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Musbat S, Reuveni I, Magnezi R. Improvements in mental health associated with increased electronic communication and deterioration in physical health in adults aged 50+ during the COVID-19 pandemic. Front Public Health 2024; 12:1369707. [PMID: 38975353 PMCID: PMC11224488 DOI: 10.3389/fpubh.2024.1369707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 06/04/2024] [Indexed: 07/09/2024] Open
Abstract
Background Previous studies have documented changes in physical health, mental health and social parameters during COVID-19. At the same time, there are no comprehensive analyses of these parameters designed as longitudinal studies on large-scale older populations before and during the pandemic. Objective This longitudinal study aims to provide a quantitative analysis of the COVID-19 impact on the physical, mental, and social parameters in adults aged 50 and older before, in the early stages, and during the COVID-19 pandemic. Methods The data for this study were collected from three waves of the Survey of Health, Ageing and Retirement in Europe (SHARE), a supranational longitudinal database: pre-COVID (October 2019-March 2020), early-COVID (June-September 2020), and during-COVID (June-August 2021). The sample included 31,526 individuals, compared across the three-time points through nonparametric group comparison tests. Results Physical health was subjectively rated as poorer in the during-COVID wave compared to the pre-COVID wave. Additionally, the number of illnesses or health conditions reported in the during-COVID wave was significantly higher than in the pre-COVID wave, with the biggest increases registered for cardiovascular diseases. The results also show that employment and overall social contact decreased while loneliness increased over time. Unexpectedly, mental health issues, such as sadness or depression and trouble sleeping, decreased significantly in the COVID waves compared to the pre-COVID wave. The analysis of two additional pre-COVID waves (2015, 2017) revealed that poorer pre-COVID mental health reflected in high values of sadness or depression and trouble sleeping was not an isolated peak but represented a typical baseline. The positive influence on the individuals' mental health during COVID-19 was found to be electronic communication, which showed higher values than face-to-face communication and lowered the odds of sadness or depression. Conclusion Future policies should thus consider the positive impact of electronic contacts on mental health to promote overall health in adults aged 50 and older.
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Affiliation(s)
- Shay Musbat
- Department of Management, Health Systems Management Program, Bar-Ilan University, Ramat Gan, Israel
| | - Inbal Reuveni
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel
| | - Racheli Magnezi
- Department of Management, Health Systems Management Program, Bar-Ilan University, Ramat Gan, Israel
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2
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Hein K, Conkey-Morrison C, Burleigh TL, Poulus D, Stavropoulos V. Examining how gamers connect with their avatars to assess their anxiety: A novel artificial intelligence approach. Acta Psychol (Amst) 2024; 246:104298. [PMID: 38701623 DOI: 10.1016/j.actpsy.2024.104298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/29/2024] [Accepted: 04/29/2024] [Indexed: 05/05/2024] Open
Abstract
Research has supported that a gamer's attachment to their avatar can offer significant insights about their mental health, including anxiety. To assess this hypothesis, longitudinal data from 565 adult and adolescent participants (Mage = 29.3 years, SD = 10.6) was analyzed at two points, six months apart. Respondents were assessed using the User-Avatar Bond (UAB) scale and the Depression Anxiety Stress Scale (DASS) to measure their connection with their avatar and their risk for anxiety. The records were processed using both untuned and tuned artificial intelligence [AI] classifiers to evaluate present and future anxiety. The findings indicated that AI models are capable of accurately and autonomously discerning cases of anxiety risk based on the gamers' self-reported UAB, age, and duration of gaming, both at present and after six months. Notably, random forest algorithms surpassed other AI models in effectiveness, with avatar compensation emerging as the most significant factor in model training for prospective anxiety. The implications for assessment, prevention, and clinical practice are discussed.
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Affiliation(s)
- Kaiden Hein
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
| | - Connor Conkey-Morrison
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia; College of Health and Biomedicine, Victoria University, Melbourne, Victoria, Australia
| | - Tyrone L Burleigh
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia.
| | - Dylan Poulus
- Faculty of Health, Southern Cross University, Queensland, Australia
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Mușat MI, Militaru F, Gheorman V, Udriștoiu I, Mitran SI, Cătălin B. Moderate Alcohol Consumption Increases the Risk of Clinical Relapse in Male Depressed Patients Treated with Serotonin-Norepinephrine Reuptake Inhibitors. Diagnostics (Basel) 2024; 14:1140. [PMID: 38893667 PMCID: PMC11171480 DOI: 10.3390/diagnostics14111140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/13/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND While depression can be associated with multiple comorbidities, the association between depression and liver injury significantly increases the mortality risk. The aim of this study was to evaluate if moderate alcohol intake affects the rate of clinical relapses in patients treated with antidepressants as monotherapy. METHODS We assessed, over a period of 30 months, the clinical records of 254 patients with depressive disorder, of either gender, without additional pathologies, receiving monotherapy treatment with antidepressants. Thirty-three patients with alcohol abuse, alcoholism or significant cognitive impairment were excluded. The medical and psychiatric history, medication and liver enzyme values were collected and analyzed. RESULTS Out of the 221 patients who met the inclusion criteria, 78 experienced relapses of depression. The rate of relapse did not correlate with the levels of liver enzymes. Alcohol consumption, as objectified based on GGT levels and the AST/ALT ratio, suggested that men had higher alcohol intake compared to women. Patients treated with serotonin-norepinephrine reuptake inhibitors (SNRIs) with elevated AST levels were approximately 9 times more likely to relapse, while the ones with elevated GGT had a 5.34 times higher risk. While GGT levels remained a marker for relapse in men with elevated GGT, ALT and not AST proved to be a better risk indicator for relapses in male patients. CONCLUSION The use of SNRIs in depressed male patients with moderate alcohol intake should be carefully considered, as they might be susceptible to higher risks of relapse compared to alternative antidepressant therapies.
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Affiliation(s)
- Mădălina Iuliana Mușat
- U.M.F. Doctoral School Craiova, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
- Experimental Research Centre for Normal and Pathological Aging, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Felicia Militaru
- Department of Psychiatry, University of Medicine and Pharmacy, 200349 Craiova, Romania; (F.M.); (V.G.)
| | - Victor Gheorman
- Department of Psychiatry, University of Medicine and Pharmacy, 200349 Craiova, Romania; (F.M.); (V.G.)
| | - Ion Udriștoiu
- Department of Psychiatry, University of Medicine and Pharmacy, 200349 Craiova, Romania; (F.M.); (V.G.)
| | - Smaranda Ioana Mitran
- Experimental Research Centre for Normal and Pathological Aging, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
- Department of Physiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Bogdan Cătălin
- Experimental Research Centre for Normal and Pathological Aging, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
- Department of Physiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
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Zheng J, Zong X, Tang L, Guo H, Zhao P, Womer FY, Zhang X, Tang Y, Wang F. Characterizing the distinct imaging phenotypes, clinical behavior, and genetic vulnerability of brain maturational subtypes in mood disorders. Psychol Med 2024:1-11. [PMID: 38804091 DOI: 10.1017/s0033291724000886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
BACKGROUND Mood disorders are characterized by great heterogeneity in clinical manifestation. Uncovering such heterogeneity using neuroimaging-based individual biomarkers, clinical behaviors, and genetic risks, might contribute to elucidating the etiology of these diseases and support precision medicine. METHODS We recruited 174 drug-naïve and drug-free patients with major depressive disorder and bipolar disorder, as well as 404 healthy controls. T1 MRI imaging data, clinical symptoms, and neurocognitive assessments, and genetics were obtained and analyzed. We applied regional gray matter volumes (GMV) and quantile normative modeling to create maturation curves, and then calculated individual deviations to identify subtypes within the patients using hierarchical clustering. We compared the between-subtype differences in GMV deviations, clinical behaviors, cell-specific transcriptomic associations, and polygenic risk scores. We also validated the GMV deviations based subtyping analysis in a replication cohort. RESULTS Two subtypes emerged: subtype 1, characterized by increased GMV deviations in the frontal cortex, cognitive impairment, a higher genetic risk for Alzheimer's disease, and transcriptionally associated with Alzheimer's disease pathways, oligodendrocytes, and endothelial cells; and subtype 2, displaying globally decreased GMV deviations, more severe depressive symptoms, increased genetic vulnerability to major depressive disorder and transcriptionally related to microglia and inhibitory neurons. The distinct patterns of GMV deviations in the frontal, cingulate, and primary motor cortices between subtypes were shown to be replicable. CONCLUSIONS Our current results provide vital links between MRI-derived phenotypes, spatial transcriptome, genetic vulnerability, and clinical manifestation, and uncover the heterogeneity of mood disorders in biological and behavioral terms.
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Affiliation(s)
- Junjie Zheng
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, China
| | - Xiaofen Zong
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Lili Tang
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, China
| | - Huiling Guo
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, China
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China
| | - Pengfei Zhao
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, China
| | - Fay Y Womer
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Xizhe Zhang
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China
| | - Yanqing Tang
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, China
- Brain Function Research Section, The First Hospital of China Medical University, Shenyang, China
- Department of Gerontology, The First Hospital of China Medical University, Shenyang, China
- Department of Psychiatry, Shengjing Hospital of China Medical University, Shenyang, China
| | - Fei Wang
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, China
- Department of Mental Health, School of Public Health, Nanjing Medical University, Nanjing, China
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Chichester S, Rahmoune A, Dashti HS. Home parenteral nutrition, sleep patterns, and depressive symptoms: Secondary analysis of cross-sectional data. JPEN J Parenter Enteral Nutr 2024. [PMID: 38644052 DOI: 10.1002/jpen.2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 03/17/2024] [Accepted: 03/24/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND Patients receiving home parenteral nutrition (HPN) are known to experience psychological distress and have profoundly disrupted sleep. The aim of this analysis was to examine the relationship between sleep patterns with depressive symptoms and HPN characteristics. METHODS The study was a secondary analysis of cross-sectional data examining sleep patterns using subjective and objective measures. Sleep was assessed by surveys and 7-day actigraphy. The Patient Health Questionnaire-8 was used to evaluate depressive symptoms. Participants provided information on HPN. Spearman correlations were calculated between sleep measures with depressive symptoms and HPN characteristics. Correlations were further examined in multivariable linear regression models. RESULTS Thirty-two adults (age = 53 years; 75% female; 94% White) were included. Lower sleep quality (r = 0.54-0.60; P < 0.001) and later sleep timing (r = -0.35; P = 0.049) were correlated with higher depressive symptoms. Sleep patterns were also correlated with several HPN characteristics (r = -0.47 to 0.51). In linear regression models, rate of infusion was associated with sleep duration (β = -0.004 [0.002] h; P = 0.046) in which each 100 mL/h was associated with 24-min shorter duration. Higher total energy was associated with lower sleep quality (β = 0.0004 [0.0002] log-unit; P = 0.042), and higher volume was associated with longer sleep onset latency (β = 0.0006 [0.0003] log-min; P = 0.049). CONCLUSIONS We provide evidence supporting the link between poor and later sleep with higher depressive symptoms and identify potentially modifiable infusion characteristics (notably, slower rate of infusion and lower total energy and volume) that, on further verification, may support sleep among those receiving HPN.
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Affiliation(s)
- Sierra Chichester
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
- The Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Adline Rahmoune
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Hassan S Dashti
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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Menicucci D, Bastiani L, Malloggi E, Denoth F, Gemignani A, Molinaro S. Impaired Well-Being and Insomnia as Residuals of Resolved Medical Conditions: Survey in the Italian Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:129. [PMID: 38397620 PMCID: PMC10888320 DOI: 10.3390/ijerph21020129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/12/2024] [Accepted: 01/17/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Well-being encompasses physical, mental, social, and cultural aspects. Sleep quality and pathologies are among the objective conditions jeopardising it. Chronic insomnia, inflammatory-based diseases, and mood disorders often occur in a single cluster, and inflammation can negatively impact sleep, potentially harming well-being. Some evidence from specific clinical populations suggests that also some resolved past diseases could still have an impact on present sleep quality and well-being. The aim of the present study is to investigate, in the general population, whether and to what degree well-being and insomnia are associated with resolved pathologies. METHODS A cross-sectional survey (IPSAD®) was carried out using anonymous postal questionnaires that investigated past and present general health, well-being, and insomnia. A total of 10,467 subjects answered the questionnaire. RESULTS Several classes of both current and resolved pathologies resulted in increased odds ratios for current insomnia (odds ratios = 1.90; 1.43, respectively) and impaired well-being (odds ratios = 1.75; 1.33, respectively), proportional to the number of the displayed pathologies. Notably, both current and resolved past psychiatric disorders were strongly associated with both current impaired well-being (odds ratios = 5.38; 1.70, respectively) and insomnia (odds ratios = 4.99; 2.15, respectively). CONCLUSIONS To explain these associations, we suggest that systemic inflammation conveyed by several medical conditions disrupts homeostatic processes, with final effects on sleep quality and behaviour.
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Affiliation(s)
- Danilo Menicucci
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (D.M.); (E.M.); (A.G.)
| | - Luca Bastiani
- Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy; (L.B.); (F.D.)
| | - Eleonora Malloggi
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (D.M.); (E.M.); (A.G.)
| | - Francesca Denoth
- Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy; (L.B.); (F.D.)
| | - Angelo Gemignani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (D.M.); (E.M.); (A.G.)
- Clinical Psychology Branch, Azienda Ospedaliero-Universitaria Pisana, 56100 Pisa, Italy
| | - Sabrina Molinaro
- Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy; (L.B.); (F.D.)
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Vos CF, Birkenhäger TK, Nolen WA, van den Broek WW, ter Hark SE, Schellekens AF, Verkes RJ, Janzing JG. The Relationship of Early Sleep Improvement With Response to Pharmacotherapy in Unipolar Psychotic Depression. J Clin Psychopharmacol 2023; 43:486-492. [PMID: 37930199 PMCID: PMC10662627 DOI: 10.1097/jcp.0000000000001756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/08/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Since insomnia and depression are interrelated, improved sleep early in antidepressant pharmacotherapy may predict a positive treatment outcome. We investigated whether early insomnia improvement (EII) predicted treatment outcome in psychotic depression (PD) and examined if there was an interaction effect between EII and treatment type to assess if findings were treatment-specific. METHODS This study is a secondary analysis of a randomized trial comparing 7 weeks treatment with the antidepressants venlafaxine, imipramine and venlafaxine plus the antipsychotic quetiapine in PD ( n = 114). Early insomnia improvement, defined as ≥20% reduced insomnia after 2 weeks, was assessed by the Hamilton Rating Scale for Depression (HAM-D-17). Associations between EII and treatment outcome were examined using logistic regressions. Subsequently, we added interaction terms between EII and treatment type to assess interaction effects. The predictive value of EII was compared with early response on overall depression (≥20% reduced HAM-D-17 score after 2 weeks). RESULTS EII was associated with response (odds ratio [OR], 7.9; 95% confidence interval [CI], 2.7-23.4; P = <0.001), remission of depression (OR, 6.1; 95% CI, 1.6-22.3; P = 0.009), and remission of psychosis (OR, 4.1; 95% CI, 1.6-10.9; P = 0.004). We found no interaction effects between EII and treatment type on depression outcome. Early insomnia improvement and early response on overall depression had a comparable predictive ability for treatment outcome. CONCLUSIONS Early insomnia improvement was associated with a positive outcome in pharmacotherapy of PD, regardless of the medication type. Future studies are needed to confirm our findings and to examine the generalizability of EII as predictor in treatment of depression.
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Affiliation(s)
- Cornelis F. Vos
- From the Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
| | - Tom K. Birkenhäger
- Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, the Netherlands
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium
| | - Willem A. Nolen
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | | | - Sophie E. ter Hark
- From the Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
| | - Arnt F.A. Schellekens
- From the Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
| | - Robbert-Jan Verkes
- From the Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
| | - Joost G.E. Janzing
- From the Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
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Lu G, Xiao S, He J, Xie W, Ge W, Meng F, Yang Y, Yu S, Liu R. Prevalence of depression and its correlation with anxiety, headache and sleep disorders among medical staff in the Hainan Province of China. Front Public Health 2023; 11:1122626. [PMID: 37441641 PMCID: PMC10333496 DOI: 10.3389/fpubh.2023.1122626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 06/05/2023] [Indexed: 07/15/2023] Open
Abstract
Objective This cross-sectional survey aimed to investigate the prevalence of depression among medical staff and its risk factors as well as the association between depression, anxiety, headache, and sleep disorders. Methods Stratified random cluster sampling was used to select medical staff from various departments of four hospitals in Sanya City. The Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), and Pittsburgh Sleep Quality Index (PSQI) were used to quantitatively assess depression, anxiety, and sleep disorders. Correlation and regression analyses were performed to determine factors affecting the depression occurrence and scores. Results Among 645 medical staff members, 548 (85%) responded. The 1-year prevalence of depression was 42.7% and the prevalence of depression combined with anxiety, headache, and sleep disorders was 23, 27, and 34.5%, respectively. The prevalence of depression in women, nurses, the unmarried or single group, and the rotating-shift population was significantly higher than that in men (48.3% vs. 27.1%, odds ratio OR = 2.512), doctors (55.2% vs. 26.7%, OR = 3.388), the married group (50.5% vs. 35.8%, OR = 1.900), and the day-shift population (35.2% vs. 7.5%, OR = 1.719). The occurrence of depression was correlated with anxiety, sleep disorders, headache, and migraines, with anxiety having the highest correlation (Spearman's Rho = 0.531). The SDS was significantly correlated with the SAS and PSQI (Spearman's Rho = 0.801, 0.503) and was also related to the presence of headache and migraine (Spearman Rho = 0.228, 0.159). Multiple logistic regression indicated that nurse occupation and anxiety were risk factors for depression, while grades of anxiety, sleep disorders and nurse occupation were risk factors for the degree of depression in multiple linear regression. Conclusion The prevalence of depression among medical staff was higher than that in the general population, especially among women, nurses, unmarried people, and rotating-shift workers. Depression is associated with anxiety, sleep disorders, headache, and migraines. Anxiety and nursing occupation are risk factors for depression. This study provides a reference for the promotion of occupational health among medical professionals.
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Affiliation(s)
- Guangshuang Lu
- Department of Pediatrics, The Lu’an Hospital Affiliated to Anhui Medical University, The Lu’an People’s Hospital, Lu’an, China
- Medical School of Chinese PLA, Beijing, China
- Department of Neurology, International Headache Center, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shaobo Xiao
- Medical School of Chinese PLA, Beijing, China
- Department of Neurology, International Headache Center, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jiaji He
- Medical School of Chinese PLA, Beijing, China
- Department of Neurology, International Headache Center, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Wei Xie
- Medical School of Chinese PLA, Beijing, China
- Department of Neurology, International Headache Center, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Wei Ge
- Medical School of Chinese PLA, Beijing, China
| | - Fanchao Meng
- Medical School of Chinese PLA, Beijing, China
- Department of Neurology, International Headache Center, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Ying Yang
- Medical School of Chinese PLA, Beijing, China
- Department of Neurology, International Headache Center, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shengyuan Yu
- Medical School of Chinese PLA, Beijing, China
- Department of Neurology, International Headache Center, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Ruozhuo Liu
- Medical School of Chinese PLA, Beijing, China
- Department of Neurology, International Headache Center, The First Medical Center of Chinese PLA General Hospital, Beijing, China
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Drakatos P, O'Regan D, Liao Y, Panayiotou C, Higgins S, Kabiljo R, Benson J, Pool N, Tahmasian M, Romigi A, Nesbitt A, Stokes PRA, Kumari V, Young AH, Rosenzweig I. Profile of sleep disturbances in patients with recurrent depressive disorder or bipolar affective disorder in a tertiary sleep disorders service. Sci Rep 2023; 13:8785. [PMID: 37258713 DOI: 10.1038/s41598-023-36083-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 05/29/2023] [Indexed: 06/02/2023] Open
Abstract
Bidirectional relationship between sleep disturbances and affective disorders is increasingly recognised, but its underlying mechanisms are far from clear, and there is a scarcity of studies that report on sleep disturbances in recurrent depressive disorder (RDD) and bipolar affective disorder (BPAD). To address this, we conducted a retrospective study of polysomnographic and clinical records of patients presenting to a tertiary sleep disorders clinic with affective disorders. Sixty-three BPAD patients (32 female; mean age ± S.D.: 41.8 ± 12.4 years) and 126 age- and gender-matched RDD patients (62 female; 41.5 ± 12.8) were studied. Whilst no significant differences were observed in sleep macrostructure parameters between BPAD and RDD patients, major differences were observed in comorbid sleep and physical disorders, both of which were higher in BPAD patients. Two most prevalent sleep disorders, namely obstructive sleep apnoea (OSA) (BPAD 50.8.0% vs RDD 29.3%, P = 0.006) and insomnia (BPAD 34.9% vs RDD 15.0%, P = 0.005) were found to be strongly linked with BPAD. In summary, in our tertiary sleep clinic cohort, no overt differences in the sleep macrostructure between BPAD and RDD patients were demonstrated. However, OSA and insomnia, two most prevalent sleep disorders, were found significantly more prevalent in patients with BPAD, by comparison to RDD patients. Also, BPAD patients presented with significantly more severe OSA, and with higher overall physical co-morbidity. Thus, our findings suggest an unmet/hidden need for earlier diagnosis of those with BPAD.
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Affiliation(s)
- Panagis Drakatos
- Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Faculty of Life Sciences and Medicine, King's College London, London, UK
- Department of Neuroimaging, Sleep and Brain Plasticity Centre, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, Box 089, London, SE5 8AF, UK
| | - David O'Regan
- Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Faculty of Life Sciences and Medicine, King's College London, London, UK
- Department of Neuroimaging, Sleep and Brain Plasticity Centre, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, Box 089, London, SE5 8AF, UK
| | - Yingqi Liao
- Department of Neuroimaging, Sleep and Brain Plasticity Centre, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, Box 089, London, SE5 8AF, UK
| | - Constantinos Panayiotou
- Department of Neuroimaging, Sleep and Brain Plasticity Centre, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, Box 089, London, SE5 8AF, UK
| | - Sean Higgins
- Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Department of Neuroimaging, Sleep and Brain Plasticity Centre, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, Box 089, London, SE5 8AF, UK
| | - Renata Kabiljo
- Department of Neuroimaging, Sleep and Brain Plasticity Centre, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, Box 089, London, SE5 8AF, UK
- Department of Biostatistics and Health Informatics, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, London, SE5 8AF, UK
| | - Joshua Benson
- Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Norman Pool
- Department of Neuropsychiatry, St George's Hospital, South West London and St George's Mental Health NHS Trust, London, UK
| | - Masoud Tahmasian
- Institute of Neuroscience and Medicine Research, Brain and Behaviour (INM-7), Jülich Research Center, Jülich, Germany & Institute for Systems Neuroscience, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Andrea Romigi
- IRCCS Neuromed Istituto Neurologico Mediterraneo Pozzilli (IS), Pozzilli, Italy
| | - Alexander Nesbitt
- Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Department of Neuroimaging, Sleep and Brain Plasticity Centre, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, Box 089, London, SE5 8AF, UK
- Department of Neurology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Paul R A Stokes
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Veena Kumari
- Division of Psychology, Department of Life Sciences, & Centre for Cognitive Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, London, UK
| | - Allan H Young
- Department of Psychological Medicine, King's College London & South London and Maudsley NHS Foundation Trust, Institute of Psychiatry, Psychology and Neuroscience, Bethlem Royal Hospital, Beckenham, UK
| | - Ivana Rosenzweig
- Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK.
- Department of Neuroimaging, Sleep and Brain Plasticity Centre, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, Box 089, London, SE5 8AF, UK.
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10
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Kantor S, Lanigan M, Giggins L, Lione L, Magomedova L, de Lannoy I, Upton N, Duxon M. Ketamine supresses REM sleep and markedly increases EEG gamma oscillations in the Wistar Kyoto rat model of treatment-resistant depression. Behav Brain Res 2023; 449:114473. [PMID: 37146722 DOI: 10.1016/j.bbr.2023.114473] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 03/10/2023] [Accepted: 03/20/2023] [Indexed: 05/07/2023]
Abstract
Wistar-Kyoto (WKY) rats exhibit depression-like characteristics and decreased sensitivity to monoamine-based antidepressants, making them a suitable model of treatment-resistant depression (TRD). Ketamine has emerged recently as a rapidly acting antidepressant with high efficacy in TRD. Our aim was to determine whether subanaesthetic doses of ketamine can correct sleep and electroencephalogram (EEG) alterations in WKY rats and whether any ketamine-induced changes differentially affect WKY rats compared to Sprague-Dawley (SD) rats. Thus, we surgically implanted 8SD and 8 WKY adult male rats with telemetry transmitters and recorded their EEG, electromyogram, and locomotor activity after vehicle or ketamine (3, 5 or 10mg/kg, s.c.) treatment. We also monitored the plasma concentration of ketamine and its metabolites, norketamine and hydroxynorketamine in satellite animals. We found that WKY rats, have an increased amount of rapid eye movement (REM) sleep, fragmented sleep-wake pattern, and increased EEG delta power during non-REM sleep compared to SD rats. Ketamine suppressed REM sleep and increased EEG gamma power during wakefulness in both strains, but the gamma increase was almost twice as large in WKY rats than in SD rats. Ketamine also increased beta oscillations, but only in WKY rats. These differences in sleep and EEG are unlikely to be caused by dissimilarities in ketamine metabolism as the plasma concentrations of ketamine and its metabolites were similar in both strains. Our data suggest an enhanced antidepressant-like response to ketamine in WKY rats, and further support the predictive validity of acute REM sleep suppression as a measure of antidepressant responsiveness.
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Affiliation(s)
- Sandor Kantor
- Transpharmation Ltd, 2 Royal College Street, London, NW1 0NH, United Kingdom; Transpharmation Canada, Fergus, ON, N1M 2W8, Canada.
| | - Michael Lanigan
- Transpharmation Ltd, 2 Royal College Street, London, NW1 0NH, United Kingdom; University of Hertfordshire, College Lane, Hatfield, Herts, AL10 9AD, United Kingdom
| | - Lauren Giggins
- Transpharmation Ltd, 2 Royal College Street, London, NW1 0NH, United Kingdom
| | - Lisa Lione
- University of Hertfordshire, College Lane, Hatfield, Herts, AL10 9AD, United Kingdom
| | | | | | - Neil Upton
- Transpharmation Ltd, 2 Royal College Street, London, NW1 0NH, United Kingdom
| | - Mark Duxon
- Transpharmation Ltd, 2 Royal College Street, London, NW1 0NH, United Kingdom; Transpharmation Canada, Fergus, ON, N1M 2W8, Canada
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11
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Damsgaard L, Janbek J, Laursen TM, Erlangsen A, Spira AP, Waldemar G. Hospital-diagnosed sleep disorders and incident dementia: a nationwide observational cohort study. Eur J Neurol 2022; 29:3528-3536. [PMID: 35916072 PMCID: PMC9805192 DOI: 10.1111/ene.15517] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/21/2022] [Accepted: 07/27/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND PURPOSE Several smaller, community-based studies have suggested a link between sleep disorders and dementia with a focus on sleep as a modifiable risk factor for dementia. Studies on neurodegenerative diseases are prone to reverse causation, and few studies have examined the association with long follow-up time. Our aim was to explore the possible association between sleep disorders and late-onset dementia in an entire population. METHODS In a nationwide cohort with 40-year follow-up, associations between hospital-based sleep disorder diagnoses and late-onset dementia were assessed. Incidence rate ratios (IRR) were calculated using Poisson regression. RESULTS The cohort consisted of 1,491,276 people. Those with any sleep disorder had a 17% higher risk of dementia (IRR 1.17, 95% confidence interval [CI] 1.11-1.24) compared to people with no sleep disorder, adjusted for age, sex, calendar year, highest attained educational level at age 50, and somatic and psychiatric comorbidity. The risk of dementia was significantly increased 0-5 years after sleep disorder diagnosis (IRR 1.35, 95% CI 1.25-1.47), whilst the association after 5 years or more was non-significant (1.05, 95% CI 0.97-1.13). CONCLUSIONS Our findings show an increased short-term risk of dementia following a hospital-based sleep disorder diagnosis, whilst weaker evidence of a long-term risk was found. This could potentially point towards sleep disorders as an early symptom of dementia. Further research is needed to distinguish sleep disorders as an early symptom of dementia, a risk factor, or both.
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Affiliation(s)
- Line Damsgaard
- Danish Dementia Research Centre, Section 8008, Department of NeurologyCopenhagen University Hospital—RigshospitaletCopenhagenDenmark
| | - Janet Janbek
- Danish Dementia Research Centre, Section 8008, Department of NeurologyCopenhagen University Hospital—RigshospitaletCopenhagenDenmark
| | - Thomas Munk Laursen
- Department of Economics and Business EconomicsNational Centre for Register‐based Research, Aarhus BSS, Aarhus UniversityAarhus VDenmark
| | - Annette Erlangsen
- Danish Research Institute for Suicide Prevention, Mental Health Centre CopenhagenHellerupDenmark,Department of Mental HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA,Copenhagen Research Centre for Mental HealthHellerupDenmark,Center of Mental Health ResearchAustralian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Adam P. Spira
- Department of Mental HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA,Department of Psychiatry and Behavioral SciencesJohns Hopkins School of MedicineBaltimoreMarylandUSA,Johns Hopkins Center on Aging and HealthBaltimoreMarylandUSA
| | - Gunhild Waldemar
- Danish Dementia Research Centre, Section 8008, Department of NeurologyCopenhagen University Hospital—RigshospitaletCopenhagenDenmark,Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
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12
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Mediterranean Diet on Sleep: A Health Alliance. Nutrients 2022; 14:nu14142998. [PMID: 35889954 PMCID: PMC9318336 DOI: 10.3390/nu14142998] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 07/17/2022] [Accepted: 07/20/2022] [Indexed: 12/19/2022] Open
Abstract
The Mediterranean diet is a plant-based, antioxidant-rich, unsaturated fat dietary pattern that has been consistently associated with lower rates of noncommunicable diseases and total mortality, so that it is considered one of the healthiest dietary patterns. Clinical trials and mechanistic studies have demonstrated that the Mediterranean diet and its peculiar foods and nutrients exert beneficial effects against inflammation, oxidative stress, dysmetabolism, vascular dysfunction, adiposity, senescence, cognitive decline, neurodegeneration, and tumorigenesis, thus preventing age-associated chronic diseases and improving wellbeing and health. Nocturnal sleep is an essential physiological function, whose alteration is associated with health outcomes and chronic diseases. Scientific evidence suggests that diet and sleep are related in a bidirectional relationship, and the understanding of this association is important given their role in disease prevention. In this review, we surveyed the literature concerning the current state of evidence from epidemiological studies on the impact of the Mediterranean diet on nighttime sleep quantity and quality. The available studies indicate that greater adherence to the Mediterranean diet is associated with adequate sleep duration and with several indicators of better sleep quality. Potential mechanisms mediating the effect of the Mediterranean diet and its foods and nutrients on sleep are described, and gap-in-knowledge and new research agenda to corroborate findings are discussed.
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13
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Simon KC, Whitehurst LN, Zhang J, Mednick SC. Zolpidem Maintains Memories for Negative Emotions Across a Night of Sleep. AFFECTIVE SCIENCE 2022; 3:389-399. [PMID: 35791418 PMCID: PMC9249708 DOI: 10.1007/s42761-021-00079-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 09/01/2021] [Indexed: 11/27/2022]
Abstract
Zolpidem, a common medication for sleep complaints, also shows secondary, unexpected memory benefits. We previously found that zolpidem prior to a nap enhanced negative, highly arousing picture memory. As zolpidem is typically administered at night, how it affects overnight emotional memory processing is relevant. We used a double-blind, placebo-controlled, within-subject, cross-over design to investigate if zolpidem boosted negative compared to neutral picture memory. Subjects learned both pictures sets in the morning. That evening, subjects were administered zolpidem or placebo and slept in the lab. Recognition was tested that evening and the following morning. We found that zolpidem maintained negative picture memory compared to forgetting in the placebo condition. Furthermore, zolpidem increased slow-wave sleep time, decreased rapid eye movement sleep time, and increased the fast spindle range in NREM. Our results suggest that zolpidem may enhance negative memory longevity and salience. These findings raise concerns for zolpidem administration to certain clinical populations.
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Affiliation(s)
- Katharine C. Simon
- Department of Cognitive Science, University of California, Irvine, 2201 Social & Behavioral Sciences Gateway, Irvine, CA 92697 USA
| | | | - Jing Zhang
- Department of Cognitive Science, University of California, Irvine, 2201 Social & Behavioral Sciences Gateway, Irvine, CA 92697 USA
| | - Sara C. Mednick
- Department of Cognitive Science, University of California, Irvine, 2201 Social & Behavioral Sciences Gateway, Irvine, CA 92697 USA
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14
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Qian D, Wong J. Sleep disturbances, sleep-disordered breathing, and cognitive impairment in older adults: perioperative implications. Int Anesthesiol Clin 2022; 60:20-26. [PMID: 35261342 DOI: 10.1097/aia.0000000000000359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Dorothy Qian
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jean Wong
- University Health Network, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
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15
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Pre-pregnancy sleep duration and postpartum depression: a multicenter study in Japan. Arch Womens Ment Health 2022; 25:181-189. [PMID: 34255202 DOI: 10.1007/s00737-021-01136-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 04/19/2021] [Indexed: 10/20/2022]
Abstract
Postpartum depression (PPD) is as a major public health issue and clinical priority worldwide. This study aimed to investigate the association between pre-pregnancy sleep duration and PPD. A multicenter retrospective study was conducted using clinical data of women who delivered at term between 2014 and 2018 at 12 maternity care hospitals in Japan. A total of 15,314 women were stratified into five groups according to their pre-pregnancy sleep duration: < 6, 6-7, 7-8, 8-9, and ≥ 9 h. Univariate and multivariate regression analyses were conducted to determine whether pre-pregnancy sleep duration affects the Edinburgh Postnatal Depression Scale (EPDS) scores at 1 month postpartum. We also evaluated whether the risk for PPD differs between primipara and multipara women classified according to pre-pregnancy sleep duration. The adjusted odds ratio for high EPDS scores (≥ 9) among women who slept for < 6 h and 6-7 h was 2.08 (95% confidence interval [CI]: 1.60-2.70) and 1.41 (95% CI: 1.18-1.68), respectively, relative to that in women with 7-8 h of sleep as the reference group. A 1-h increase in sleep duration was associated with an approximately 14% reduction in the risk for high EPDS scores. The association between short sleep duration and high EPDS scores was more remarkable in multipara women than in primipara women. Short pre-pregnancy sleep duration is associated with high EPDS scores, and this association is more significant in multipara women than in primipara women. Our findings emphasize the importance of collecting information on pre-pregnancy sleep duration to identify women at a high risk for PPD.
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16
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Radwan B, Jansen G, Chaudhury D. Sleep-wake dynamics pre- and post-exposure to chronic social stress. iScience 2021; 24:103204. [PMID: 34703999 PMCID: PMC8524188 DOI: 10.1016/j.isci.2021.103204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 09/16/2021] [Accepted: 09/28/2021] [Indexed: 10/28/2022] Open
Abstract
An analytical approach combining the statistical distributions of the sleep-wake bouts and the Markov transition matrix is used to explain the under-examined association between the microarchitecture of the sleep-wake cycle and susceptibility to chronic social stress in C57BL/6J mice. We separated the sleep-wake transitions into distinct sleep-wake sequences, NREM↔Wake and NREM→REM→Wake, which are controlled by independent neural circuits. Our findings imply greater pull toward the wake leading to early termination and fragmentation of the sleep bouts in the light in both sleep-wake sequences pre- and post-stress. Moreover, the stability of NREM in the NREM↔Wake transition was lower, and the probability of transitioning to wake was higher in susceptible relative to resilient or stress-naïve mice pre- and post-stress. Our findings help elucidate the mechanistic interplay between sleep and mood by suggesting the potential neural underpinnings of sleep disturbances responsible the aberrant transitions of sleep-wake bouts exhibited by the stress-susceptible phenotype.
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Affiliation(s)
- Basma Radwan
- Department of Biology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Gloria Jansen
- Wellcome Trust Developmental Mechanisms, Cambridge University, Cambridge, UK
| | - Dipesh Chaudhury
- Department of Biology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
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17
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Abstract
Understanding of the evolved biological function of sleep has advanced considerably in the past decade. However, no equivalent understanding of dreams has emerged. Contemporary neuroscientific theories often view dreams as epiphenomena, and many of the proposals for their biological function are contradicted by the phenomenology of dreams themselves. Now, the recent advent of deep neural networks (DNNs) has finally provided the novel conceptual framework within which to understand the evolved function of dreams. Notably, all DNNs face the issue of overfitting as they learn, which is when performance on one dataset increases but the network's performance fails to generalize (often measured by the divergence of performance on training versus testing datasets). This ubiquitous problem in DNNs is often solved by modelers via "noise injections" in the form of noisy or corrupted inputs. The goal of this paper is to argue that the brain faces a similar challenge of overfitting and that nightly dreams evolved to combat the brain's overfitting during its daily learning. That is, dreams are a biological mechanism for increasing generalizability via the creation of corrupted sensory inputs from stochastic activity across the hierarchy of neural structures. Sleep loss, specifically dream loss, leads to an overfitted brain that can still memorize and learn but fails to generalize appropriately. Herein this "overfitted brain hypothesis" is explicitly developed and then compared and contrasted with existing contemporary neuroscientific theories of dreams. Existing evidence for the hypothesis is surveyed within both neuroscience and deep learning, and a set of testable predictions is put forward that can be pursued both in vivo and in silico.
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Affiliation(s)
- Erik Hoel
- Allen Discovery Center, Tufts University, Medford, MA, USA
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18
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Risk factors for sleep disorders in patients undergoing peritoneal dialysis. Sleep Biol Rhythms 2021. [DOI: 10.1007/s41105-021-00311-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AbstractSleep disorders in patients with end-stage renal disease are common but have rarely been reported in previous studies. Therefore, we examined the prevalence of sleep disorders and the risk factors for declining sleep quality in patients undergoing peritoneal dialysis (PD). A multicenter prospective cohort study was conducted at five PD centers across different provinces in China. A total of 449 patients who underwent PD between March to November 2013 were enrolled. Demographic data, laboratory indicators, presence of depression, and sleep assessment data were collected. Sleep questionnaires reflecting five categories of sleep disorders, namely, insomnia, restless legs syndrome, excessive daytime sleepiness, possible narcolepsy, and sleepwalking and nightmares, were administered at baseline and at 24 months postoperatively. Sleep disorders were diagnosed when a patient had at least one sleep problem. At baseline, 335 (74.6%) patients had at least one type of sleep disorder. Depression, diabetes mellitus (DM), and male were found to be associated with the presence of a sleep disorder. At follow-up, the prevalence of insomnia, restless legs syndrome, and excessive daytime sleepiness had significantly increased in 285 patients. Furthermore, cardiovascular disease (CVD) was found to be associated with the presence of sleep disorders in patients with one or more disorders at baseline, whereas a low serum albumin level was found to be associated with sleep disorders in patients without any sleep disorders at baseline. The prevalence of sleep disorders was relatively high among PD patients at baseline and increased afterthe2-year follow-up. Depression, DM, and male were associated with all sleep disorders at baseline. CVD was associated with the presence of a sleep disorder at baseline and worse sleep quality at the 2-year follow-up; whereas a low serum albumin level was associated with the risk of acquiring a sleep disorder at the 2-year follow-up among patients with normal sleep status at baseline.
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19
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Li M, Cui J, Xu B, Wei Y, Fu C, Lv X, Xiong L, Qin D. Sleep Disturbances and Depression Are Co-morbid Conditions: Insights From Animal Models, Especially Non-human Primate Model. Front Psychiatry 2021; 12:827541. [PMID: 35145441 PMCID: PMC8821160 DOI: 10.3389/fpsyt.2021.827541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 12/31/2021] [Indexed: 02/05/2023] Open
Abstract
The incidence rates of depression are increasing year by year. As one of the main clinical manifestations of depression, sleep disorder is often the first complication. This complication may increase the severity of depression and lead to poor prognosis in patients. In the past decades, there have been many methods used to evaluate sleep disorders, such as polysomnography and electroencephalogram, actigraphy, and videography. A large number of rodents and non-human primate models have reproduced the symptoms of depression, which also show sleep disorders. The purpose of this review is to examine and discuss the relationship between sleep disorders and depression. To this end, we evaluated the prevalence, clinical features, phenotypic analysis, and pathophysiological brain mechanisms of depression-related sleep disturbances. We also emphasized the current situation, significance, and insights from animal models of depression, which would provide a better understanding for the pathophysiological mechanisms between sleep disturbance and depression.
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Affiliation(s)
- Meng Li
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Jieqiong Cui
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Bonan Xu
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Yuanyuan Wei
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Chenyang Fu
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Xiaoman Lv
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Lei Xiong
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Dongdong Qin
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
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20
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Radwan B, Jansen G, Chaudhury D. Sleep-Wake Dynamics Pre- and Post-Exposure to Chronic Social Stress. SSRN ELECTRONIC JOURNAL 2021. [DOI: 10.2139/ssrn.3869114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2023]
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21
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Alfini AJ, Won J, Weiss LR, Nyhuis CC, Shackman AJ, Spira AP, Smith JC. Impact of exercise on older adults' mood is moderated by sleep and mediated by altered brain connectivity. Soc Cogn Affect Neurosci 2020; 15:1238-1251. [PMID: 33201227 PMCID: PMC7745152 DOI: 10.1093/scan/nsaa149] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/25/2020] [Accepted: 10/27/2020] [Indexed: 01/01/2023] Open
Abstract
Older adults comprise the fastest growing global demographic and are at increased risk of poor mental health outcomes. Although aerobic exercise and sleep are critical to the preservation of emotional well-being, few studies have examined their combined mood-enhancing effects, or the potential neural mechanisms underlying these effects. Here, we used a randomized crossover design to test the impact of acute exercise on mood and the intrinsic functional connectivity (iFC) of the cingulo-opercular network in physically healthy older adults. Wrist actigraphy provided objective indices of sleep. Results revealed that 30 min of moderate-intensity aerobic exercise acutely enhanced positive affect (PA) and reduced iFC between the cingulo-opercular network and the hippocampus. Both effects were magnified among older adults with greater sleep disturbance. Exercise-induced changes in hippocampal iFC mediated relations between sleep disturbance and exercise-induced increases in PA. These findings provide evidence that aerobic exercise enhances mood, that it does so by altering connectivity between the anterior insula-a key hub in the cingulo-opercular network-and the hippocampus and that lower sleep quality is a stronger predictor of these effects among older adults. These observations underscore the benefits of moderate-intensity exercise-a safe and scalable behavioral intervention-and provide new clues about the neural circuitry underlying the interactive effects of sleep and exercise on mood.
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Affiliation(s)
- Alfonso J Alfini
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Junyeon Won
- Department of Kinesiology, University of Maryland School of Public Health, College Park, MD 20742, USA
| | - Lauren R Weiss
- Department of Kinesiology, University of Maryland School of Public Health, College Park, MD 20742, USA
- Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD 20742, USA
| | - Casandra C Nyhuis
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Alexander J Shackman
- Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD 20742, USA
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
- Center on Aging and Health, Johns Hopkins School of Medicine and Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - J Carson Smith
- Department of Kinesiology, University of Maryland School of Public Health, College Park, MD 20742, USA
- Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD 20742, USA
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22
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Ben Simon E, Vallat R, Barnes CM, Walker MP. Sleep Loss and the Socio-Emotional Brain. Trends Cogn Sci 2020; 24:435-450. [DOI: 10.1016/j.tics.2020.02.003] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 01/21/2020] [Accepted: 02/07/2020] [Indexed: 01/11/2023]
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23
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Early Life Trauma Has Lifelong Consequences for Sleep And Behavior. Sci Rep 2019; 9:16701. [PMID: 31723235 PMCID: PMC6853921 DOI: 10.1038/s41598-019-53241-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 10/30/2019] [Indexed: 12/13/2022] Open
Abstract
Sleep quality varies widely across individuals, especially during normal aging, with impaired sleep contributing to deficits in cognition and emotional regulation. Sleep can also be impacted by a variety of adverse events, including childhood adversity. Here we examined how early life adverse events impacted later life sleep structure and physiology using an animal model to test the relationship between early life adversity and sleep quality across the life span. Rat pups were exposed to an Adversity-Scarcity model from postnatal day 8–12, where insufficient bedding for nest building induces maternal maltreatment of pups. Polysomnography and sleep physiology were assessed in weaning, early adult and older adults. Early life adversity induced age-dependent disruptions in sleep and behavior, including lifelong spindle decreases and later life NREM sleep fragmentation. Given the importance of sleep in cognitive and emotional functions, these results highlight an important factor driving variation in sleep, cognition and emotion throughout the lifespan that suggest age-appropriate and trauma informed treatment of sleep problems.
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24
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Salas-Crisóstomo M, Torterolo P, Veras AB, Rocha NB, Machado S, Murillo-Rodríguez E. Therapeutic Approaches for the Management of Sleep Disorders in Geriatric Population. Curr Med Chem 2019; 26:4775-4785. [PMID: 30182852 DOI: 10.2174/0929867325666180904113115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 09/25/2017] [Accepted: 08/16/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Aging is a natural biological phenomenon that occurs in human beings. With increasing of age, there is an appearance of deleterious changes related to progression onto pathological conditions, including hypertension, heart disease, diabetes, hearing and vision impairments, as well as sleep disorders. It is important to recognize that some sleep disturbances reported by aged subjects include insomnia, obstructive sleep apnea, restless legs syndrome, among others. Moreover, accumulating evidence indicates that coexistence of medical issues with sleep disorders constitutes clinical challenges for treatment of comorbidities in elderly. Here, we have attempted to review and summarize the available literature that assesses the sleep disturbances in aging. In addition, we highlight the management of sleep disorders associated with aging. Due to the particular health condition of aged adults, the development of effective pharmacological interventions for sleep disorders treatment in aging is warranted. METHODS Review of studies retrieved from the PubMed. RESULTS The sleep-wake cycle includes abnormalities classified as sleep disorders. Comorbidity between sleep disturbances and aging-related health issues will represent a public health challenge to be addressed in the near future. Moreover, this scenario will suggest an area that requires further drug investigation and design of new pharmacological and pharmaceutical strategies to treat sleep disorders in the elderly population. CONCLUSION The review highlights the sleep disturbances in aging. We focus on current knowledge in medicinal chemistry and further design of new treatments tools for managing sleep disturbances in the aged population.
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Affiliation(s)
- Mireille Salas-Crisóstomo
- Laboratorio de Neurociencias Moleculares e Integrativas. Escuela de Medicina División Ciencias de la Salud. Universidad Anáhuac Mayab, Mérida, Yucatán, México.,Grupo de Investigacion en Envejecimiento. Division Ciencias de la Salud, Universidad Anahuac Mayab. Merida, Yucatan, Mexico.,Intercontinental Neuroscience Research Group, Montevideo, Uruguay
| | - Pablo Torterolo
- Intercontinental Neuroscience Research Group, Montevideo, Uruguay.,Laboratorio de Neurobiologia del Sueno. Depto. de Fisiologia, Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay
| | - André Barciela Veras
- Intercontinental Neuroscience Research Group, Montevideo, Uruguay.,Institute of Psychiatry. Federal University of Rio de Janeiro. Rio de Janeiro, Brazil.,Dom Bosco Catholic University. Campo Grande, Mato Grosso del Sur, Brazil
| | - Nuno Barbosa Rocha
- Intercontinental Neuroscience Research Group, Montevideo, Uruguay.,Health School Sciences, Polytechnic Institute of Porto, Porto, Portugal
| | - Sérgio Machado
- Intercontinental Neuroscience Research Group, Montevideo, Uruguay.,Laboratory of Panic and Respiration, Institute of Psychiatry of Federal University of Rio de Janeiro, Rio de Janeiro. Brazil.,Physical Activity Neuroscience Laboratory, Physical Activity Sciences Postgraduate Program of Salgado de Oliveira University. Niterói, Brazil
| | - Eric Murillo-Rodríguez
- Laboratorio de Neurociencias Moleculares e Integrativas. Escuela de Medicina División Ciencias de la Salud. Universidad Anáhuac Mayab, Mérida, Yucatán, México.,Grupo de Investigacion en Envejecimiento. Division Ciencias de la Salud, Universidad Anahuac Mayab. Merida, Yucatan, Mexico.,Intercontinental Neuroscience Research Group, Montevideo, Uruguay
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25
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Bagherzadeh-Azbari S, Khazaie H, Zarei M, Spiegelhalder K, Walter M, Leerssen J, Van Someren EJW, Sepehry AA, Tahmasian M. Neuroimaging insights into the link between depression and Insomnia: A systematic review. J Affect Disord 2019; 258:133-143. [PMID: 31401541 DOI: 10.1016/j.jad.2019.07.089] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 07/06/2019] [Accepted: 07/30/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Insomnia is a common symptom of Major Depressive Disorder (MDD) and genome-wide association studies pointed to their strong genetic association. Although the prevalence of insomnia symptoms in MDD is noticeable and evidence supports their strong bidirectional association, the number of available neuroimaging findings on patients of MDD with insomnia symptoms is limited. However, such neuroimaging studies could verily improve our understanding of their shared pathophysiology and advance corresponding theories. METHODS Based on the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guideline, we have conducted a literature search using PubMed, EMBASE, and Scopus databases and systematically explored 640 studies using various neuroimaging modalities in MDD patients with different degrees of insomnia symptoms. RESULTS Despite inconsistencies, current findings from eight studies suggested structural and functional disturbances in several brain regions including the amygdala, prefrontal cortex and anterior cingulate cortex and insula. The aberrant functional connectivity within and between the main hubs of the salience and default mode networks could potentially yield new insights into the link between MDD and insomnia, which needs further assessment. LIMITATIONS The number of studies reviewed herein is limited. The applied methods for assessing structural and functional neural mechanisms of insomnia and depression were variable. CONCLUSION Neuroimaging methods demonstrated the overlapping underlying neural mechanisms between MDD and insomnia. Future studies may facilitate better understanding of their pathophysiology to allow development of specific treatment.
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Affiliation(s)
- Shadi Bagherzadeh-Azbari
- Institute of Medical Sciences and Technology, Shahid Beheshti University, Tehran, Iran; Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mojtaba Zarei
- Institute of Medical Sciences and Technology, Shahid Beheshti University, Tehran, Iran
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Martin Walter
- Department of Psychiatry, University of Tübingen, Tübingen, Germany; Clinical Affective Neuroimaging Laboratory, Leibniz Institute for Neurobiology, Otto-von-Guericke University, Magdeburg, Germany
| | - Jeanne Leerssen
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences, 1105 BA, Amsterdam, Netherlands; Departments of Psychiatry and Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, Vrije Universtiteit Amsterdam, Amsterdam UMC, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands
| | - Eus J W Van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences, 1105 BA, Amsterdam, Netherlands; Departments of Psychiatry and Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, Vrije Universtiteit Amsterdam, Amsterdam UMC, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands
| | - Amir A Sepehry
- Clinical and Counselling Psychology Program, Adler University, Vancouver, BC, Canada
| | - Masoud Tahmasian
- Institute of Medical Sciences and Technology, Shahid Beheshti University, Tehran, Iran.
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Sleep Impact on Perception, Memory, and Emotion in Adults and the Effects of Early-Life Experience. HANDBOOK OF SLEEP RESEARCH 2019. [DOI: 10.1016/b978-0-12-813743-7.00039-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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27
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Ghazi Sherbaf F, Rostam Abadi Y, Mojtahed Zadeh M, Ashraf-Ganjouei A, Sanjari Moghaddam H, Aarabi MH. Microstructural Changes in Patients With Parkinson's Disease Comorbid With REM Sleep Behaviour Disorder and Depressive Symptoms. Front Neurol 2018; 9:441. [PMID: 29997561 PMCID: PMC6028696 DOI: 10.3389/fneur.2018.00441] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 05/25/2018] [Indexed: 12/14/2022] Open
Abstract
The diagnosis of Parkinson's disease (PD) is currently anchored on clinical motor symptoms, which appear more than 20 years after initiation of the neurotoxicity. Extra-nigral involvement in the onset of PD with probable nonmotor manifestations before the development of motor signs, lead us to the preclinical (asymptomatic) or prodromal stages of the disease (various nonmotor or subtle motor signs). REM sleep behavior disorder (RBD) and depression are established prodromal clinical markers of PD and predict worse motor and cognitive outcomes. Nevertheless, taken by themselves, these markers are not yet claimed to be practical in identifying high-risk individuals. Combining promising markers may be helpful in a reliable diagnosis of early PD. Therefore, we aimed to detect neural correlates of RBD and depression in 93 treatment-naïve and non-demented early PD by means of diffusion MRI connectometry. Comparing four groups of PD patients with or without comorbid RBD and/or depressive symptoms with each other and with 31 healthy controls, we found that these two non-motor symptoms are associated with lower connectivity in several white matter tracts including the cerebellar peduncles, corpus callosum and long association fibers such as cingulum, fornix, and inferior longitudinal fasciculus. For the first time, we were able to detect the involvement of short association fibers (U-fibers) in PD neurodegenerative process. Longitudinal studies on larger sample groups are needed to further investigate the reported associations.
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28
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Rogers A, Morrison I, Rorie DA, Mackenzie IS, MacDonald TM. Protocol for assessment of sleep quality and duration in the Treatment In Morning versus Evening (TIME) study: a randomised controlled trial using online patient-reported outcome measures. BMJ Open 2018; 8:e021890. [PMID: 29880573 PMCID: PMC6009625 DOI: 10.1136/bmjopen-2018-021890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION We will use the existing online mechanisms of the Treatment in Morning versus Evening (TIME) study to collect patient-reported outcome measures of sleep quality to determine whether nocturnal dosing of antihypertensives affects sleep quality, when compared with morning dosing.The TIME study aims to determine if morning or evening dosing of antihypertensive medications is more effective in preventing heart attacks and strokes. The cardiovascular end points in TIME are identified by individual-level linkage to routinely collected hospital admissions and mortality data; these data are supplemented with participant-completed follow-up questionnaires, administered online.This substudy will provide information regarding the relative acceptability of morning and evening dosing of antihypertensives that will be essential should the TIME study results prompt doctors to consider advising particular dosing times to their patients. METHODS AND ANALYSIS TIME participants are aged over 18 years and prescribed at least one antihypertensive drug, taken once a day. They are self-enrolled and consented on the secure TIME website (www.timestudy.co.uk) and then randomised to dosing time. Study follow-up is conducted by automated email. Average participant follow-up is expected to be 4 years. Participants in the sleep substudy are asked to complete an online sleep quality questionnaire at baseline, after 3 months and annually. This includes a Pittsburgh Sleep Quality Index (PSQI), a Hospital Anxiety and Depression Scale and an Epworth Sleepiness Scale. The primary outcome of the TIME Sleep substudy is sleep quality as measured by the PSQI. Secondary outcomes include sleep quantity and duration, and an analysis of any association between sleep quality and the main outcome measures of the TIME study (heart attack, stroke and vascular death). ETHICS AND DISSEMINATION Ethical approval has been obtained from the Tayside Committee on Medical Research Ethics (MREC reference: 11/AL/0309), and results will be published in a peer-reviewed journal. PROTOCOL VERSION 9 (approved 19 July 2017). TRIAL REGISTRATION NUMBER UKCRN ID: 17071. ISRCTN 18157641. Pre-results.
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Affiliation(s)
- Amy Rogers
- University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Ian Morrison
- NHS Tayside, Ninewells Hospital and Medical School, Dundee, UK
| | - David A Rorie
- University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Isla S Mackenzie
- University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
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29
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Mondal G, Bajaj V, Goyal BL, Mukherjee N. Prevalence of sleep disorders and severity of insomnia in psychiatric outpatients attending a tertiary level mental health care facility in Punjab, India. Asian J Psychiatr 2018; 32:8-13. [PMID: 29197711 DOI: 10.1016/j.ajp.2017.11.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 10/26/2017] [Accepted: 11/26/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Sleep disorders are frequently associated with psychiatric disorders and can be both cause and effect of the same. AIM To study the prevalence of sleep disorders and the severity of insomnia in psychiatric outpatients. METHODS 500 patients were randomly selected using purposive sampling from patients attending a tertiary level mental health care facility were evaluated for the presence of any sleep disorder along with their sleep quality. In patients having insomnia, severity of the same was determined. RESULTS 83.4% of the population had some type of sleep disorder. Symptoms of insomnia were reported by 78.2% of the population and 29.2% had moderate to severe insomnia. 78.4% of the population had poor sleep quality. Significant difference was noted among the different psychiatric groups when insomnia severity index (ISI) was compared. In multinomial logistic regression, chance of severe insomnia is more if the diagnosis is depression, but less if mania or ocd, compared to psychosis. CONCLUSION This study was the first in India to assess the prevalence of sleep disorders in psychiatric outpatients. Our study underscores the importance of careful evaluation of sleep problems for proper management of the patients.
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Affiliation(s)
- Gargi Mondal
- Institute of Mental Health, Amritsar, Punjab, 143001, India.
| | - Vikrant Bajaj
- Institute of Mental Health, Amritsar, Punjab, 143001, India.
| | - B L Goyal
- Institute of Mental Health, Amritsar, Punjab, 143001, India
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30
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Chirinos DA, Gurubhagavatula I, Broderick P, Chirinos JA, Teff K, Wadden T, Maislin G, Saif H, Chittams J, Cassidy C, Hanlon AL, Pack AI. Depressive symptoms in patients with obstructive sleep apnea: biological mechanistic pathways. J Behav Med 2017; 40:955-963. [PMID: 28639107 PMCID: PMC9926999 DOI: 10.1007/s10865-017-9869-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 06/16/2017] [Indexed: 12/30/2022]
Abstract
This study examined the association between depressive symptoms, as well as depressive symptom dimensions, and three candidate biological pathways linking them to Obstructive sleep apnea (OSA): (1) inflammation; (2) circulating leptin; and (3) intermittent hypoxemia. Participants included 181 obese adults with moderate-to-severe OSA enrolled in the Cardiovascular Consequences of Sleep Apnea (COSA) trial. Depressive symptoms were measured using the Beck Depression Inventory-II (BDI-II). We assessed inflammation using C-reactive protein levels (CRP), circulating leptin by radioimmunoassay using a double antibody/PEG assay, and intermittent hypoxemia by the percentage of sleep time each patient had below 90% oxyhemoglobin saturation. We found no significant associations between BDI-II total or cognitive scores and CRP, leptin, or percentage of sleep time below 90% oxyhemoglobin saturation after controlling for relevant confounding factors. Somatic symptoms, however, were positively associated with percentage of sleep time below 90% saturation (β = 0.202, P = 0.032), but not with CRP or circulating leptin in adjusted models. Another significant predictor of depressive symptoms included sleep efficiency (βBDI Total = -0.230, P = 0.003; βcognitive = -0.173, P = 0.030 (βsomatic = -0.255, P = 0.001). In patients with moderate-to-severe OSA, intermittent hypoxia may play a role in somatic rather than cognitive or total depressive symptoms.
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Affiliation(s)
| | - Indira Gurubhagavatula
- University of Pennsylvania, School of Medicine/Hospital of the University of Pennsylvania. Philadelphia, PA.,Philadelphia VA Medical Center. Philadelphia, PA
| | - Preston Broderick
- University of Pennsylvania, School of Medicine/Hospital of the University of Pennsylvania. Philadelphia, PA
| | - Julio A Chirinos
- University of Pennsylvania, School of Medicine/Hospital of the University of Pennsylvania. Philadelphia, PA.,Philadelphia VA Medical Center. Philadelphia, PA
| | - Karen Teff
- Monell Chemical Senses Center, Philadelphia, PA
| | - Thomas Wadden
- University of Pennsylvania, School of Medicine/Hospital of the University of Pennsylvania. Philadelphia, PA
| | - Greg Maislin
- University of Pennsylvania, School of Medicine/Hospital of the University of Pennsylvania. Philadelphia, PA
| | | | - Jesse Chittams
- University of Pennsylvania, School of Nursing. Philadelphia, PA
| | - Caitlin Cassidy
- LaSalle University, Department of Psychology, Philadelphia, PA
| | | | - Allan I. Pack
- University of Pennsylvania, School of Medicine/Hospital of the University of Pennsylvania. Philadelphia, PA
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31
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Tashjian SM, Goldenberg D, Galván A. Neural connectivity moderates the association between sleep and impulsivity in adolescents. Dev Cogn Neurosci 2017; 27:35-44. [PMID: 28777996 PMCID: PMC6987861 DOI: 10.1016/j.dcn.2017.07.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 07/19/2017] [Accepted: 07/24/2017] [Indexed: 01/19/2023] Open
Abstract
Adolescence is characterized by chronic insufficient sleep and extensive brain development, but the relation between adolescent sleep and brain function remains unclear. We report the first functional magnetic resonance imaging study to investigate functional connectivity as a moderator between sleep and impulsivity, a problematic behavior during this developmental period. Naturalistic differences in sleep have not yet been explored as treatable contributors to adolescent impulsivity. Although public and scientific attention focuses on sleep duration, we report individual differences in sleep quality, not duration, in fifty-five adolescents (ages 14-18) yielded significant differences in functional connectivity between the prefrontal cortex and default mode network. Poor sleep quality was related to greater affect-related impulsivity among adolescents with low, but not high, connectivity, suggesting neural functioning relates to individual differences linking sleep quality and impulsivity. Response inhibition and cognitive impulsivity were not related to sleep quality, suggesting that sleep has a greater impact on affect-related impulsivity. Exploring environmental contributors of poor sleep quality, we demonstrated pillow comfort was uniquely related to sleep quality over age, sex, and income, a promising advance ripe for intervention.
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Affiliation(s)
- Sarah M Tashjian
- Department of Psychology, University of California, Los Angeles, CA 90095, USA.
| | - Diane Goldenberg
- Department of Psychology, University of California, Los Angeles, CA 90095, USA
| | - Adriana Galván
- Department of Psychology, University of California, Los Angeles, CA 90095, USA; Brain Research Institute, University of California, Los Angeles, CA 90095, USA.
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32
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Vyazovskiy VV, Walton ME, Peirson SN, Bannerman DM. Sleep homeostasis, habits and habituation. Curr Opin Neurobiol 2017; 44:202-211. [PMID: 28575718 DOI: 10.1016/j.conb.2017.05.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 04/06/2017] [Accepted: 05/01/2017] [Indexed: 02/08/2023]
Abstract
The importance of sleep for behavioural performance during waking is long-established, but the underlying reasons and mechanisms remain elusive. Waking and sleep are associated with changes in the levels of GluA1 AMPAR subunit in synaptic membranes, while studies using genetically-modified mice have identified an important role for GluA1-dependent synaptic plasticity in a non-associative form of memory that underlies short-term habituation to recently experienced stimuli. Here we posit that sleep may play a role in dishabituation, which restores attentional capacity and maximises the readiness of the animal for learning and goal-directed behaviour during subsequent wakefulness. Furthermore we suggest that sleep disturbance may fundamentally change the nature of behaviour, making it more model-free and habitual as a result of reduced attentional capacity.
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Affiliation(s)
- Vladyslav V Vyazovskiy
- Department of Physiology, Anatomy and Genetics, University of Oxford, Parks Road, Oxford, OX1 3PT, United Kingdom; Sleep and Circadian Neuroscience Institute, Oxford Molecular Pathology Institute, Sir William Dunn School of Pathology, South Parks Road, Oxford OX1 3RE, United Kingdom.
| | - Mark E Walton
- Department of Experimental Psychology, University of Oxford,South Parks Road, Oxford OX1 3UD, United Kingdom
| | - Stuart N Peirson
- Sleep and Circadian Neuroscience Institute, Oxford Molecular Pathology Institute, Sir William Dunn School of Pathology, South Parks Road, Oxford OX1 3RE, United Kingdom
| | - David M Bannerman
- Sleep and Circadian Neuroscience Institute, Oxford Molecular Pathology Institute, Sir William Dunn School of Pathology, South Parks Road, Oxford OX1 3RE, United Kingdom; Department of Experimental Psychology, University of Oxford,South Parks Road, Oxford OX1 3UD, United Kingdom
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33
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Lazzerini Ospri L, Prusky G, Hattar S. Mood, the Circadian System, and Melanopsin Retinal Ganglion Cells. Annu Rev Neurosci 2017; 40:539-556. [PMID: 28525301 DOI: 10.1146/annurev-neuro-072116-031324] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The discovery of a third type of photoreceptors in the mammalian retina, intrinsically photosensitive retinal ganglion cells (ipRGCs), has had a revolutionary impact on chronobiology. We can now properly account for numerous non-vision-related functions of light, including its effect on the circadian system. Here, we give an overview of ipRGCs and their function as it relates specifically to mood and biological rhythms. Although circadian disruptions have been traditionally hypothesized to be the mediators of light's effects on mood, here we present an alternative model that dispenses with assumptions of causality between the two phenomena and explains mood regulation by light via another ipRGC-dependent mechanism.
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Affiliation(s)
- Lorenzo Lazzerini Ospri
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205;
| | - Glen Prusky
- Department of Physiology and Biophysics, Cornell University, Ithaca, New York 10065
| | - Samer Hattar
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205; .,Department of Biology, Johns Hopkins University, Baltimore, Maryland 21218
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34
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Sensory Hypersensitivity Predicts Reduced Sleeping Quality in Patients With Major Affective Disorders. J Psychiatr Pract 2017; 23:11-24. [PMID: 28072641 DOI: 10.1097/pra.0000000000000210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The goal of this study was to examine the sensory profile (expressed as hypersensitivity or hyposensitivity) of patients with major affective disorders and its relative contribution to the prediction of sleep quality while considering affective temperaments and depression, which may impact sleep quality. We recruited 176 participants (mean age, 47.3 y), of whom 56.8% had a diagnosis of unipolar major depressive disorder and 43.2% a diagnosis of bipolar disorder. Reduced sleep quality was evaluated using the Pittsburgh Sleep Quality Index. Affective temperaments were assessed using the Temperament Evaluation of Memphis, Pisa, Paris and San Diego. Sensory hypersensitivity, assessed using the Adolescent/Adult Sensory Profile, significantly distinguished between poor and good sleepers. Sleep quality was mainly predicted by the Beck Depression Inventory-II total score and anxious temperament. Sensory hypersensitivity contributed to this prediction mainly with regard to sleep efficiency and related daytime dysfunction.
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35
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Kamal RM, van Noorden MS, Franzek E, Dijkstra BAG, Loonen AJM, De Jong CAJ. The Neurobiological Mechanisms of Gamma-Hydroxybutyrate Dependence and Withdrawal and Their Clinical Relevance: A Review. Neuropsychobiology 2016; 73:65-80. [PMID: 27003176 DOI: 10.1159/000443173] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 11/29/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE x03B3;-Hydroxybutyrate (GHB) has gained popularity as a drug of abuse. In the Netherlands the number of patients in treatment for GHB dependence has increased sharply. Clinical presentation of GHB withdrawal can be life threatening. We aim, through this overview, to explore the neurobiological pathways causing GHB dependency and withdrawal, and their implications for treatment choices. METHODS In this work we review the literature discussing the findings from animal models to clinical studies focused on the neurobiological pathways of endogenous but mainly exogenous GHB. RESULTS Chronic abuse of GHB exerts multifarious neurotransmitter and neuromodulator effects on x03B3;-aminobutyric acid (GABA), glutamate, dopamine, serotonin, norepinephrine and cholinergic systems. Moreover, important effects on neurosteroidogenesis and oxytocin release are wielded. GHB acts mainly via a bidirectional effect on GABAB receptors (GABABR; subunits GABAB1 and GABAB2), depending on the subunit of the GIRK (G-protein-dependent ion inwardly rectifying potassium) channel involved, and an indirect effect of the cortical and limbic inputs outside the nucleus accumbens. GHB also activates a specific GHB receptor and β1-subunits of α4-GABAAR. Reversing this complex interaction of neurobiological mechanisms by the abrupt cessation of GHB use results in a withdrawal syndrome with a diversity of symptoms of different intensity, depending on the pattern of GHB abuse. CONCLUSION The GHB withdrawal symptoms cannot be related to a single mechanism or neurological pathway, which implies that different medication combinations are needed for treatment. A single drug class, such as benzodiazepines, gabapentin or antipsychotics, is unlikely to be sufficient to avoid life-threatening complications. Detoxification by means of titration and tapering of pharmaceutical GHB can be considered as a promising treatment that could make polypharmacy redundant.
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Affiliation(s)
- Rama M Kamal
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Nijmegen, The Netherlands
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36
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Ahnaou A, Raeyemaekers L, Huysmans H, Drinkenburg W. Off-target potential of AMN082 on sleep EEG and related physiological variables: Evidence from mGluR7 (−/−) mice. Behav Brain Res 2016; 311:287-297. [DOI: 10.1016/j.bbr.2016.05.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 04/27/2016] [Accepted: 05/16/2016] [Indexed: 02/08/2023]
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Ángeles-Castellanos M, Ramírez-Gonzalez F, Ubaldo-Reyes L, Rodriguez-Mayoral O, Escobar C. Loss of melatonin daily rhythmicity is asociated with delirium development in hospitalized older adults. ACTA ACUST UNITED AC 2016; 9:285-288. [PMID: 28154742 PMCID: PMC5279931 DOI: 10.1016/j.slsci.2016.08.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 07/23/2016] [Accepted: 08/01/2016] [Indexed: 11/29/2022]
Abstract
Delirium is associated with circadian rhythm disruption. In this study we have explored whether circadian variation of melatonin is an indicator for delirium. Melatonin levels were determined from the first day of hospitalization and up to three days after the onset of delirium. Patients who did not developed delirium exhibited a daily melatonin rhythm, while in patients that developed delirium, the melatonin rhythm was lost and mean melatonin levels were found decreased as early as three days before the diagnosis of delirium, indicating that on arrival to the hospital circadian melatonin disruption can be used as an indicator of delirium.
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Affiliation(s)
| | | | | | | | - Carolina Escobar
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico
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Abstract
Circadian alignment is crucial for body-weight management, and for metabolic health. In this context, circadian alignment consists of alignment of sleep, meal patterns and physical activity. During puberty a significant reduction in sleep duration occurs, and pubertal status is inversely associated with sleep duration. A consistent inverse association between habitual sleep duration and body-weight development occurs, independent of possible confounders. Research on misalignment reveals that circadian misalignment affects sleep-architecture and subsequently disturbs glucose–insulin metabolism, substrate oxidation, leptin- and ghrelin concentrations, appetite, food reward, hypothalamic–pituitary–adrenal-axis activity and gut-peptide concentrations enhancing positive energy balance and metabolic disturbance. Not only aligning meals and sleep in a circadian way is crucial, also regular physical activity during the day strongly promotes the stability and amplitude of circadian rhythm, and thus may serve as an instrument to restore poor circadian rhythms. Endogenicity may play a role in interaction of these environmental variables with a genetic predisposition. In conclusion, notwithstanding the separate favourable effects of sufficient daily physical activity, regular meal patterns, sufficient sleep duration and quality sleep on energy balance, the overall effect of the amplitude and stability of the circadian rhythm, perhaps including genetic predisposition, may integrate the separate effects in an additive way.
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40
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Ahnaou A, de Boer P, Lavreysen H, Huysmans H, Sinha V, Raeymaekers L, Van De Casteele T, Cid J, Van Nueten L, Macdonald G, Kemp J, Drinkenburg W. Translational neurophysiological markers for activity of the metabotropic glutamate receptor (mGluR2) modulator JNJ-40411813: Sleep EEG correlates in rodents and healthy men. Neuropharmacology 2016; 103:290-305. [DOI: 10.1016/j.neuropharm.2015.11.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 11/28/2015] [Accepted: 11/28/2015] [Indexed: 12/31/2022]
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Asaad T, Sabry W, Rabie M, El-Rassas H. Polysomnographic characteristics of bipolar hypomanic patients: Comparison with unipolar depressed patients. J Affect Disord 2016; 191:274-9. [PMID: 26688496 DOI: 10.1016/j.jad.2015.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 11/24/2015] [Accepted: 12/04/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND Sleep profile in bipolar disorder has received little attention in comparison to sleep studies in major depressive disorders. Specific sleep abnormalities especially in REM sleep parameters have been detected in depression. The current study aimed at investigating whether bipolar disorder shares the same polysomnographic (PSG) changes or not. METHODS All night polysomnographic assessments were made for 20 patients diagnosed to have hypomania, in addition to 20 patients with major depression and 20 healthy matched controls. All participants were examined using Standardized Sleep Questionnaire, SCID-I for psychiatric diagnosis, based on DSM-IV criteria, YMRS (for hypomanic patients), HAMD (for major depression patients), and all-night polysomnography (for all subjects). RESULTS The two patient groups differed significantly from controls in their sleep profile, especially regarding sleep continuity measures, Short REML (Rapid Eye Movement Latency), with increased REMD (Rapid Eye Movement sleep density). High similarity was found in EEG sleep profile of the two patient groups, though the changes were more robust in patients with depression LIMITATIONS A relatively small sample size, the absence of follow up assessment, lack of consideration of other variables like body mass index, nicotine and caffeine intake. CONCLUSION Similarity in EEG sleep profile between Bipolar disorder patients and patients with major depression suggests a common biological origin for both conditions, with the difference being "quantitative" rather than "qualitative". This quantitative difference in sleep efficiency and SWS (Slow wave sleep), being higher in hypomania, might explain the rather "refreshing" nature of sleep in hypomanic patients, compared to depression.
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Affiliation(s)
- Tarek Asaad
- Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Egypt
| | - Walaa Sabry
- Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Egypt
| | - Menan Rabie
- Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Egypt
| | - Hanan El-Rassas
- Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Egypt
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Parletta N, Aljeesh Y, Baune BT. Health Behaviors, Knowledge, Life Satisfaction, and Wellbeing in People with Mental Illness across Four Countries and Comparisons with Normative Sample. Front Psychiatry 2016; 7:145. [PMID: 27597833 PMCID: PMC4993073 DOI: 10.3389/fpsyt.2016.00145] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 08/05/2016] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND People with chronic mental illness have poorer physical health and higher mortality than the general population. We investigated lifestyle factors in people with mental illness across four countries and compared with a normative sample. DESIGN AND METHODS Data were collected from N = 672 people (Germany, n = 375; Palestine, n = 192; London, n = 63; Australia, n = 42) with substance abuse disorder (n = 224), schizophrenia (n = 158), mood disorders (n = 227), and somatoform disorders (n = 63). The General Health Behaviour Questionnaire measured behaviors and knowledge related to nutrition, physical activity, alcohol, smoking, sleep, life satisfaction, and wellbeing. The normative samples were derived from a German population (N = 1,019). Data were analyzed using ANOVAs and t-tests. RESULTS The Palestine sample did not differ from the Western samples on reported life satisfaction and wellbeing. However, they reported unhealthier diets, less physical activity, and lower knowledge about the impact of diet, physical activity, smoking, and sleep on health than the Western samples. Comparing the Western and normative samples, people with mental illness reported lower intake of healthy foods/drinks, higher intake of unhealthy foods, higher exercise, higher alcohol consumption, less cigarettes, less sleep, and more sleep problems. Their knowledge was lower for nutrition, physical activity, and smoking. All participants reported lower life satisfaction and wellbeing than the normative sample (P-values <0.001). CONCLUSION Education on health-related lifestyle factors present important targets for primary care, quality of life and prevention of illness in people with mental illness. Further research will clarify specific predictors of health behaviors in each country.
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Affiliation(s)
- Natalie Parletta
- Centre for Population Health Research, School of Health Sciences, University of South Australia , Adelaide, SA , Australia
| | - Yousef Aljeesh
- Faculty of Nursing, Islamic University of Gaza , Gaza , Palestine
| | - Bernhard T Baune
- Department of Psychiatry, University of Adelaide , Adelaide, SA , Australia
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mGlu2 Receptor Agonism, but Not Positive Allosteric Modulation, Elicits Rapid Tolerance towards Their Primary Efficacy on Sleep Measures in Rats. PLoS One 2015; 10:e0144017. [PMID: 26658273 PMCID: PMC4684355 DOI: 10.1371/journal.pone.0144017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Accepted: 11/12/2015] [Indexed: 12/17/2022] Open
Abstract
G-protein-coupled receptor (GPCR) agonists are known to induce both cellular adaptations resulting in tolerance to therapeutic effects and withdrawal symptoms upon treatment discontinuation. Glutamate neurotransmission is an integral part of sleep-wake mechanisms, which processes have translational relevance for central activity and target engagement. Here, we investigated the efficacy and tolerance potential of the metabotropic glutamate receptors (mGluR2/3) agonist LY354740 versus mGluR2 positive allosteric modulator (PAM) JNJ-42153605 on sleep-wake organisation in rats. In vitro, the selectivity and potency of JNJ-42153605 were characterized. In vivo, effects on sleep measures were investigated in rats after once daily oral repeated treatment for 7 days, withdrawal and consecutive re-administration of LY354740 (1–10 mg/kg) and JNJ-42153605 (3–30 mg/kg). JNJ-42153605 showed high affinity, potency and selectivity at mGluR2. Binding site analyses and knowledge-based docking confirmed the specificity of JNJ-42153605 at the mGluR2 allosteric binding site. Acute LY354740 and JNJ-42153605 dose-dependently decreased rapid eye movement (REM) sleep time and prolonged its onset latency. Sub chronic effects of LY354740 on REM sleep measures disappeared from day 3 onwards, whereas those of JNJ-42153605 were maintained after repeated exposure. LY354740 attenuated REM sleep homeostatic recovery, while this was preserved after JNJ-42153605 administration. JNJ-42153605 enhanced sleep continuity and efficiency, suggesting its potential as an add-on medication for impaired sleep quality during early stages of treatment. Abrupt cessation of JNJ-42153605 did not induce withdrawal phenomena and sleep disturbances, while the initial drug effect was fully reinstated after re-administration. Collectively, long-term treatment with JNJ-42153605 did not induce tolerance phenomena to its primary functional effects on sleep measures, nor adverse effects at withdrawal, while it promoted homeostatic recovery sleep. From the translational perspective, the present rodent findings suggest that mGluR2 positive allosteric modulation has therapeutic potential based on its superior long term efficacy over agonists in psychiatric disorders, particularly of those commonly occurring with REM sleep overdrive.
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Pace-Schott EF, Germain A, Milad MR. Sleep and REM sleep disturbance in the pathophysiology of PTSD: the role of extinction memory. BIOLOGY OF MOOD & ANXIETY DISORDERS 2015; 5:3. [PMID: 26034578 PMCID: PMC4450835 DOI: 10.1186/s13587-015-0018-9] [Citation(s) in RCA: 137] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 05/12/2015] [Indexed: 01/04/2023]
Abstract
Post-traumatic stress disorder (PTSD) is accompanied by disturbed sleep and an impaired ability to learn and remember extinction of conditioned fear. Following a traumatic event, the full spectrum of PTSD symptoms typically requires several months to develop. During this time, sleep disturbances such as insomnia, nightmares, and fragmented rapid eye movement sleep predict later development of PTSD symptoms. Only a minority of individuals exposed to trauma go on to develop PTSD. We hypothesize that sleep disturbance resulting from an acute trauma, or predating the traumatic experience, may contribute to the etiology of PTSD. Because symptoms can worsen over time, we suggest that continued sleep disturbances can also maintain and exacerbate PTSD. Sleep disturbance may result in failure of extinction memory to persist and generalize, and we suggest that this constitutes one, non-exclusive mechanism by which poor sleep contributes to the development and perpetuation of PTSD. Also reviewed are neuroendocrine systems that show abnormalities in PTSD, and in which stress responses and sleep disturbance potentially produce synergistic effects that interfere with extinction learning and memory. Preliminary evidence that insomnia alone can disrupt sleep-dependent emotional processes including consolidation of extinction memory is also discussed. We suggest that optimizing sleep quality following trauma, and even strategically timing sleep to strengthen extinction memories therapeutically instantiated during exposure therapy, may allow sleep itself to be recruited in the treatment of PTSD and other trauma and stress-related disorders.
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Affiliation(s)
- Edward F. Pace-Schott
- />Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital—East, CNY 149 13th Street Room 2624, Charlestown, MA 02129 USA
| | - Anne Germain
- />Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA USA
| | - Mohammed R. Milad
- />Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital—East, CNY 149 13th Street Room 2624, Charlestown, MA 02129 USA
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Medina AB, Lechuga DA, Escandón OS, Moctezuma JV. Update of sleep alterations in depression. Sleep Sci 2014; 7:165-9. [PMID: 26483922 PMCID: PMC4559588 DOI: 10.1016/j.slsci.2014.09.015] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2013] [Revised: 08/12/2014] [Accepted: 08/27/2014] [Indexed: 01/23/2023] Open
Abstract
Sleep disturbances in depression are up to 70%. Patients frequently have difficulty in falling asleep, frequent awakenings during the night and non-restorative sleep. Sleep abnormalities in depression are mainly characterized by increased rapid eye movement (REM) sleep and reduced slow wave sleep. Among the mechanisms of sleep disturbances in depression are hyperactivation of the hypothalamic-pituitary-adrenal axis, CLOCK gene polymorphism and primary sleep disorders. The habenula is a structure regulating the activities of monoaminergic neurons in the brain. The hyperactivation of the habenula has also been implicated, together with sleep disturbances, in depression. The presence of depression in primary sleep disorders is common. Sleep disturbances treatment include pharmacotherapy or Cognitive Behavioral Therapy.
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Nelson AM, Coe CL, Juckett MB, Rumble ME, Rathouz PJ, Hematti P, Costanzo ES. Sleep quality following hematopoietic stem cell transplantation: longitudinal trajectories and biobehavioral correlates. Bone Marrow Transplant 2014; 49:1405-11. [PMID: 25133898 PMCID: PMC4221490 DOI: 10.1038/bmt.2014.179] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 06/04/2014] [Accepted: 06/25/2014] [Indexed: 12/24/2022]
Abstract
The present study examined changes in sleep quality following hematopoietic stem cell transplantation (HSCT) and investigated associations with biobehavioral factors. Individuals undergoing HSCT for hematologic malignancies (N=228) completed measures of sleep quality and psychological symptoms pre-transplant and 1, 3, 6, and 12 months post-transplant. Circulating inflammatory cytokines (IL-6, TNF-α) were also assessed. Sleep quality was poorest at one month post-transplant, improving and remaining relatively stable after 3 months post-transplant. However, approximately half of participants continued to experience significant sleep disturbance at 6 and 12 months post-transplant. Mixed-effects linear regression models indicated that depression and anxiety were associated with poorer sleep quality, while psychological well-being was associated with better sleep. Higher circulating levels of IL-6 were also linked with poorer sleep. Subject-level fixed effects models demonstrated that among individual participants, changes in depression, anxiety, and psychological well-being were associated with corresponding changes in sleep after covarying for the effects of time since transplant. Sleep disturbance was most severe when depression and anxiety were greatest, and psychological well-being was lowest. Findings indicate that sleep disturbance is a persistent problem during the year following HSCT. Patients experiencing depression or anxiety and those with elevated inflammation may be at particular risk for poor sleep.
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Affiliation(s)
- A M Nelson
- Department of Health Outcomes & Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - C L Coe
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
| | - M B Juckett
- 1] Hematology/Oncology Division, Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA [2] Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
| | - M E Rumble
- 1] Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA [2] Center for Sleep Medicine and Research, University of Wisconsin-Madison, Madison, WI, USA
| | - P J Rathouz
- Department of Biostatistics & Medical Informatics, University of Wisconsin-Madison, Madison, WI, USA
| | - P Hematti
- 1] Hematology/Oncology Division, Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA [2] Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
| | - E S Costanzo
- 1] Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA [2] Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
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Abstract
Background Headache and sleep mechanisms share multiple levels of physiological interaction. Pharmacological treatment of headache syndromes may be associated with a broad range of sleep disturbances, either as a direct result of the pharmacology of the drug used, or by unmasking physiological alterations in sleep propensity seen as part of the headache symptom complex. Purpose This review summarises known sleep and circadian effects of various drugs commonly used in the management of headache disorders, with particular attention paid to abnormal sleep function emerging as a result of treatment. Method Literature searches were performed using MEDLINE, PubMed, and the Cochrane database using search terms and strings relating to generic drug names of commonly used compounds in the treatment of headache and their effect on sleep in humans with review of additional pre-clinical evidence where theoretically appropriate. Conclusions Medications used to treat headache disorders may have a considerable impact on sleep physiology. However, greater attention is needed to characterise the direction of the changes of these effects on sleep, particularly to avoid exacerbating detrimental sleep complaints, but also to potentially capitalise on homeostatically useful properties of sleep which may reduce the individual burden of headache disorders on patients.
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Affiliation(s)
- Alexander D Nesbitt
- Headache Group, Department of Clinical Neuroscience, Institute of Psychiatry, King’s College London, UK
- Surrey Sleep Research Centre, University of Surrey, UK
- Sleep Disorders Centre, Guy’s and St Thomas’ NHS Foundation Trust, UK
| | - Guy D Leschziner
- Sleep Disorders Centre, Guy’s and St Thomas’ NHS Foundation Trust, UK
| | - Richard C Peatfield
- Department of Neurology, Charing Cross Hospital, Imperial College Healthcare NHS Foundation Trust, UK
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Ahnaou A, Ver Donck L, Drinkenburg WHIM. Blockade of the metabotropic glutamate (mGluR2) modulates arousal through vigilance states transitions: evidence from sleep-wake EEG in rodents. Behav Brain Res 2014; 270:56-67. [PMID: 24821401 DOI: 10.1016/j.bbr.2014.05.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 04/15/2014] [Accepted: 05/02/2014] [Indexed: 02/03/2023]
Abstract
Accumulating data continue to support the therapeutic potential of glutamate metabotropic (mGluR2) receptors for treatment of psychiatric disorders such as depression, anxiety and schizophrenia. Glutamate neurotransmission is an integral component of sleep-wake mechanisms, which have translational relevance to assess on-target activity of drugs. Here, we investigated the influence of mGluR2 inactivation upon sleep-wake electroencephalogram (EEG) in rodents. Rats were administered with vehicle, the specific mGluR2 antagonist LY341495 (2.5, 5, 10mg/kg) or negative allosteric modulator (NAM) Ro-4491533 (2.5, 10 and 40 mg/kg) at lights onset. mGluR2 (-/-) mice were used to confirm the selectivity of functional response. Both LY341495 and Ro-4491533 induced an immediate and endured desynchronized cortical activity during 3-6h associated with enhanced theta and gamma oscillations and depressed slow oscillations during sleep. The arousal-promoting effect is consistent with the marked lengthening of sleep onset latency, an increased number of state transitions from light sleep to waking and the gradual increase in homeostatic compensatory sleep. The arousal response to mGluR2 blockade was not accompanied by sharp rebound hypersomnolence as found with the classical psycho-stimulant amphetamine. mGluR2 (-/-) mice and their WT littermates exhibited similar sleep-wake phenotype, while Ro-4491533 (40 mg/kg) enhanced waking associated with increased locomotor activity and body temperature in WT but not in mGluR2 (-/-) mice, which confirm the role of mGluR2 inactivation in the arousal response. Our results lend support for a role of mGluR2 blockade in promoting cortical arousal associated with theta/gamma oscillations as well as high thresholds transitions from sleep to waking.
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Affiliation(s)
- A Ahnaou
- Department of Neurosciences, Janssen Research & Development, A Division of Janssen Pharmaceutica NV, Turnhoutseweg 30, B-2340 Beerse, Belgium.
| | - L Ver Donck
- Department of Neurosciences, Janssen Research & Development, A Division of Janssen Pharmaceutica NV, Turnhoutseweg 30, B-2340 Beerse, Belgium
| | - W H I M Drinkenburg
- Department of Neurosciences, Janssen Research & Development, A Division of Janssen Pharmaceutica NV, Turnhoutseweg 30, B-2340 Beerse, Belgium
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Sygna K, Aasvang GM, Aamodt G, Oftedal B, Krog NH. Road traffic noise, sleep and mental health. ENVIRONMENTAL RESEARCH 2014; 131:17-24. [PMID: 24637180 DOI: 10.1016/j.envres.2014.02.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 12/21/2013] [Accepted: 02/19/2014] [Indexed: 06/03/2023]
Abstract
This study examines the relationship between road traffic noise, self-reported sleep quality and mental health. The study is cross-sectional and based on data from a survey conducted in Oslo, Norway, in 2000. Psychological distress (Hopkins Symptom Checklist, HSCL-25) was measured along with self-reported somatic health, sleep quality, noise sensitivity and socioeconomic variables. Questionnaire data were combined with modeled estimates of noise exposure. The total study sample consisted of 2898 respondents. After adjustment for potential confounders and stratifying for sleep quality, we found a positive, but not statistically significant association between noise exposure and symptoms of psychological distress among participants with poor sleep quality (slope=0.06, 95% CI: -0.02 to 0.13, per 10 dB increase in noise exposure). In the same sleep quality group, we found a borderline statistically significant association between noise exposure and a symptom level indicating a probable mental disorder (HSCL≥1.55) (odds ratio=1.47, 95% CI: 0.99-1.98, per 10 dB increase in noise exposure). We found no association between road traffic noise and mental health among subjects reporting good and medium sleep quality. The results suggest that road traffic noise may be associated with poorer mental health among subjects with poor sleep. Individuals with poor sleep quality may be more vulnerable to effects of road traffic noise on mental health than individuals with better sleep quality.
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Affiliation(s)
- Karin Sygna
- Department of Air Pollution and Noise, Division of Environmental Medicine, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, N-0403 Oslo, Norway; Department of Mathematical Sciences and Technology, Norwegian University of Life Sciences, P.O. Box 5003, NO-1432 Aas, Norway
| | - Gunn Marit Aasvang
- Department of Air Pollution and Noise, Division of Environmental Medicine, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, N-0403 Oslo, Norway
| | - Geir Aamodt
- Department of Mathematical Sciences and Technology, Norwegian University of Life Sciences, P.O. Box 5003, NO-1432 Aas, Norway; Department of Chronic Diseases, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Bente Oftedal
- Department of Air Pollution and Noise, Division of Environmental Medicine, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, N-0403 Oslo, Norway
| | - Norun Hjertager Krog
- Department of Air Pollution and Noise, Division of Environmental Medicine, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, N-0403 Oslo, Norway.
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Cohrs S, Rodenbeck A, Riemann D, Szagun B, Jaehne A, Brinkmeyer J, Gründer G, Wienker T, Diaz-Lacava A, Mobascher A, Dahmen N, Thuerauf N, Kornhuber J, Kiefer F, Gallinat J, Wagner M, Kunz D, Grittner U, Winterer G. Impaired sleep quality and sleep duration in smokers-results from the German Multicenter Study on Nicotine Dependence. Addict Biol 2014; 19:486-96. [PMID: 22913370 DOI: 10.1111/j.1369-1600.2012.00487.x] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Cigarette smoking is a severe health burden being related to a number of chronic diseases. Frequently, smokers report about sleep problems. Sleep disturbance, in turn, has been demonstrated to be involved in the pathophysiology of several disorders related to smoking and may be relevant for the pathophysiology of nicotine dependence. Therefore, determining the frequency of sleep disturbance in otherwise healthy smokers and its association with degree of nicotine dependence is highly relevant. In a population-based case-control study, 1071 smokers and 1243 non-smokers without lifetime Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis I disorder were investigated. Sleep quality (SQ) of participants was determined by the Pittsburgh Sleep Quality Index. As possible confounders, age, sex and level of education and income, as well as depressiveness, anxiety, attention deficit hyperactivity, alcohol drinking behaviour and perceived stress, were included into multiple regression analyses. Significantly more smokers than non-smokers (28.1% versus 19.1%; P < 0.0001) demonstrated a disturbed global SQ. After controlling for the confounders, impaired scores in the component scores of sleep latency, sleep duration and global SQ were found significantly more often in smokers than non-smokers. Consistently, higher degrees of nicotine dependence and intensity of smoking were associated with shorter sleep duration. This study demonstrates for the first time an elevated prevalence of sleep disturbance in smokers compared with non-smokers in a population without lifetime history of psychiatric disorders even after controlling for potentially relevant risk factors. It appears likely that smoking is a behaviourally modifiable risk factor for the occurrence of impaired SQ and short sleep duration.
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Affiliation(s)
- Stefan Cohrs
- Department of Sleep Medicine; St. Hedwig Clinic Berlin; Berlin Germany
- Institute of Physiology, Sleepresearch & Clinical Chronobiology, Charité; Berlin Germany
- Department of Psychiatry and Psychotherapy; Georg-August University Göttingen; Göttingen Germany
| | - Andrea Rodenbeck
- Institute of Physiology, Sleepresearch & Clinical Chronobiology, Charité; Berlin Germany
- Department of Psychiatry and Psychotherapy; Georg-August University Göttingen; Göttingen Germany
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy; University of Freiburg; Freiburg Germany
| | - Bertram Szagun
- University of Applied Sciences; Ravensburg-Weingarten Germany
| | - Andreas Jaehne
- Department of Psychiatry and Psychotherapy; University of Freiburg; Freiburg Germany
| | - Jürgen Brinkmeyer
- Department of Psychiatry; Heinrich-Heine University Düsseldorf; Düsseldorf Germany
| | - Gerhard Gründer
- Department of Psychiatry, Psychotherapy, and Psychosomatics; RWTH Aachen University; Aachen Germany
| | - Thomas Wienker
- Institute of Medical Biometry, Informatics and Epidemiology; University of Bonn; Bonn Germany
| | - Amalia Diaz-Lacava
- Institute of Medical Biometry, Informatics and Epidemiology; University of Bonn; Bonn Germany
- Cologne Center for Genomics (CCG); Cologne University; Cologne Germany
| | - Arian Mobascher
- Department of Psychiatry; Johannes Gutenberg University; Mainz Germany
| | - Norbert Dahmen
- Department of Psychiatry; Johannes Gutenberg University; Mainz Germany
| | - Norbert Thuerauf
- Department of Psychiatry; Friedrich-Alexander University; Erlangen-Nuernberg Germany
| | - Johannes Kornhuber
- Department of Psychiatry; Friedrich-Alexander University; Erlangen-Nuernberg Germany
| | - Falk Kiefer
- Department of Addictive Behavior and Addictive Medicine; Central Institute of Mental Health; Mannheim Germany
| | - Jürgen Gallinat
- Department of Psychiatry; Charité University Hospital; Berlin Germany
| | - Michael Wagner
- Department of Psychiatry; University of Bonn; Bonn Germany
| | - Dieter Kunz
- Department of Sleep Medicine; St. Hedwig Clinic Berlin; Berlin Germany
- German Heart Institute; Berlin Germany
| | - Ulrike Grittner
- Department of Biostatistics and Clinical Epidemiology; Charité- University Medicine; Berlin Germany
| | - Georg Winterer
- Cologne Center for Genomics (CCG); Cologne University; Cologne Germany
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