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Chen J, Cheng X, Wang Q, Wang R, Zhang J, Liu J. Childhood maltreatment predicts poor sleep quality in Chinese adults: The influence of coping style tendencies. J Affect Disord 2024; 363:366-372. [PMID: 39029677 DOI: 10.1016/j.jad.2024.07.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 06/29/2024] [Accepted: 07/16/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND This longitudinal study assessed the prospective link between childhood maltreatment and sleep quality in adulthood, with a specific focus on examining whether different coping style tendencies influence these associations. METHODS The baseline sample included 1600 adult participants, with 1140 participants successfully followed up 5 years later. The key variables were measured using the Childhood Trauma Questionnaire (CTQ), Simplified Coping Style Questionnaire (SCSQ), and Pittsburgh Sleep Quality Index (PSQI). Generalized linear mixed models were employed to estimate unstandardized β estimates and 95 % confidence intervals (95%CIs). Structural equation modeling was used to test the mediation model. RESULTS Individuals reported childhood maltreatment at baseline were at an increased risk for sleep disturbances at follow-up. Childhood maltreatment negatively predicted the baseline coping style tendency (β = -0.29, P < 0.001), the baseline coping style tendencies negatively predicted the follow-up sleep quality (β = -0.10, P < 0.001), and childhood maltreatment positively predicted the follow-up sleep quality (β = 0.42, P < 0.01). The mediating effect of baseline coping style tendencies between childhood maltreatment and the follow-up sleep quality was significant, with an effect value of 0.03. LIMITATIONS First, the sample was from a single province (Shandong), which limits the generalizability of the findings. Second, recall bias was unavoidable in this adult sample study. CONCLUSIONS Developing positive coping strategies is an important way to reduce the risk of sleep problems in adults with a history of childhood maltreatment.
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Affiliation(s)
- Jie Chen
- Shandong Mental Health Center, Shandong University, Jinan, China
| | - Xiaojing Cheng
- Institute of Mental Health, Occupational Diseases Hospital of Shandong First Medical University, Jinan, China
| | - Qian Wang
- Institute of Mental Health, Occupational Diseases Hospital of Shandong First Medical University, Jinan, China
| | - Ruzhan Wang
- Shandong Mental Health Center, Shandong University, Jinan, China
| | - Jingxuan Zhang
- Shandong Mental Health Center, Shandong University, Jinan, China.
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2
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Tao Y, Wang H, Luo J, Zhang H, Zhang W, Yu M, Ji S, Peng S, Zhang X. The Association between Adverse Childhood Experiences and Frailty: A Systematic Review. J Am Med Dir Assoc 2024; 25:105042. [PMID: 38796164 DOI: 10.1016/j.jamda.2024.105042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/10/2024] [Accepted: 04/14/2024] [Indexed: 05/28/2024]
Abstract
OBJECTIVE Based on life-course theory, adverse childhood experiences (ACEs) have emerged as risk factors for health in later life. This study aimed to explore the association between ACEs and frailty. DESIGN Systematic review. SETTING AND PARTICIPANTS Frail older adults who have experienced ACEs. METHODS We searched 7 databases: PubMed, Cochrane Library, Embase, Web of Science, Scopus, PsycINFO, and China National Knowledge Infrastructure (CNKI). The last searched date was October 27, 2023. Included studies should have investigated the association between exposure to at least 1 ACE and frailty. Two researchers independently assessed the risk of bias in the included studies using the Newcastle-Ottawa Scale (NOS) and an adapted version of the NOS scale and also extracted relevant characteristics and outcomes of the included studies. RESULTS A total of 14 studies were finally included. Consistent associations with increased risk of frailty were only shown in studies that assessed family members with mental illness, low neighborhood quality, emotional abuse, sexual abuse, and combinations of ACEs. In addition, women exposed to ACEs were more likely to be at risk for frailty than men, and greater numbers or types of exposure to ACEs were associated with higher odds of frailty. The results of the quality assessment showed a moderate risk of bias in half of the studies. CONCLUSIONS AND IMPLICATIONS This study summarizes for the first time the evidence for an association between ACEs and frailty. Considered collectively, increased attention to ACEs may be one way to prevent frailty, and unhealthy lifestyles resulting from ACEs may serve as a breakthrough in developing interventions.
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Affiliation(s)
- Yanmin Tao
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Hongyan Wang
- Sichuan Nursing Vocational College, Chengdu, Sichuan, China
| | - Jingsong Luo
- Jockey Club School of Public Health and Primary Care School, The Chinese University of Hong Kong, Hong Kong
| | - Hong Zhang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Wen Zhang
- Sichuan Nursing Vocational College, Chengdu, Sichuan, China
| | - Meng Yu
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Shuyang Ji
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Sihan Peng
- Affiliated hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
| | - Xiangeng Zhang
- Sichuan Nursing Vocational College, Chengdu, Sichuan, China.
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3
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Bresser T, Blanken TF, de Lange SC, Leerssen J, Foster-Dingley JC, Lakbila-Kamal O, Wassing R, Ramautar JR, Stoffers D, van de Heuvel MP, van Someren EJW. Insomnia subtypes have differentiating deviations in brain structural connectivity. Biol Psychiatry 2024:S0006-3223(24)01418-5. [PMID: 38944140 DOI: 10.1016/j.biopsych.2024.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 06/10/2024] [Accepted: 06/18/2024] [Indexed: 07/01/2024]
Abstract
OBJECTIVE Insomnia disorder is the most common sleep disorder. A better understanding of insomnia-related deviations in the brain could inspire better treatment. Insufficiently recognized heterogeneity within the insomnia population could obscure detection of involved brain circuits. The present study investigated whether structural brain connectivity deviations differ between recently discovered and validated insomnia subtypes. METHODS Structural and diffusion weighted 3-Tesla MRI data of four independent studies were harmonized. The sample consisted of 73 controls without sleep complaints and 204 participants with insomnia grouped into five subtypes based on their fingerprint of mood and personality traits assessed with the Insomnia Type Questionnaire. Linear regression correcting for age and sex evaluated group differences in structural connectivity strength, indicated by fractional anisotropy, streamline volume density and mean diffusivity, and evaluated within three different atlases. RESULTS Insomnia subtypes showed differentiating profiles of deviating structural connectivity which concentrated in different functional networks. Permutation testing against randomly drawn heterogeneous subsamples indicated significant specificity of deviation profiles in four of the five subtypes: highly distressed, moderately distressed reward sensitive, slightly distressed low reactive and slightly distressed high reactive. Connectivity deviation profile significance ranged from p= 0.001 to p=0.049 for different resolutions of brain parcellation and connectivity weight. CONCLUSIONS Our results provide a first indication that different insomnia subtypes exhibit distinct profiles of deviations in structural brain connectivity. Subtyping of insomnia could be essential for a better understanding of brain mechanisms that contribute to insomnia vulnerability.
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Affiliation(s)
- Tom Bresser
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands,; Vrije Universiteit Amsterdam, Department of Integrative Neurophysiology, Amsterdam, Netherlands; Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Tessa F Blanken
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands,; University of Amsterdam, Department of Psychological Methods, Amsterdam, Netherlands
| | - Siemon C de Lange
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands,; Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jeanne Leerssen
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands
| | - Jessica C Foster-Dingley
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands
| | - Oti Lakbila-Kamal
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands,; Vrije Universiteit Amsterdam, Department of Integrative Neurophysiology, Amsterdam, Netherlands; Department of Psychiatry, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Rick Wassing
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands,; Woolcock Institute and School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia; Sydney Local Health District, Sydney, NSW, Australia
| | - Jennifer R Ramautar
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands,; N=You Neurodevelopmental Precision Center, Amsterdam Neuroscience, Amsterdam Reproduction and Development, Amsterdam UMC, Amsterdam, The Netherlands; Child and Adolescent Psychiatry and Psychosocial Care, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Diederick Stoffers
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands,; Spinoza Centre for Neuroimaging, Amsterdam, The Netherlands
| | - Martijn P van de Heuvel
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Department of Child and Adolescent Psychiatry and Psychology, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Eus J W van Someren
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands,; Vrije Universiteit Amsterdam, Department of Integrative Neurophysiology, Amsterdam, Netherlands; Department of Psychiatry, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
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4
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Qi W, He X, Wang Z. Childhood unpredictability and sleep quality in adulthood: the mediating roles of life history strategy and perceived stress. Front Psychol 2024; 15:1347365. [PMID: 38699575 PMCID: PMC11063338 DOI: 10.3389/fpsyg.2024.1347365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 04/04/2024] [Indexed: 05/05/2024] Open
Abstract
Background Early environmental risk have been found to be related to lifelong health. However, the impact of childhood unpredictability, a type of early environmental risk, on health, especially on sleep quality in adulthood, has not been adequately studied. The present study aimed to examine the relationship between childhood unpredictability and sleep quality in adulthood and to explore the possible mediating roles of life history strategy and perceived stress. Methods A cross-sectional study was conducted on 472 participants from a university in Zhejiang Province, China. The questionnaire inquired about demography, childhood unpredictability, life history strategy (Mini-K), perceived stress (14-item Perceived Stress Scale), and Sleep Quality (Pittsburgh Global Sleep Quality Index). Results Higher childhood unpredictability was significantly associated with worse sleep quality in adulthood. Moreover, the link between higher childhood unpredictability and worse sleep quality in adulthood was explained by the chain mediation of life history strategy and perceived stress. Conclusion In line with the life history theory, individuals who have experienced higher unpredictability in childhood tend to develop a faster life history strategy and become more sensitive to stress in adulthood, and subsequently suffer a decrease in sleep quality.
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Affiliation(s)
- Wei Qi
- Department of Psychology, Zhejiang Sci-Tech University, Hangzhou, Zhejiang, China
| | - Xiangyang He
- Department of Psychology, Zhejiang Sci-Tech University, Hangzhou, Zhejiang, China
| | - Zhechen Wang
- School of Social Development and Public Policy, Fudan University, Shanghai, China
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
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Rogers EM, Banks NF, Jenkins NDM. The effects of sleep disruption on metabolism, hunger, and satiety, and the influence of psychosocial stress and exercise: A narrative review. Diabetes Metab Res Rev 2024; 40:e3667. [PMID: 37269143 DOI: 10.1002/dmrr.3667] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 04/27/2023] [Accepted: 05/18/2023] [Indexed: 06/04/2023]
Abstract
Sleep deficiency is a ubiquitous phenomenon among Americans. In fact, in the United States, ∼78% of teens and 35% of adults currently get less sleep than recommended for their age-group, and the quality of sleep appears to be getting worse for many. The consequences of sleep disruption manifest in a myriad of ways, including insulin resistance and disrupted nutrient metabolism, dysregulation of hunger and satiety, and potentially increased body weight and adiposity. Consequently, inadequate sleep is related to an increased risk of various cardiometabolic diseases, including obesity, diabetes, and heart disease. Exercise has the potential to be an effective therapeutic to counteract the deleterious effects of sleep disruption listed above, whereas chronic psychosocial stress may causally promote sleep disruption and cardiometabolic risk. Here, we provide a narrative review of the current evidence on the consequences of short sleep duration and poor sleep quality on substrate metabolism, circulating appetite hormones, hunger and satiety, and weight gain. Secondly, we provide a brief overview of chronic psychosocial stress and its impact on sleep and metabolic health. Finally, we summarise the current evidence regarding the ability of exercise to counteract the adverse metabolic health effects of sleep disruption. Throughout the review, we highlight areas where additional interrogation and future exploration are necessary.
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Affiliation(s)
- Emily M Rogers
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, The University of Iowa, Iowa City, Iowa, USA
| | - Nile F Banks
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, The University of Iowa, Iowa City, Iowa, USA
| | - Nathaniel D M Jenkins
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, The University of Iowa, Iowa City, Iowa, USA
- Abboud Cardiovascular Research Center, The University of Iowa, Iowa City, Iowa, USA
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Rosenblum S, Cohen Elimelech O. Daily Functional Characteristics and Health Among Older Adults During COVID-19: A Structural Equation Modeling Approach. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241233430. [PMID: 38385207 PMCID: PMC10885779 DOI: 10.1177/00469580241233430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Within a few years, 1 in 6 people will be aged 60 years or older. Extreme situations, such as the COVID-19 crisis, constitute a challenge to older adults. However, the literature on the daily functional characteristics of older adults in the past and during the COVID-19 crisis and their relationships to their physical and mental health is scarce. This study aimed to examine the past and present daily functional factors associated with physical and mental health in older adults. Using an online platform, 204 Israelis aged 60 years and older reported their physical health symptoms and anxiety levels. They completed questionnaires about past (negative life events and childhood daily functional self-actualization) and present (adulthood daily functional self-actualization, functional cognition and sleep quality) factors. Structural equation modeling revealed correlations between functional cognition and childhood daily functional self-actualization (β = -.18) and anxiety (β = .15); adulthood daily functional self-actualization and past negative life events (β = -.18), anxiety (β = -.50), and physical symptoms (β = -16); and sleep quality and past childhood daily functional self-actualization (β = -.19), negative life events (β = .22), anxiety (β = .18), and physical symptoms (β = .40). These findings shed light on potential functional factors for older adults' health, indicating that these functional factors play a vital role in reducing health problems in later life.
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Oken E, Rifas-Shiman SL, Joffe H, Manson JE, Spagnolo PA, Bertisch SM, Klerman EB, Chavarro JE. Associations of adverse childhood and lifetime experiences with sleep quality and duration among women in midlife. Sleep Health 2023; 9:860-867. [PMID: 37923668 PMCID: PMC10840935 DOI: 10.1016/j.sleh.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/24/2023] [Accepted: 09/09/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVES Many women experience sleep problems during midlife. Associations of adverse lifetime experiences-more common among women-with sleep outcomes are understudied. METHODS We studied 476 women enrolled in Project Viva 1999-2002. At enrollment, participants reported any lifetime history of abuse and/or financial hardship. At midlife follow-up ∼20 years later, they reported a history of up to 10 adverse childhood experiences (ACEs); 7-day sleep quality (patient-reported outcomes measurement information system sleep disturbance and sleep-related impairment T-scores); and past month average sleep duration. We examined associations of adverse experiences with sleep outcomes, adjusted for childhood sociodemographic variables. We also explored mediation by current depression and anxiety symptoms, hot flash severity, general health, and body mass index. RESULTS ACEs were common: 301 women (63%) reported one or more. Each additional ACE was associated with higher midlife sleep disturbance (adjusted β = 0.65 points, 95% confidence interval [CI]: 0.27, 1.02) and sleep-related impairment (0.98, 95% CI: 0.54, 1.41) T-scores, and with sleep duration <6 hour/night (odds ratio 1.19, 95% CI: 1.00, 1.42), but not with continuous sleep duration (-2 minutes, 95% CI: -5, 1). Adverse experiences in adulthood were less consistently associated with sleep quality but were associated with sleep duration, for example, financial hardship during the index pregnancy was associated with 75 minutes (95% CI: -120, -29) shorter sleep duration 2 decades later. Associations of ACEs with sleep disturbance and sleep-related impairment were mediated by midlife depression anxiety and physical health but not by hot flash severity or body mass index. CONCLUSIONS Adverse lifetime experiences have deleterious associations with sleep duration and quality in midlife women.
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Affiliation(s)
- Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA; Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA.
| | | | - Hadine Joffe
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Connors Center for Women Health and Gender Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - JoAnn E Manson
- Connors Center for Women Health and Gender Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Primavera Alessandra Spagnolo
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Connors Center for Women Health and Gender Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Suzanne M Bertisch
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Elizabeth B Klerman
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Jorge E Chavarro
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
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8
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He J, Wang R, Liu J, Yip P. Effects of Adverse Childhood Experiences on Sleep Quality in People With Drug Addiction and Non-Addicts and the Role of Resilience Between Them. Psychol Rep 2023; 126:2158-2171. [PMID: 35353658 DOI: 10.1177/00332941221076776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
People with drug addiction are more likely to suffer from sleep disorders than non-addicts. The roles that childhood adversity experiences and resilience play in the development of sleep disorders will be explored in this study. A total of 459 participants with drug addiction and 400 non-addicts were investigated with the Adverse Childhood Experiences (ACEs) Scale, Pittsburgh Sleep Quality Index (PSQI), and Connor-Davidson Resilience Scale from April 2019 to December 2020. Our results suggested that participants with drug addiction had worse sleep quality compared to non-addicts. Resilience acted as a mediator and significantly affected the relationship between ACEs and sleep quality. For all participants who experienced ACEs, individuals with high resilience reported lower PSQI score, the regulatory effect of medium and high resilience on sleep quality was better than that of low resilience. Moreover, comparing to the non-addicts who experienced mild ACEs, high resilience showed a good buffer effect on the sleep quality for people with drug addiction. And high resilience played a stronger regulatory role in females as compared to males. The results help to broaden the relevant research in the field of sleep and we should pay attention to the role of resilience in regulating sleep quality.
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Affiliation(s)
- Jingzhen He
- Health Psychology Institution, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Rufang Wang
- Health Psychology Institution, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jun Liu
- Sichuan Drug Rehabilitation Administration, Chengdu, China
| | - Peter Yip
- Physical Therapy Department, Florida Southern College, Lakeland, FL, USA
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Desch J, Bakour C, Mansuri F, Tran D, Schwartz S. The association between adverse childhood experiences and insomnia symptoms from adolescence to adulthood: Evidence from the Add Health study. Sleep Health 2023; 9:646-653. [PMID: 37419708 DOI: 10.1016/j.sleh.2023.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 05/25/2023] [Accepted: 06/01/2023] [Indexed: 07/09/2023]
Abstract
OBJECTIVES Adverse childhood experiences are potentially traumatic events that occur up to age 17, including abuse, neglect, and household dysfunction. Such trauma often results in chronic stress and poor sleep health, which are linked to negative health outcomes across the lifespan. This study examines the longitudinal association between adverse childhood experiences (ACEs) and insomnia symptoms from adolescence to adulthood. METHODS Data from the National Longitudinal Study of Adolescent to Adult Health were used to examine the association between ACEs and insomnia symptoms (trouble falling asleep or staying asleep, dichotomized based on self-reported frequency of 3 times per week or more). We used weighted logistic regression to examine the association between cumulative ACE score (0, 1, 2-3, 4+), 10 specific ACEs, and insomnia symptoms. RESULTS Of 12,039 participants, 75.3% experienced at least one adverse childhood experience and 14.7% experienced 4 or more. We found specific adverse childhood experiences, including physical abuse, emotional abuse, neglect, parental incarceration, parental alcoholism, foster home placement, and community violence were associated with experiencing insomnia symptoms throughout the entire 22-year follow-up period from adolescence to mid-adulthood (p < .05), while childhood poverty was only associated with insomnia symptoms in mid-adulthood. The number of adverse childhood experiences showed a dose-response association with insomnia symptoms in adolescence (1 adverse childhood experience: adjusted odds ratio (aOR)=1.47 [1.16, 1.87], 4+ adverse childhood experiences: aOR= 2.76, [2.18, 3.50]), early adulthood (1 adverse childhood experience: aOR= 1.43 [1.16, 1.75], 4+ adverse childhood experiences: aOR= 3.07 [2.47, 3.83]) and mid-adulthood (1 adverse childhood experience: aOR= 1.13 [0.94, 1.37], 4+ adverse childhood experiences: aOR= 1.89 [confidence interval: 1.53, 2.32]). CONCLUSIONS Adverse childhood experiences are associated with an increased risk for insomnia symptoms across the lifespan.
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Affiliation(s)
- Jill Desch
- College of Public Health, University of South Florida, Tampa, Florida, USA.
| | - Chighaf Bakour
- College of Public Health, University of South Florida, Tampa, Florida, USA.
| | - Fahad Mansuri
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Dieu Tran
- College of Public Health, University of South Florida, Tampa, Florida, USA.
| | - Skai Schwartz
- College of Public Health, University of South Florida, Tampa, Florida, USA.
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10
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Simon L, Admon R. From childhood adversity to latent stress vulnerability in adulthood: the mediating roles of sleep disturbances and HPA axis dysfunction. Neuropsychopharmacology 2023; 48:1425-1435. [PMID: 37391592 PMCID: PMC10425434 DOI: 10.1038/s41386-023-01638-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/29/2023] [Accepted: 06/16/2023] [Indexed: 07/02/2023]
Abstract
Childhood adversity is a prominent predisposing risk factor for latent stress vulnerability, expressed as an elevated likelihood of developing stress-related psychopathology upon subsequent exposure to trauma in adulthood. Sleep disturbances have emerged as one of the most pronounced maladaptive behavioral outcomes of childhood adversity and are also a highly prevalent core feature of stress-related psychopathology, including post-traumatic stress disorder (PTSD). After reviewing the extensive literature supporting these claims, the current review addresses the notion that childhood adversity-induced sleep disturbances may play a causal role in elevating individuals' stress vulnerability in adulthood. Corroborating this, sleep disturbances that predate adult trauma exposure have been associated with an increased likelihood of developing stress-related psychopathology post-exposure. Furthermore, novel empirical evidence suggests that sleep disturbances, including irregularity of the sleep-wake cycle, mediate the link between childhood adversity and stress vulnerability in adulthood. We also discuss cognitive and behavioral mechanisms through which such a cascade may evolve, highlighting the putative role of impaired memory consolidation and fear extinction. Next, we present evidence to support the contribution of the hypothalamic-pituitary-adrenal (HPA) axis to these associations, stemming from its critical role in stress and sleep regulatory pathways. Childhood adversity may yield bi-directional effects within the HPA stress and sleep axes in which sleep disturbances and HPA axis dysfunction reinforce each other, leading to elevated stress vulnerability. To conclude, we postulate a conceptual path model from childhood adversity to latent stress vulnerability in adulthood and discuss the potential clinical implications of these notions, while highlighting directions for future research.
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Affiliation(s)
- Lisa Simon
- School of Psychological Sciences, University of Haifa, Haifa, Israel
| | - Roee Admon
- School of Psychological Sciences, University of Haifa, Haifa, Israel.
- The Integrated Brain and Behavior Research Center (IBBRC), University of Haifa, Haifa, Israel.
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11
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Irwin MR, Straub RH, Smith MT. Heat of the night: sleep disturbance activates inflammatory mechanisms and induces pain in rheumatoid arthritis. Nat Rev Rheumatol 2023; 19:545-559. [PMID: 37488298 DOI: 10.1038/s41584-023-00997-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2023] [Indexed: 07/26/2023]
Abstract
Sleep has a homeostatic role in the regulation of the immune system and serves to constrain activation of inflammatory signalling and expression of cellular inflammation. In patients with rheumatoid arthritis (RA), a misaligned inflammatory profile induces a dysregulation of sleep-wake activity, which leads to excessive inflammation and the induction of increased sensitivity to pain. Given that multiple biological mechanisms contribute to sleep disturbances (such as insomnia), and that the central nervous system communicates with the innate immune system via neuroendocrine and neural effector pathways, potential exists to develop prevention opportunities to mitigate the risk of insomnia in RA. Furthermore, understanding these risk mechanisms might inform additional insomnia treatment strategies directed towards steering and reducing the magnitude of the inflammatory response, which together could influence outcomes of pain and disease activity in RA.
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Affiliation(s)
- Michael R Irwin
- Department of Psychiatry and Behavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience and Human Behaviour, Los Angeles, CA, USA.
| | - Rainer H Straub
- Laboratory of Experimental Rheumatology and Neuroendocrine Immunology, Department of Internal Medicine I, University Hospital, Regensburg, Germany
| | - Michael T Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
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12
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Wang T, Ma YN, Zhang CC, Liu X, Sun YX, Wang HL, Wang H, Zhong YH, Su YA, Li JT, Si TM. The Nucleus Accumbens CRH-CRHR1 System Mediates Early-Life Stress-Induced Sleep Disturbance and Dendritic Atrophy in the Adult Mouse. Neurosci Bull 2023; 39:41-56. [PMID: 35750984 PMCID: PMC9849529 DOI: 10.1007/s12264-022-00903-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 05/14/2022] [Indexed: 01/24/2023] Open
Abstract
Adverse experiences in early life have long-lasting negative impacts on behavior and the brain in adulthood, one of which is sleep disturbance. As the corticotropin-releasing hormone (CRH)-corticotropin-releasing hormone receptor 1 (CRHR1) system and nucleus accumbens (NAc) play important roles in both stress responses and sleep-wake regulation, in this study we investigated whether the NAc CRH-CRHR1 system mediates early-life stress-induced abnormalities in sleep-wake behavior in adult mice. Using the limited nesting and bedding material paradigm from postnatal days 2 to 9, we found that early-life stress disrupted sleep-wake behaviors during adulthood, including increased wakefulness and decreased non-rapid eye movement (NREM) sleep time during the dark period and increased rapid eye movement (REM) sleep time during the light period. The stress-induced sleep disturbances were accompanied by dendritic atrophy in the NAc and both were largely reversed by daily systemic administration of the CRHR1 antagonist antalarmin during stress exposure. Importantly, Crh overexpression in the NAc reproduced the effects of early-life stress on sleep-wake behavior and NAc morphology, whereas NAc Crhr1 knockdown reversed these effects (including increased wakefulness and reduced NREM sleep in the dark period and NAc dendritic atrophy). Together, our findings demonstrate the negative influence of early-life stress on sleep architecture and the structural plasticity of the NAc, and highlight the critical role of the NAc CRH-CRHR1 system in modulating these negative outcomes evoked by early-life stress.
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Affiliation(s)
- Ting Wang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Yu-Nu Ma
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Chen-Chen Zhang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Xiao Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Ya-Xin Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Hong-Li Wang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Han Wang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Yu-Heng Zhong
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, 200032, China
| | - Yun-Ai Su
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Ji-Tao Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
| | - Tian-Mei Si
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
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Holzer DW, Counts CJ, Ashmore EP, Hammock C, John-Henderson N. Childhood environments and their relationship with sleep and ambulatory blood pressure in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:190-199. [PMID: 33759718 PMCID: PMC8460682 DOI: 10.1080/07448481.2021.1885414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 12/23/2020] [Accepted: 01/31/2021] [Indexed: 06/12/2023]
Abstract
Objective: Investigate whether psychosocial risk in the childhood family environment moderates the relationship between childhood socioeconomic status (SES) and sleep, and the relationship between childhood SES and ambulatory blood pressure (ABP) in college students, two factors that are linked to future risk for cardiovascular disease. Participants: 124 American college students. Methods: Childhood SES and psychosocial risk in childhood family environments were measured by self-report instruments. Sleep was measured with self-report and actigraphy (over 5 days) and ABP over a 2-day period. Results: Linear regressions adjusting for age, sex, current SES, and current depressive symptoms indicated that SES and psychosocial risk in family environments during childhood interact to inform sleep quality, actigraphy derived wake after sleep onset (WASO), actigraphy derived Sleep Efficiency (SE) and ABP. Conclusions: Psychosocial risk in the childhood family environment may offset previously documented relationships between childhood SES and health-relevant outcomes in college students.
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14
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Tao H, Zeng X, Hou M, Chen S, Shen J, Liao X, Zou C. Association of adverse childhood experiences and depression among medical students: the role of family functioning and insomnia. Front Psychol 2023; 14:1134631. [PMID: 37205075 PMCID: PMC10185847 DOI: 10.3389/fpsyg.2023.1134631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 04/11/2023] [Indexed: 05/21/2023] Open
Abstract
Background Few studies have explored the mechanisms linking adverse childhood experiences (ACEs) to depression in medical students. This study aimed to investigate the relationship between ACEs and depression through the serial mediation effect of family functioning and insomnia. Methods A cross-sectional survey was conducted with 368 medical students from university in Chengdu in 2021. The participants were asked to complete four self-report questionnaires, including ACEs scale, the family APGAR index, the ISI and PHQ-9. Singe and serial mediation analyses were conducted using structural equation modeling by Mplus 8.3. Results ACEs had a significant direct effect on depression (β = 0.438, p < 0.001) and through three significantly indirect pathways: (1) through family functioning (β = 0.026, 95% CI: 0.007-0.060), accounting for 5.9% of the total effect; (2) through insomnia (β = 0.103, 95% CI: 0.011-0.187), accounting for 23.5% of the total effect; and (3) through the serial mediators involving in family functioning and insomnia (β = 0.038, 95% CI: 0.015-0.078), accounting for 8.7% of the total effect. The total indirect effect was 38.1%. Limitations This cross-sectional study prevented us from establishing causality. Conclusion This study highlights the role of family functioning and insomnia as serial mediators of the relationship between ACEs and depression. Findings help to elucidate the mechanism that underlines the pathway between ACEs and depression in medical students. These findings may indicate developing measures to strengthen family functioning and improve insomnia aiming to reduce depression in medical students with ACEs.
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Affiliation(s)
- Hongxia Tao
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- The Department of General Practice, Chengdu Fifth People’s Hospital, Chengdu University of TCM, Chengdu, China
| | - Xin Zeng
- The Department of General Practice, Chengdu Fifth People’s Hospital, Chengdu University of TCM, Chengdu, China
| | - Mutian Hou
- Psychological Research and Counseling Center, Southwest Jiaotong University, Chengdu, China
| | - Shanping Chen
- The Department of Geriatric Medicine, Chengdu Fifth People’s Hospital, Chengdu University of TCM, Chengdu, China
| | - Jing Shen
- The Department of General Practice, Chengdu Fifth People’s Hospital, Chengdu University of TCM, Chengdu, China
| | - Xiaoyang Liao
- General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Xiaoyang Liao, ; Chuan Zou,
| | - Chuan Zou
- The Department of General Practice, Chengdu Fifth People’s Hospital, Chengdu University of TCM, Chengdu, China
- *Correspondence: Xiaoyang Liao, ; Chuan Zou,
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15
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Oh CH, Wallace ML, Germain A. Childhood trauma and gender: Synergistic and additive effects on sleep in healthy young adults. Sleep Health 2022; 8:498-504. [PMID: 35965190 DOI: 10.1016/j.sleh.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 05/13/2022] [Accepted: 06/15/2022] [Indexed: 10/15/2022]
Abstract
OBJECTIVES To examine whether gender moderates the effects of childhood trauma on subjective and objective sleep measures. DESIGN Secondary data analysis, exploratory SETTINGS: Sleep research lab PARTICIPANTS: A total of 213 men and 278 women aged 18-30 completed subjective measures. A subsample of 172 participants without any psychiatric, medical, or sleep disorders completed objective polysomnography for 1 night at baseline, before sleep manipulation. MEASUREMENTS Subjective measures: Childhood Trauma Questionnaire (CTQ), Pittsburgh Sleep Quality Index, Insomnia Severity Index, and Epworth Sleepiness Scale. Objective measures: Standard polysomnography measures. Multiple regressions determined whether gender moderated CTQ score on any objective or subjective sleep measures. If gender was not a moderator, we examined additive effects of gender and CTQ score. Models were adjusted for race and age. RESULTS Gender and CTQ score interactions were non-significant for both subjective (p > .675) and objective (p > .110) sleep. Women demonstrated better subjective sleep quality (Pittsburgh Sleep Quality Index, B = -0.264, p = .041) and more delta sleep than men (B = 3.032, p =.005). Greater CTQ score was associated with increased sleepiness (Epworth Sleepiness Scale, B = 0.029, p = .042), increased insomnia severity (Insomnia Severity Index, B = 0.027, p = .005), and lower REM density (B = -0.132, p = .045). CONCLUSION Our finding of greater delta sleep and better subjective overall sleep quality in women suggests that, among people without comorbidities, women may experience better sleep. Childhood trauma is associated with objective and subjective sleep measures, but this association is non-specific to gender. Clear links between childhood trauma and sleep are detectable in a sample of healthy sleepers with no comorbidities.
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Affiliation(s)
- Cristine H Oh
- Department of Psychiatry, University of Pittsburgh School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Meredith L Wallace
- Departments of Psychiatry, Statistics and Biostatistics, University of Pittsburgh, Pittsburgh PA, United States
| | - Anne Germain
- Department of Psychiatry, University of Pittsburgh, Pittsburgh PA, United States.
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16
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Abstract
Adverse childhood experiences (ACEs) before the age of 18 years are pervasive and noteworthy public health concerns. The ACEs are associated with sleep disorders in later life. In this study, we conduct a systematic review to explore the effects of ACEs on sleep in adulthood. Using Medical Subject Headings keywords, we searched Medline, PubMed, PubMed Central, the American Psychological Association PsycArticles, and PsychInfo databases to evaluate the association between ACEs and sleep disturbances. ACEs increase the odds of developing chronic short sleep duration, that is, <6 hours of sleep per night compared with optimal sleep duration of 7-9 hours per night during adulthood. The ACEs are positively associated with poor sleep characteristics such as short sleep duration and long-term sleep problems. Clinicians should pay close attention to developmental trauma care, access community health programs, and help develop better coping skills, resiliency, and good sleep habits in their patients.
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17
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Işik M, Kirli U. The mediating effect of attachment insecurity on circadian consequences of childhood trauma. Chronobiol Int 2022; 39:936-947. [PMID: 35300548 DOI: 10.1080/07420528.2022.2050385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Circadian preferences have been associated with mental health as well as social and physical health in recent years. However, factors associated with circadian preferences have not been fully elucidated. The main aim of this study is to investigate the associations of childhood trauma and attachment styles with circadian preferences. A total of 673 participants were evaluated using the Morningness-Eveningness Questionnaire (MEQ), the Childhood Trauma Questionnaire 28 (CTQ-28), and the Experiences in Close Relationships-Revised (ECR-R) questionnaire. The results indicated that 14.9% (n = 100) of the participants were morning type, 20.6% (n = 139) were evening type, and 64.5% (n = 434) were intermediate type. Both childhood trauma and attachment-related anxiety/avoidance scores were associated with being evening type (p < .01). Moreover, attachment-related anxiety and avoidance fully mediated the association between childhood trauma and circadian preferences. The present study showed that attachment styles might be associated with circadian preferences. Further studies are needed to replicate these results and to infer explanatory mechanisms for these cross-sectional associations.
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Affiliation(s)
- Mesut Işik
- Faculty of Medicine, Department of Psychiatry, Van Yuzuncu Yil University, Van, Turkey
| | - Umut Kirli
- Department of Drug Abuse, Ege University, Institute on Drug Abuse, Toxicology and Pharmaceutical Science, Izmir, Turkey
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18
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Brown SM, Rodriguez KE, Smith AD, Ricker A, Williamson AA. Associations between Childhood Maltreatment and Behavioral Sleep Disturbances Across the Lifespan: A Systematic Review. Sleep Med Rev 2022; 64:101621. [PMID: 35367857 PMCID: PMC9441474 DOI: 10.1016/j.smrv.2022.101621] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/26/2022] [Accepted: 02/28/2022] [Indexed: 01/10/2023]
Abstract
Childhood maltreatment has a range of long-term developmental and health consequences. Emerging research suggests that sleep disturbances may be a key behavioral health risk factor implicated in the relationship between maltreatment and poor health across the lifespan. This systematic review examined the association between maltreatment and behavioral sleep disturbances in childhood and adulthood. Studies were identified through PsycINFO, PubMed, and alternative search strategies such as Google Scholar and reference list checks, with an end date of July 2021. Quantitative, peer-reviewed articles examining behavioral sleep outcomes and/or characteristics among maltreatment-exposed samples were included. We assessed the potential risk of bias by examining study design and sleep and maltreatment assessment methods. Across 73 studies included in this review, there was a robust association between childhood maltreatment and behavioral sleep disturbances. Findings suggest that linkages between maltreatment and sleep outcomes diverge with respect to maltreatment characteristics, type of behavioral sleep disturbance assessed, use of subjective versus objective measures, and study design. Given that behavioral sleep disturbances are modifiable, more research is needed that incorporates objective measures of sleep and longitudinal designs to identify specific points of intervention to mitigate the potential long-term impacts of childhood maltreatment on health across socio-demographically diverse populations.
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19
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Brammer WA, Conn BM, Iverson E, Lankenau SE, Dodson C, Wong CF. Coping Motives Mediate the Association of Trauma History with Problematic Cannabis Use in Young Adult Medical Cannabis Patients and Non-Patient Cannabis Users. Subst Use Misuse 2022; 57:684-697. [PMID: 35193442 PMCID: PMC11148629 DOI: 10.1080/10826084.2022.2026970] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background: Despite evidence of the contribution of childhood trauma to the development of problematic cannabis use, its mediating pathways are largely unknown. Given the link between cannabis motives with trauma and problematic cannabis use, motives of use may represent a construct through which trauma impacts problematic cannabis use. Methods: A sample of 339 medical cannabis patient and non-patient young adult users from the Los Angeles area were sampled at baseline and one year later. The current study examined the impact of childhood trauma on problematic use through a variety of cannabis use motives. Results: Controlling for age, socioeconomic status, perceived stress, and baseline problematic use, endorsing the use of cannabis to cope with distress at baseline uniquely mediated the associations between different childhood trauma types (e.g., physical abuse, neglect, sexual trauma) and problematic use one year later. Experience of any childhood trauma was positively associated with coping motives, whereas emotional and physical abuse were positively associated with pain motives, and sexual abuse was positively associated with sleep motives. Using cannabis for coping and increasing attention/focus were also positively associated with higher problematic use, whereas using cannabis for sleep was inversely associated with problematic use one year later. Conclusions: The motives of coping with distress and inattention may represent intermediate constructs through which trauma leads to later problematic cannabis use. Results highlight the need to clarify the pathways between health and non-health-oriented motives and cannabis use over time.
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Affiliation(s)
- Whitney A Brammer
- Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Bridgid M Conn
- Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA
- Keck School of Medicine, Department of Pediatrics, University of Southern California, Los Angeles, California, USA
| | - Ellen Iverson
- Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA
- Keck School of Medicine, Department of Pediatrics, University of Southern California, Los Angeles, California, USA
| | - Stephen E Lankenau
- Dornsife School of Public Health, Department of Community Health and Prevention, Drexel University, Philadelphia, Pennsylvania, USA
| | - Chaka Dodson
- Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Carolyn F Wong
- Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA
- Keck School of Medicine, Department of Pediatrics, University of Southern California, Los Angeles, California, USA
- Division of Research on Children, Youth, & Families, Children's Hospital Los Angeles, Los Angeles, California, USA
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20
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Friedmann F, Hill H, Santangelo P, Ebner-Priemer U, Neubauer AB, Rausch S, Steil R, Müller-Engelmann M, Lis S, Fydrich T, Priebe K. Women with abuse-related PTSD sleep more fitfully but just as long as healthy controls: an actigraphic study. Sleep 2021; 45:6473455. [PMID: 34932818 DOI: 10.1093/sleep/zsab296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/06/2021] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES Subjective reports of sleep impairments are common in individuals with posttraumatic stress disorder (PTSD), but objective assessments of sleep have yielded mixed results. METHODS We investigated sleep via actigraphy and e-diary on 6 consecutive nights in a group of 117 women with PTSD after childhood abuse (CA; PTSD group), a group of 31 mentally healthy women with a history of CA (healthy trauma controls, HTC group) and a group of 36 non-traumatized mentally healthy women (healthy controls, HC group). RESULTS The PTSD group reported lower sleep quality, more nights with nightmares, and shorter sleep duration than both HTC and HC. Actigraphic measures showed more and longer sleep interruptions in the PTSD group compared to HTC and HC, but no difference in sleep duration. While the PTSD group underestimated their sleep duration, both HTC and HC overestimated their sleep duration. HTC did not differ from HC regarding sleep impairments. CONCLUSIONS Sleep in women with PTSD after CA seems to be more fragmented but not shorter compared to sleep patterns of mentally healthy control subjects. The results suggest a stronger effect of PTSD psychopathology on sleep compared to the effect of trauma per se.
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Affiliation(s)
- Franziska Friedmann
- Department of Psychology, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany
| | - Holger Hill
- Mental mHealth Lab, Institute of Sport and Sport Sciences, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Philip Santangelo
- Mental mHealth Lab, Institute of Sport and Sport Sciences, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Ulrich Ebner-Priemer
- Mental mHealth Lab, Institute of Sport and Sport Sciences, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany.,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim/Medical Faculty Mannheim, Heidelberg University, J5, 68159 Mannheim, Germany
| | - Andreas B Neubauer
- Department of Education and Human Development, DIPF
- Leibniz Institute for Research and Information in Education, P.O. Box 900270, 60442 Frankfurt am Main, Germany
| | - Sophie Rausch
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Mannheim/Medical Faculty Mannheim, Heidelberg University, J5, 68159 Mannheim, Germany
| | - Regina Steil
- Department of Clinical Psychology and Psychotherapy, Goethe University Frankfurt, 60323 Frankfurt am Main, Germany
| | - Meike Müller-Engelmann
- Department of Clinical Psychology and Psychotherapy, Goethe University Frankfurt, 60323 Frankfurt am Main, Germany
| | - Stefanie Lis
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Mannheim/Medical Faculty Mannheim, Heidelberg University, J5, 68159 Mannheim, Germany
| | - Thomas Fydrich
- Department of Psychology, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany
| | - Kathlen Priebe
- Department of Psychology, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany.,Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
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21
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Javakhishvili M, Spatz Widom C. Childhood Maltreatment, Sleep Disturbances, and Anxiety and Depression: A Prospective Longitudinal Investigation. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2021; 77:101351. [PMID: 34898778 PMCID: PMC8654238 DOI: 10.1016/j.appdev.2021.101351] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This research sought to determine whether inadequate sleep conditions in childhood and sleep problems in young adulthood in part explain the relationship between childhood abuse and neglect and anxiety and depression later in life. Children with documented histories of abuse and neglect and matched controls were followed up and assessed in young and middle adulthood. Abused and neglected children were more likely to report experiencing inadequate sleep conditions in childhood, sleep problems in young adulthood, and higher levels of depression and anxiety later in middle adulthood. Results revealed significant indirect paths from childhood maltreatment to anxiety and depression in middle adulthood through inadequate sleep conditions in childhood and sleep problems in young adulthood. This longitudinal follow-up of children with documented cases of maltreatment reveals the important role of sleep disturbances in the lives of maltreated children and adults and sleep disturbances in the development of subsequent anxiety and depression.
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Affiliation(s)
- Magda Javakhishvili
- Psychology Department, John Jay College, City University of New York, 524 West 59 Street, New York City, NY
| | - Cathy Spatz Widom
- Psychology Department, John Jay College, City University of New York, 524 West 59 Street, New York City, NY
- Graduate Center, City University of New York, 365 Fifth Avenue, New York, NY 10016
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22
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Pfaff A, Schlarb AA. Consequences of child maltreatment: A glimpse at stress and sleep. J Sleep Res 2021; 31:e13456. [PMID: 34363278 DOI: 10.1111/jsr.13456] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 11/28/2022]
Abstract
The present study goal was to provide further information on the association of maltreatment experiences in childhood (CM) and impaired sleep taking the hyperarousal theory of insomnia and stress reaction into account. In all, 62 participants took part in the study. CM history (Childhood Trauma Questionnaire) and subjective sleep quality (Pittsburgh Sleep Quality Index) were assessed before study commencement. In addition, participants wore an actigraph for 6-7 consecutive nights and completed a sleep log during this time. After 3-4 days, the participants took part in a laboratory stress paradigm (Maastricht Acute Stress Test) with 29 participants in the experimental and 31 in the control condition. Saliva cortisol samples were taken before and after the experiment and heart rate variability was assessed. CM was positively correlated with impaired subjectively assessed sleep in adulthood. The stress manipulation led to heightened subjective and physiological stress. Although lower cortisol changes after and lower mean heart rate values during the stress induction were found in the CM group, the differences were not statistically significant. There was no observable sleep reactivity on the stress induction. Stress and CM appear to have long-term effects on subjective sleep. Acute social stress does not directly worsen sleep quality, neither in participants with nor without a history of CM. However, the association underlines the importance of prevention and intervention. When treating sleep impairments, potential CM experiences should be taken into account.
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Affiliation(s)
- Angela Pfaff
- Fakultät für Psychologie und Sportwissenschaft, Universität Bielefeld, Bielefeld, Germany
| | - Angelika A Schlarb
- Fakultät für Psychologie und Sportwissenschaft, Universität Bielefeld, Bielefeld, Germany
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23
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Wang YS, Friedman AL, Jakubowski KP, Wescott DL, Iyiewuare P, Feldman JS, Shaw DS, Roecklein KA. Childhood maltreatment reports in adult seasonal affective disorder: Associations with sleep disturbances, maladaptive cognitions, and brooding. J Affect Disord 2021; 288:31-40. [PMID: 33839556 PMCID: PMC8154709 DOI: 10.1016/j.jad.2021.03.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 02/25/2021] [Accepted: 03/17/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Although childhood maltreatment has been studied in multiple psychopathologies, its role in Seasonal Affective Disorder (SAD) is unknown. The current study examined possible mediators of the relationship between retrospectively-reported childhood maltreatment and adult SAD symptom severity during a major depressive episode in winter. METHODS Participants (N = 113), ages 18 to 65, completed measures of childhood maltreatment, SAD severity, sleep disturbances, ruminative brooding, and maladaptive cognitions. Mediation analyses testing the relationship between childhood maltreatment and SAD symptom severity via sleep and cognitive factors were conducted using PROCESS (Hayes, 2012). RESULTS Mediation analyses suggested that insomnia, hypersomnia, brooding, and seasonal maladaptive beliefs may account for the association between childhood maltreatment and SAD symptom severity. LIMITATIONS Analyses were cross-sectional and should be interpreted with caution. Participants completed self-report childhood trauma measure retrospectively as adults. CONCLUSION The present study is the first to examine childhood maltreatment in SAD, a disorder commonly viewed with circadian etiology. Covariance between childhood maltreatment and SAD symptom severity is indirectly explained by sleep difficulties, cognitive factors, and brooding, which may suggest therapeutic targets if replicated in longitudinal or experimental manipulations of sleep and cognition.
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Affiliation(s)
- Yuqi S Wang
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Abbey L Friedman
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Karen P Jakubowski
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Delainey L Wescott
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Praise Iyiewuare
- Department of Psychology, University of Vermont, Burlington, Vermont, United States
| | - Julia S Feldman
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Daniel S Shaw
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Kathryn A Roecklein
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States.
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24
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Davidson P, Pace-Schott E. Go to Bed and You MIGHT Feel Better in the Morning—the Effect of Sleep on Affective Tone and Intrusiveness of Emotional Memories. CURRENT SLEEP MEDICINE REPORTS 2021. [DOI: 10.1007/s40675-020-00200-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Abstract
Purpose of Review
It is important to examine what effect sleep has after an emotional experience. More knowledge about this topic could help inform us whether there are any potential sleep interventions that could help make sure that memories of negative emotional experiences are processed in the most adaptive manner possible.
Recent Findings
Findings on the role of sleep in altering reactivity to emotional stimuli have been highly varied, with significant findings in opposite directions. A new exciting development in the field is several studies finding that sleep seems to make memories of negative experiences less intrusive.
Summary
This review has mainly aimed to give an overview of the field, and of which issues need to be resolved. We argue for there being a strong need for standardization of how data are analyzed and presented, as well as for better methods for determining to what extent the effects of sleep are specific for a particular memory, or represent general changes in emotional reactivity.
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Fuligni AJ, Chiang JJ, Tottenham N. Sleep disturbance and the long-term impact of early adversity. Neurosci Biobehav Rev 2021; 126:304-313. [PMID: 33757816 DOI: 10.1016/j.neubiorev.2021.03.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 02/04/2021] [Accepted: 03/18/2021] [Indexed: 12/24/2022]
Abstract
Sleep disturbance may be a central, yet underappreciated mechanism by which early adversity has a long-term impact upon mental and physical health. The fundamental regulatory processes shaped by early adversity - neural, neuroendocrine, and immune - are also central to sleep. Sleep problems, in turn, lead to a similar constellation of chronic health problems that have been linked to early adversity. We bring together work from the fields of early adversity and sleep in order to suggest a model by which sleep disturbance plays a critical role in the far-reaching impacts of early adversity on health. Future research should employ more longitudinal designs and pay particular attention to the impact of developmental periods such as adolescence and midlife when maturational and environmental factors conspire to create a unique time of sleep disturbance. We also suggesting that intervening to minimize sleep disturbance may be a promising means by which to test the model, as well as potentially blunt the long-term impact of early adversity on health.
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Socioeconomic Status Moderates the Impact of Emotional but not Physical Childhood Abuse on Women's Sleep. ACTA ACUST UNITED AC 2021; 2:169-179. [PMID: 33758827 PMCID: PMC7971391 DOI: 10.1007/s42844-021-00035-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2021] [Indexed: 11/06/2022]
Abstract
A recent systematic review highlighted associations between childhood abuse and adult sleep quality, and the need for research focused specifically on women and the role of moderating variables. The objectives of the present study were (1) to assess the impact of frequent physical and emotional child abuse on adult sleep among women; and (2) to assess the role that childhood socioeconomic status (SES) could play in moderating these associations. In-person data were collected from women living in a mid-sized city in western Canada in 2019–2020 (N = 185; M age = 40 years). Sleep quality was measured using the Pittsburgh Sleep Quality Index. Physical and emotional abuse experienced often or very often in childhood were assessed using single items (yes or no). Childhood SES was assessed by a single item and dichotomized at the sample median. Linear regression models examined associations between each form of abuse and continuous adult sleep quality score adjusted for covariates. Statistically significant interactions were stratified and examined by child SES group. Frequent physical and emotional childhood abuse were each associated with clinically and statistically significant increases in past-month sleep problem scores among women in adjusted models. This association was moderated by childhood SES for emotional child abuse, but not physical child abuse. Findings suggest that growing up in an upper-middle to upper SES household may buffer the adverse impact of frequent emotional child abuse on later adult sleep, but may not promote resilience in the context of frequent physical child abuse.
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Boynton-Jarrett R, Sponholtz TR, Rosenberg L, Palmer JR, Bethea TN, Wise LA. Abuse in Childhood and Risk for Sleep Disruption in Adulthood in the Black Women's Health Study. Sleep Med 2021; 83:260-270. [PMID: 34049046 DOI: 10.1016/j.sleep.2021.02.053] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 02/08/2021] [Accepted: 02/23/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To investigate the association of early life abuse with sleep disruption risk in adulthood among U.S. Black women. METHODS We analyzed data from the Black Women's Health Study, a prospective cohort study. In 2005, 29,998 women completed a self-administered questionnaire on early-life experiences of abuse (child and teen) and exposure to danger at any life stage. Participants reported on their sleep quality (snoring and diagnosed sleep apnea) in 2001, whether their "sleep was restless" in 2005, and their average sleep duration in 2009. We used log-binomial regression models to derive risk ratios (RRs) and 95% confidence intervals (CIs) for the association of child/teen abuse and danger at any life stage with snoring, diagnosis of sleep apnea, restless sleep, and short sleep duration. RESULTS Nearly 50% of participants reported one or more measure of sleep disruption in adulthood. Higher severity of physical abuse was associated with increased risk of sleep disruption and higher severity of sexual abuse was associated with increased risk for most sleep disruptions. The RR comparing child/teen physical and sexual abuse relative to no abuse was highest for diagnosed sleep apnea (2.03, 95% CI: 1.70, 2.41). Feeling in danger at any life stage (child, teen, adult, past year) was generally associated with greater increases in risk of sleep disruption among women with a history of early life abuse than among women without such a history. CONCLUSIONS Our findings suggest that abuse as a child and/or teen is related to disrupted sleep in adulthood.
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Affiliation(s)
- Renée Boynton-Jarrett
- Division of General Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA.
| | - Todd R Sponholtz
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Lynn Rosenberg
- Slone Epidemiology Center at Boston University, Boston, MA, USA
| | - Julie R Palmer
- Slone Epidemiology Center at Boston University, Boston, MA, USA
| | - Traci N Bethea
- Office of Minority Health and Health Disparities Research, Georgetown Lombardi Comprehensive Cancer Center, Washington DC, USA
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
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The Relationship between Adverse Childhood Experiences and Sleep Problems among Adolescent Students: Mediation by Depression or Anxiety. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010236. [PMID: 33396920 PMCID: PMC7794994 DOI: 10.3390/ijerph18010236] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/24/2020] [Accepted: 12/26/2020] [Indexed: 01/04/2023]
Abstract
Adverse childhood experiences (ACEs) are known to be closely related to depression, anxiety and sleep problems. However, it remains unclear whether adolescents with ACEs have sleep problems regardless of depression or anxiety or under a mediating effect from depression or anxiety. Therefore, our aim was to examine whether depression or anxiety mediates the relationship between ACEs and sleep problems in adolescents by using a community sample. The Early Trauma Inventory Self Report–Short Form (ETISR-SF) and List of Threatening Experiences Questionnaire (LTE-Q) were used to assess traumatic ACEs. Ultimately, data from 737 students (M = 448, F = 289, 15.1 ± 1.4 years old) were included in the statistical analysis. A total of 576 (78.1%) participants reported that they had experienced one or more ACEs. Adolescents with ACEs had higher levels of depression, anxiety and sleep problems than did adolescents without ACEs, and boys tended to experience more trauma than girls. Depression and anxiety partially mediated the relationship between ACEs and sleep problems. The results of this study suggest the need for depression and anxiety interventions for adolescents with ACEs to reduce the long-term consequences, including sleep problems and physical health problems.
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Effects of tobacco addiction on links between early life adversities, sleep disturbance, and depression: A moderated mediation approach. Prev Med Rep 2020; 20:101225. [PMID: 33194536 PMCID: PMC7642869 DOI: 10.1016/j.pmedr.2020.101225] [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: 01/06/2020] [Revised: 09/09/2020] [Accepted: 10/10/2020] [Indexed: 11/22/2022] Open
Abstract
Despite the well-established relationship between early life adversities (ELA) and depression, the underlying mechanisms for this link remain less clear and need to be developed. The aim of this study was to advance our understanding of this link by testing the mediating role of sleep disturbances and the moderating role of tobacco use in this mediation. A total of 579 smokers and non-smokers were recruited in two US communities (Duluth and Minneapolis, MN). Simple and moderated mediation analyses were performed using the PROCESS macro for SPSS, with the number of ELA as an independent variable, depression symptoms assessed by the Patient Health Questionnaire-9 (PHQ-9) as a dependent variable, sleep quality assessed by the Pittsburgh Sleep Quality Index (PSQI) as a mediator, and smoking status as a moderator variable. The study demonstrated that ELA and depressive symptoms were positively correlated; and sleep quality fully mediated this relationship. This mediation was moderated by tobacco use (index of moderated mediation = 0.10, 95%CI [0.03; 0.19]) and was more pronounced among smokers (b = 0.14, 95%CI [0.07; 0.23]) than non-smokers (b = 0.04, 95%CI [0.0002; 0.10]). Subsequent mediation analyses run separately for each component of the PSQI suggested that individuals who experienced ELA and who were smokers had greater delays in sleep onset and were more likely to sleep for a shorter duration, both of which predicted greater depressive symptoms. Sleep quality is therefore a promising ELA-related target for preventive and therapeutic interventions as well as for further research in depression and tobacco addiction.
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Stress & sleep: A relationship lasting a lifetime. Neurosci Biobehav Rev 2020; 117:65-77. [DOI: 10.1016/j.neubiorev.2019.08.024] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 07/28/2019] [Accepted: 08/31/2019] [Indexed: 12/29/2022]
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Steine IM, Winje D, Krystal JH, Milde AM, Bjorvatn B, Nordhus IH, Grønli J, Pallesen S. Longitudinal Relationships between Perceived Social Support and Symptom Outcomes: Findings from a sample of Adult Survivors of Childhood Sexual Abuse. CHILD ABUSE & NEGLECT 2020; 107:104566. [PMID: 32526550 DOI: 10.1016/j.chiabu.2020.104566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 05/12/2020] [Accepted: 05/25/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Cross-sectional studies have consistently reported an inverse association between perceived social support and the severity of mental health symptoms among adult survivors of childhood sexual abuse (CSA). However, there is a lack of longitudinal studies investigating the bidirectional association between social support and the severity of symptoms among adult CSA-survivors, as well as the role of relational problems in predicting perceived social support and symptom levels over time. The present study addressed these questions in a sample of primarily female CSA-survivors. METHODS In a three-wave, four-year longitudinal study of 506 CSA-survivors (94.9% women, 5.1% men) recruited from support centers for sexual abuse survivors in Norway, we used cross-lagged panel structural equation modeling to examine the directionality of the longitudinal associations between perceived social support and symptoms of posttraumatic stress, anxiety, depression and insomnia. RESULTS Cross-lagged panel analyses revealed significant weak reciprocal associations between perceived social support and depression, posttraumatic stress symptoms and anxiety symptoms, but not with insomnia symptoms. The observed effects were partly overlapping and partly inconsistent across the different symptom domains. Relational problems predicted social support cross-sectionally and longitudinally, whereas only cross-sectional associations were found between the relational problems variable and mental health symptoms. Theoretical and clinical implications of the findings are discussed, alongside methodological limitations of the study.
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Affiliation(s)
- Iris M Steine
- UC Berkeley, Department of Psychology, 2121 Berkeley Way, Berkeley, CA 94704, USA; Department of Psychosocial Science, University of Bergen, Christiesgate 12, 5015 Bergen, Norway.
| | - Dagfinn Winje
- Department of Clinical Psychology, University of Bergen, Christiesgate 12, 5015 Bergen, Norway
| | - John H Krystal
- Clinical Neuroscience Division, VA National Center for PTSD, 950 Campbell Avenue, West Haven, CT 06516, USA; Department of Psychiatry, Yale University School of Medicine, 300 George Street, Suite 901, New Haven, CT 06511, USA
| | - Anne Marita Milde
- NORCE AS - Regional Centre for Child and Youth Mental Health and Child Welfare, Postbox 7810, 5020 Bergen, Norway; Department of Biological and Medical Psychology, University of Bergen, Jonas Lies vei 91, 5009 Bergen, Norway
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Health Care, University of Bergen, Kalfarveien 31, 5018 Bergen, Norway; Norwegian Competence Center of Sleep Disorders, Haukeland University Hospital, PO Box 1400, 5021 Bergen, Norway
| | - Inger Hilde Nordhus
- Department of Clinical Psychology, University of Bergen, Christiesgate 12, 5015 Bergen, Norway; Institute of Basic Medical Sciences, University of Oslo, PO Box 1110, Blindern, 0317 Oslo, Norway
| | - Janne Grønli
- Department of Biological and Medical Psychology, University of Bergen, Jonas Lies vei 91, 5009 Bergen, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Christiesgate 12, 5015 Bergen, Norway; Norwegian Competence Center of Sleep Disorders, Haukeland University Hospital, PO Box 1400, 5021 Bergen, Norway
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Van Someren EJW. Brain mechanisms of insomnia: new perspectives on causes and consequences. Physiol Rev 2020; 101:995-1046. [PMID: 32790576 DOI: 10.1152/physrev.00046.2019] [Citation(s) in RCA: 163] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
While insomnia is the second most common mental disorder, progress in our understanding of underlying neurobiological mechanisms has been limited. The present review addresses the definition and prevalence of insomnia and explores its subjective and objective characteristics across the 24-hour day. Subsequently, the review extensively addresses how the vulnerability to develop insomnia is affected by genetic variants, early life stress, major life events, and brain structure and function. Further supported by the clear mental health risks conveyed by insomnia, the integrated findings suggest that the vulnerability to develop insomnia could rather be found in brain circuits regulating emotion and arousal than in circuits involved in circadian and homeostatic sleep regulation. Finally, a testable model is presented. The model proposes that in people with a vulnerability to develop insomnia, the locus coeruleus is more sensitive to-or receives more input from-the salience network and related circuits, even during rapid eye movement sleep, when it should normally be sound asleep. This vulnerability may ignite a downward spiral of insufficient overnight adaptation to distress, resulting in accumulating hyperarousal, which, in turn, impedes restful sleep and moreover increases the risk of other mental health adversity. Sensitized brain circuits are likely to be subjectively experienced as "sleeping with one eye open". The proposed model opens up the possibility for novel intervention studies and animal studies, thus accelerating the ignition of a neuroscience of insomnia, which is direly needed for better treatment.
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Affiliation(s)
- Eus J W Van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands; Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit University Amsterdam, Amsterdam, The Netherlands; and Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
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Mishra AA, Friedman EM, Mihalec-Adkins BP, Evich CD, Christ SL, Marceau K. Childhood maltreatment exposure and physical functional limitations in late adulthood: examining subjective sleep quality in midlife as a mediator. Psychol Health 2020; 35:573-592. [PMID: 31496306 PMCID: PMC7061057 DOI: 10.1080/08870446.2019.1657576] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 07/19/2019] [Accepted: 08/13/2019] [Indexed: 12/28/2022]
Abstract
Objective: The present study had three major aims: 1) To identify sub-groups of adults with differing combinations of childhood maltreatment exposures, 2) to understand the association of childhood maltreatment sub-group membership with subjective sleep quality in midlife, and 3) to assess poor sleep quality in midlife as a mechanism between childhood maltreatment sub-group membership and physical functional limitations in late adulthood. Design: Data come from the Biomarker project of the Midlife Development in the United States study (n = 1251). Outcome measures: The Pittsburgh Sleep Quality Index (Buysse et al., 1989) was used to assess sleep quality in midlife. Functional limitations in late adulthood were measured using a version of the SF-36 (Brazier et al., 1992). Results: Two vulnerable childhood maltreatment sub-groups emerged (Physical and Emotional Maltreatment Sub-group, n = 49, and Sexual Abuse Sub-group, n = 105) and a normative sub-group (n = 1087; low exposure to childhood maltreatment). Poor sleep quality in midlife mediated the association between both maltreatment sub-groups and functional limitations in late adulthood. Conclusion: Results highlight the role of sleep in linking childhood maltreatment with functional impairments in adulthood and offer a potential target for interventions to improve quality of life in older adults.
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Affiliation(s)
- Aura Ankita Mishra
- Department of Human Development and Family Studies, Purdue University, West Lafayette, Indianapolis, USA
- Public Health Program, Purdue University, West Lafayette, Indianapolis, USA
| | - Elliot M Friedman
- Department of Human Development and Family Studies, Purdue University, West Lafayette, Indianapolis, USA
| | - Brittany P Mihalec-Adkins
- Department of Human Development and Family Studies, Purdue University, West Lafayette, Indianapolis, USA
| | - Carly D Evich
- Department of Human Development and Family Studies, Purdue University, West Lafayette, Indianapolis, USA
- Public Health Program, Purdue University, West Lafayette, Indianapolis, USA
| | - Sharon L Christ
- Department of Human Development and Family Studies, Purdue University, West Lafayette, Indianapolis, USA
- Department of Statistics, Purdue University, West Lafayette, Indianapolis, USA
| | - Kristine Marceau
- Department of Human Development and Family Studies, Purdue University, West Lafayette, Indianapolis, USA
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Nurius P, LaValley K, Kim MH. Victimization, Poverty, and Resilience Resources: Stress Process Considerations for Adolescent Mental Health. SCHOOL MENTAL HEALTH 2020; 12:124-135. [PMID: 32431758 PMCID: PMC7236761 DOI: 10.1007/s12310-019-09335-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Growing evidence suggests that exposure to early life adversity poses risk to youth development, with impaired mental health a central concern. This population-representative study of adolescent students (n=11,222) investigates the effects of two key forms of early adversity- victimization and poverty-on adolescent mental health in a step-wise fashion, also accounting for mutable and accessible resilience resources. Victimization and poverty prevalence reflected social patterning wherein being female, racial and ethnic minority youth, and those with lower resilience resources all reported significantly higher levels of victimization and family poverty. Greater levels of these adversities were significantly associated with lower levels of resilience resources. Poverty and particularly victimization demonstrated significant cumulative and distinct contributions across three indicators of compromised mental health-depression, suicidality, and broader psychological well-being. Resilience resources of family bondedness, school engagement, and sleep sufficiency all carried significant effects and accompanied lesser explanatory strength of victimization and family poverty. In separate analyses, each of four forms of victimization-adult maltreatment, bullying, dating violence, and feeling unsafe at school-were significant contributors to mental health, with cumulative exposure conveying the strongest unique effects. Implications and opportunities for prevention and remedial strategies are discussed, with particular attention to school-based responding.
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Early-life stress alters sleep structure and the excitatory-inhibitory balance in the nucleus accumbens in aged mice. Chin Med J (Engl) 2020; 132:1582-1590. [PMID: 31045908 PMCID: PMC6616240 DOI: 10.1097/cm9.0000000000000279] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: Exposure to adverse experiences in early life may profoundly reshape the neurodevelopmental trajectories of the brain and lead to long-lasting behavioral and neural alterations. One deleterious effect of early-life stress that manifests in later life is sleep disturbance, but this has not been examined in aged mice and the underlying neural mechanisms remain unknown. Considering the important role of the nucleus accumbens (NAc) in the sleep-wake regulation, this study aimed to assess the effects of early-life stress on the sleep behaviors in aged mice and the potential involvement of the NAc in stress-induced sleep abnormalities. Methods: Twenty aged male C57BL/6 mice (>16 months, n = 10 per group) were used in this study. During post-natal days 2 to 9, dams were provided with either sufficient (control) or a limited nesting and bedding materials (stressed). When the mice were 16 to 17 months old, their sleep-wake behaviors were recorded over 24 h using electroencephalogram and electromyelogram. The amount of each sleep-wake stage, mean duration, and stage transition was analyzed. Then, five animals were randomly chosen from each group and were used to measure the expression levels of vesicular glutamate transporter-1 (VGluT1) and vesicular transporters of γ-aminobutyric acid (VGAT) in the NAc using immunohistochemistry. Group comparisons were carried out using Student t test or analysis of variances when appropriate. Results: Compared with the control mice, the early-life stressed aged mice spent less time awake over 24 h (697.97 ± 77.47 min vs. 631.33 ± 34.73 min, t17 = 2.376, P = 0.030), accordingly, non-rapid eye movement sleep time was increased (667.37 ± 62.07 min vs. 723.54 ± 39.21 min, t17 = 2.326, P = 0.033) and mean duration of rapid eye movement sleep was prolonged (73.00 ± 8.98 min vs. 89.39 ± 12.69 min, t17 = 3.277, P = 0.004). Meanwhile, we observed decreased VGluT1/VGAT ratios in the NAc in the stressed group (F(1, 16) = 81.04, P < 0.001). Conclusion: Early adverse experiences disrupt sleep behaviors in aged mice, which might be associated with the excitatory-inhibitory imbalance in the NAc.
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Rodrigues PM, Marques DR, Gomes AA. Differences in Early Maladaptive Schemas between Young Adults Displaying Poor Versus Good Sleep Quality. Psychiatr Q 2019; 90:733-746. [PMID: 31352549 DOI: 10.1007/s11126-019-09662-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Research on the connection between sleep-related problems and Early Maladaptive Schemas (EMS) is scarce. The aim of the current study was to investigate a potential link between EMSs and poor sleep quality. Participants (n = 249) were selected from a larger sample of 1253 European Portuguese college students who completed the BaSIQS and the YSQ-S3. The major inclusion criteria for the selected participants were high versus low scores on the BaSIQS (poor versus good sleep quality). Students with poor sleep quality had significantly higher levels of Abandonment/ Instability, Mistrust/Abuse, Social Isolation/Alienation, Vulnerability to Harm or Illness, Entitlement/Grandiosity, Self-Sacrifice, and Negativity/Pessimism. These data suggest that EMSs are associated with poor sleep quality. However, additional studies are necessary to better understand this relationship.
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Affiliation(s)
- Patrícia Monteiro Rodrigues
- Department of Education and Psychology, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
| | - Daniel Ruivo Marques
- Department of Education and Psychology, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal. .,CINEICC - Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
| | - Ana Allen Gomes
- CINEICC - Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.,Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal
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Nightmare experience and family relationships in healthy volunteers and nightmare disorder patients. BMC Psychiatry 2019; 19:297. [PMID: 31604462 PMCID: PMC6788100 DOI: 10.1186/s12888-019-2299-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 09/20/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Nightmares are associated with parental bonding styles and various psychiatric disorders, but the exact connections between different nightmare experience features and family relationships in healthy volunteers and nightmare disorder patients are still unclear. METHODS We therefore invited 62 nightmare disorder patients and 135 healthy volunteers to undergo tests of the Nightmare Experience Questionnaire (NEQ), the Family Relationship Questionnaire (FRQ), and the Plutchik - van Praag Depression Inventory (PVP). RESULTS Besides the higher nightmare frequency and the higher PVP and four NEQ scale scores, the nightmare disorder patients had higher scores of FRQ Paternal Abuse, and lower ones of General Attachment, Maternal Encouragement, Maternal Freedom Release, and Paternal Freedom Release. The PVP was correlated with some NEQ and FRQ scales in both healthy volunteers and patients, and it functioned as a mediator between Physical Effect and Maternal Dominance in patients. Regarding predicting NEQ by FRQ, Paternal Abuse predicted Physical Effect, Maternal Dominance predicted Physical Effect and Horrible Stimulation, General Attachment predicted Horrible Stimulation (-) in healthy volunteers; Maternal Dominance predicted Physical Effect, Meaning Interpretation, and Horrible Stimulation, Paternal Freedom Release predicted Physical Effect (-), and Paternal Dominance predicted Meaning Interpretation and nightmare frequency in patients. CONCLUSIONS Our study has demonstrated that the inappropriate family relationships were linked with different aspects of nightmare experience, especially in nightmare disorder patients.
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Melaku YA, Appleton S, Reynolds AC, Sweetman AM, Stevens DJ, Lack L, Adams R. Association Between Childhood Behavioral Problems and Insomnia Symptoms in Adulthood. JAMA Netw Open 2019; 2:e1910861. [PMID: 31490538 PMCID: PMC6735491 DOI: 10.1001/jamanetworkopen.2019.10861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 07/22/2019] [Indexed: 11/23/2022] Open
Abstract
Importance Life-course determinants of insomnia, particularly the long-term association of childhood behavioral problems with insomnia later in life, are unknown. As childhood behaviors are measurable and potentially modifiable, understanding their associations with insomnia symptoms may provide novel insights into early intervention strategies to reduce the burden. Objective To investigate the association between behavioral problems at 5, 10, and 16 years of age and self-reported insomnia symptoms at 42 years of age. Design, Setting, and Participants This cohort study used data from the United Kingdom 1970 Birth Cohort Study, an ongoing large-scale follow-up study. Participants were followed up from birth (1970) to age 42 years (2012). Missing data were imputed via multiple imputation. Statistical analysis was performed from February 1 to July 15, 2019. Exposures Behavior measured at 5, 10, and 16 years of age using the Rutter Behavioral Scale (RBS). Children's behavior was classified as normal (≤80th percentile), moderate behavioral problems (>80th to ≤95th percentile), and severe behavioral problems (>95th percentile) based on their RBS score. Main Outcomes and Measures Self-reported difficulties initiating or maintaining sleep (DIMS) were collected using a self-administered questionnaire at 42 years of age. Log-binomial logistic regression, adjusted for several potential confounders, was used to estimate the association of childhood behavioral problems with insomnia symptoms in adulthood. Sensitivity analyses were conducted to check robustness of the findings. Results Participants were followed up from a baseline age of 5 years (n = 8050; 3854 boys and 4196 girls), 10 years (n = 9090; 4365 boys and 4725 girls), or 16 years (n = 7653; 3575 boys and 4078 girls) until age 42 years. There was a 39% higher risk of DIMS (odds ratio [OR], 1.39; 95% CI, 1.04-1.84; P = .06 for trend) for participants with severe behavioral problems at 5 years of age compared with those with a normal RBS score. The odds of DIMS plus not feeling rested on waking (DIMS plus) in participants with severe behavioral problems at 5 years of age were 29% higher (odds ratio, 1.29; 95% CI, 0.97-1.70; P = .14 for trend) than participants with a normal RBS score, although this result was not statistically significant. Moderate and severe behavioral problems at 16 years of age were positively associated with DIMS and DIMS plus (moderate: OR, 1.28; 95% CI, 1.07-1.52; severe: OR, 1.67; 95% CI, 1.22-2.30; P < .001 for trend) and DIMS plus (moderate: OR, 1.32; 95% CI, 1.11-1.56; severe: OR, 1.47; 95% CI, 1.09-1.98; P < .001 for trend). Externalizing behavioral problems at 5 and 10 years of age were positively associated with insomnia symptoms at 42 years of age. Conclusions and Relevance This study is the first to show associations of early-life behavioral problems, particularly early- and middle-childhood externalizing problems, with insomnia symptoms in adulthood. These findings underline the importance of addressing insomnia from a life-course perspective and considering the benefits of early behavioral intervention to sleep health.
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Affiliation(s)
- Yohannes Adama Melaku
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Sarah Appleton
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- The Health Observatory, Discipline of Medicine, The Queen Elizabeth Hospital Campus, University of Adelaide, Woodville, South Australia, Australia
- Freemason’s Centre for Men’s Health, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Amy C. Reynolds
- The Appleton Institute, The University of Central Queensland, Wayville, South Australia, Australia
- School of Health, Medical and Applied Sciences, The University of Central Queensland Adelaide Campus, Wayville, South Australia, Australia
| | - Alexander M. Sweetman
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - David J. Stevens
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Leon Lack
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- College of Education, Psychology, and Social Work, Flinders University of South Australia, Adelaide, South Australia, Australia
| | - Robert Adams
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Freemason’s Centre for Men’s Health, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
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Stickley A, Leinsalu M, DeVylder JE, Inoue Y, Koyanagi A. Sleep problems and depression among 237 023 community-dwelling adults in 46 low- and middle-income countries. Sci Rep 2019; 9:12011. [PMID: 31427590 PMCID: PMC6700183 DOI: 10.1038/s41598-019-48334-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 07/31/2019] [Indexed: 01/24/2023] Open
Abstract
Sleep problems are considered a core symptom of depression. However, there is little information about the comorbidity of sleep problems and depression in low- and middle-income countries (LMICs), and whether sleep problems with depression confer additional risk for decrements in health compared to sleep problems alone. This study thus examined the association between sleep problems and depression and whether sleep problems with depression are associated with an increased risk for poorer health in 46 LMICs. Cross-sectional, community-based data from 237 023 adults aged ≥18 years from the World Health Survey (WHS) 2002–2004 were analyzed. Information on sleep problems (severe/extreme) and International Classification of Diseases 10th Revision depression/depression subtypes was collected. Multivariable logistic (binary and multinomial) and linear regression analyses were performed. Sleep problems were associated with subsyndromal depression (odds ratio [OR]: 2.23, 95% confidence interval [CI]: 1.84–2.70), brief depressive episode (OR = 2.48, 95% CI = 2.09–2.95) and depressive episode (OR = 3.61, 95% CI = 3.24–4.03). Sleep problems with depression (vs. sleep problems alone) conferred additional risk for anxiety, perceived stress and decrements in health in the domains of mobility, self-care, pain, cognition, and interpersonal activities. Clinicians should be aware that the co-occurrence of sleep problems and depression is associated with a variety of adverse health outcomes in LMICs. Detecting this co-occurrence may be important for treatment planning.
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Affiliation(s)
- Andrew Stickley
- The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, 141 89, Sweden. .,Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashicho, Kodaira, Tokyo, 187-8553, Japan.
| | - Mall Leinsalu
- The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, 141 89, Sweden.,Department of Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia
| | - Jordan E DeVylder
- Graduate School of Social Service, Fordham University, New York City, NY, USA
| | - Yosuke Inoue
- Carolina Population Center, The University of North Carolina at Chapel Hill, 123 West Franklin St, Chapel Hill, NC, 27516, USA
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, CIBERSAM, Dr Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, 08830, Spain.,ICREA, Pg. Lluis Companys 23, Barcelona, Spain
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40
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McWhorter KL, Parks CG, D’Aloisio AA, Rojo-Wissar DM, Sandler DP, Jackson CL. Traumatic childhood experiences and multiple dimensions of poor sleep among adult women. Sleep 2019; 42:zsz108. [PMID: 31260523 PMCID: PMC6941710 DOI: 10.1093/sleep/zsz108] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 03/29/2019] [Indexed: 12/31/2022] Open
Abstract
STUDY OBJECTIVES Exposure to traumatic childhood experiences (TCEs) may contribute to poor sleep in adulthood. Previous studies have been limited to mainly investigating physical and sexual abuse and did not consider betrayal trauma, or whether the victim regarded the perpetrator as someone socially close to them, the age group at occurrence, and trauma-related distress/anxiety. METHODS We used a large cohort of US women, 35-74 years old, enrolled in the Sister Study from 2003 to 2009. Self-reports of specific TCEs occurring before the age of 18 years included sexual, physical, and psychological/emotional trauma; natural disasters; major accidents; and household dysfunction. Participants self-reported average sleep duration (short: <7 hours vs recommended: 7-9 hours), sleep onset latency (SOL) at least 30 vs less than 30 minutes, at least 3 night awakenings once asleep at least 3 times/week (Night awakenings [NA], yes vs no), and napping at least 3 vs less than 3 times/week. RESULTS Among 40 082 women, 55% reported a TCE, with 82% reporting betrayal trauma. Compared to women reporting no TCE, women with any TCE were more likely to report short sleep (prevalence ratio [PR] = 1.08, [95% confidence interval (CI) = 1.04 to 1.11]), longer SOL (1.11, [1.06 to 1.16]), frequent NAs (1.06, [1.00 to 1.11]), and frequent napping (1.05, [0.99 to 1.12]). The relationship between experiencing any TCE and short sleep was stronger for TCEs by a perpetrator considered socially close vs not close (1.12, [1.09 to 1.16]), SOL (1.27, [1.22 to 1.33]), NA (1.20, [1.14 to 1.27]), and napping (1.24, [1.17 to 1.32]). CONCLUSIONS TCEs were associated with poor sleep in women with greater impact when the perpetrator was regarded as close. More research is warranted to better understand pathways between childhood trauma and sleep health in adulthood to develop effective interventions.
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Affiliation(s)
- Ketrell L McWhorter
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC
| | - Christine G Parks
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC
| | | | - Darlynn M Rojo-Wissar
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC
- Intramural Program, National Institute on Minority Health and Health Disparities, Department of Health and Human Services, Bethesda, MD
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Sullivan K, Rochani H, Huang LT, Donley DK, Zhang J. Adverse childhood experiences affect sleep duration for up to 50 years later. Sleep 2019; 42:5485469. [DOI: 10.1093/sleep/zsz087] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 02/25/2019] [Indexed: 01/10/2023] Open
Abstract
Abstract
Study Objectives
The main objective for this study was to assess the association of adverse childhood experiences (ACEs) and subsequent short sleep duration among adults.
Methods
This cross-sectional examination used data from the 2011 Behavioral Risk Factor Surveillance System, a nationwide telephone-administered survey. Participants completed a standardized questionnaire to report childhood experiences of abuse, neglect, household challenges, and sleep time. Multinominal logistic regression analyses included survey weighting procedures and adjusted for age, race, education, income, sex, and body mass index; associations were also examined by age strata, using age as a proxy for time since ACEs occurred.
Results
Complete data were available for 22 403 adults (mean age = 46.66 years) including 14 587 (65%) with optimum sleep duration (7–9 h/night) and 2069 (9%) with short sleep duration (<6 h/night). Compared with adults with optimum sleep duration, the number of ACEs was associated with the odds of short sleep duration (odds ratio [OR] = 1.22, 95% CI = 1.16 to 1.28), and the odds increased as the number of ACEs increased. The association held for each decade of age until the 60s, although the magnitude attenuated. Mental health challenges or poor physical health did not account for the association.
Conclusion
ACEs increased the odds of chronic short sleep duration during adulthood and showed both a time-dependent and dose–response nature. These associations were independent of self-reported mental health challenges or poor physical health. The association of ACEs with short sleep duration throughout the adult lifespan emphasizes the importance of child health and identifying underlying psychological challenges in adults with sleep difficulties.
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Affiliation(s)
- Kelly Sullivan
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Georgia Southern University, Statesboro, GA
| | - Haresh Rochani
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Georgia Southern University, Statesboro, GA
| | - Li-Ting Huang
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Georgia Southern University, Statesboro, GA
| | | | - Jian Zhang
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Georgia Southern University, Statesboro, GA
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Miadich SA, Doane LD, Davis MC, Lemery-Chalfant K. Early parental positive personality and stress: Longitudinal associations with children's sleep. Br J Health Psychol 2019; 24:629-650. [PMID: 31004419 DOI: 10.1111/bjhp.12372] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 04/04/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The current study examined the influence of early parental stress and positive parent personality during infancy on sleep in middle childhood. Further, the role of positive parent personality as a buffer of the association between parental stress and sleep was considered. METHODS Participants included 381 twins and their primary caregivers who were recruited from birth records in the United States. Primary caregivers completed survey assessments via phone when twins were 12 and 30 months of age to assess multiple dimensions of parental stress and positive parent personality. Approximately 6 years later (M = 5.78, SD = 0.42), twins participated in an intensive assessment that included wearing actigraph watches to provide an objective measurement of sleep, while primary caregivers completed daily diaries regarding twins' sleep. RESULTS Positive parent personality was associated prospectively with longer actigraphy sleep duration and higher parent-reported sleep quality/daytime functioning. Parental stress was associated prospectively with greater variability in sleep duration. Positive parent personality moderated the parental stress - sleep-timing relation, such that greater parental stress was associated with a later midpoint of the sleep period only for children with parents low on positive personality (e.g., low optimism). All other findings were non-significant. CONCLUSIONS Findings suggest that both positive attributes and stress may influence sleep in middle childhood and that low parent positive personality may exacerbate associations between parental stress and later timing of sleep periods in children. Early interventions to promote healthy sleeping may consider focusing on decreasing parental stress and increasing parental empathy and optimism as early as infancy. Statement of contribution What is already known on this subject? Early-life experiences, especially adversity, have been related to health outcomes among adults and children, such that negative experiences are associated with poor health outcomes. Poor sleep (e.g., short duration, poor quality) among children is associated with negative outcomes including poorer cognitive performance and higher adiposity. What does this study add? This study used a prospective design to understand relations between early parent-related factors and child sleep. Early parental stress and positive parent personality were associated with objective sleep quality. Positive parent personality during infancy may have promotive/protective influences on sleep later in childhood.
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Affiliation(s)
| | - Leah D Doane
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Mary C Davis
- Department of Psychology, Arizona State University, Tempe, AZ, USA
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Brindle RC, Cribbet MR, Samuelsson LB, Gao C, Frank E, Krafty RT, Thayer JF, Buysse DJ, Hall MH. The Relationship Between Childhood Trauma and Poor Sleep Health in Adulthood. Psychosom Med 2019; 80:200-207. [PMID: 29215455 PMCID: PMC5794533 DOI: 10.1097/psy.0000000000000542] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Childhood trauma has been related to adverse behavioral, mental, and health outcomes later in life. Sleep may be a potential mechanism through which childhood trauma is related to adverse health. The current retrospective study aimed to characterize the relationship between childhood trauma exposure and sleep health, a novel multidimensional measure of sleep. METHODS Participants (N = 161; mean [standard deviation] age = 59.85 [9.06] years; 67.7% female) retrospectively reported trauma exposure using the Trauma History Questionnaire. Childhood trauma was defined as the number of reported traumatic events before 18 years of age. Trauma exposure after 18 years of age and across the life-span was also recorded. Sleep health was derived both from diary- and actigraphy-assessed measures of sleep regularity, timing, efficiency, and duration, subjective sleep satisfaction, and daytime sleepiness from the Epworth Sleepiness Scale. The relationships between childhood trauma exposure and sleep health were examined using hierarchical linear regression, controlling for relevant covariates. RESULTS In unadjusted models, a greater number of childhood trauma exposures were associated with poorer diary- and actigraphy-measured sleep health in adulthood. After adjustment for current stress, depression history, and other sociodemographic covariates, greater childhood trauma remained significantly associated with poorer sleep health (diary: β = -0.20, ΔR = 0.032; actigraphy: β = -0.19, ΔR = 0.027). Trauma exposure after 18 years of age and across the life-span did not relate to diary- or actigraphy-based sleep health. CONCLUSIONS Childhood trauma may affect sleep health in adulthood. These findings align with the growing body of evidence linking childhood trauma to adverse health outcomes later in life.
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Affiliation(s)
| | | | | | - Chenlu Gao
- Department of Psychology and Neuroscience, Baylor University
| | - Ellen Frank
- Department of Psychiatry, University of Pittsburgh
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Botchway EN, Godfrey C, Anderson V, Nicholas CL, Catroppa C. Outcomes of Subjective Sleep–Wake Disturbances Twenty Years after Traumatic Brain Injury in Childhood. J Neurotrauma 2019; 36:669-678. [DOI: 10.1089/neu.2018.5743] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Edith N. Botchway
- Murdoch Children's Research Institute, Melbourne, Australia
- Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Celia Godfrey
- Murdoch Children's Research Institute, Melbourne, Australia
- Royal Children's Hospital, Melbourne, Australia
| | - Vicki Anderson
- Murdoch Children's Research Institute, Melbourne, Australia
- Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Christian L. Nicholas
- Murdoch Children's Research Institute, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
| | - Cathy Catroppa
- Murdoch Children's Research Institute, Melbourne, Australia
- Royal Children's Hospital, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
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45
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Hash JB, Oxford ML, Fleming CB, Ward TM, Spieker SJ, Lohr MJ. Impact of a home visiting program on sleep problems among young children experiencing adversity. CHILD ABUSE & NEGLECT 2019; 89:143-154. [PMID: 30665020 PMCID: PMC6526956 DOI: 10.1016/j.chiabu.2018.12.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 12/14/2018] [Accepted: 12/20/2018] [Indexed: 05/10/2023]
Abstract
BACKGROUND Adversity may negatively impact young children's sleep but receiving home visitation services could buffer children from this potential consequence of adversity. OBJECTIVE This study examined whether young children's adverse experiences increased their risk for sleep problems and if Promoting First Relationships® (PFR), a home visitation program, reduced children's risk for sleep problems both directly and indirectly through increased parenting sensitivity. PARTICIPANTS AND SETTING Participants were 247 parents and their 10- to 24-month-old child recruited from Child Protective Services offices. METHODS A secondary analysis of a randomized controlled trial comparing PFR to a resource and referral control condition was conducted. Four time points of data were collected from baseline to 6 months post-intervention. Parenting sensitivity was measured at all time points using a parent-child interaction tool. Children's adversities were measured at various time points using caregiver report tools and official state records. Children's sleep problems were reported by parents at 6 months post-intervention. RESULTS The likelihood of having a sleep problem increased as children's adversities increased (β = .23, SE = .08, p = .005). There was no effect (direct or indirect) of treatment assignment on children's sleep problems (ps > .05). Post hoc analyses showed a treatment assignment by adversity interaction such that children's odds of having a sleep problem increased as their adversities increased, but only among children in the control condition (b = -0.37, SE = 0.17, p = .030). CONCLUSIONS Experiencing more adversities associated with a greater risk for sleep problems, but PFR buffered children from this risk.
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Affiliation(s)
- Jonika B Hash
- Department of Biobehavioral Nursing & Health Informatics, University of Washington, Seattle, WA, 98195, USA.
| | - Monica L Oxford
- Department of Family & Child Nursing, University of Washington, Seattle, WA, 98195, USA
| | - Charles B Fleming
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, 98195, USA
| | - Teresa M Ward
- Department of Psychosocial & Community Health, University of Washington, Seattle, WA, 98195, USA
| | - Susan J Spieker
- Department of Family & Child Nursing, University of Washington, Seattle, WA, 98195, USA
| | - Mary Jane Lohr
- Department of Family & Child Nursing, University of Washington, Seattle, WA, 98195, USA
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Later Chronotype Is Associated with Higher Alcohol Consumption and More Adverse Childhood Experiences in Young Healthy Women. Clocks Sleep 2019; 1:126-139. [PMID: 33089159 PMCID: PMC7509686 DOI: 10.3390/clockssleep1010012] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 01/31/2019] [Indexed: 12/15/2022] Open
Abstract
This study aimed at examining potential associations of mid sleep timing (chronotype) and social jetlag with intake of alcohol and caffeine, depressive symptoms, and body mass index (BMI) in a sample of healthy young women. Furthermore, it was explored whether these behavioral sleep–wake parameters are associated with adverse childhood experiences (ACEs). In total, 146 women (21.7 ± 1.7 years) took part in a two-week assessment on daily consumption of alcohol and caffeine. They completed questionnaires on ACEs, chronotype, sleep quality and depressive symptoms. Partial correlations and Chi-Square tests were calculated to assess the relationships between the assessed variables. Results show an association on a trend level for chronotype (r = 0.162, p = 0.053) and a significant association for social jetlag (r = 0.169, p = 0.044) with average alcohol intake. Furthermore, participants with above-median ACEs were more likely to be late chronotypes compared to the below-median group (X2(2) = 6.595, p = 0.037). We could replicate the association among late chronotype, social jetlag and higher alcohol consumption in a sample of healthy, young women. Furthermore, our results suggest a relationship between ACEs and chronotype. Although it can be hypothesized that it is rather ACEs that have an impact on chronotype, further research is needed to explore this relationship more and to shed more light on the direction of the association between chronotype and ACEs as well as on underlying mechanisms and possible mediators.
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Agorastos A, Pervanidou P, Chrousos GP, Baker DG. Developmental Trajectories of Early Life Stress and Trauma: A Narrative Review on Neurobiological Aspects Beyond Stress System Dysregulation. Front Psychiatry 2019; 10:118. [PMID: 30914979 PMCID: PMC6421311 DOI: 10.3389/fpsyt.2019.00118] [Citation(s) in RCA: 185] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 02/15/2019] [Indexed: 12/21/2022] Open
Abstract
Early life stressors display a high universal prevalence and constitute a major public health problem. Prolonged psychoneurobiological alterations as sequelae of early life stress (ELS) could represent a developmental risk factor and mediate risk for disease, leading to higher physical and mental morbidity rates in later life. ELS could exert a programming effect on sensitive neuronal brain networks related to the stress response during critical periods of development and thus lead to enduring hyper- or hypo-activation of the stress system and altered glucocorticoid signaling. In addition, alterations in emotional and autonomic reactivity, circadian rhythm disruption, functional and structural changes in the brain, as well as immune and metabolic dysregulation have been lately identified as important risk factors for a chronically impaired homeostatic balance after ELS. Furthermore, human genetic background and epigenetic modifications through stress-related gene expression could interact with these alterations and explain inter-individual variation in vulnerability or resilience to stress. This narrative review presents relevant evidence from mainly human research on the ten most acknowledged neurobiological allostatic pathways exerting enduring adverse effects of ELS even decades later (hypothalamic-pituitary-adrenal axis, autonomic nervous system, immune system and inflammation, oxidative stress, cardiovascular system, gut microbiome, sleep and circadian system, genetics, epigenetics, structural, and functional brain correlates). Although most findings back a causal relation between ELS and psychobiological maladjustment in later life, the precise developmental trajectories and their temporal coincidence has not been elucidated as yet. Future studies should prospectively investigate putative mediators and their temporal sequence, while considering the potentially delayed time-frame for their phenotypical expression. Better screening strategies for ELS are needed for a better individual prevention and treatment.
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Affiliation(s)
- Agorastos Agorastos
- II. Department of Psychiatry, Division of Neurosciences, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Panagiota Pervanidou
- Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, School of Medicine, Aghia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George P Chrousos
- Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, School of Medicine, Aghia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dewleen G Baker
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States.,VA Center of Excellence for Stress and Mental Health, San Diego, La Jolla, CA, United States
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Agorastos A, Nicolaides NC, Bozikas VP, Chrousos GP, Pervanidou P. Multilevel Interactions of Stress and Circadian System: Implications for Traumatic Stress. Front Psychiatry 2019; 10:1003. [PMID: 32047446 PMCID: PMC6997541 DOI: 10.3389/fpsyt.2019.01003] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 12/19/2019] [Indexed: 12/11/2022] Open
Abstract
The dramatic fluctuations in energy demands by the rhythmic succession of night and day on our planet has prompted a geophysical evolutionary need for biological temporal organization across phylogeny. The intrinsic circadian timing system (CS) represents a highly conserved and sophisticated internal "clock," adjusted to the 24-h rotation period of the earth, enabling a nyctohemeral coordination of numerous physiologic processes, from gene expression to behavior. The human CS is tightly and bidirectionally interconnected to the stress system (SS). Both systems are fundamental for survival and regulate each other's activity in order to prepare the organism for the anticipated cyclic challenges. Thereby, the understanding of the temporal relationship between stressors and stress responses is critical for the comprehension of the molecular basis of physiology and pathogenesis of disease. A critical loss of the harmonious timed order at different organizational levels may affect the fundamental properties of neuroendocrine, immune, and autonomic systems, leading to a breakdown of biobehavioral adaptative mechanisms with increased stress sensitivity and vulnerability. In this review, following an overview of the functional components of the SS and CS, we present their multilevel interactions and discuss how traumatic stress can alter the interplay between the two systems. Circadian dysregulation after traumatic stress exposure may represent a core feature of trauma-related disorders mediating enduring neurobiological correlates of trauma through maladaptive stress regulation. Understanding the mechanisms susceptible to circadian dysregulation and their role in stress-related disorders could provide new insights into disease mechanisms, advancing psychochronobiological treatment possibilities and preventive strategies in stress-exposed populations.
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Affiliation(s)
- Agorastos Agorastos
- Department of Psychiatry, Division of Neurosciences, Faculty of Medical Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.,VA Center of Excellence for Stress and Mental Health (CESAMH), VA San Diego Healthcare System, San Diego, CA, United States
| | - Nicolas C Nicolaides
- First Department of Pediatrics, Division of Endocrinology, Metabolism and Diabetes, School of Medicine, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Vasilios P Bozikas
- Department of Psychiatry, Division of Neurosciences, Faculty of Medical Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George P Chrousos
- First Department of Pediatrics, Division of Endocrinology, Metabolism and Diabetes, School of Medicine, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece.,Unit of Developmental & Behavioral Pediatrics, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Panagiota Pervanidou
- Unit of Developmental & Behavioral Pediatrics, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
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Agorastos A, Pervanidou P, Chrousos GP, Kolaitis G. Early life stress and trauma: developmental neuroendocrine aspects of prolonged stress system dysregulation. Hormones (Athens) 2018; 17:507-520. [PMID: 30280316 DOI: 10.1007/s42000-018-0065-x] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 09/13/2018] [Indexed: 12/13/2022]
Abstract
Experience of early life stress (ELS) and trauma is highly prevalent in the general population and has a high public health impact, as it can trigger a health-related risk cascade and lead to impaired homeostatic balance and elevated cacostatic load even decades later. The prolonged neuropsychobiological impact of ELS can, thus, be conceptualized as a common developmental risk factor for disease associated with increased physical and mental morbidity in later life. ELS during critical periods of brain development with elevated neuroplasticity could exert a programming effect on particular neuronal networks related to the stress response and lead to enduring neuroendocrine alterations, i.e., hyper- or hypoactivation of the stress system, associated with adult hypothalamic-pituitary-adrenal axis and glucocorticoid signaling dysregulation. This paper reviews the pathophysiology of the human stress response and provides evidence from human research on the most acknowledged stress axis-related neuroendocrine pathways exerting the enduring adverse effects of ELS and mediating the cumulative long-term risk of disease vulnerability in adulthood.
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Affiliation(s)
- Agorastos Agorastos
- Department of Psychiatry, Division of Neurosciences, School of Medicine, Faculty of Medical Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
- Thessaloniki General Hospital "G. Papanicolaou", Psychiatric Hospital of Thessaloniki, Lagkada Str. 196, Stavroupoli, 56430, Thessaloniki, Greece.
| | - Panagiota Pervanidou
- Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, School of Medicine, "Aghia Sophia" Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George P Chrousos
- Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, School of Medicine, "Aghia Sophia" Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Gerasimos Kolaitis
- Department of Child Psychiatry, School of Medicine, "Aghia Sophia" Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Duffy KA, McLaughlin KA, Green PA. Early life adversity and health-risk behaviors: proposed psychological and neural mechanisms. Ann N Y Acad Sci 2018; 1428:151-169. [PMID: 30011075 PMCID: PMC6158062 DOI: 10.1111/nyas.13928] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 06/06/2018] [Accepted: 06/18/2018] [Indexed: 12/18/2022]
Abstract
Early life adversity (ELA) is associated with poorer health in adulthood, an association explained, at least in part, by increased engagement in health-risk behaviors (HRBs). In this review, we make the case that ELA influences brain development in ways that increase the likelihood of engaging in HRBs. We argue that ELA alters neural circuitry underpinning cognitive control as well as emotional processing, including networks involved in processing threat and reward. These neural changes are associated psychologically and behaviorally with heightened emotional reactivity, blunted reward responsivity, poorer emotion regulation, and greater delay discounting. We then demonstrate that these adaptations to ELA are associated with an increased risk of smoking cigarettes, drinking alcohol, and eating high-fat, high-sugar foods. Furthermore, we explore how HRBs affect the brain in ways that reinforce addiction and further explain clustering of HRBs.
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Affiliation(s)
- Korrina A. Duffy
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | | | - Paige A. Green
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, National Cancer Institute, National Institutes of Health, Bethesda, MD
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