.5 ± 2.9 yrs) completed an incremental exercise test on a bicycle ergometer. Sleep, fatigue, and motivation were assessed with the Pittsburgh Sleep Quality Index and two visual analogue scales, respectively. Differences in VO2peak, Wmax, HRmax, self-perceived fatigue and motivation were compared between good and bad sleepers and sleep duration >/<7.5 h, while regression analysis defined the predictors of VO2peak, Wmax, and HRmax. In the male sample, good and bad sleepers' differences were significant only for self-perceived fatigue (p = 0.04). The female sample showed no statistically significant differences between good and bad sleepers and different sleep durations. In the male sample, linear regression analysis showed a significant inverse correlation between Wmax and the PSQI score (-0.4, p = 0.004). The stepwise regression model indicated that sleep (β = -0.3, p = 0.02) was a significant predictor of VO2peak in males accounting for 20% of the variance, whereas physical performance seems more affected by fatigue (β = -0.4, p = 0.03) in females. In conclusion, chronic inadequate and self-reported sleep quality seems to be one of the factors compromising cardiovascular performance in males.
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Affiliation(s)
- Lucia Castelli
- Department of Biomedical Sciences for Health, University of Milan, Via Giuseppe Colombo 71, 20133 Milan, Italy
| | - David Walzik
- Division for Performance and Health (Sports Medicine), Institute for Sport and Sport Science, TU Dortmund University Otto‑Hahn‑Straße, 344227 Dortmund, Germany
| | - Niklas Joisten
- Division for Performance and Health (Sports Medicine), Institute for Sport and Sport Science, TU Dortmund University Otto‑Hahn‑Straße, 344227 Dortmund, Germany
| | - Matthew Watson
- Institute of Psychology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
| | - Angela Montaruli
- Department of Biomedical Sciences for Health, University of Milan, Via Giuseppe Colombo 71, 20133 Milan, Italy; IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy
| | - Max Oberste
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Medical Statistics and Computational Biology, Cologne, Germany
| | - Eliana Roveda
- Department of Biomedical Sciences for Health, University of Milan, Via Giuseppe Colombo 71, 20133 Milan, Italy; IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy
| | - Philipp Zimmer
- Division for Performance and Health (Sports Medicine), Institute for Sport and Sport Science, TU Dortmund University Otto‑Hahn‑Straße, 344227 Dortmund, Germany.
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Arentson-Lantz EJ, Deer RR, Kokonda M, Wen CL, Pecha TA, Carreon SA, Ngyen TM, Volpi E, Nowakowski S. Improvements in sleep quality and fatigue are associated with improvements in functional recovery following hospitalization in older adults. FRONTIERS IN SLEEP 2022; 1:1011930. [PMID: 37251511 PMCID: PMC10217784 DOI: 10.3389/frsle.2022.1011930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Study objectives Poor sleep quality, a frequent problem in older adults, has been shown to be associated with reduced physical function and wellbeing. However, little is known about the relationship between sleep quality and the recovery of physical function following hospitalization. Thus, we conducted this study to examine the association between sleep quality and functional recovery after an acute hospitalization in community dwelling older adults. Methods Older adult patients (N = 23, mean age = 74 ± 9 years) were recruited during an acute hospitalization (average length of stay 3.9 days) with a cardiovascular (56%), pulmonary (22%), or metabolic (13%) admission diagnosis. Objective physical function was measured using the Short Physical Performance Battery (SPPB) and self-reported function was assessed with Katz Index of Independence in Activities of Daily Living (ADL) and Lawton Instrumental Activities of Daily Living Scale (IADL). Sleep quality was measured using Pittsburgh Sleep Quality Index (PSQI) global score and Iowa Fatigue Score (IFS). Testing was performed prior to discharge (baseline) and 4-weeks post-discharge (follow-up). Results Regression models showed PSQI Subjective Sleep Quality change scores from baseline to 4-week follow-up predicted a change in ADL (β = -0.22); PSQI Use of Sleep Medications change scores predicted a change in SPPB Total (β = 1.62) and SPPB Chair Stand (β = 0.63); IFS change scores predicted SPPB Total (β = -0.16) and SPPB Chair Stand performance (β = -0.07) change scores. Conclusions For older adults, changes in sleep medication use, daytime dysfunction, and fatigue were associated with improvements in functional recovery (including physical performance and independence) from acute hospitalization to 4-week follow-up. These results suggest that interventions focused on improving sleep quality, daytime consequences, and fatigue might help enhance physical functioning following hospitalization. Clinical trial registration ClinicalTrials.gov, identifier: NCT02203656.
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Affiliation(s)
- Emily J. Arentson-Lantz
- Department of Nutrition, Metabolism, and Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX, United States
| | - Rachel R. Deer
- Department of Nutrition, Metabolism, and Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX, United States
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, United States
| | - Manasa Kokonda
- Center for Innovation in Quality, Effectiveness, and Safety, Michael DeBakey VA Medical Center, Houston, TX, United States
- Department of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Chelsey L. Wen
- School of Public Health, University of Texas Health Science Center, Houston, TX, United States
| | - Thomas A. Pecha
- School of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Samantha A. Carreon
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Trung M. Ngyen
- School of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Elena Volpi
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, United States
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, United States
| | - Sara Nowakowski
- Department of Nutrition, Metabolism, and Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX, United States
- Center for Innovation in Quality, Effectiveness, and Safety, Michael DeBakey VA Medical Center, Houston, TX, United States
- Department of Medicine, Baylor College of Medicine, Houston, TX, United States
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Mirzaei-Azandaryani Z, Abdolalipour S, Mirghafourvand M. The effect of vitamin D on sleep quality: A systematic review and meta-analysis. Nutr Health 2022; 28:515-526. [PMID: 35578558 DOI: 10.1177/02601060221082367] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Poor sleep quality is a common problem in the general population that affects the quality of life of individuals. Aim: This systematic review aimed to determine the effect of vitamin D on sleep quality (primary outcome) and side effects (secondary outcome). Methods: A systematic search was performed using Cochrane Library, PubMed, Embase, Web of Sciences, Scopus, Google Scholar, SID, and Magiran databases with no limit at the time of publication. Cochrane collaboration instrument was used to evaluate the quality of the included studies. RevMan software was used for meta-analysis. Mean Difference was calculated due to the same sleep quality measurement tools in all studies. Heterogeneity of studies was assessed using I-squared (I2). Due to high heterogeneity (I2 > 75%), Random Effect was used instead of Fixed Effect. Results: Out of a total of 1637 titles and abstracts found, after removing duplicate items (23 items), 1596 items were removed due to irrelevance and lack of inclusion criteria. 18 articles were fully studied due to insufficient abstract information and finally, 5 articles were entered into systematic review and meta-analysis. The results of the meta-analysis showed that the use of vitamin D supplementation significantly improves sleep quality (MD: -1.32; 95%CI: -2.55 to -0.09; P = 0.04). Conclusions: Also, according to the findings of this study, receiving vitamin D supplementation did not cause any side effects. According to the results of this review study, sleep quality in people receiving vitamin D significantly improved compared to the control group.
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Affiliation(s)
- Zahra Mirzaei-Azandaryani
- Department of Midwifery, Students Research Committee, Faculty of Nursing and Midwifery, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Somyieh Abdolalipour
- Department of Midwifery, Faculty of Nursing and Midwifery, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Faculty of Nursing and Midwifery, Social determinants of Health Research Center, 48432Tabriz University of Medical Sciences, Tabriz, Iran
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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] [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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Yao Y, Jia Y, Wen Y, Cheng B, Cheng S, Liu L, Yang X, Meng P, Chen Y, Li C, Zhang J, Zhang Z, Pan C, Zhang H, Wu C, Wang X, Ning Y, Wang S, Zhang F. Genome-Wide Association Study and Genetic Correlation Scan Provide Insights into Its Genetic Architecture of Sleep Health Score in the UK Biobank Cohort. Nat Sci Sleep 2022; 14:1-12. [PMID: 35023977 PMCID: PMC8747788 DOI: 10.2147/nss.s326818] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 12/19/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Most previous genetic studies of sleep behaviors were conducted individually, without comprehensive consideration of the complexity of various sleep behaviors. Our aim is to identify the genetic architecture and potential biomarker of the sleep health score, which more powerfully represents overall sleep traits. PATIENTS AND METHODS We conducted a genome-wide association study (GWAS) of sleep health score (overall assessment of sleep duration, snoring, insomnia, chronotype, and daytime dozing) using 336,463 participants from the UK Biobank. Proteome-wide association study (PWAS) and transcriptome-wide association study (TWAS) were then performed to identify candidate genes at the protein and mRNA level, respectively. We finally used linkage disequilibrium score regression (LDSC) to estimate the genetic correlations between sleep health score and other functionally relevance traits. RESULTS GWAS identified multiple variants near known candidate genes associated with sleep health score, such as MEIS1, FBXL13, MED20 and SMAD5. HDHD2 (PPWAS = 0.0146) and GFAP (PPWAS = 0.0236) were identified associated with sleep health score by PWAS. TWAS identified ORC4 (PTWAS = 0.0212) and ZNF732 (PTWAS = 0.0349) considering mRNA expression level. LDSC found significant genetic correlations of sleep health score with 3 sleep behaviors (including insomnia, snoring, dozing), 4 psychiatry disorders (major depressive disorder, attention deficit/hyperactivity disorder, schizophrenia, autism spectrum disorder), and 9 plasma protein (such as Stabilin-1, Stromelysin-2, Cytochrome c) (all LDSC PLDSC < 0.05). CONCLUSION Our results advance the comprehensive understanding of the aetiology and genetic architecture of the sleep health score, refine the understanding of the relationship of sleep health score with other traits and diseases, and may serve as potential targets for future mechanistic studies of sleep phenotype.
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Affiliation(s)
- Yao Yao
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Yumeng Jia
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Yan Wen
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Bolun Cheng
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Shiqiang Cheng
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Li Liu
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Xuena Yang
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Peilin Meng
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Yujing Chen
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Chun'e Li
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Jingxi Zhang
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Zhen Zhang
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Chuyu Pan
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Huijie Zhang
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Cuiyan Wu
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Xi Wang
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Yujie Ning
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Sen Wang
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
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Papadakis Z, Forsse JS, Peterson MN. Effects of High-Intensity Interval Exercise and Acute Partial Sleep Deprivation on Cardiac Autonomic Modulation. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2021; 92:824-842. [PMID: 32841103 DOI: 10.1080/02701367.2020.1788206] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 06/13/2020] [Indexed: 06/11/2023]
Abstract
Sleep deprivation in healthy adults has been associated with disrupted autonomic nervous system function, which in turn has been linked to cardiovascular health. High-intensity interval exercise (HIIE) may affect both sleep and cardiac autonomic modulation. Purpose: To investigate the impact of acute partial sleep deprivation on autonomic cardiac regulation before and after an acute bout of HIIE and the length of time for the autonomic system to return to resting levels. Methods: Fifteen healthy males with body mass index (BMI) of 25.8 ± 2.7 kg·m-2 and age 31 ± 5 y participated in a reference sleep (~9.5 hr) with no HIIE (RS), a reference sleep with HIIE (RSX), and an acute partial sleep deprivation (~3.5 hr) with HIIE (SDX). HIIE was performed in 3:2 intervals at 90% and 40% of VO2 reserve. Autonomic regulation through HRV selected time and frequency domain indices were recorded the night before, the morning of the next day, 1 hr-, 2 hr-, 4hr-, and 6-hr post-exercise. Results: HIIE performed in a 3:2 W:R ratio decreased the HRV (p < .05) at 1-hr post exercise and it took up to 4 hr to return to baseline levels. Parasympathetic related HRV indices increased the morning of the next day for SDX (p < .05). Acute partial sleep deprivation and HIIE did not modify the HRV responses compared to reference sleep and HIIE. Conclusion: HRV disturbance typically seen in responses to an acute episode of HIIE is not influenced by acute partial sleep deprivation.
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Panza GS, Sutor T, Gee CM, Graco M, McCully KK, Chiodo A, Badr MS, Nash MS. Is Sleep Disordered Breathing Confounding Rehabilitation Outcomes in Spinal Cord Injury Research? Arch Phys Med Rehabil 2021; 103:1034-1045. [PMID: 34537222 DOI: 10.1016/j.apmr.2021.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 08/24/2021] [Indexed: 11/02/2022]
Abstract
The purpose of this article is to highlight the importance of considering sleep-disordered breathing (SDB) as a potential confounder to rehabilitation research interventions in spinal cord injury (SCI). SDB is highly prevalent in SCI, with increased prevalence in individuals with higher and more severe lesions, and the criterion standard treatment with continuous positive airway pressure remains problematic. Despite its high prevalence, SDB is often untested and untreated in individuals with SCI. In individuals without SCI, SDB is known to negatively affect physical function and many of the physiological systems that negatively affect physical rehabilitation in SCI. Thus, owing to the high prevalence, under testing, low treatment adherence, and known negative effect on the physical function, it is contended that underdiagnosed SDB in SCI may be confounding physical rehabilitation research studies in individuals with SCI. Studies investigating the effect of treating SDB and its effect on physical rehabilitation in SCI were unable to be located. Thus, studies investigating the likely integrated relationship among physical rehabilitation, SDB, and proper treatment of SDB in SCI are needed. Owing to rapid growth in both sleep medicine and physical rehabilitation intervention research in SCI, the authors contend it is the appropriate time to begin the conversations and collaborations between these fields. We discuss a general overview of SDB and physical training modalities, as well as how SDB could be affecting these studies.
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Affiliation(s)
- Gino S Panza
- John D. Dingell Veterans Affairs Medical Center, Detroit, MI; Department of Physiology, Wayne State University School of Medicine, Detroit, MI.
| | - Tommy Sutor
- Research Service, Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VA
| | - Cameron M Gee
- International Collaboration on Repair Discoveries, Vancouver, BC, Canada
| | - Marnie Graco
- Institute for Breathing and Sleep, Austin Health; and School of Physiotherapy, University of Melbourne, Melbourne, Australia
| | | | - Anthony Chiodo
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - M Safwan Badr
- John D. Dingell Veterans Affairs Medical Center, Detroit, MI; Department of Internal Medicine, Wayne State University School of Medicine, Detroit, MI
| | - Mark S Nash
- Department of Neurological Surgery, Physical Medicine & Rehabiliation, and Physical Therapy, Miami, FL; The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL
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11
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Remchak MME, Piersol KL, Bhatti S, Spaeth AM, Buckman JF, Malin SK. Considerations for Maximizing the Exercise "Drug" to Combat Insulin Resistance: Role of Nutrition, Sleep, and Alcohol. Nutrients 2021; 13:1708. [PMID: 34069950 PMCID: PMC8157556 DOI: 10.3390/nu13051708] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/24/2021] [Accepted: 05/13/2021] [Indexed: 01/12/2023] Open
Abstract
Insulin resistance is a key etiological factor in promoting not only type 2 diabetes mellitus but also cardiovascular disease (CVD). Exercise is a first-line therapy for combating chronic disease by improving insulin action through, in part, reducing hepatic glucose production and lipolysis as well as increasing skeletal muscle glucose uptake and vasodilation. Just like a pharmaceutical agent, exercise can be viewed as a "drug" such that identifying an optimal prescription requires a determination of mode, intensity, and timing as well as consideration of how much exercise is done relative to sitting for prolonged periods (e.g., desk job at work). Furthermore, proximal nutrition (nutrient timing, carbohydrate intake, etc.), sleep (or lack thereof), as well as alcohol consumption are likely important considerations for enhancing adaptations to exercise. Thus, identifying the maximal exercise "drug" for reducing insulin resistance will require a multi-health behavior approach to optimize type 2 diabetes and CVD care.
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Affiliation(s)
- Mary-Margaret E. Remchak
- Department of Kinesiology & Health, Rutgers University, New Brunswick, NJ 08901, USA; (M.-M.E.R.); (K.L.P.); (A.M.S.); (J.F.B.)
| | - Kelsey L. Piersol
- Department of Kinesiology & Health, Rutgers University, New Brunswick, NJ 08901, USA; (M.-M.E.R.); (K.L.P.); (A.M.S.); (J.F.B.)
| | - Sabha Bhatti
- Division of Cardiovascular Medicine, Rutgers University, New Brunswick, NJ 08901, USA;
| | - Andrea M. Spaeth
- Department of Kinesiology & Health, Rutgers University, New Brunswick, NJ 08901, USA; (M.-M.E.R.); (K.L.P.); (A.M.S.); (J.F.B.)
| | - Jennifer F. Buckman
- Department of Kinesiology & Health, Rutgers University, New Brunswick, NJ 08901, USA; (M.-M.E.R.); (K.L.P.); (A.M.S.); (J.F.B.)
- Center of Alcohol Studies, Rutgers University, Piscataway, NJ 08854, USA
| | - Steven K. Malin
- Department of Kinesiology & Health, Rutgers University, New Brunswick, NJ 08901, USA; (M.-M.E.R.); (K.L.P.); (A.M.S.); (J.F.B.)
- Division of Endocrinology, Metabolism & Nutrition, Rutgers University, New Brunswick, NJ 08901, USA
- New Jersey Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, NJ 08901, USA
- Institute of Translational Medicine and Science, Rutgers University, New Brunswick, NJ 08901, USA
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12
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Osailan AM, Elnaggar RK, Alsubaie SF, Alqahtani BA, Abdelbasset WK. The Association between Cardiorespiratory Fitness and Reported Physical Activity with Sleep Quality in Apparently Healthy Adults: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084263. [PMID: 33920540 PMCID: PMC8072608 DOI: 10.3390/ijerph18084263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Recently, poor cardiorespiratory fitness (CRF) has been postulated as an adverse health outcome related to poor sleep quality. However, studies investigating the relationship between CRF and a subjective sleep quality index are scarce. Thus, the current study aimed to investigate the association between CRF and the Pittsburgh Sleep Quality Index (PSQI) in apparently healthy people. The secondary aim was to investigate the association between reported physical activity (PA) and PSQI. METHODS Thirty-three healthy male participants volunteered to participate. CRF (VO2PEAK) was measured via cardiopulmonary exercise testing on a treadmill. A short form of the International Physical Activity Questionnaire (IPAQ) was used to measure PA, and PSQI was used for the sleep quality index. RESULTS There was no correlation between CRF and PSQI total score or any component of the PSQI. There was a significant inverse correlation between IPAQ and PSQI total score (r = -0.36, p = 0.04). Categorical data analysis of the two questionnaires revealed that 42.4% of the participants who reported low physical activity also had poor sleep quality. CONCLUSIONS The current study showed no association between CRF and the subjective sleep quality index but demonstrated a moderate inverse association between reported PA and subjective sleep quality index. The findings suggest that the more reported PA, the better the overall sleep quality.
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Affiliation(s)
- Ahmad M. Osailan
- Physical Therapy and Health Rehabilitation Department, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Alkharj 16278, Saudi Arabia; (R.K.E.); (S.F.A.); (B.A.A.); (W.K.A.)
- Correspondence:
| | - Ragab K. Elnaggar
- Physical Therapy and Health Rehabilitation Department, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Alkharj 16278, Saudi Arabia; (R.K.E.); (S.F.A.); (B.A.A.); (W.K.A.)
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza 12613, Egypt
| | - Saud F. Alsubaie
- Physical Therapy and Health Rehabilitation Department, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Alkharj 16278, Saudi Arabia; (R.K.E.); (S.F.A.); (B.A.A.); (W.K.A.)
| | - Bader A. Alqahtani
- Physical Therapy and Health Rehabilitation Department, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Alkharj 16278, Saudi Arabia; (R.K.E.); (S.F.A.); (B.A.A.); (W.K.A.)
| | - Walid Kamal Abdelbasset
- Physical Therapy and Health Rehabilitation Department, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Alkharj 16278, Saudi Arabia; (R.K.E.); (S.F.A.); (B.A.A.); (W.K.A.)
- Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza 12613, Egypt
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13
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Papadakis Z, Forsse JS, Stamatis A. High-Intensity Interval Exercise Performance and Short-Term Metabolic Responses to Overnight-Fasted Acute-Partial Sleep Deprivation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3655. [PMID: 33915744 PMCID: PMC8037712 DOI: 10.3390/ijerph18073655] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 03/11/2021] [Accepted: 03/29/2021] [Indexed: 11/30/2022]
Abstract
People practicing high-intensity interval exercise (HIIE) fasted during the morning hours under a lack of sleep. Such a habit may jeopardize the health benefits related to HIIE and adequate sleep. Fifteen habitually good sleeper males (age 31.1 ± 5.3 SD year) completed on a treadmill two isocaloric (500 kcal) HIIE sessions (3:2 min work:rest) averaged at 70% VO2reserve after 9-9.5 h of reference sleep exercise (RSE) and after 3-3.5 h of acute-partial sleep deprivation exercise (SSE). Diet and sleep patterns were controlled both 1 week prior and 2 days leading up to RSE and SSE. HIIE related performance and substrate utilization data were obtained from the continuous analysis of respiratory gases. Data were analyzed using repeated measures ANOVA with the baseline maximum oxygen uptake (VO2max) and body fat percentage (BF%) as covariates at p < 0.05. No difference was observed in VO2max, time to complete the HIIE, VE, RER, CHO%, and FAT% utilization during the experimental conditions. Whether attaining an adequate amount of sleep or not, the fasted HIIE performance and metabolism were not affected. We propose to practice the fasted HIIE under adequate sleep to receive the pleiotropic beneficial effects of sleep to the human body.
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Affiliation(s)
| | - Jeffrey S. Forsse
- Baylor Laboratories for Exercise Science and Technologies, Baylor University, Waco, TX 40385, USA;
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14
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Gao C, Zhao Z, Li F, Liu JL, Xu H, Zeng Y, Yang L, Chen J, Lu X, Wang C, Guo Q. The impact of individual lifestyle and status on the acquisition of COVID-19: A case-Control study. PLoS One 2020; 15:e0241540. [PMID: 33152004 PMCID: PMC7643946 DOI: 10.1371/journal.pone.0241540] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 10/17/2020] [Indexed: 01/08/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) has spread to the world. Whether there is an association between lifestyle behaviors and the acquisition of COVID-19 remains unclear. Methods In this case-control study, we recruited 105 patients with SARS-CoV-2 infection as a case group from the Wuhan Tongji Hospital (Wuhan, China). For each case two control subjects were recruited. Participants were randomly selected from communities in Wuhan and matched for sex, age (± 2yrs), and pre-existing comorbidities (hypertension and diabetes). Results A total of 105 patients diagnosed with COVID-19 and 210 controls were included. Compared with control group, the case group had higher proportions of lack of sleep (30.5% vs. 14.8%, P = 0.001) and increased physical activities (56.2% vs. 32.9%, P < 0.001). And patients in the case group were more likely to have alopecia (28.6% vs. 10.0%, P < 0.001) than people from the control group. Overall, we found that lack of sleep [adjusted odds ratio (OR) 1.56, 95% confidence interval (CI) 1.03–2.39)], physical activities (≥ 5 times a week) (adjusted OR 2.05, 95%CI 1.39–3.02) and alopecia (adjusted OR 1.73, 95%CI 1.13–2.66) were independent risk factors for COVID-19 infection. Conversely, low-dose alcohol intake (<100g alcohol per week), hand hygiene, and fruits intake (daily) were significantly associated with a decrease in morbidity. Conclusions Individual lifestyle behaviors and health status can affect the occurrence of COVID-19.
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Affiliation(s)
- Chang Gao
- Department of Critical Care Medicine, Suzhou Dushu Lake Hospital (Dushu Lake Hospital Affiliated to Soochow University), Suzhou, Jiangsu, China
- Department of Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Zhi Zhao
- Department of Infectious Disease, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Fengyuan Li
- Department of Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- Soochow University, Suzhou, Jiangsu, China
| | - Jia-lin Liu
- Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hongyang Xu
- Department of Critical Care Medicine, WuXi People's Hospital Affiliated to Nanjing Medical University, WuXi, JiangSu, China
| | - Yuanying Zeng
- Department of Oncology, Suzhou Municipal Hospital, Suzhou, Jingsu, China
| | - Ling Yang
- Department of Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- Soochow University, Suzhou, Jiangsu, China
| | - Jiahao Chen
- Department of Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- Soochow University, Suzhou, Jiangsu, China
| | - Xiaoting Lu
- Department of Critical Care Medicine, Changshu No.2 People’s Hospital, Suzhou, Jiangsu, China
| | - Can Wang
- Department of Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- * E-mail: (QG); (CW)
| | - Qiang Guo
- Department of Critical Care Medicine, Suzhou Dushu Lake Hospital (Dushu Lake Hospital Affiliated to Soochow University), Suzhou, Jiangsu, China
- Department of Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- * E-mail: (QG); (CW)
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15
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Burgess VN, Antonio J, Bland HW, Wagner R, Tartar JL, Melton BF. The Effect of Timing and Type of Exercise on the Quality of Sleep in Trained Individuals. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2020; 13:837-858. [PMID: 32922649 PMCID: PMC7449340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Sleep is an extremely important component for overall health and for a well-balanced training program. Recent studies have highlighted the interaction between sleep, recovery, and performance in elite and recreational athletes alike. Exercise has been known to affect the quality of sleep, nevertheless the impact is not well understood in the current research, particularly the effects of exercise timing and intensity on sleep quality. The purpose of this study was to understand if exercise timing and intensity significantly impact sleep quality among recreational exercisers. The participants involved were recreational exercisers who were self-grouped into an AM or PM exercise group. They participated in a seven-day quantitative, quasi-experimental, exploratory study wearing an Actigraph watch. The participant's intensity was also self-grouped into moderate intensity or high intensity based on criteria cut points. Data was analyzed using a factorial ANOVA to examine if there was a significant difference between exercise timing and intensity on sleep quality of the participants. There were no significant differences in sleep quality in either the time group (AM vs PM) or the intensity group (MOD vs VIG) within the four measures of sleep that were looked at throughout this study; total sleep time, sleep onset latency, sleep efficiency % and wake after sleep onset (TST, SOL, SE, and WASO). Results within both, the AM and PM group and the MOD and VIG group, results showed no significant differences. These results conclude that neither exercise intensity or timing had an effect on sleep quality.
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Affiliation(s)
| | - Jose Antonio
- Department of Health and Human Performance, Nova Southeastern University, Davie, FL, USA
| | - Helen W Bland
- College of Human Performance, Concordia University, Chicago, IL, USA
| | - Ronald Wagner
- College of Human Performance, Concordia University, Chicago, IL, USA
| | - Jaime L Tartar
- Department of Psychology and Neuroscience, Nova Southeastern University, Davie, FL, USA
| | - Bridget F Melton
- College of Human Performance, Concordia University, Chicago, IL, USA
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16
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Functional training program: the impact on depression, anxiety and sleep quality in adolescents. SPORT SCIENCES FOR HEALTH 2020. [DOI: 10.1007/s11332-020-00679-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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17
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Ironside AK, Murray NM, Hedayat LM, Murchison CC, Kirkpatrick CA, Foulds HJ. Associations of physical fitness and physical activity with sleep among middle-aged women. J Sports Med Phys Fitness 2020; 60:1502-1506. [PMID: 32674534 DOI: 10.23736/s0022-4707.20.10976-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Sleep is an important component of health. Sleep disturbances increase in women as they enter menopause. Physical activity has been associated with improved sleep among older populations. The purpose of this study was to determine if physical activity and/or physical fitness are associated with sleep quantity and quality in middle-aged women. METHODS This study recruited 114 healthy women, aged 30-55 (43±8 y) from Saskatoon, Saskatchewan, from 2015-2019. Sleep quantity and quality were evaluated. Participants were classified on their aerobic fitness, based on estimated peak aerobic capacity, as high or low grip strength and, as active or inactive. RESULTS The high aerobic fitness group had a greater mean sleep duration of 7.04±1.02 h compared to the low fit group 6.61±1.00 h after adjusting for age, Body Mass Index, waist circumference and menstrual status (P=0.01). The percentage of high aerobic fitness women who felt rested was greater than low aerobic fitness women (67±6% vs. 45±7%, P=0.03), after adjusting for age, Body Mass Index, waist circumference and menstrual status. Our study found a significant difference between women with higher aerobic fitness levels getting more sleep each night and feeling more rested. CONCLUSIONS The continued examination of physical fitness and its relationship to sleep holds importance for women's health.
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Affiliation(s)
- Avery K Ironside
- College of Kinesiology, University of Saskatchewan, Saskatoon, Canada
| | - Nicole M Murray
- College of Kinesiology, University of Saskatchewan, Saskatoon, Canada
| | - Lila M Hedayat
- College of Kinesiology, University of Saskatchewan, Saskatoon, Canada
| | | | | | - Heather J Foulds
- College of Kinesiology, University of Saskatchewan, Saskatoon, Canada -
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18
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Stine JG, Schreibman I, Navabi S, Kang M, Dahmus J, Soriano C, Rivas G, Hummer B, Beyer M, Tressler H, Kimball SR, Patterson AD, Schmitz K, Sciamanna C. Nonalcoholic steatohepatitis Fitness Intervention in Thrombosis (NASHFit): Study protocol for a randomized controlled trial of a supervised aerobic exercise program to reduce elevated clotting risk in patients with NASH. Contemp Clin Trials Commun 2020; 18:100560. [PMID: 32309672 PMCID: PMC7154986 DOI: 10.1016/j.conctc.2020.100560] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/17/2020] [Accepted: 03/28/2020] [Indexed: 02/07/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease worldwide affecting upwards of one third the global population. For reasons not fully understood, individuals with NAFLD and its more severe variant, nonalcoholic steatohepatitis (NASH), are at increased risk for venous thromboembolism which significantly increases morbidity and mortality. Lifestyle changes centering around exercise training are the mainstay of treatment for NAFLD/NASH. While exercise training can lessen venous thromboembolic risk in healthy persons and those with cardiovascular disease, whether or not this benefit is seen in patients with NAFLD/NASH remains unknown. In order to better understand how exercise training impacts thrombosis risk in NAFLD, we present the design of a thirty-two week randomized controlled clinical trial of 42 sedentary subjects age 18-69 with biopsy proven NASH. The main aim is to determine the impact of an aerobic exercise training program on the abnormal hemostatic system unique to NAFLD/NASH. The main outcome is change in plasminogen activator inhibitor one level, an established marker for venous thromboembolism. Secondary outcomes include body composition, cardiorespiratory fitness, control of comorbid metabolic conditions (e.g., obesity, hypertension, hyperlipidemia, diabetes), dietary composition, health related quality of life, liver enzymes and histology, NAFLD/NASH disease activity (e.g., biomarkers, clinical decision aids), microbiome, other markers of hemostasis, and PNPLA3 gene expression. The study represents the first clinical trial of an exercise training program to reduce elevated clotting risk in subjects with NAFLD/NASH.
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Affiliation(s)
- Jonathan G. Stine
- Division of Gastroenterology and Hepatology, Department of Medicine, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Public Health Sciences, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
- Liver Center, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
- Cancer Institute, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Ian Schreibman
- Division of Gastroenterology and Hepatology, Department of Medicine, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
- Liver Center, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Seyedehsan Navabi
- Division of Gastroenterology and Hepatology, Department of Medicine, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Mitchell Kang
- Division of Gastroenterology and Hepatology, Department of Medicine, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Jessica Dahmus
- Division of Gastroenterology and Hepatology, Department of Medicine, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Christopher Soriano
- Department of Medicine, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Gloriany Rivas
- Division of Gastroenterology and Hepatology, Department of Medicine, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Breianna Hummer
- Division of Gastroenterology and Hepatology, Department of Medicine, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Megan Beyer
- Division of Gastroenterology and Hepatology, Department of Medicine, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Heather Tressler
- Division of Gastroenterology and Hepatology, Department of Medicine, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Scot R. Kimball
- Department of Physiology, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Andrew D. Patterson
- Department of Biochemistry and Molecular Biology, The Pennsylvania State University, University Park, PA, USA
| | - Kathryn Schmitz
- Department of Public Health Sciences, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
- Cancer Institute, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Kinesiology, The Pennsylvania State University- College of Medicine, Hershey, PA, USA
- Department of Physical Medicine & Rehabilitation, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Christopher Sciamanna
- Department of Public Health Sciences, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
- Cancer Institute, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Medicine, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
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Benjamin CL, Curtis RM, Huggins RA, Sekiguchi Y, Jain RK, McFadden BA, Casa DJ. Sleep Dysfunction and Mood in Collegiate Soccer Athletes. Sports Health 2020; 12:234-240. [PMID: 32271137 DOI: 10.1177/1941738120916735] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Sleep and mood are critical factors that contribute to health and wellness and are of particular interest to collegiate athletes who are juggling high physical, academic, and social demands. The aim of this study was to examine how psychological measures, player status, and sex-related factors were associated with perceived sleep quality. HYPOTHESIS Higher levels of global sleep dysfunction will be related to poor mood and increased anxiety, and there will be differences in sleep dysfunction in male compared with female athletes as well as regarding playing status. STUDY DESIGN Prospective cohort study. LEVEL OF EVIDENCE Level 4. METHODS During the 2016 through 2018 National Collegiate Athletic Association (NCAA) seasons, the Pittsburgh Sleep Quality Index (PSQI), Profile of Mood States, and Sports Anxiety Scale-2 questionnaires were administered to 230 soccer athletes at 6 separate time points throughout each season. RESULTS PSQI results yielded scores ≥5 in 54% of observations. Increased sleep dysfunction was significantly related to decreased vigor and increased tension, depression, anger, fatigue, somatic anxiety, worry, and concentration disruption, although effect sizes (ES) were trivial (ES, -0.03 to 0.15). The odds ratio (OR) of reporting global sleep dysfunction increased by 8%, 9%, and 25% for every 1-unit increase in tension (OR, 1.08; 95% CI, 1.02-1.16; P = 0.015), fatigue (OR, 1.09; 95% CI, 1.03-1.16; P = 0.002), and concentration disruption (OR, 1.25; 95% CI, 1.09-1.45; P = 0.002), respectively. The odds of reporting global sleep dysfunction were 55% lower for males than females (OR, 0.45; 95% CI, 0.25-0.79; P = 0.006). CONCLUSION Global sleep dysfunction was prevalent in NCAA soccer players and was related to negative mental health outcomes. Female participants experienced increased odds of reporting global sleep dysfunction. CLINICAL RELEVANCE Regular monitoring allows for a greater understanding of the interrelatedness between sleep and mental health in athletes.
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Affiliation(s)
- Courteney L Benjamin
- Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs, Connecticut
| | - Ryan M Curtis
- Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs, Connecticut
| | - Robert A Huggins
- Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs, Connecticut
| | - Yasuki Sekiguchi
- Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs, Connecticut
| | - Rajat K Jain
- Northwestern Athletics, Northwestern University, Evanston, Illinois
| | - Bridget A McFadden
- IFNH Center for Health and Human Performance, Rutgers University, New Brunswick, New Jersey
| | - Douglas J Casa
- Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs, Connecticut
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Harnessing wearable device data to improve state-level real-time surveillance of influenza-like illness in the USA: a population-based study. LANCET DIGITAL HEALTH 2020; 2:e85-e93. [PMID: 33334565 DOI: 10.1016/s2589-7500(19)30222-5] [Citation(s) in RCA: 138] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 12/02/2019] [Accepted: 12/06/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Acute infections can cause an individual to have an elevated resting heart rate (RHR) and change their routine daily activities due to the physiological response to the inflammatory insult. Consequently, we aimed to evaluate if population trends of seasonal respiratory infections, such as influenza, could be identified through wearable sensors that collect RHR and sleep data. METHODS We obtained de-identified sensor data from 200 000 individuals who used a Fitbit wearable device from March 1, 2016, to March 1, 2018, in the USA. We included users who wore a Fitbit for at least 60 days and used the same wearable throughout the entire period, and focused on the top five states with the most Fitbit users in the dataset: California, Texas, New York, Illinois, and Pennsylvania. Inclusion criteria included having a self-reported birth year between 1930 and 2004, height greater than 1 m, and weight greater than 20 kg. We excluded daily measurements with missing RHR, missing wear time, and wear time less than 1000 min per day. We compared sensor data with weekly estimates of influenza-like illness (ILI) rates at the state level, as reported by the US Centers for Disease Control and Prevention (CDC), by identifying weeks in which Fitbit users displayed elevated RHRs and increased sleep levels. For each state, we modelled ILI case counts with a negative binomial model that included 3-week lagged CDC ILI rate data (null model) and the proportion of weekly Fitbit users with elevated RHR and increased sleep duration above a specified threshold (full model). We also evaluated weekly change in ILI rate by linear regression using change in proportion of elevated Fitbit data. Pearson correlation was used to compare predicted versus CDC reported ILI rates. FINDINGS We identified 47 249 users in the top five states who wore a Fitbit consistently during the study period, including more than 13·3 million total RHR and sleep measures. We found the Fitbit data significantly improved ILI predictions in all five states, with an average increase in Pearson correlation of 0·12 (SD 0·07) over baseline models, corresponding to an improvement of 6·3-32·9%. Correlations of the final models with the CDC ILI rates ranged from 0·84 to 0·97. Week-to-week changes in the proportion of Fitbit users with abnormal data were associated with week-to-week changes in ILI rates in most cases. INTERPRETATION Activity and physiological trackers are increasingly used in the USA and globally to monitor individual health. By accessing these data, it could be possible to improve real-time and geographically refined influenza surveillance. This information could be vital to enact timely outbreak response measures to prevent further transmission of influenza cases during outbreaks. FUNDING Partly supported by the US National Institutes of Health National Center for Advancing Translational Sciences.
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Liu C, Meng Z, Wiggin TD, Yu J, Reed ML, Guo F, Zhang Y, Rosbash M, Griffith LC. A Serotonin-Modulated Circuit Controls Sleep Architecture to Regulate Cognitive Function Independent of Total Sleep in Drosophila. Curr Biol 2019; 29:3635-3646.e5. [PMID: 31668619 DOI: 10.1016/j.cub.2019.08.079] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 08/26/2019] [Accepted: 08/30/2019] [Indexed: 12/20/2022]
Abstract
Both the structure and the amount of sleep are important for brain function. Entry into deep, restorative stages of sleep is time dependent; short sleep bouts selectively eliminate these states. Fragmentation-induced cognitive dysfunction is a feature of many common human sleep pathologies. Whether sleep structure is normally regulated independent of the amount of sleep is unknown. Here, we show that in Drosophila melanogaster, activation of a subset of serotonergic neurons fragments sleep without major changes in the total amount of sleep, dramatically reducing long episodes that may correspond to deep sleep states. Disruption of sleep structure results in learning deficits that can be rescued by pharmacologically or genetically consolidating sleep. We identify two reciprocally connected sets of ellipsoid body neurons that form the heart of a serotonin-modulated circuit that controls sleep architecture. Taken together, these findings define a circuit essential for controlling the structure of sleep independent of its amount.
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Affiliation(s)
- Chang Liu
- Complex Systems, Brandeis University, Waltham, MA 02454, USA; Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen 518055, China.
| | - Zhiqiang Meng
- Complex Systems, Brandeis University, Waltham, MA 02454, USA; Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen 518055, China
| | | | - Junwei Yu
- Complex Systems, Brandeis University, Waltham, MA 02454, USA
| | - Martha L Reed
- Complex Systems, Brandeis University, Waltham, MA 02454, USA
| | - Fang Guo
- Complex Systems, Brandeis University, Waltham, MA 02454, USA; Howard Hughes Medical Institute, Brandeis University, Waltham, MA 02454, USA; Department of Neurobiology, Zhejiang University School of Medicine, Hangzhou, Zhejiang province 310058, China
| | - Yunpeng Zhang
- Complex Systems, Brandeis University, Waltham, MA 02454, USA
| | - Michael Rosbash
- Complex Systems, Brandeis University, Waltham, MA 02454, USA; Howard Hughes Medical Institute, Brandeis University, Waltham, MA 02454, USA
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Caldwell JA, Caldwell JL, Thompson LA, Lieberman HR. Fatigue and its management in the workplace. Neurosci Biobehav Rev 2019; 96:272-289. [DOI: 10.1016/j.neubiorev.2018.10.024] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 10/04/2018] [Accepted: 10/31/2018] [Indexed: 01/01/2023]
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