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Yang X, Cheng B, Cheng S, Liu L, Pan C, Meng P, Li C, Chen Y, Zhang J, Zhang H, Zhang Z, Wen Y, Jia Y, Liu H, Zhang F. A genome-wide association study identifies candidate genes for sleep disturbances in depressed individuals. Hum Genomics 2024; 18:51. [PMID: 38778419 PMCID: PMC11110369 DOI: 10.1186/s40246-024-00609-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 04/15/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE This study aimed to identify candidate loci and genes related to sleep disturbances in depressed individuals and clarify the co-occurrence of sleep disturbances and depression from the genetic perspective. METHODS The study subjects (including 58,256 self-reported depressed individuals and 6,576 participants with PHQ-9 score ≥ 10, respectively) were collected from the UK Biobank, which were determined based on the Patient Health Questionnaire (PHQ-9) and self-reported depression status, respectively. Sleep related traits included chronotype, insomnia, snoring and daytime dozing. Genome-wide association studies (GWASs) of sleep related traits in depressed individuals were conducted by PLINK 2.0 adjusting age, sex, Townsend deprivation index and 10 principal components as covariates. The CAUSALdb database was used to explore the mental traits associated with the candidate genes identified by the GWAS. RESULTS GWAS detected 15 loci significantly associated with chronotype in the subjects with self-reported depression, such as rs12736689 at RNASEL (P = 1.00 × 10- 09), rs509476 at RGS16 (P = 1.58 × 10- 09) and rs1006751 at RFX4 (P = 1.54 × 10- 08). 9 candidate loci were identified in the subjects with PHQ-9 ≥ 10, of which 2 loci were associated with insomnia such as rs115379847 at EVC2 (P = 3.50 × 10- 08), and 7 loci were associated with daytime dozing, such as rs140876133 at SMYD3 (P = 3.88 × 10- 08) and rs139156969 at ROBO2 (P = 3.58 × 10- 08). Multiple identified genes, such as RNASEL, RGS16, RFX4 and ROBO2 were reported to be associated with chronotype, depression or cognition in previous studies. CONCLUSION Our study identified several candidate genes related to sleep disturbances in depressed individuals, which provided new clues for understanding the biological mechanism underlying the co-occurrence of depression and sleep disorders.
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Affiliation(s)
- Xuena Yang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Bolun Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Shiqiang Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Li Liu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Chuyu Pan
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Peilin Meng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Chun'e Li
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yujing Chen
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Jingxi Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Huijie Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Zhen Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yan Wen
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yumeng Jia
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Huan Liu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China.
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
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Lim J, Lee J, Jeon S, Lee S, Kim SJ. Effects of co-sleeping with a shift worker on sleep, mood and cognition. SSM Popul Health 2023; 24:101530. [PMID: 37869583 PMCID: PMC10587613 DOI: 10.1016/j.ssmph.2023.101530] [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: 04/15/2023] [Revised: 10/04/2023] [Accepted: 10/04/2023] [Indexed: 10/24/2023] Open
Abstract
Objective Although the negative effects of shift work on workers' sleep and mood are well-known, the effects of shift work on their sleep partners' sleep and mood have rarely been investigated. The current study explored the effects of co-sleeping with a shift worker (SW) on the partner's subjective sleep quality, daytime sleepiness, depressive symptoms, and cognitive disturbances. Methods Online sleep and work-environment self-report questionnaires (e.g., including the presence of co-sleepers, work schedules of the co-sleepers, and their work schedules) were administered. The questionnaires also included the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the Cognitive Failures Questionnaire (CFQ), and the short-term Center for Epidemiologic Studies-Depression scale (CES-D). Participants consisted of co-sleepers of SWs (n = 657), co-sleepers of non-SWs (n = 2186), and solo sleepers (n = 2432). Results Significant between-group differences in the PSQI, ESS, CFQ, and CES-D were observed after controlling for age, gender, work shift, and parenting (p < 0.001). Co-sleepers of SWs showed higher PSQI, ESS, CFQ, and CES-D scores than co-sleepers of non-SWs and solo sleepers. Solo sleepers reported significantly higher PSQI and CES-D scores than co-sleepers of non-SWs. The PSQI, ESS, CFQ, and CES-D scores were significantly correlated in all groups. The association between the ESS and PSQI was stronger in co-sleepers of SWs than in solo sleepers. The association between the ESS and CES-D was stronger in co-sleepers of SWs than in solo sleepers. Conclusions Co-sleeping with SWs is associated with poor sleep quality, daytime sleepiness, depressive symptoms, and cognitive disturbances in the partner.
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Affiliation(s)
- Joonyoung Lim
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Jooyoung Lee
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Sehyun Jeon
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Somi Lee
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Seog Ju Kim
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
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Kim SY, Lee KH, Lee HY, Jeon JE, Park CW, Shin J, Seo MC, Jeon S, Kim SJ, Lee YJ. Circadian misalignment alters resting-state functional connectivity of the salience network in rotating shift workers. Sleep 2023; 46:zsad237. [PMID: 37682120 DOI: 10.1093/sleep/zsad237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/14/2023] [Indexed: 09/09/2023] Open
Abstract
STUDY OBJECTIVES This study compared resting-state functional connectivity (rsFC) of the salience network (SN) between rotating shift workers (RSWs) and controls. Furthermore, we examined whether rsFC of the SN was correlated with sleep, emotion, cognition, and attention. METHODS The 60 RSWs and 57 controls enrolled in this study completed self-report questionnaires and sleep diaries to assess subjective sleep quality, and polysomnography and actigraphy to evaluate objective sleep and 24-hour rest-activity rhythm parameters. The participants also underwent resting-state functional magnetic resonance imaging and structural T1 scans. We performed a seed-based rsFC analysis of the SN using the anterior cingulate cortex (ACC) and anterior insula (AI) as seed regions. Furthermore, AI and ACC rsFC were compared in RSWs and controls, and we analyzed correlations between rsFC and variables of interest showing significant group differences. RESULTS Compared with controls, RSWs showed reduced rsFC between the ACC and right insula, and increased rsFC of the ACC with the left occipital lobe and right superior frontal gyrus extending to the supplementary motor area (SFG/SMA). Moreover, RSWs showed reduced rsFC between the right AI and right superior parietal lobule (SPL). Finally, rsFC between the ACC and right AI was correlated with 24-hour rest-activity rhythmicity. CONCLUSIONS Although RSWs did not show sleep disturbance, emotional distress, cognitive impairment, or attention deficits, alterations of right insula, left occipital lobe, right SFG/SMA, and right SPL rsFC in the SN indicate that impairments in salience detection and top-down attentional control may emerge in shift workers over time.
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Affiliation(s)
- Sun-Young Kim
- Department of Psychiatry, Ewha Womans University College of Medicine, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea
| | - Kyung Hwa Lee
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ha Young Lee
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jeong Eun Jeon
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Cho Won Park
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jiyoon Shin
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Min Cheol Seo
- Department of Psychiatry, Veteran Health Service Medical Center, Seoul, Republic of Korea
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sehyun Jeon
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Seog Ju Kim
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Yu Jin Lee
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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Depression and bipolar disorder subtypes differ in their genetic correlations with biological rhythms. Sci Rep 2022; 12:15740. [PMID: 36131119 PMCID: PMC9492698 DOI: 10.1038/s41598-022-19720-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 09/02/2022] [Indexed: 11/29/2022] Open
Abstract
Major Depression and Bipolar Disorder Type I (BIP-I) and Type II (BIP-II), are characterized by depressed, manic, and hypomanic episodes in which specific changes of physical activity, circadian rhythm, and sleep are observed. It is known that genetic factors contribute to variation in mood disorders and biological rhythms, but unclear to what extent there is an overlap between their underlying genetics. In the present study, data from genome-wide association studies were used to examine the genetic relationship between mood disorders and biological rhythms. We tested the genetic correlation of depression, BIP-I, and BIP-II with physical activity (overall physical activity, moderate activity, sedentary behaviour), circadian rhythm (relative amplitude), and sleep features (sleep duration, daytime sleepiness). Genetic correlations of depression, BIP-I, and BIP-II with biological rhythms were compared to discover commonalities and differences. A gene-based analysis tested for associations of single genes and common circadian genes with mood disorders. Depression was negatively correlated with overall physical activity and positively with sedentary behaviour, while BIP-I showed associations in the opposite direction. Depression and BIP-II had negative correlations with relative amplitude. All mood disorders were positively correlated with daytime sleepiness. Overall, we observed both genetic commonalities and differences across mood disorders in their relationships with biological rhythms: depression and BIP-I differed the most, while BIP-II was in an intermediate position. Gene-based analysis suggested potential targets for further investigation. The present results suggest shared genetic underpinnings for the clinically observed associations between mood disorders and biological rhythms. Research considering possible joint mechanisms may offer avenues for improving disease detection and treatment.
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Zhang Y, Tian W, Han X, Yan G, Ma Y, Huo S, Shi Y, Dai S, Ni X, Li Z, Fan L, Zhang Q. Assessing the depression risk in the U.S. adults using nomogram. BMC Public Health 2022; 22:416. [PMID: 35232400 PMCID: PMC8889727 DOI: 10.1186/s12889-022-12798-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 02/15/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Depression has received a lot of attention as a common and serious illness. However, people are rarely aware of their current depression risk probabilities. We aimed to develop and validate a predictive model applicable to the risk of depression in US adults. METHODS This study was conducted using the database of the National Health and Nutrition Examination Survey (NHANES, 2017-2012). In particular, NHANES (2007-2010) was used as the training cohort (n = 6015) for prediction model construction and NHANES (2011-2012) was used as the validation cohort (n = 2812) to test the model. Depression was assessed (defined as a binary variable) by the Patient Health Questionnaire (PHQ-9). Socio-demographic characteristics, sleep time, illicit drug use and anxious days were assessed using a self-report questionnaire. Logistic regression analysis was used to evaluate independent risk factors for depression. The nomogram has the advantage of being able to visualize complex statistical prediction models as risk estimates of individualized disease probabilities. Then, we developed two depression risk nomograms based on the results of logistic regression. Finally, several validation methods were used to evaluate the prediction performance of nomograms. RESULTS The predictors of model 1 included gender, age, income, education, marital status, sleep time and illicit drug use, and model 2, furthermore, included anxious days. Both model 1 and model 2 showed good discrimination ability, with a bootstrap-corrected C index of 0.71 (95% CI, 0.69-0.73) and 0.85 (95% CI, 0.83-0.86), and an externally validated C index of 0.71 (95% CI, 0.68-0.74) and 0.83 (95% CI, 0.81-0.86), respectively, and had well-fitted calibration curves. The area under the receiver operating characteristic curve (AUC) values of the models with 1000 different weighted random sampling and depression scores of 10-17 threshold range were higher than 0.7 and 0.8, respectively. Calculated net reclassification improvement (NRI) and integrated discrimination improvement (IDI) showed the discrimination or accuracy of the prediction models. Decision curve analysis (DCA) demonstrated that the depression models were practically useful. The network calculators work for participants to make personalized predictions. CONCLUSIONS This study presents two prediction models of depression, which can effectively and accurately predict the probability of depression as well as helping the U.S. civilian non-institutionalized population to make optimal treatment decisions.
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Affiliation(s)
- Yafeng Zhang
- Department of Health Management, School of Health Management, Harbin Medical University, No.157 Baojian Road, Harbin, 150081, China
| | - Wei Tian
- Department of Biostatistics, School of Public Health, Harbin Medical University, No.157 Baojian Road, Harbin, 150081, China
| | - Xinhao Han
- Department of Biostatistics, School of Public Health, Harbin Medical University, No.157 Baojian Road, Harbin, 150081, China
| | - Guangcan Yan
- Department of Biostatistics, School of Public Health, Harbin Medical University, No.157 Baojian Road, Harbin, 150081, China
| | - Yuanshuo Ma
- Department of Health Management, School of Health Management, Harbin Medical University, No.157 Baojian Road, Harbin, 150081, China
| | - Shan Huo
- Sichuan Kelun Pharmaceutical Co, No. 36 Baihua West Road, Chengdu, 610071, China
| | - Yu Shi
- Department of Health Management, School of Health Management, Harbin Medical University, No.157 Baojian Road, Harbin, 150081, China
| | - Shanshan Dai
- People's medical publishing house, No. 19 Panjiayuan South Road, Beijing, 100021, China
| | - Xin Ni
- Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No. 56 Nanlishi Road, Beijing, 100045, China
| | - Zhe Li
- Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No. 56 Nanlishi Road, Beijing, 100045, China
| | - Lihua Fan
- Department of Health Management, School of Health Management, Harbin Medical University, No.157 Baojian Road, Harbin, 150081, China.
| | - Qiuju Zhang
- Department of Biostatistics, School of Public Health, Harbin Medical University, No.157 Baojian Road, Harbin, 150081, China.
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Maruani J, Geoffroy PA. Multi-Level Processes and Retina-Brain Pathways of Photic Regulation of Mood. J Clin Med 2022; 11:jcm11020448. [PMID: 35054142 PMCID: PMC8781294 DOI: 10.3390/jcm11020448] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 02/06/2023] Open
Abstract
Light exerts powerful biological effects on mood regulation. Whereas the source of photic information affecting mood is well established at least via intrinsically photosensitive retinal ganglion cells (ipRGCs) secreting the melanopsin photopigment, the precise circuits that mediate the impact of light on depressive behaviors are not well understood. This review proposes two distinct retina–brain pathways of light effects on mood: (i) a suprachiasmatic nucleus (SCN)-dependent pathway with light effect on mood via the synchronization of biological rhythms, and (ii) a SCN-independent pathway with light effects on mood through modulation of the homeostatic process of sleep, alertness and emotion regulation: (1) light directly inhibits brain areas promoting sleep such as the ventrolateral preoptic nucleus (VLPO), and activates numerous brain areas involved in alertness such as, monoaminergic areas, thalamic regions and hypothalamic regions including orexin areas; (2) moreover, light seems to modulate mood through orexin-, serotonin- and dopamine-dependent pathways; (3) in addition, light activates brain emotional processing areas including the amygdala, the nucleus accumbens, the perihabenular nucleus, the left hippocampus and pathways such as the retina–ventral lateral geniculate nucleus and intergeniculate leaflet–lateral habenula pathway. This work synthetizes new insights into the neural basis required for light influence mood
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Affiliation(s)
- Julia Maruani
- Département de Psychiatrie et d’Addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat—Claude Bernard, F-75018 Paris, France
- NeuroDiderot, INSERM U1141, Université de Paris, F-75019 Paris, France
- Correspondence: (J.M.); (P.A.G.); Tel.: +33-(0)1-40-25-82-62 (J.M. & P.A.G.)
| | - Pierre A. Geoffroy
- Département de Psychiatrie et d’Addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat—Claude Bernard, F-75018 Paris, France
- NeuroDiderot, INSERM U1141, Université de Paris, F-75019 Paris, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, 5 rue Blaise Pascal, F-67000 Strasbourg, France
- GHU Paris—Psychiatry & Neurosciences, 1 Rue Cabanis, F-75014 Paris, France
- Correspondence: (J.M.); (P.A.G.); Tel.: +33-(0)1-40-25-82-62 (J.M. & P.A.G.)
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Lin W, Bai G, He W, Yang F, Li W, Min Y, Lu Y, Hsing A, Zhu S. Association between napping status and depressive symptoms in urban residents during the COVID-19 epidemic. Zhejiang Da Xue Xue Bao Yi Xue Ban 2021; 50:741-747. [PMID: 35347909 PMCID: PMC8931595 DOI: 10.3724/zdxbyxb-2021-0296] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/09/2021] [Indexed: 06/14/2023]
Abstract
: To explore the association between napping status and depressive symptoms in urban residents during the coronavirus disease 2019 (COVID-19) epidemic. : The survey was embedded in the Wellness Living Laboratory-China (WELL China) cohort study. Health and lifestyle information during the COVID-19 epidemic were obtained via the telephone interview from April 8, 2020 to May 29, 2020. A total of 3075 residents aged 18 to from Gongshu district of Hangzhou city with complete data were included in the analyses. The World Health Organization-Five Well-being Index (WHO-5) was used to measure depressive symptoms. Multiple logistic regression model was used to assess the association between napping status and depressive symptoms in the participants. : The prevalence of depressive symptoms was 20.6% in the participants during the epidemic. Daytime napping behavior, especially napping time ≤30 min, was associated with a lower risk of prevalent depressive symptoms (=0.61, 95%: 0.47-0.79, <0.01) and incident depressive symptoms in the population (=0.66, 95%: 0.50-0.88, <0.01). Among those with depressive symptoms at baseline, napping time ≤ was beneficial for the outcome of depressive symptoms (=0.42, 95%: 0.21-0.82, <0.05). : One in five urban residents have depressive symptoms during the COVID-19 epidemic, and a short nap during the day may be a protective factor against depressive symptoms.
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Affiliation(s)
- Wenhui Lin
- 1. School of Public Health, Zhejiang University, Hangzhou 310058, China
| | - Guannan Bai
- 2. Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou 310052, China
| | - Wei He
- 1. School of Public Health, Zhejiang University, Hangzhou 310058, China
| | - Fei Yang
- 1. School of Public Health, Zhejiang University, Hangzhou 310058, China
| | - Wei Li
- 1. School of Public Health, Zhejiang University, Hangzhou 310058, China
| | - Yan Min
- 3. Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford 94305, USA
| | - Ying Lu
- 4. Department of Biomedical Data Science, Stanford University School of Medicine, Stanford 94305, USA
| | - Ann Hsing
- 3. Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford 94305, USA
| | - Shankuan Zhu
- 1. School of Public Health, Zhejiang University, Hangzhou 310058, China
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Fatigue is associated with depression independent of excessive daytime sleepiness in the general population. Sleep Breath 2021; 26:933-940. [PMID: 34292460 DOI: 10.1007/s11325-021-02448-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/05/2021] [Accepted: 07/14/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE This study aimed to investigate sleep problems and comorbid conditions associated with fatigue in the general population. METHODS The data were obtained from a nationwide cross-sectional survey conducted in 2018. The Fatigue Severity Scale was used to assess fatigue. We examined sleep habits, such as workday sleep duration, chronotype, and free-day catch-up sleep, excessive daytime sleepiness (EDS), depression, and other comorbid conditions. We conducted multiple logistic regression analysis with the presence of fatigue as a dependent variable. RESULTS Of 2,493 adults aged 19 to 92 years, 50% men, mean age was 47.9 ± 16.4 years. The average workday sleep duration was 7.1 ± 1.1 h, and the prevalence of fatigue was 31%. After adjusting for potential confounders, fatigue was associated with EDS (odds ratio [OR] 3.751, 95% confidence interval [CI] 2.928-4.805), depression (OR 3.736, 95% CI 2.701-5.169), perceived insufficient sleep (OR 1.516, 95% CI 1.249-1.839), free-day catch-up sleep (OR 1.123, 95% CI 1.020-1.235), less alcohol intake (OR 0.570, 95% CI 0.432-0.752), and physical inactivity (OR 0.737, 95% CI 0.573-0.948). On subgroup analysis, fatigue was additionally associated with short workday sleep duration (OR 0.899, 95% CI 0.810-0.997) in individuals without EDS. However, among those with EDS, only depression (OR 2.842, 95% CI 1.511-5.343) and less alcohol intake (OR 0.476, 95% CI 0.247-0.915) were associated with fatigue. CONCLUSION Fatigue was significantly associated with depression independent of EDS. Further research is warranted to better understand the pathophysiological relationship between fatigue, depression, and sleep.
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Axelsson J, Ingre M, Kecklund G, Lekander M, Wright KP, Sundelin T. Sleepiness as motivation: a potential mechanism for how sleep deprivation affects behavior. Sleep 2021; 43:5648004. [PMID: 31782961 PMCID: PMC7294403 DOI: 10.1093/sleep/zsz291] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 10/16/2019] [Indexed: 01/07/2023] Open
Abstract
STUDY OBJECTIVES To determine how sleepiness and sleep deprivation drive the motivation to engage in different behaviors. METHODS We studied the sleepiness of 123 participants who had been randomized to sleep deprivation or normal sleep, and their willingness to engage in a range of everyday behaviors. RESULTS Self-reported sleepiness was a strong predictor of the motivation to engage in sleep-preparatory behaviors such as shutting one's eyes (OR = 2.78, 95% CI: 2.19-3.52 for each step up on the Karolinska Sleepiness Scale) and resting (OR = 3.20, CI: 2.46-4.16). Sleepiness was also related to the desire to be cared for by a loved one (OR = 1.49, CI: 1.22-1.82), and preparedness to utilize monetary and energy resources to get to sleep. Conversely, increased sleepiness was associated with a decreased motivation for social and physical activities (e.g. be with friends OR = 0.71, CI: 0.61-0.82; exercise OR = 0.65, CI: 0.56-0.76). Sleep deprivation had similar effects as sleepiness on these behaviors. Neither sleepiness nor sleep deprivation had strong associations with hunger, thirst, or food preferences. CONCLUSIONS Our findings indicate that sleepiness is a dynamic motivational drive that promotes sleep-preparatory behaviors and competes with other drives and desired outcomes. Consequently, sleepiness may be a central mechanism by which impaired alertness, for example, due to insufficient sleep, contributes to poor quality of life and adverse health. We propose that sleepiness helps organize behaviors toward the specific goal of assuring sufficient sleep, in competition with other needs and incentives. A theoretical framework on sleepiness and its behavioral consequences are likely to improve our understanding of several disease mechanisms.
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Affiliation(s)
- John Axelsson
- Stress Research Institute, Stockholm University, Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Michael Ingre
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Institute for Globally Distributed Research and Education (IGDORE), Stockholm, Sweden
| | - Göran Kecklund
- Stress Research Institute, Stockholm University, Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Mats Lekander
- Stress Research Institute, Stockholm University, Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Kenneth P Wright
- Department of Integrative Physiology, University of Colorado Boulder, CO
| | - Tina Sundelin
- Stress Research Institute, Stockholm University, Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Psychology, New York University, NY
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Rojas M, Chávez-Castillo M, Pírela D, Ortega Á, Salazar J, Cano C, Chacín M, Riaño M, Batista MJ, Díaz EA, Rojas-Quintero J, Bermúdez V. Chronobiology and Chronotherapy in Depression: Current Knowledge and Chronotherapeutic Promises. CURRENT PSYCHIATRY RESEARCH AND REVIEWS 2021. [DOI: 10.2174/2666082216999201124152432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Depression is a heavily prevalent mental disorder. Symptoms of depression
extend beyond mood, cognition, and behavior to include a spectrum of somatic manifestations in all
organic systems. Changes in sleep and neuroendocrine rhythms are especially prominent, and disruptions
of circadian rhythms have been closely related to the neurobiology of depression. With the
advent of increased research in chronobiology, various pathophysiologic mechanisms have been
proposed, including anomalies of sleep architecture, the effects of clock gene polymorphisms in
monoamine metabolism, and the deleterious impact of social zeitgebers. The identification of these
chronodisruptions has propelled the emergence of several chronotherapeutic strategies, both pharmacological
and non-pharmacological, with varying degrees of clinical evidence.
Methods:
The fundamental objective of this review is to integrate current knowledge about the role
of chronobiology and depression and to summarize the interventions developed to resynchronize
biorhythms both within an individual and with geophysical time.
Results:
We have found that among the non-pharmacological alternatives, triple chronotherapywhich
encompasses bright light therapy, sleep deprivation therapy, and consecutive sleep phase
advance therapy-has garnered the most considerable scientific interest. On the other hand,
agomelatine appears to be the most promising pharmacological option, given its unique melatonergic
pharmacodynamics.
Conclusions:
Research in chronotherapy as a treatment for depression is currently booming. Novel
interventions could play a significant role in adopting new options for the treatment of depression,
with Tripe Cronotherapy standing out as the most promising treatment.
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Affiliation(s)
- Milagros Rojas
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Mervin Chávez-Castillo
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Daniela Pírela
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Ángel Ortega
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Juan Salazar
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Clímaco Cano
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Maricarmen Chacín
- Universidad Simon Bolivar, Facultad de Ciencias de la Salud, Barranquilla, Colombia
| | - Manuel Riaño
- Universidad Simon Bolívar, Facultad de Ciencias Juridicas y Sociales, Cucuta, Colombia
| | - María Judith Batista
- Universidad Simon Bolívar, Facultad de Ciencias Juridicas y Sociales, Cucuta, Colombia
| | - Edgar Alexis Díaz
- Universidad Simon Bolívar, Facultad de Ciencias Juridicas y Sociales, Cucuta, Colombia
| | - Joselyn Rojas-Quintero
- Pulmonary and Critical Care Medicine Department, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, United States
| | - Valmore Bermúdez
- Universidad Simon Bolivar, Facultad de Ciencias de la Salud, Barranquilla, Colombia
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Circadian misalignment increases mood vulnerability in simulated shift work. Sci Rep 2020; 10:18614. [PMID: 33122670 PMCID: PMC7596056 DOI: 10.1038/s41598-020-75245-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 10/08/2020] [Indexed: 01/05/2023] Open
Abstract
Night shift work can associate with an increased risk for depression. As night workers experience a 'misalignment' between their circadian system and daily sleep-wake behaviors, with negative health consequences, we investigated whether exposure to circadian misalignment underpins mood vulnerability in simulated shift work. We performed randomized within-subject crossover laboratory studies in non-shift workers and shift workers. Simulated night shifts were used to induce a misalignment between the endogenous circadian pacemaker and sleep/wake cycles (circadian misalignment), while environmental conditions and food intake were controlled. Circadian misalignment adversely impacted emotional state, such that mood and well-being levels were significantly decreased throughout 4 days of continuous exposure to circadian misalignment in non-shift workers, as compared to when they were under circadian alignment (interaction of "circadian alignment condition" vs. "day", mood: p < 0.001; well-being: p < 0.001; adjusted p-values). Similarly, in shift workers, mood and well-being levels were significantly reduced throughout days of misalignment, as compared to circadian alignment (interaction of "circadian alignment condition" vs. "day", mood: p = 0.002; well-being: p = 0.002; adjusted p-values). Our findings indicate that circadian misalignment is an important biological component for mood vulnerability, and that individuals who engage in shift work are susceptible to its deleterious mood effects.
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12
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Association between Co-Morbidities and the Prevalence of Excessive Daytime Sleepiness over a Four-Year Period. Clocks Sleep 2020; 1:459-470. [PMID: 33089180 PMCID: PMC7445813 DOI: 10.3390/clockssleep1040035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 09/18/2019] [Indexed: 12/04/2022] Open
Abstract
Excessive daytime sleepiness (EDS) is a common problem in general the Canadian population. It can effect day-to-day activities and is also associated with several health issues. This study aimed to investigate the association between co-morbidities and the prevalence of EDS over a four-year period in adults living in two First Nation communities. Data collected during the First Nations Lung Health Project (FNLHP) conducted in two Cree First Nation communities in Saskatchewan in 2012–2013 (Cycle 1) and 2016 (Cycle 2) were used for this analysis. There were 859 participants aged 18 years and older at baseline (Cycle 1) and 821 participants aged 18 years and older at follow-up (Cycle 2) who completed the interviewer-administered questionnaire. An Epworth Sleepiness Scale (ESS) score > 10 was considered to be abnormal and identified as a case of EDS at both time points. A multilevel logistic regression model using a generalized estimating equations approach was used to analyze the data. The prevalence of EDS at baseline (Cycle 1) was 11.2% (91/815) and 10.0% (80/803) at follow-up (Cycle 2). Based on the predicted model, longitudinal change in the prevalence of EDS was −0.11% for 358 individuals who participated in both cycles. There were 49% males at baseline and 48% males at follow-up. Multivariate regression model results revealed that crowding, shortness of breath, loud snoring, chronic lung disease, depression and gastric reflux were the main significant predictors of EDS. In addition, the interaction between sex and age was significant. Some of the co-morbid conditions were associated with EDS. Therefore, managing such conditions requires considerations in strategies to decrease the prevalence of daytime sleepiness.
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13
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Goldstone A, Javitz HS, Claudatos SA, Buysse DJ, Hasler BP, de Zambotti M, Clark DB, Franzen PL, Prouty DE, Colrain IM, Baker FC. Sleep Disturbance Predicts Depression Symptoms in Early Adolescence: Initial Findings From the Adolescent Brain Cognitive Development Study. J Adolesc Health 2020; 66:567-574. [PMID: 32046896 PMCID: PMC7183901 DOI: 10.1016/j.jadohealth.2019.12.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 11/05/2019] [Accepted: 12/04/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE The aim of the study was to investigate associations between sleep disturbances and mental health in adolescents. METHODS Data are from a national sample of 11,670 U.S. participants (5,594 females, aged 9-10 years, 63.5% white) in the Adolescent Brain Cognitive Development study. Initial longitudinal analyses were conducted for a subset of the sample (n = 4,951). Measures of youth sleep disturbance (disorders of initiating and maintaining sleep, sleep-wake transition disorders, and disorders of excessive somnolence) and "typical" total sleep time (number of hours slept on most nights in the past 6 months) were obtained from the parent-report Sleep Disturbance Scale (Data Release 2.0). Parent-report measures of youth mental health (depression, internalizing, and externalizing behaviors) from the Child Behavior Checklist and typical screen time were included. RESULTS At baseline, greater sleep disturbance and shorter total sleep time were associated with greater internalizing, externalizing, and depression scores. After controlling for baseline mental health symptoms, baseline sleep disturbance significantly predicted depression and internalizing and externalizing scores at 1-year follow-up. A significant interaction with sex indicated that the association between disorders of excessive somnolence and depression 1 year later was steeper for girls, compared with boys (p < .001; 95% confidence interval 1.04-3.45). CONCLUSIONS Sleep disturbances predicted future mental health, particularly depression in this young sample, highlighting the potential to harness sleep as a tool to mitigate the persistence of depression across early adolescence and potentially prevent an adolescent onset of major depressive disorder.
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Affiliation(s)
- Aimée Goldstone
- Center for Health Sciences, SRI International, Menlo Park, California.
| | - Harold S. Javitz
- Center for Health Sciences, SRI International, Menlo Park, California
| | | | - Daniel J. Buysse
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Brant P. Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | | - Duncan B. Clark
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Peter L. Franzen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Devin E. Prouty
- Center for Health Sciences, SRI International, Menlo Park, California
| | - Ian M. Colrain
- Center for Health Sciences, SRI International, Menlo Park, California,Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Fiona C. Baker
- Center for Health Sciences, SRI International, Menlo Park, California,Brain Function Research Group, School of Physiology, University of Witwatersrand, Johannesburg, South Africa
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14
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Potential predictors of quality of life in Parkinson’s Disease: Sleep and mood disorders. J Clin Neurosci 2019; 70:113-117. [DOI: 10.1016/j.jocn.2019.08.058] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/06/2019] [Indexed: 12/31/2022]
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15
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Sleep disturbances and their co‑occurrence with emotional and behavioural problems in elementary school children. SOMNOLOGIE 2019. [DOI: 10.1007/s11818-019-00216-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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16
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Hein M, Lanquart JP, Loas G, Hubain P, Linkowski P. Prevalence and risk factors of excessive daytime sleepiness in major depression: A study with 703 individuals referred for polysomnography. J Affect Disord 2019; 243:23-32. [PMID: 30223136 DOI: 10.1016/j.jad.2018.09.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 07/30/2018] [Accepted: 09/10/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND To date, few studies have investigated the prevalence and risk factors of excessive daytime sleepiness (EDS) in major depression. Thus, the aim of the present study was to examine the prevalence and risk factors of EDS in a large sample of individuals with major depression. METHODS Data from 703 individuals with major depression were retrospectively collected from the sleep laboratory research database of Erasme Hospital for analysis. A score of > 10 on the Epworth Sleepiness Scale was used as the cut-off for EDS. Logistic regression analyses were conducted to examine the clinical and demographic risk factors of EDS in major depression. RESULTS The prevalence of EDS in our sample was 50.8%. Multivariate logistic regression analysis revealed that the following were significant risk factors of EDS in major depression: non-use of short to intermediate half-life benzodiazepine receptor agonists, BMI ≥ 25 kg/m², age < 60 years, C-reactive protein > 7 mg/L, Beck Depression Inventory score ≥ 16, atypical depression, apnea-hypopnea index ≥ 15/h, and use of selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors. LIMITATIONS To evaluate EDS, we used the Epworth Sleepiness Scale, which only allows for a subjective measure of daytime sleepiness. CONCLUSION EDS is a common symptom in individuals with major depression. In this subpopulation, interventions are possible for most risk factors of EDS, which justifies improved management of this symptom to avoid its negative consequences.
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Affiliation(s)
- Matthieu Hein
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium.
| | - Jean-Pol Lanquart
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium
| | - Gwenolé Loas
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium
| | - Philippe Hubain
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium
| | - Paul Linkowski
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium
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17
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Jariyasakulroj S, Mitrirattanakul S. Excessive daytime sleepiness in temporomandibular disorder patients. Cranio 2018; 38:144-148. [DOI: 10.1080/08869634.2018.1525116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | - Somsak Mitrirattanakul
- Department of Masticatory Science, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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18
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Karunanayake CP, Dosman JA, Rennie DC, Lawson JA, Kirychuk S, Fenton M, Ramsden VR, Seeseequasis J, Abonyi S, Pahwa P. Incidence of Daytime Sleepiness and Associated Factors in Two First Nations Communities in Saskatchewan, Canada. Clocks Sleep 2018; 1:13-25. [PMID: 33089152 PMCID: PMC7509673 DOI: 10.3390/clockssleep1010003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 09/18/2018] [Indexed: 11/25/2022] Open
Abstract
Excessive daytime sleepiness (EDS) is the tendency to sleep at inappropriate times during the day. It can interfere with day-to-day activities and lead to several health issues. The objective of this study was to investigate the association between income, housing conditions, and incidence of EDS in adults living in two Cree First Nations communities. The data for this study involved 317 individuals aged 18 years and older who participated in baseline and follow-up evaluations (after four years) of the First Nations Lung Health Project, which was conducted in Saskatchewan in 2012–2013 and 2016. Both at baseline and follow-up survey after four years, an Epworth Sleepiness Scale (ESS) score >10 was considered to be abnormal. Logistic regression models were used to assess relationships between abnormal ESS and covariates at baseline. In 2016, 7.6% (24/317) of the participants reported an ESS >10 with the mean being 12.8 ± 2.0. For the same group, the mean ESS at baseline was 6.9 ± 2.2. The incidence of subjective EDS based on the ESS >10 was estimated at 7.6% over four years. This study showed an association between incidence of subjective EDS and less money left over at end of the month, having a house in need of repairs, having water or dampness in the past 12 months, and damage caused by dampness.
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Affiliation(s)
- Chandima P. Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Correspondence: ; Tel.: +1-306-966-1647
| | - James A. Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Donna C. Rennie
- College of Nursing, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Joshua A. Lawson
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
| | - Shelley Kirychuk
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
| | - Mark Fenton
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
| | - Vivian R. Ramsden
- Department of Academic Family Medicine, University of Saskatchewan, West Winds Primary Health Centre, 3311 Fairlight Drive, Saskatoon, SK S7M 3Y5, Canada
| | | | - Sylvia Abonyi
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada
| | - Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada
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Dickinson DL, Wolkow AP, Rajaratnam SMW, Drummond SPA. Personal sleep debt and daytime sleepiness mediate the relationship between sleep and mental health outcomes in young adults. Depress Anxiety 2018; 35:775-783. [PMID: 29790238 DOI: 10.1002/da.22769] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 03/06/2018] [Accepted: 04/10/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Sleep duration and chronotype (i.e., morningness-eveningness) are associated with increased depression and anxiety risk, but differences in individual sleep need and lifestyle may mean these sleep parameters do not present the same risk across all individuals. This study explored the mediating role of sleep debt and daytime sleepiness in the relationship between sleep and mental health symptoms in young adults, a particularly vulnerable population. METHODS Young adult university students (n = 2,218) and young adults from the general population in the United States (n = 992) provided estimates of actual and optimal sleep duration, and completed validated measures of sleepiness, chronotype, and depression and anxiety risk. Mediation models examining sleepiness and sleep debt (i.e., difference between optimal and actual sleep) as parallel mediators were tested. RESULTS Sleepiness and sleep debt mediated the relationship between short sleep and depression and anxiety risk in the university sample, while sleepiness mediated these relationships in the general population sample. Sleepiness and sleep debt also mediated the impact of evening-type preferences on depression and anxiety risk in university students, but no mediation of this effect was found in young adults from the general population. CONCLUSIONS This study reports potential mediating mechanisms related to the increased mental health risk conferred by short sleep and evening chronotype. These results have implications for how primary care physicians assess psychopathology risk, arguing for a focus on the assessment of daytime sleepiness and sleep debt in university populations, while for young adults in the general population, these factors may be less important.
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Affiliation(s)
- David L Dickinson
- Department of Economics and Center for Economic Research and Policy Analysis, Appalachian State University, Boone, NC, USA.,IZA Institute of Labor Economics, Bonn, Germany.,Economic Science Institute, Chapman University, Orange, CA, USA
| | - Alexander P Wolkow
- Monash Institute of Cognitive and Clinical Neuroscience, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Shantha M W Rajaratnam
- Monash Institute of Cognitive and Clinical Neuroscience, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Sean P A Drummond
- Monash Institute of Cognitive and Clinical Neuroscience, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
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20
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Ohashi M, Kohno T, Kohsaka S, Fukuoka R, Hayashida K, Yuasa S, Sano M, Takatsuki S, Fukuda K. Excessive Daytime Sleepiness Is Associated With Depression Scores, But Not With Sleep-Disordered Breathing in Patients With Cardiovascular Diseases. Circ J 2018; 82:2175-2183. [PMID: 29899174 DOI: 10.1253/circj.cj-17-1395] [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] [Indexed: 11/09/2022]
Abstract
BACKGROUND Excessive daytime sleepiness (EDS) is a significant public health concern, with sleep-disordered breathing (SDB) being a common cause. However, their precise relationship in patients with cardiovascular disease (CVD) is unclear. Furthermore, whether comorbid psychological disorders could contribute to EDS remains unknown. We aimed to assess the prevalence of EDS and its related factors, including SDB and depression, in patients with CVD.Methods and Results:We analyzed data from 1,571 patients admitted for various CVDs in a single university hospital (median age, 67 [56-76] years; 29.6% women). We assessed EDS using the Japanese version of the Epworth Sleepiness Scale (ESS; median 6.0 [4.0-9.0]). The presence of EDS (ESS >10, n=297 [18.9%]) did not differ between patients with and without SDB, which was screened with nocturnal pulse oximetry. In contrast, the patients with EDS had higher depression scores (Hospital Anxiety and Depression Scale subscore for depression [HADS-D] and Patient Healthcare Questionnaire [PHQ]-9). The depression scores, measured by HADS-D (odds ratio [OR] 1.14; 95% confidence interval [CI], 1.07-1.22) and PHQ-9 (OR, 1.14; 95% CI, 1.07-1.20) were independent determinants of EDS. These relationships among EDS, SDB, and depression were consistent among the subgroups with cardiovascular comorbidities. CONCLUSIONS The presence of EDS is associated with depressive symptoms, but not with SDB, in patients with CVD, suggesting that these patients should be thoroughly assessed for psychological disturbances.
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Affiliation(s)
- Mikiko Ohashi
- Division of Cardiology, Department of Medicine, Keio University School of Medicine
| | - Takashi Kohno
- Division of Cardiology, Department of Medicine, Keio University School of Medicine
| | - Shun Kohsaka
- Division of Cardiology, Department of Medicine, Keio University School of Medicine
| | - Ryoma Fukuoka
- Division of Cardiology, Department of Medicine, Keio University School of Medicine
| | - Kentaro Hayashida
- Division of Cardiology, Department of Medicine, Keio University School of Medicine
| | - Shinsuke Yuasa
- Division of Cardiology, Department of Medicine, Keio University School of Medicine
| | - Motoaki Sano
- Division of Cardiology, Department of Medicine, Keio University School of Medicine
| | - Seiji Takatsuki
- Division of Cardiology, Department of Medicine, Keio University School of Medicine
| | - Keiichi Fukuda
- Division of Cardiology, Department of Medicine, Keio University School of Medicine
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21
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Liu Y, Peng T, Zhang S, Tang K. The relationship between depression, daytime napping, daytime dysfunction, and snoring in 0.5 million Chinese populations: exploring the effects of socio-economic status and age. BMC Public Health 2018; 18:759. [PMID: 29914433 PMCID: PMC6007059 DOI: 10.1186/s12889-018-5629-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 05/29/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Daytime napping has been postulated as both a protective and a risk factor for depression in previous studies. In addition to these conflicting results, research gaps also exist with regard to controlling confounding bias between daytime napping and depression and examining the potential association within the Chinese population. To facilitate the prevention and diagnosis of depression, this study aims to provide insight into the association of daytime napping and depression in 0.5 million Chinese adults by fully controlling confounders, and further examine the modifying effects of socio-economic status (SES) and age. METHODS Data were drawn from the baseline of a Chinese cohort study of 0.5 million adults. Depressive status was measured by the Composite International Diagnostic Inventory (CIDI). Logistic regression models were used to examine the association between depression and daytime napping adjusted for SES, sleep-related factors, lifestyle factors and related diseases. Further stratified analyses were conducted to identify the modifying effects of socio-economic status and age. RESULTS The odds ratio of depression by daytime napping was 1.15 (95% CI: 1.01-1.31) in females and 1.42 (95% CI: 1.18-1.71) in males. Factors including living in a rural area (OR = 1.31, 95% CI: 1.13-1.52), receiving less education (OR = 1.42, 95% CI: 1.22-1.66), getting married (OR = 1.24, 95% CI: 1.10-1.40) and being 45-65 years old (OR = 1.29, 95% CI: 1.12-1.49) had a modifying effect on daytime napping and depression that could strengthen the association. CONCLUSIONS A significantly positive association was found between depression and daytime napping, as well as daytime dysfunction, snoring and both shorter and longer sleep duration. Lower SES and age could possibly modify the association. Further clinical or epidemiological studies are needed to investigate the mechanism and facilitate the prevention of depression.
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Affiliation(s)
- Yuning Liu
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Tingting Peng
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Siqiao Zhang
- Department of Global Health, Emory University Rollins School of Public Health, Atlanta, USA
| | - Kun Tang
- School of Public Health, Peking University Health Science Center, 38th Xueyuan Road, Haidian District, Beijing, China
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22
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Zaki NFW, Spence DW, BaHammam AS, Pandi-Perumal SR, Cardinali DP, Brown GM. Chronobiological theories of mood disorder. Eur Arch Psychiatry Clin Neurosci 2018; 268:107-118. [PMID: 28894915 DOI: 10.1007/s00406-017-0835-5] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Accepted: 08/22/2017] [Indexed: 12/13/2022]
Abstract
Major depressive disorder (MDD) remains the most prevalent mental disorder and a leading cause of disability, affecting approximately 100 million adults worldwide. The disorder is characterized by a constellation of symptoms affecting mood, anxiety, neurochemical balance, sleep patterns, and circadian and/or seasonal rhythm entrainment. However, the mechanisms underlying the association between chronobiological parameters and depression remain unknown. A PubMed search was conducted to review articles from 1979 to the present, using the following search terms: "chronobiology," "mood," "sleep," and "circadian rhythms." We aimed to synthesize the literature investigating chronobiological theories of mood disorders. Current treatments primarily include tricyclic antidepressants and selective serotonin reuptake inhibitors, which are known to increase extracellular concentrations of monoamine neurotransmitters. However, these antidepressants do not treat the sleep disturbances or circadian and/or seasonal rhythm dysfunctions associated with depressive disorders. Several theories associating sleep and circadian rhythm disturbances with depression have been proposed. Current evidence supports the existence of associations between these, but the direction of causality remains elusive. Given the existence of chronobiological disturbances in depression and evidence regarding their treatment in improving depression, a chronobiological approach, including timely use of light and melatonin agonists, could complement the treatment of MDD.
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Affiliation(s)
- Nevin F W Zaki
- Department of Psychiatry, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
| | | | - Ahmed S BaHammam
- University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Daniel P Cardinali
- BIOMED-UCA-CONICET and Department of Teaching and Research, Faculty of Medical Sciences, Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
| | - Gregory M Brown
- Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, M5T 1R8, Canada
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Sunwoo JS, Hwangbo Y, Kim WJ, Chu MK, Yun CH, Yang KI. Sleep characteristics associated with drowsy driving. Sleep Med 2017; 40:4-10. [PMID: 29221776 DOI: 10.1016/j.sleep.2017.08.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 08/21/2017] [Accepted: 08/22/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate sleep characteristics associated with drowsy driving in an adult population. METHODS The study subjects consisted of 1675 adults aged 19 years or older who completed a population-based questionnaire survey on sleep habits. Experiences of drowsy driving were obtained from self-reported data. We investigated sleep-related variables including sleep duration, sleep efficiency, chronotype, subjective sleep perception, daytime sleepiness, sleep quality, and snoring. We performed multivariate logistic regression analysis to determine sleep characteristics independently associated with drowsy driving. RESULTS The mean age of the subjects was 43.2 years, and 66.3% were men. The prevalence of self-reported drowsy driving was 23.6% (396 of 1675), and 33.1% of subjects experienced dozing at the wheel at least once a month. Multivariate analysis demonstrated that men, office and manual workers, excessive daytime sleepiness, depression, habitual snoring, and perceived insufficient sleep were independently associated with drowsy driving. Subgroup analyses revealed that reduced weekday sleep duration was a risk factor of drowsy driving in adults with perceived sufficient sleep. On the other hand, frequent alcohol drinking significantly increased risk of drowsy driving in the subgroup with perceived sleep insufficiency. Furthermore, ordinal regression analyses confirmed the association between sleep characteristics and drowsy driving across different drowsy driving frequencies. CONCLUSION Excessive daytime sleepiness, depression, habitual snoring, and perceived insufficient sleep were sleep-related risk factors for drowsy driving. In addition to maintaining healthy sleep habits, individuals at high risk should be encouraged to evaluate underlying sleep disorders or psychiatric problems to prevent drowsy driving.
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Affiliation(s)
- Jun-Sang Sunwoo
- Department of Neurology, Soonchunhyang University College of Medicine, Seoul Hospital, Seoul, South Korea
| | - Young Hwangbo
- Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan, South Korea
| | - Won-Joo Kim
- Department of Neurology, Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul, South Korea
| | - Min Kyung Chu
- Department of Neurology, Hallym University College of Medicine, Seoul, South Korea
| | - Chang-Ho Yun
- Department of Neurology, Bundang Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Kwang Ik Yang
- Sleep Disorders Center, Department of Neurology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, South Korea.
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Mirsu-Paun A, Jaussent I, Komar G, Courtet P, Lopez-Castroman J. Sleep complaints associated with wish to die after a suicide crisis-an exploratory study. J Sleep Res 2017; 26:726-731. [DOI: 10.1111/jsr.12537] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 03/12/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Anca Mirsu-Paun
- ‘Francisc Rainer’ Institute for Anthropology of the Romanian Academy; Bucharest Romania
| | - Isabelle Jaussent
- Inserm u1061; Montpellier France
- Universitéde Montpellier; Montpellier France
| | | | - Philippe Courtet
- Universitéde Montpellier; Montpellier France
- FondaMental Foundation; Créteil France
- Department of Psychiatric Emergency and Post-Acute Care; Lapeyronie Hospital; Montpellier France
| | - Jorge Lopez-Castroman
- Inserm u1061; Montpellier France
- Universitéde Montpellier; Montpellier France
- Department of Adult Psychiatry; Nimes University Hospital France
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Tsai SY, Lee PL, Lin JW, Lee CN. Persistent and new-onset daytime sleepiness in pregnant women: A prospective observational cohort study. Int J Nurs Stud 2016; 66:1-6. [PMID: 27865988 DOI: 10.1016/j.ijnurstu.2016.11.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 11/03/2016] [Accepted: 11/05/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND Daytime sleepiness is a frequent complaint in women during pregnancy. It has also been linked to negative obstetric consequences. Although high prevalence of excessive daytime sleepiness throughout pregnancy is well-documented, neither the causes of persistent daytime sleepiness nor new-onset daytime sleepiness during pregnancy have been investigated. Identifying predictive factors may play an important role in the management of daytime sleepiness in pregnant women and improve prenatal care and maternal-fetal outcomes. OBJECTIVES To examine first-trimester maternal characteristics associated with the persistence and new-onset daytime sleepiness in pregnant women. DESIGN A longitudinal, prospective cohort design. SETTING One medical center in Taipei, Taiwan and participating women's homes. PARTICIPANTS A total of 204 pregnant women. METHODS First-trimester pregnant women recruited from an outpatient obstetric clinic at a medical center provided socio-demographic and health information, wore an actigraphy monitor for 7 days, and completed sleep, mood, and daytime sleepiness questionnaires. Data were collected again when the women were in the second and third trimester. RESULTS Thirty-one (15.2%) women experienced excessive daytime sleepiness that persisted across all three trimesters. Nulliparous women and women who snored in the first trimester were 2.28 and 2.10 times more at risk of being classified of persistent daytime sleepiness than multiparous women and women who did not snore in the first trimester, respectively. Thirty-one (15.2%) women developed new-onset daytime sleepiness with advancing gestation. Women were more likely to develop new-onset daytime sleepiness if they worked longer hours per week (OR=1.04, p<0.001), if they reported snoring (OR=6.75, p<0.001), and if they had elevated depressive symptoms in the first trimester of pregnancy (OR=1.09, p=0.01). CONCLUSIONS Snoring in the first trimester is involved in both the persistence and new-onset of daytime sleepiness with elevated depressive symptoms related to new-onset daytime sleepiness in pregnant women. Findings suggest that intervention strategies for alleviating daytime sleepiness in pregnant women should focus on managing snoring and symptoms of depression in early trimesters with special attention to nulliparous and employed women.
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Affiliation(s)
- Shao-Yu Tsai
- School of Nursing, National Taiwan University, No. 1, Sec. 1, Jen-Ai Rd, Taipei, 10051, Taiwan.
| | - Pei-Lin Lee
- Department of Internal Medicine, National Taiwan University, Taipei, Taiwan; Center of Sleep Disorder, National Taiwan University Hospital, Taipei, Taiwan; Division of Pulmonary and Critical Care Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Jou-Wei Lin
- Department of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chien-Nan Lee
- Department of Obstetrics and Gynecology, National Taiwan University, Taipei, Taiwan
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Nuyen BA, Fox RS, Malcarne VL, Wachsman SI, Sadler GR. Excessive Daytime Sleepiness as an Indicator of Depression in Hispanic Americans. HISPANIC HEALTH CARE INTERNATIONAL 2016; 14:116-123. [PMID: 27465932 PMCID: PMC5154620 DOI: 10.1177/1540415316660616] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Excessive daytime sleepiness (EDS) has been shown to be associated with depression; however, this relationship has not been confirmed among Hispanic Americans. METHOD This study examined the link between EDS and depression among Hispanic Americans (N = 411) and explored the potential moderating roles of age, gender, income, education, health status, and acculturation. The Epworth Sleepiness Scale and Patient Health Questionnaire-9 measured EDS and depression, respectively. RESULTS Hierarchical linear regression demonstrated that EDS was significantly related to depression. Receiver operating characteristic curve analysis suggested that the Epworth Sleepiness Scale discriminated with adequate sensitivity and specificity between participants with moderately severe depression and those with less severe symptoms. No sociodemographic variables moderated the EDS-depression relationship. CONCLUSION These findings suggest that depression should be considered when Hispanic Americans present with EDS.
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Affiliation(s)
- Brian A. Nuyen
- University of California, San Diego (UC San Diego) School of Medicine
| | - Rina S. Fox
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology
- UC San Diego Moores Cancer Center
| | - Vanessa L. Malcarne
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology
- UC San Diego Moores Cancer Center
- San Diego State University
| | | | - Georgia Robins Sadler
- University of California, San Diego (UC San Diego) School of Medicine
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology
- UC San Diego Moores Cancer Center
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Adams RJ, Appleton SL, Vakulin A, Lang C, Martin SA, Taylor AW, McEvoy RD, Antic NA, Catcheside PG, Wittert GA. Association of daytime sleepiness with obstructive sleep apnoea and comorbidities varies by sleepiness definition in a population cohort of men. Respirology 2016; 21:1314-21. [DOI: 10.1111/resp.12829] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 03/29/2016] [Accepted: 04/13/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Robert J. Adams
- The Health Observatory, Discipline of Medicine; University of Adelaide; Woodville South Australia Australia
| | - Sarah L. Appleton
- The Health Observatory, Discipline of Medicine; University of Adelaide; Woodville South Australia Australia
- Freemasons Centre for Men's Health, Discipline of Medicine; University of Adelaide; Adelaide South Australia Australia
| | - Andrew Vakulin
- Adelaide Institute for Sleep Health, a Flinders Centre of Research Excellence, School of Medicine, Faculty of Medicine, Nursing and Health Sciences; Flinders University; Bedford Park South Australia Australia
- NHMRC Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Central Clinical School; University of Sydney; Sydney New South Wales Australia
| | - Carol Lang
- The Health Observatory, Discipline of Medicine; University of Adelaide; Woodville South Australia Australia
| | - Sean A. Martin
- Freemasons Centre for Men's Health, Discipline of Medicine; University of Adelaide; Adelaide South Australia Australia
| | - Anne W. Taylor
- Population Research & Outcomes Studies, Discipline of Medicine; University of Adelaide; Adelaide South Australia Australia
| | - R. Doug McEvoy
- Adelaide Institute for Sleep Health, a Flinders Centre of Research Excellence, School of Medicine, Faculty of Medicine, Nursing and Health Sciences; Flinders University; Bedford Park South Australia Australia
- Department of Medicine; Flinders University; Bedford Park, Adelaide South Australia Australia
| | - Nick A. Antic
- Adelaide Institute for Sleep Health, a Flinders Centre of Research Excellence, School of Medicine, Faculty of Medicine, Nursing and Health Sciences; Flinders University; Bedford Park South Australia Australia
- Department of Medicine; Flinders University; Bedford Park, Adelaide South Australia Australia
| | - Peter G. Catcheside
- Adelaide Institute for Sleep Health, a Flinders Centre of Research Excellence, School of Medicine, Faculty of Medicine, Nursing and Health Sciences; Flinders University; Bedford Park South Australia Australia
- Department of Medicine; Flinders University; Bedford Park, Adelaide South Australia Australia
| | - Gary A. Wittert
- The Health Observatory, Discipline of Medicine; University of Adelaide; Woodville South Australia Australia
- Freemasons Centre for Men's Health, Discipline of Medicine; University of Adelaide; Adelaide South Australia Australia
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Kalchiem-Dekel O, Westreich R, Regev A, Novack V, Goldberg M, Maimon N. Snoring intensity and excessive daytime sleepiness in subjects without obstructive sleep apnea. Laryngoscope 2016; 126:1696-701. [DOI: 10.1002/lary.25876] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 11/10/2015] [Accepted: 12/21/2015] [Indexed: 12/15/2022]
Affiliation(s)
- Or Kalchiem-Dekel
- Institute of Pulmonology and Department of Medicine B, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev; Beer-Sheva Israel
| | - Roi Westreich
- Institute of Pulmonology and Department of Medicine B, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev; Beer-Sheva Israel
| | - Adi Regev
- Clinical Research Center, Soroka University Medical Center; Beer-Sheva Israel
| | - Victor Novack
- Clinical Research Center, Soroka University Medical Center; Beer-Sheva Israel
| | - Mordechai Goldberg
- Clinical Research Center, Soroka University Medical Center; Beer-Sheva Israel
| | - Nimrod Maimon
- Institute of Pulmonology and Department of Medicine B, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev; Beer-Sheva Israel
- Division of Respirology; Department of Medicine; University of Toronto and University Health Network; Toronto Ontario Canada
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Malone SK, Patterson F, Lu Y, Lozano A, Hanlon A. Ethnic differences in sleep duration and morning-evening type in a population sample. Chronobiol Int 2015; 33:10-21. [PMID: 26654569 DOI: 10.3109/07420528.2015.1107729] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This cross-sectional population study examined associations of sleep duration and morning-evening type with sociodemographic and cardiometabolic disease in adults participating in the UK Biobank study (N = 439 933). Multivariable Poisson regression models of sleep duration and morning-evening type with a robust error variance were generated to estimate adjusted prevalence ratios and their 95% confidence intervals. All models were adjusted for sex, race, college attendance, employment status and age. Twenty five percent of the sample reported short sleep; 27% were morning, 64% intermediate and 9% evening type. Black ethnicity emerged as most strongly associated with sleep behavior. Short sleep was twice as prevalent, and morning versus intermediate type was 1.4 times more prevalent in Black than White participants. The greater prevalence of short sleep and morning type among Blacks suggests that sleep-based approaches to improving cardiometabolic outcomes may require a more multidimensional approach that encompasses adequate sleep and circadian alignment in this population.
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Affiliation(s)
- Susan Kohl Malone
- a University of Pennsylvania School of Nursing , Philadelphia , PA , USA
| | - Freda Patterson
- b Department of Behavioral Health and Nutrition, College of Health Sciences, University of Delaware , Newark , DE , USA
| | - Yinghui Lu
- a University of Pennsylvania School of Nursing , Philadelphia , PA , USA
| | - Alicia Lozano
- a University of Pennsylvania School of Nursing , Philadelphia , PA , USA
| | - Alexandra Hanlon
- a University of Pennsylvania School of Nursing , Philadelphia , PA , USA
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Abstract
In this chapter, we review studies investigating the role of sleep in emotional functions. In particular, evidence has recently accumulated to show that brain regions involved in the processing of emotional and reward-related information are activated during sleep. We suggest that such activation of emotional and reward systems during sleep underlies the reprocessing and consolidation of memories with a high affective and motivational relevance for the organism. We also propose that these mechanisms occurring during sleep promote adapted cognitive and emotional responses in the waking state, including overnight performance improvement, creativity, and sexual functions. Activation across emotional-limbic circuits during sleep also appears to promote emotional maturation and the emergence of consciousness in the developing brain.
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Loomis S, McCarthy A, Baxter C, Kellett DO, Edgar DM, Tricklebank M, Gilmour G. Distinct pro-vigilant profile induced in rats by the mGluR5 potentiator LSN2814617. Psychopharmacology (Berl) 2015; 232:3977-89. [PMID: 25902875 PMCID: PMC4600478 DOI: 10.1007/s00213-015-3936-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 04/02/2015] [Indexed: 12/30/2022]
Abstract
While treatment options are available, excessive daytime sleepiness (EDS) remains a significant unmet medical need for many patients. Relatively little rodent behavioural pharmacology has been conducted in this context to assess potential pro-vigilant compounds for their ability to restore functional capacity following experimentally induced sleep loss. Male Wistar rats were prepared for electroencephalographic (EEG) recording and subject to 11 h of sleep restriction using a biofeedback-induced cage rotation protocol. A simple response latency task (SRLT) was used to behaviourally index sleep restriction and the effects of pro-vigilant compounds: modafinil, D-amphetamine, caffeine, and the mGlu5-positive allosteric modulator LSN2814617. Sleep restriction resulted in a consistent, quantified loss of non-rapid eye movement (NREM) and REM sleep that impaired SRLT performance in a manner suggestive of progressive task disengagement. In terms of EEG parameters, all compounds induced wakefulness. Amphetamine treatment further decreased SRLT performance capacity, whereas the other three compounds decreased omissions and allowed animals to re-engage in the task. Caffeine and modafinil also significantly increased premature responses during this period, an effect not observed for LSN2814617. While all compounds caused compensatory sleep responses, the magnitude of compensation observed for LSN2814617 was much smaller than would be predicted to result from the prolongation of wakefulness exhibited. Using simple response latencies to index performance, an mGlu5 PAM dramatically increased wakefulness and improved functional capacity of sleep-restricted animals, without eliciting a proportionate compensatory sleep response. This effect was qualitatively distinct from that of amphetamine, caffeine and modafinil.
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Affiliation(s)
- Sally Loomis
- Lilly Research Laboratories, Eli Lilly & Co. Ltd, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey, GU20 6PH England UK
| | - Andrew McCarthy
- Lilly Research Laboratories, Eli Lilly & Co. Ltd, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey, GU20 6PH England UK
| | - Christopher Baxter
- Lilly Research Laboratories, Eli Lilly & Co. Ltd, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey, GU20 6PH England UK
| | - Daniel O. Kellett
- Lilly Research Laboratories, Eli Lilly & Co. Ltd, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey, GU20 6PH England UK
| | - Dale M. Edgar
- Lilly Research Laboratories, Eli Lilly & Co. Ltd, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey, GU20 6PH England UK
| | - Mark Tricklebank
- Lilly Research Laboratories, Eli Lilly & Co. Ltd, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey, GU20 6PH England UK
| | - Gary Gilmour
- Lilly Research Laboratories, Eli Lilly & Co. Ltd, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey, GU20 6PH, England, UK.
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Gest S, Legenbauer T, Bogen S, Schulz C, Pniewski B, Holtmann M. Chronotherapeutics: An alternative treatment of juvenile depression. Med Hypotheses 2014; 82:346-9. [DOI: 10.1016/j.mehy.2014.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 12/11/2013] [Accepted: 01/03/2014] [Indexed: 01/25/2023]
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Depressive feelings in children with narcolepsy. Sleep Med 2014; 15:309-14. [PMID: 24503472 DOI: 10.1016/j.sleep.2013.08.798] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 07/28/2013] [Accepted: 08/04/2013] [Indexed: 12/27/2022]
Abstract
OBJECTIVES We aimed to evaluate depressive feelings and their correlations in children and adolescents with narcolepsy collected in national reference centers for narcolepsy. METHODS We compared clinical and sleep characteristics of patients with and without depressive symptoms evaluated on the Children's Depression Inventory (CDI). RESULTS Our study sample included 88 children (44 boys; 44 de novo patients) with a mean age of 11.9 ± 3.1 years at diagnosis (37.5% were aged ⩽ 10 years). Obesity was found in 59% of the sample and cataplexy was present in 80.7%. The DQB1*0602 allele was positive in 93.5% of our sample. There were 25% of children who had clinically depressive feelings (CDI>16), especially girls older than the age of 10 years. Bivariate associations indicated that depressive feelings were associated with fatigue (48%), hyperactivity (31%), insomnia (16%), and excessive daytime sleepiness (EDS) (14-24%). In the multivariate model adjusted for gender and age, only fatigue explained the variability of the depression score. CONCLUSION In our large cohort, high levels of depressive symptoms essentially expressed by fatigue affected 25% of children with narcolepsy. The girls older than 10 years of age were especially vulnerable. The similar prevalence of depressive feelings in treated vs never-treated patients suggests a specific need for diagnosing and managing this symptom in young patients with narcolepsy.
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Hayley AC, Williams LJ, Berk M, Kennedy GA, Jacka FN, Pasco JA. The relationship between excessive daytime sleepiness and depressive and anxiety disorders in women. Aust N Z J Psychiatry 2013; 47:772-8. [PMID: 23677847 DOI: 10.1177/0004867413490036] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Excessive daytime sleepiness (EDS) is a common clinical symptom that affects women more than men. However, the association of excessive sleepiness with depressive and anxiety disorders in the broader population is unclear. The aim of this study was, therefore, to examine the association between excessive daytime sleepiness as measured by the Epworth Sleepiness Scale, and depressive and anxiety disorders in a population-based sample of women. METHODS Using the Structured Clinical Interview for DSM-IV Disorders (Non-Patient) (SCID-I/NP), 944 women aged 20-97 years (median 49 years, IQR 33-65 years) were assessed for depressive and anxiety disorders as part of the Geelong Osteoporosis Study. EDS was assessed using the Epworth Sleepiness Scale (ESS, cut-off > 10). Lifestyle factors were documented by self-report, height and weight were measured, and socioeconomic status categorised according to the Index of Relative Socio-Economic Advantage and Disadvantage. RESULTS Overall, 125 (13.2%) of the women were identified with EDS. EDS was associated with an increased likelihood for both current (OR = 2.11, 95% CI 1.10-4.06) and lifetime history (OR = 1.95, 95% CI 1.28-2.97) of depressive disorders, but not anxiety disorders, independent of age and alcohol consumption. These findings were not explained by antidepressant or sedative use, body mass index, physical activity, smoking, or socioeconomic status. CONCLUSIONS These results suggest that excessive daytime sleepiness is associated with current and lifetime depressive, but not anxiety disorders. Clinically, this highlights the need to take into account the possible bidirectional relationship between depressive disorders and excessive sleepiness when assessing mental health issues in patients with EDS.
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Affiliation(s)
- Amie C Hayley
- School of Medicine, Deakin University, Geelong, Australia.
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Walz JC, Magalhães PV, Reckziegel R, Costanzi M, Giglio L, Kapczinski F. Daytime sleepiness, sleep disturbance and functioning impairment in bipolar disorder. Acta Neuropsychiatr 2013; 25:101-4. [PMID: 25287311 DOI: 10.1111/j.1601-5215.2012.00673.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To verify the prevalence and clinical impact of excessive daytime sleepiness (EDS) in outpatients with bipolar disorder. METHODS Eighty-one outpatients with bipolar disorder and 79 healthy control subjects were recruited. Patients were required not to be acutely manic or depressed. We used the Epworth Sleepiness Scale, the Pittsburgh Sleep Quality Index and the Functioning Assessment Short Test to assess sleepiness, sleep problems and functioning, respectively. RESULTS Patients had a higher prevalence of sleepiness (40%) than the control group (18%). Sleepiness and sleep disturbance had independent impacts on disability in the multivariable model. CONCLUSIONS This study suggests that EDS is a relevant clinical dimension in patients with bipolar disorder. It is a frequent symptom that often overlaps with other sleep disturbances. This study also reveals that once present it has the potential to increase functional impairment.
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Affiliation(s)
- Julio C Walz
- 1 Bipolar Disorders Program & INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Pedro V Magalhães
- 1 Bipolar Disorders Program & INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Ramiro Reckziegel
- 1 Bipolar Disorders Program & INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Monise Costanzi
- 1 Bipolar Disorders Program & INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Larriany Giglio
- 1 Bipolar Disorders Program & INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Flávio Kapczinski
- 1 Bipolar Disorders Program & INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Endophénotypes des rythmes biologiques et du sommeil dans la dépression. Encephale 2012; 38 Suppl 3:S116-20. [DOI: 10.1016/s0013-7006(12)70089-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Stephenson KM, Schroder CM, Bertschy G, Bourgin P. Complex interaction of circadian and non-circadian effects of light on mood: shedding new light on an old story. Sleep Med Rev 2012; 16:445-54. [PMID: 22244990 DOI: 10.1016/j.smrv.2011.09.002] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Revised: 09/22/2011] [Accepted: 09/22/2011] [Indexed: 01/01/2023]
Abstract
In addition to its role in vision, light exerts strong effects on behavior. Its powerful role in the modulation of mood is well established, yet remains poorly understood. Much research has focused on the effects of light on circadian rhythms and subsequent interaction with alertness and depression. The recent discovery of a third photoreceptor, melanopsin, expressed in a subset of retinal ganglion cells, allows major improvement of our understanding of how photic information is processed. Light affects behavior in two ways, either indirectly through the circadian timing system, or directly through mechanisms that are independent of the circadian system. These latter effects have barely been studied in regard to mood, but recent investigations on the direct effects of light on sleep and alertness suggest additional pathways through which light could influence mood. Based on our recent findings, we suggest that light, via melanopsin, may exert its antidepressant effect through a modulation of the homeostatic process of sleep. Further research is needed to understand how these mechanisms interplay and how they contribute to the photic regulation of mood. Such research could improve therapeutic management of affective disorders and influence the management of societal lighting conditions.
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Affiliation(s)
- Kathryn M Stephenson
- Department of Biological Rhythms, Institut des Neurosciences Cellulaires et Intégratives, CNRS-UPR 3212, Strasbourg, France.
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Grzywacz JG, Chatterjee AB, Quandt SA, Talton JW, Chen H, Weir M, Arcury TA. Depressive symptoms and sleepiness among Latino farmworkers in eastern North Carolina. J Agromedicine 2011; 16:251-60. [PMID: 21958399 PMCID: PMC3286788 DOI: 10.1080/1059924x.2011.605722] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Depression and sleepiness are both risk factors for occupational accidents and unintentional injury. Relatively little is known about the experiences of these risk factors in the immigrant Latino farmworker population. This analysis uses prospective panel data from a sample of Latino farmworkers in eastern North Carolina that were collected at monthly intervals during the 2008 agricultural season to (1) describe depressive symptoms and daytime sleepiness among immigrant Latino farmworkers across the agricultural season; (2) delineate associations of depressive symptoms with sleepiness across time; and (3) determine whether depressive symptoms precede sleepiness, or if sleepiness precedes depressive symptoms. Results indicated that 45% of farmworkers experienced elevated depressive symptoms across the season, whereas 20% experienced elevated sleepiness. Elevated depressive symptoms were more common among farmworkers living in barracks, and less common among those living in trailers. Sleepiness was more common among women than men. There was no evidence that depressive symptoms contributed to sleepiness, or that sleepiness contributed to depressive symptoms. The pattern of results suggests that a substantial proportion of Latino farmworkers experience levels of depressive symptoms or sleepiness that places them at risk for occupational accident or unintentional injury. The results also suggest that depressive symptoms and sleepiness do not cause each other; rather, the association of depressive symptoms with sleepiness hints at the possibility of a common physiologic mechanism such as circadian disruption.
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Affiliation(s)
- Joseph G Grzywacz
- Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
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Pringuey D, Fakra E, Cherikh F, Bottaï T, Tible O, Maurel M, Richieri R, Adida M, Kaladjian A, Azorin JM. [Affective disorders: News in chronobiological models]. Encephale 2011; 36 Suppl 6:S157-66. [PMID: 21237350 DOI: 10.1016/s0013-7006(10)70051-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Good news on chronobiological models of affective disorders are coming from a therapeutic innovation in the field of antidepressive action. Coming back to fundamentals by reconsidering the importance of the role of biological rhythms impairment in dysthymic pathology, a new interest bored on studies exploring short periodicities, so-called "ultradian" ones, on the basis of pharmacodynamics in the concept of therapeutic "window" of administration. The priority of circadian rhythms due to the major external biological desynchronization in depression, as well as the importance of sleep and alertness pathology, the spectacular relief of the depressive mood upon sleep deprivation, and the strong reduction of sleep need in mania, delayed exploration of ultradian exaltation of harmonic circadian components, marking a "buzz" of rhythmic structure and calling a "chronobiotic compound" which would be able to apply a "reset" to the temporal organisation. Another return to the origin leads to the experimental genomics, informing nor the "depressivity" but manic pathogenesis, in a mouse gene model which queries on the share of addictive and affective disorders.
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Affiliation(s)
- D Pringuey
- Clinique de Psychiatrie et de Psychologie Médicale, Pôle des Neurosciences Cliniques, Fédération du Sommeil, Hôpital Pasteur, CHU de Nice, av. de la Voie Romaine, BP 1069, 06002 Nice cedex, France.
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