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Huang CJ, Hsu NW, Chen HC. Prevalence, dimensions, and correlates of excessive daytime sleepiness in community-dwelling older adults: the Yilan study, Taiwan. Ann Med 2024; 56:2352028. [PMID: 38803075 PMCID: PMC11136468 DOI: 10.1080/07853890.2024.2352028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/22/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Daytime sleepiness is an important health problem. However, the dimensionality of the Epworth Sleepiness Scale (ESS) in older adults remains unclear. This study aimed to determine the prevalence of ESS-defined excessive daytime sleepiness in older adults. Furthermore, the dimensionality of ESS and its respective correlates were also compared. MATERIALS AND METHODS This is a community-based survey in which community-dwelling older adults aged ≥ 65 years participated. Excessive daytime sleepiness was assessed using the ESS and was defined as an ESS score of > 10. Exploratory factor analysis was performed to identify the ESS factors. Multiple logistic regression analysis was used to examine the independent correlates of the ESS-defined and factor-specific correlates of excessive daytime sleepiness. RESULTS In total, 3978 older adults participated in this study. The mean age was 76.6 ± 6.7 years, with 53.8% ≥ 75 years, and 57.1% were female. The prevalence of ESS-defined excessive daytime sleepiness was 16.0%. An exploratory factor analysis revealed two factors in the ESS, which were designated as 'passive' and 'active' according to the soporific levels of ESS items loaded in each factor. Multiple logistic regression showed that male, illiteracy, depression, disability, short sleep duration and no exposure to hypnotics were risk indicators for ESS-defined excessive daytime sleepiness. However, the correlates for passive and active factor-defined excessive daytime sleepiness differ in pattern, especially in variables related to education, exercise, mental health, and sleep. CONCLUSIONS The prevalence of ESS-defined excessive daytime sleepiness is high, and its correlates vary among older adults. This study also suggests a dual ESS structure in community-dwelling older adults.
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Affiliation(s)
- Chiu-Jui Huang
- Department of Medical Education, National Taiwan University Hospital, Taiwan
| | - Nai-Wei Hsu
- Division of Cardiology, Department of Internal Medicine & Community Medicine Center, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Public Health Bureau, Yilan County, Taiwan
| | - Hsi-Chung Chen
- Department of Psychiatry & Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan
- School of Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
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Younes M, Gerardy B, Giannouli E, Raneri J, Ayas NT, Skomro R, John Kimoff R, Series F, Hanly PJ, Beaudin A. Contribution of obstructive sleep apnea to disrupted sleep in a large clinical cohort of patients with suspected obstructive sleep apnea. Sleep 2023; 46:zsac321. [PMID: 36591638 PMCID: PMC10334732 DOI: 10.1093/sleep/zsac321] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/23/2022] [Indexed: 01/03/2023] Open
Abstract
STUDY OBJECTIVES The response of sleep depth to CPAP in patients with OSA is unpredictable. The odds-ratio-product (ORP) is a continuous index of sleep depth and wake propensity that distinguishes different sleep depths within sleep stages, and different levels of vigilance during stage wake. When expressed as fractions of time spent in different ORP deciles, nine distinctive patterns are found. Only three of these are associated with OSA. We sought to determine whether sleep depth improves on CPAP exclusively in patients with these three ORP patterns. METHODS ORP was measured during the diagnostic and therapeutic components of 576 split-night polysomnographic (PSG) studies. ORP architecture in the diagnostic section was classified into one of the nine possible ORP patterns and the changes in sleep architecture were determined on CPAP for each of these patterns. ORP architecture was similarly determined in the first half of 760 full-night diagnostic PSG studies and the changes in the second half were measured to control for differences in sleep architecture between the early and late portions of sleep time in the absence of CPAP. RESULTS Frequency of the three ORP patterns increased progressively with the apnea-hypopnea index. Sleep depth improved significantly on CPAP only in the three ORP patterns associated with OSA. Changes in CPAP in the other six patterns, or in full diagnostic PSG studies, were insignificant or paradoxical. CONCLUSIONS ORP architecture types can identify patients in whom OSA adversely affects sleep and whose sleep is expected to improve on CPAP therapy.
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Affiliation(s)
- Magdy Younes
- Sleep Disorders Center, Misericordia Health Center, University of Manitoba, Winnipeg, Canada
- YRT Limited, Winnipeg, Manitoba, Canada
| | | | - Eleni Giannouli
- Sleep Disorders Center, Misericordia Health Center, University of Manitoba, Winnipeg, Canada
| | - Jill Raneri
- Sleep Centre, Foothills Medical Centre, Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Najib T Ayas
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Robert Skomro
- Division of Respirology, Critical Care and Sleep Medicine, University of Saskatchewan, Saskatoon, Canada
| | - R John Kimoff
- Respiratory Division, McGill University Health Centre, Respiratory Epidemiology Clinical Research Unit and Meakins-Christie Laboratories, McGill University, Montreal, QC, Canada
| | - Frederic Series
- Unité de Recherche en Pneumologie, Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada
| | - Patrick J Hanly
- Sleep Centre, Foothills Medical Centre, Department of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Andrew Beaudin
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Li Z, Cao L, Zhou Z, Han M, Fu C. Factors influencing the progression from prehypertension to hypertension among Chinese middle-aged and older adults: a 2-year longitudinal study. BMC Public Health 2023; 23:339. [PMID: 36793011 PMCID: PMC9930240 DOI: 10.1186/s12889-022-14410-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/20/2022] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND This study aimed to investigate the proportion of prehypertension cases progressing to hypertension among Chinese middle-aged and elderly populations over a 2-year period and related influencing factors. METHODS Data were obtained from the China Health and Retirement Longitudinal Study, and 2,845 individuals who were ≥ 45 years old and prehypertensive at baseline were followed from 2013-2015. Structured questionnaires were administered, and blood pressure (BP) and anthropometric measurements were performed by trained personnel. Multiple logistic regression analysis was done to investigate factors associated with prehypertension progressing to hypertension. RESULTS Over the 2-year follow-up, 28.5% experienced progression of prehypertension to hypertension; this occurred more frequently in men than women (29.7% vs. 27.1%). Among men, older age (55-64 years: adjusted odds ratio [aOR] = 1.414, 95% confidence interval [CI]:1.032-1.938; 65-74 years: aOR = 1.633, 95%CI: 1.132-2.355; ≥ 75 years: aOR = 2.974, 95%CI: 1.748-5.060), obesity (aOR = 1.634, 95%CI: 1.022-2.611), and number of chronic diseases (1: aOR = 1.366, 95%CI: 1.004-1.859; ≥ 2: aOR = 1.568, 95%CI: 1.134-2.169) were risk factors for progression to hypertension whereas being married/cohabiting (aOR = 0.642, 95% CI: 0.418-0.985) was a protective factor. Among women, risk factors included older age (55-64 years: aOR = 1.755, 95%CI: 1.256-2.450; 65-74 years: aOR = 2.430, 95%CI: 1.605-3.678; ≥ 75 years: aOR = 2.037, 95% CI: 1.038-3.995), married/cohabiting (aOR = 1.662, 95%CI: 1.052-2.626), obesity (aOR = 1.874, 95%CI: 1.229-2.857), and longer naps (≥ 30 and < 60 min: aOR = 1.682, 95%CI: 1.072-2.637; ≥ 60 min: aOR = 1.387, 95%CI: 1.019-1.889). CONCLUSIONS Chinese middle-aged and elderly individuals experienced a risk of prehypertension progressing to hypertension over a 2-year period, although the influencing factors differed by sex; this should be considered in interventions.
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Affiliation(s)
- Zhen Li
- Yantai Center for Disease Control and Prevention, No.17 Fuhou Road, Yantai, 264003 Shandong China
| | - Lianmeng Cao
- grid.452240.50000 0004 8342 6962Department of Gastrointestinal Surgery Bariatric and Metabolic Surgery, Binzhou Medical University Hospital, No. 661 2nd Huanghe Road, Binzhou, 256603 Shandong China
| | - Ziyu Zhou
- Department of Anesthesiology, the 80Th Army Hospital, No. 256 Beigongxijie Rd, Weifang, Shandong, 261021 China
| | - Maozhi Han
- Department of Pharmacy, the 80Th Army Hospital, No. 256 Beigongxijie Rd. , Weifang, 261021 Shandong China
| | - Chang Fu
- Department of Health Service and Management,School of Public Health and Management, Binzhou Medical University, No.346 Guanhai Road, Yantai, 264003, Shandong, China.
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Riha RL. Defining obstructive sleep apnoea syndrome: a failure of semantic rules. Breathe (Sheff) 2022; 17:210082. [PMID: 35035552 PMCID: PMC8753646 DOI: 10.1183/20734735.0082-2021] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 07/27/2021] [Indexed: 12/14/2022] Open
Abstract
Obstructive sleep apnoea syndrome (OSAS) is one of the most ubiquitous medical conditions in industrialised society. Since the recognition that symptoms of excessive daytime somnolence, problems with concentration, mood and cognitive impairment, as well as cardiometabolic abnormalities can arise as a consequence of obstructed breathing during sleep, it has been subject to variation in its definition. Over the past five decades, attempts have been made to standardise the definitions and scoring criteria used for apnoeas and hypopnoea, which are the hallmarks of obstructive sleep apnoea (OSA). However, applying these definitions in clinical and research practice has resulted in over- and under-estimation of the severity and prevalence of OSAS. Furthermore, the definitions may eventually become redundant in the context of rapid technological advances in breathing measurement and other signal acquisition. Increased efforts towards precision medicine have led to a focus on the pathophysiology of obstructed breathing during sleep. However, the same degree of effort has not been focused on how and why the latter does or does not result in diurnal symptoms, integral to the definition of OSAS. This review focuses on OSAS in adults and discusses some of the difficulties with current definitions and the possible reasons behind them. The definition of obstructive sleep apnoea syndrome appears to be in constant flux dependent on the definitions attributed to its diagnostic componentshttps://bit.ly/3zXrWKg
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Affiliation(s)
- Renata L Riha
- Dept of Sleep Medicine, Royal Infirmary Edinburgh, Edinburgh, UK.,Sleep Research Unit, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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5
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Gonsalvez I, Li JJ, Stevens C, Chen JA, Liu CH. Preexisting Depression and Daytime Sleepiness in Women and Men. Behav Sleep Med 2022; 20:380-392. [PMID: 34003712 PMCID: PMC8599528 DOI: 10.1080/15402002.2021.1924720] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Sleep problems can persist following the treatment of depression and remission of symptoms. The extent to which having a previous history of depression may be associated with current daytime sleepiness is largely unknown. METHODS Data were obtained from the spring 2017 American College Health Association-National College Health Assessment (ACHA-NCHA) survey (92 institutions) which assessed self-reported health in U.S. college students (n = 41,670). Among the sample, 93.5% were 18-24 year of age, and 69.6% women. Logistic regression estimated the association between reported prior lifetime diagnosis of depression and daytime sleepiness from the past 7 days, while adjusting for depressive symptoms and antidepressant use from the past year. Unadjusted and adjusted logistic regression models stratified by gender were performed. RESULTS Among those who reported problems with sleepiness, 31.6% women and 19.4% men had a preexisting depression diagnosis. Individuals with preexisting depression were more likely than those without this diagnosis to report sleepiness problems (women: OR = 1.4, CI = 1.3-1.6, p < .001; men: OR = 1.2, CI = 1.0-1.4, p < .01). However, this association differed significantly by gender, with women with a preexisting depression diagnosis having a 13.0% greater likelihood of sleepiness compared to men. CONCLUSIONS Those with a preexisting depression diagnosis, and specifically women, may be at risk for daytime sleepiness even in the absence of current depressive mood-related symptoms. Given that many individuals are at risk for daytime sleepiness, mental health initiatives, including those on college campuses, should incorporate sleep hygiene within their programming.
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Affiliation(s)
- Irene Gonsalvez
- Department of Psychiatry, St. Elizabeth’s Medical Center, Brighton, MA, USA,Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | | | | | - Justin A. Chen
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Cindy H. Liu
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Harvard Medical School, Boston, MA, USA,Department of Newborn Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Corresponding Author: Cindy H. Liu, PhD, Tel: 617-525-4131
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Quality of life and subjective sleep-related measures in bipolar disorder and major depressive disorder. Qual Life Res 2021; 31:117-124. [PMID: 34263443 PMCID: PMC8800916 DOI: 10.1007/s11136-021-02929-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2021] [Indexed: 11/30/2022]
Abstract
Purpose Diminished quality of life (QoL) has been reported in patients with mood disorders. QoL has also been shown to be decreased by sleep disturbances. Since sleep disorders are common in mood disorders, the aim of this study was to determine whether sleep characteristics are associated to QoL among patients with Bipolar Disorder (BD) and unipolar Major Depressive Disorders (MDD). Methods QoL was assessed in 170 patients with mood disorders (61 BD and 109 MDD), who also completed questionnaires measuring the severity of insomnia, sleepiness, chronotype preference and obstructive sleep apnea (OSA) probability index. Results Analyses showed that BD and MDD groups had similar QoL and sleep measures but the MDD group had higher OSA scores. In BD, correlations indicated a relationship between QoL and insomnia complaints and sleepiness, whereas in MDD, correlations indicated an association between QoL and insomnia complaints and OSA score. In both groups, QoL was related to depressive symptomatology. Linear regressions showed that, in BD, QoL was related to insomnia complaints and sleepiness even in the euthymic state, whereas in MDD, QoL was related to insomnia complaints but not in euthymic patients. Conclusion QoL is related to sleep differently in BD and MDD. The results suggest that insomnia and sleepiness are particularly high in BD even when patients are euthymic. These findings suggest that focusing on insomnia and sleepiness during different mood states of BD could increase QoL.
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Queiroz S, Ruiz F, Prado J, Silva A, Frange C, Narciso F, Cruz A, Tufik S, de Mello MT. The consequences of partial sleep restriction for habitual sleep duration, sleepiness and reaction time in healthy males. Sleep Health 2020; 6:814-821. [DOI: 10.1016/j.sleh.2020.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 01/13/2020] [Accepted: 04/05/2020] [Indexed: 11/28/2022]
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Jahrami H, Alshomili H, Almannai N, Althani N, Aloffi A, Algahtani H, Brown CA. Predictors of Excessive Daytime Sleepiness in Medical Students: A Meta-Regression. Clocks Sleep 2019; 1:209-219. [PMID: 33089164 PMCID: PMC7445829 DOI: 10.3390/clockssleep1020018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 04/09/2019] [Indexed: 12/12/2022] Open
Abstract
Excessive daytime sleepiness (EDS) is highly prevalent among medical students and can have serious negative outcomes for both students and their patients. Little is known about the magnitude and predictors of EDS among medical college students. A meta-regression analysis was conducted to achieve these two targets. A systematic search was performed for English-language studies that reported the prevalence of EDS among medical students using the Epworth sleepiness scale (ESS), age, sex, sleep duration and sleep quality as predictive variables. A total of nine observational studies (K = 9, N = 2587) were included in the analyses. Meta-regression analyses were performed using mean age (years), sex (proportion of male subjects), sleep duration (hours/night) and sleep quality index score (continuous scale) as moderators for EDS—with the prevalence of EDS as an outcome variable. An interaction term of sleep duration X sleep quality was created to assess if these two variables simultaneously influenced the outcome variable. Utilizing the ESS, the pooled prevalence of EDS among medical students was 34.6% (95% Confidence Interval (CI) 18.3–50.9%). Meta-regression models of age, sex, sleep duration and sleep quality alone revealed poor predictive capabilities. Meta-regression models of sleep duration–sleep quality interaction revealed results with high statistical significance. The findings from this review contribute supporting evidence for the relationship between sleep duration and sleep quality scores (i.e., sleep duration X sleep quality score) in predicting EDS in medical students.
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Affiliation(s)
- Haitham Jahrami
- Ministry of Health, Juffair 340, Kingdom of Bahrain
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama 329, Kingdom of Bahrain
- Correspondence: ; Tel.: +973-17286334 or +973-17286335
| | - Hajar Alshomili
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama 329, Kingdom of Bahrain
| | - Noora Almannai
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama 329, Kingdom of Bahrain
| | - Noora Althani
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama 329, Kingdom of Bahrain
| | - Adel Aloffi
- Ministry of Health, Juffair 340, Kingdom of Bahrain
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama 329, Kingdom of Bahrain
| | - Haifa Algahtani
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama 329, Kingdom of Bahrain
| | - Cary A. Brown
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada
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Hein M, Lanquart JP, Loas G, Hubain P, Linkowski P. Prevalence and risk factors of excessive daytime sleepiness in major depression: A study with 703 individuals referred for polysomnography. J Affect Disord 2019; 243:23-32. [PMID: 30223136 DOI: 10.1016/j.jad.2018.09.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 07/30/2018] [Accepted: 09/10/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND To date, few studies have investigated the prevalence and risk factors of excessive daytime sleepiness (EDS) in major depression. Thus, the aim of the present study was to examine the prevalence and risk factors of EDS in a large sample of individuals with major depression. METHODS Data from 703 individuals with major depression were retrospectively collected from the sleep laboratory research database of Erasme Hospital for analysis. A score of > 10 on the Epworth Sleepiness Scale was used as the cut-off for EDS. Logistic regression analyses were conducted to examine the clinical and demographic risk factors of EDS in major depression. RESULTS The prevalence of EDS in our sample was 50.8%. Multivariate logistic regression analysis revealed that the following were significant risk factors of EDS in major depression: non-use of short to intermediate half-life benzodiazepine receptor agonists, BMI ≥ 25 kg/m², age < 60 years, C-reactive protein > 7 mg/L, Beck Depression Inventory score ≥ 16, atypical depression, apnea-hypopnea index ≥ 15/h, and use of selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors. LIMITATIONS To evaluate EDS, we used the Epworth Sleepiness Scale, which only allows for a subjective measure of daytime sleepiness. CONCLUSION EDS is a common symptom in individuals with major depression. In this subpopulation, interventions are possible for most risk factors of EDS, which justifies improved management of this symptom to avoid its negative consequences.
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Affiliation(s)
- Matthieu Hein
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium.
| | - Jean-Pol Lanquart
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium
| | - Gwenolé Loas
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium
| | - Philippe Hubain
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium
| | - Paul Linkowski
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium
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Kim SY, Choung RS, Lee SK, Choe JW, Jung SW, Hyun JJ, Koo JS, Lee SW, Shin C. Self-reported Sleep Impairment in Functional Dyspepsia and Irritable Bowel Syndrome. J Neurogastroenterol Motil 2018; 24:280-288. [PMID: 29605983 PMCID: PMC5885727 DOI: 10.5056/jnm17098;] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 11/18/2017] [Accepted: 12/12/2017] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND/AIMS Sleep impairment is a common complaint among patients with irritable bowel syndrome (IBS) and functional dyspepsia (FD). This study aimed to evaluate the prevalence of sleep impairment in FD or IBS patients, and to determine whether IBS-FD overlap induced more sleep disturbance than FD or IBS alone. METHODS A population-based cohort in South Korea including 2251 subjects was asked about gastrointestinal symptoms including IBS and dyspepsia-related symptoms. In addition, sleep disturbance was measured using the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale questionnaires. One-way ANOVA and logistic regression were used to assess differences among the 4 groups (healthy subjects, IBS alone, FD alone, and IBS-FD overlap). RESULTS Of 2251 subjects who were surveyed by questionnaire, 2031 responded (92.5% response rate) and were analyzed. The prevalence of IBS, FD, and IBS-FD overlap was 8.0% (95% confidence interval [CI], 6.8-9.2%), 4.8% (95% CI, 3.9-5.8%), and 1.8% (95% CI, 1.2-2.4%), respectively. FD alone, but not IBS alone, was significantly associated with a poorer sleep quality index (OR, 2.68; 95% CI, 1.43-5.01) and more daytime sleepiness (OR, 2.21; 95% CI, 1.14-4.30), compared to healthy subjects. IBS-FD overlap had the greatest likelihood of a poorer sleep quality index (OR, 3.88; 95% CI, 1.83-8.19), daytime sleepiness (OR, 2.47; 95% CI, 1.01-5.67), and insomnia (OR, 2.84; 95% CI, 1.39-5.82), compared to healthy subjects. CONCLUSION A correlation between functional gastrointestinal disorders and sleep disturbance was demonstrated, which was significantly pronounced in the context of IBS-FD overlap.
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Affiliation(s)
- Seung Young Kim
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan,
Korea
| | - Rok Seon Choung
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota,
USA
| | - Seung Ku Lee
- Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan,
Korea
| | - Jung Wan Choe
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan,
Korea
| | - Sung Woo Jung
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan,
Korea
| | - Jong Jin Hyun
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan,
Korea
| | - Ja Seol Koo
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan,
Korea
| | - Sang Woo Lee
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan,
Korea
| | - Chol Shin
- Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan,
Korea
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Kim SY, Choung RS, Lee SK, Choe JW, Jung SW, Hyun JJ, Koo JS, Lee SW, Shin C. Self-reported Sleep Impairment in Functional Dyspepsia and Irritable Bowel Syndrome. J Neurogastroenterol Motil 2018; 24:280-288. [PMID: 29605983 PMCID: PMC5885727 DOI: 10.5056/jnm17098] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 11/18/2017] [Accepted: 12/12/2017] [Indexed: 12/13/2022] Open
Abstract
Background/Aims Sleep impairment is a common complaint among patients with irritable bowel syndrome (IBS) and functional dyspepsia (FD). This study aimed to evaluate the prevalence of sleep impairment in FD or IBS patients, and to determine whether IBS-FD overlap induced more sleep disturbance than FD or IBS alone. Methods A population-based cohort in South Korea including 2251 subjects was asked about gastrointestinal symptoms including IBS and dyspepsia-related symptoms. In addition, sleep disturbance was measured using the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale questionnaires. One-way ANOVA and logistic regression were used to assess differences among the 4 groups (healthy subjects, IBS alone, FD alone, and IBS-FD overlap). Results Of 2251 subjects who were surveyed by questionnaire, 2031 responded (92.5% response rate) and were analyzed. The prevalence of IBS, FD, and IBS-FD overlap was 8.0% (95% confidence interval [CI], 6.8–9.2%), 4.8% (95% CI, 3.9–5.8%), and 1.8% (95% CI, 1.2–2.4%), respectively. FD alone, but not IBS alone, was significantly associated with a poorer sleep quality index (OR, 2.68; 95% CI, 1.43–5.01) and more daytime sleepiness (OR, 2.21; 95% CI, 1.14–4.30), compared to healthy subjects. IBS-FD overlap had the greatest likelihood of a poorer sleep quality index (OR, 3.88; 95% CI, 1.83–8.19), daytime sleepiness (OR, 2.47; 95% CI, 1.01–5.67), and insomnia (OR, 2.84; 95% CI, 1.39–5.82), compared to healthy subjects. Conclusion A correlation between functional gastrointestinal disorders and sleep disturbance was demonstrated, which was significantly pronounced in the context of IBS-FD overlap.
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Affiliation(s)
- Seung Young Kim
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Rok Seon Choung
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Seung Ku Lee
- Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan, Korea
| | - Jung Wan Choe
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Sung Woo Jung
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Jong Jin Hyun
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Ja Seol Koo
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Sang Woo Lee
- Division of Gastoenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Chol Shin
- Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan, Korea
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Hein M, Lanquart JP, Loas G, Hubain P, Linkowski P. Prevalence and Risk Factors of Type 2 Diabetes in Major Depression: A Study on 703 Individuals Referred for Sleep Examinations. PSYCHOSOMATICS 2018; 59:144-157. [DOI: 10.1016/j.psym.2017.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 11/06/2017] [Accepted: 11/07/2017] [Indexed: 12/16/2022]
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Wu S, Chen S, Zhao Y, Ma X, Wang R, He J. Association Between Excessive Daytime Sleepiness and Functional Gastrointestinal Disorders: A Population-based Study in China. J Neurogastroenterol Motil 2017; 23:298-305. [PMID: 27756121 PMCID: PMC5383125 DOI: 10.5056/jnm16056] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 08/25/2016] [Accepted: 09/04/2016] [Indexed: 12/13/2022] Open
Abstract
Background/Aims Several studies have demonstrated that sleep problems are associated with functional gastrointestinal disorders (FGIDs): irritable bowel syndrome (IBS), functional dyspepsia, etc, but the relationship between excessive daytime sleepiness (EDS) and FGIDs has not been systematically studied in the general population. This study aims to explore the relationship between EDS and specific types of FGIDs and the effect of the number of FGIDs on EDS. Methods A sample of 3600 individuals (aged 18–80 years) was selected from 5 regions in China using a randomized, stratified, multi-stage sampling method. EDS was measured by the Epworth Sleepiness Scale, while gastroesophageal reflux disease (GERD) and other FGIDs were assessed by Reflux Disease Questionnaire and the Rome II diagnostic criteria, respectively. Results The survey was completed by 2906 individuals (response rate: 80.72%), and 644 individuals (22.16%) had EDS. EDS was significantly associated with ulcer-like dyspepsia (OR, 2.50; 95% CI, 1.08–5.79), diarrhea-predominant IBS (OR, 2.00; 95% CI, 1.09–3.66), alternating IBS (OR, 2.32; 95% CI, 1.30–4.13), functional constipation (OR, 1.68; 95% CI, 1.20–2.35), and GERD (OR, 1.72; 95% CI, 1.08–2.72). Risk of EDS increased along with the increasing numbers of FGIDs: with 1 FGID (OR, 1.72; 95% CI, 1.37–2.15); with 2 FGIDs (OR, 2.43; 95% CI, 1.63–3.62); and with 3 or more FGIDs (OR, 3.26; 95% CI, 1.37–7.78). Conclusions FGIDs, such as ulcer-like dyspepsia, diarrhea-predominant IBS, alternating IBS, functional constipation, and GERD, were significantly associated with EDS. Those who suffered from more kinds of FGIDs were more susceptible to EDS.
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Affiliation(s)
- Sicheng Wu
- Department of Health Statistics, Second Military Medical University, Shanghai, China
| | - Shuqi Chen
- Department of Health Statistics, Second Military Medical University, Shanghai, China
| | - Yanfang Zhao
- Department of Health Statistics, Second Military Medical University, Shanghai, China
| | - Xiuqiang Ma
- Department of Health Statistics, Second Military Medical University, Shanghai, China
| | - Rui Wang
- Department of Health Statistics, Second Military Medical University, Shanghai, China
| | - Jia He
- Department of Health Statistics, Second Military Medical University, Shanghai, China
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Abstract
Sleep and circadian rhythms significantly impact almost all aspects of human behavior and are therefore relevant to occupational sleep medicine, which is focused predominantly around workplace productivity, safety, and health. In this article, 5 main factors that influence occupational functioning are reviewed: (1) sleep deprivation, (2) disordered sleep, (3) circadian rhythms, (4) common medical illnesses that affect sleep and sleepiness, and (5) medications that affect sleep and sleepiness. Consequences of disturbed sleep and sleepiness are also reviewed, including cognitive, emotional, and psychomotor functioning and drowsy driving.
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Affiliation(s)
- Philip Cheng
- Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USA
| | - Christopher Drake
- Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USA.
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Haregu A, Gelaye B, Pensuksan WC, Lohsoonthorn V, Lertmaharit S, Rattananupong T, Tadesse MG, Williams MA. Circadian rhythm characteristics, poor sleep quality, daytime sleepiness and common psychiatric disorders among Thai college students. Asia Pac Psychiatry 2015; 7:182-9. [PMID: 24664948 PMCID: PMC4176528 DOI: 10.1111/appy.12127] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 02/06/2014] [Indexed: 12/23/2022]
Abstract
INTRODUCTION To investigate the relationship between common psychiatric disorders (CPDs) and sleep characteristics (evening chronotype, poor sleep quality and daytime sleepiness) among Thai college students. METHODS A cross-sectional study was conducted among 2,970 undergraduate students in Thailand. Students were asked to complete a self-administered questionnaire that collected information about lifestyle and demographic characteristics. The Horne and Ostberg Morningness-Eveningness Questionnaire (MEQ), Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were used to evaluate circadian preference, sleep quality and daytime sleepiness, respectively. The General Health Questionnaire-12 (GHQ-12) was used to evaluate presence of CPDs. Logistic regression models were used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) of CPDs in relation to the covariates of interest. RESULTS A total of 337 students were classified as having CPDs (11.2%; 95% CI 10.1-12.3%). Evening chronotype (OR = 3.35; 95% CI 2.09-5.37), poor sleep quality (OR = 4.89; 95% CI 3.66-6.54) and excessive daytime sleepiness (OR = 1.95; 95% CI 1.54-2.47) were statistically significantly associated with CPDs. DISCUSSION Our study demonstrated that CPDs are common among Thai college students. Further, evening chronotype, poor sleep quality and excessive daytime sleepiness were strongly associated with increased risk of CPDs. These findings highlight the importance of educating students and school administrators about the importance of sleep and their impact on mental health.
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Affiliation(s)
- Alazar Haregu
- Department of Epidemiology, Multidisciplinary Health International Research Training Program, Harvard School of Public Health, Boston, MA, USA
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Diet, exercise, sleep, sexual activity, and perceived stress in people with epilepsy in NE Thailand. Epilepsy Behav 2015; 45:39-43. [PMID: 25801753 DOI: 10.1016/j.yebeh.2015.02.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Revised: 02/07/2015] [Accepted: 02/09/2015] [Indexed: 11/21/2022]
Abstract
The aim of this study was to find out how people with epilepsy in NE Thailand feel about their levels of stress, sleep, diet, exercise habits, and sex lives using a cross-sectional design. Two hundred and three people with epilepsy (PWE) were randomly recruited from a university epilepsy clinic in Khon Kaen and then completed an interview and a questionnaire. A total of 27.6% of the patients believed that diet had an influence on their epilepsy (of those who reported changes, 41.1% stopped consuming alcohol, while 32.1% stopped drinking caffeinated beverages). A total of 47.2% of the patients exercised at least three times per week, while 52.8% exercised two times or less a week. Daytime sleeping was prevalent, with 43.3% saying that they slept during the day frequently or every day. There were 44.3% of the patients who believed that their sex lives changed after the onset of epilepsy, with decreased sexual arousal being most commonly mentioned. A total of 76.4% of the patients said that they had medium or high levels of stress, and epilepsy was listed as the most common reason for their stress (50.2%). Focusing on the problem was the most common method to reduce stress (80.3%). The findings illuminate the need to increase attention towards improving and promoting self-management of epilepsy. As a whole, diet, exercise, sleep, stress reduction, and sex therapy can be valuable tools to improve the quality of life of people with epilepsy.
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The Prevalence and Characteristics Associated With Excessive Daytime Sleepiness Among Australian Workers. J Occup Environ Med 2014; 56:935-45. [DOI: 10.1097/jom.0000000000000150] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kendzerska TB, Smith PM, Brignardello-Petersen R, Leung RS, Tomlinson GA. Evaluation of the measurement properties of the Epworth sleepiness scale: A systematic review. Sleep Med Rev 2014; 18:321-31. [DOI: 10.1016/j.smrv.2013.08.002] [Citation(s) in RCA: 182] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 07/27/2013] [Accepted: 08/13/2013] [Indexed: 12/26/2022]
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Tran J, Lertmaharit S, Lohsoonthorn V, Pensuksan WC, Rattananupong T, Tadesse MG, Gelaye B, Williams MA. Daytime Sleepiness, Circadian Preference, Caffeine Consumption and Use of Other Stimulants among Thai College Students. ACTA ACUST UNITED AC 2014; 8:202-210. [PMID: 25356368 DOI: 10.5897/jphe2014.0620] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
We conducted this study to evaluate the prevalence of daytime sleepiness and evening chronotype, and to assess the extent to which both are associated with the use of caffeinated stimulants among 3,000 Thai college students. Demographic and behavioral characteristics were collected using a self-administered questionnaire. The Epworth Sleepiness Scale and the Horne and Ostberg Morningness-Eveningness Questionnaire were used to evaluate prevalence of daytime sleepiness and circadian preference. Multivariable logistic regression models were used to evaluate the association between sleep disorders and consumption of caffeinated beverages. Overall, the prevalence of daytime sleepiness was 27.9 % (95% CI: 26.2-29.5%) while the prevalence of evening chronotype was 13% (95% CI: 11.8-14.2%). Students who use energy drinks were more likely to be evening types. For instance, the use of M100/M150 energy drinks was associated with a more than 3-fold increased odds of evening chronotype (OR 3.50; 95% CI 1.90-6.44), while Red Bull users were more than twice as likely to have evening chronotype (OR 2.39; 95% CI 1.02-5.58). Additionally, those who consumed any energy drinks were more likely to be daytime sleepers. For example, Red Bull (OR 1.72; 95% CI 1.08-2.75) or M100/M150 (OR 1.52; 95% CI 1.10-2.11) consumption was associated with increased odds of daytime sleepiness. Our findings emphasize the importance of implementing educational and prevention programs targeted toward improving sleep hygiene and reducing the consumption of energy drinks among young adults.
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Affiliation(s)
- Jason Tran
- Department of Epidemiology, Multidisciplinary Health International Research Training Program, Harvard School of Public Health, Boston, MA, USA
| | - Somrat Lertmaharit
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand ; College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Vitool Lohsoonthorn
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | - Thanapoom Rattananupong
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Mahlet G Tadesse
- Department of Epidemiology, Multidisciplinary Health International Research Training Program, Harvard School of Public Health, Boston, MA, USA ; Department of Mathematics & Statistics, Georgetown University, Washington, DC
| | - Bizu Gelaye
- Department of Epidemiology, Multidisciplinary Health International Research Training Program, Harvard School of Public Health, Boston, MA, USA
| | - Michelle A Williams
- Department of Epidemiology, Multidisciplinary Health International Research Training Program, Harvard School of Public Health, Boston, MA, USA
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Sandberg JC, Talton JW, Quandt SA, Chen H, Weir M, Doumani WR, Chatterjee AB, Arcury TA. Association between housing quality and individual health characteristics on sleep quality among Latino farmworkers. J Immigr Minor Health 2014; 16:265-72. [PMID: 23161266 PMCID: PMC3884040 DOI: 10.1007/s10903-012-9746-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Although poor sleep quality and associated sleep disorders are associated with increased risk of job injury and multiple mental and physical health problems, scant research has examined sleep quality among Latino farmworkers. Interviews were conducted with 371 male Latino farmworkers working in North Carolina during the 2010 agricultural season. Data on housing quality and sleep quality were collected. Access to air conditioning was significantly and positively associated with good sleep quality. This association remained when other housing characteristics and individual health indicators were controlled. Good sleep quality was associated with low levels of pain, depression, and anxiety. Poor sleep quality among Latino farmworkers was associated with poorer indicators of health. One important indicator of housing quality, air conditioning, was associated with better sleep quality. Further research is required to delineate how to improve the adequacy of farmworker housing to improve sleep quality and other health indicators.
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Affiliation(s)
- Joanne C Sandberg
- Department of Family and Community Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157-1084, USA,
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Hayley AC, Williams LJ, Kennedy GA, Berk M, Brennan SL, Pasco JA. Prevalence of excessive daytime sleepiness in a sample of the Australian adult population. Sleep Med 2014; 15:348-54. [PMID: 24513435 DOI: 10.1016/j.sleep.2013.11.783] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 11/14/2013] [Accepted: 11/19/2013] [Indexed: 12/11/2022]
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Sandberg JC, Suerken CK, Quandt SA, Altizer KP, Bell RA, Lang W, Nguyen HT, Grzywacz JG, Arcury TA. Self-reported sleep difficulties and self-care strategies among rural older adults. J Evid Based Complementary Altern Med 2013; 19:36-42. [PMID: 24647377 DOI: 10.1177/2156587213510005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study examined the use of self-care strategies to address difficulty sleeping among community-dwelling older adults. Data were collected from a series of 18 questionnaires administered to 195 rural African American and white older adults in North Carolina. Participants reported whether they had experienced difficulty sleeping and strategies used to respond to the symptom. The most widely used strategies included ignoring the symptom, staying in bed or resting, and praying. Herb and supplement use were not reported. Ethnicity, income, and education were associated with use of specific self-care strategies for sleep. This variation suggests that older adults may draw on cultural understandings to interpret the significance of difficulty sleeping and influence their use of self-care strategies, including complementary and alternative medicine use. This information may enable health care providers to communicate with the older patients about sleep difficulty strategies to minimize sleep problems.
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Esposito M, Roccella M, Parisi L, Gallai B, Carotenuto M. Hypersomnia in children affected by migraine without aura: a questionnaire-based case-control study. Neuropsychiatr Dis Treat 2013; 9:289-94. [PMID: 23459616 PMCID: PMC3582477 DOI: 10.2147/ndt.s42182] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The relationship between sleep and headache is meaningful and complex. Children affected by migraines tend to show many sleep disorders, such as insufficient sleep duration and excessive daytime somnolence. Therefore, the aim of this study is to assess the rate of reported sleep habits and self-reported sleepiness in a large pediatric sample of individuals affected by migraine without aura (MoA). METHODS The study population consisted of 271 children aged between 6 and 13 years affected by MoA. The control group was composed of 305 typically developing children. To assess the sleep habits of all individuals (MoA and control), parents filled out the Sleep Disturbance Scale for Children, and to check the degree of subjective perceived daytime sleepiness, all subjects were administered the Pediatric Daytime Sleepiness Scale. RESULTS The two study groups were matched for age (P = 0.124), sex distribution (P = 0.775), and body mass index z-score (P = 0.107). Parents of children affected by MoA reported a higher total score of sleep disorder symptoms (P <0.001), disorders of initiating and maintaining (P < 0.001), and disorders of arousal (P < 0.001) than did parents of controls. No significant differences were found in disorders of excessive somnolence. Conversely, in the Pediatric Daytime Sleepiness Scale, migraine children had higher scores (24.67 ± 3.19 vs 11.94 ± 4.81; P < 0.001) and a reduction in referred total sleep time mean duration (469.83 ± 98.112 vs 527.94 ± 83.02; P < 0.001) than typically developing children. CONCLUSION Our study identified differences in sleep habits and found a high prevalence of daytime somnolence in children affected by MoA, suggesting the need for routine sleep screening in the pediatric management of children with migraines.
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Affiliation(s)
- Maria Esposito
- Center for Childhood Headache, Unit of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical, and Preventive Medicine, Second University of Naples, Naples, Italy
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Arnold EM, McCall VW, Anderson A, Bryant A, Bell R. Sleep Problems, Suicidality and Depression among American Indian Youth. ACTA ACUST UNITED AC 2013; 2:119. [PMID: 25309936 DOI: 10.4172/2325-9639.1000119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
STUDY BACKGROUND Mental health and sleep problems are important public health concerns among adolescents yet little is known about the relationship between sleep, depressive symptoms, and suicidality among American Indian youth. METHODS This study examined the impact of sleep and other factors on depressive symptoms and suicidality among Lumbee American Indian adolescents (N=80) ages 11-18. RESULTS At the bivariate level, sleepiness, was associated with depression but not with suicidality. Time in bed (TIB) was not associated with depression, but more TIB decreased the likelihood of suicidality. Higher levels of depressive symptoms were associated with increased likelihood of suicidality. At the multivariate level, sleepiness, suicidality, and self-esteem were associated with depression. TIB and depressive symptoms were the only variables associated with suicidality. CONCLUSION In working with American Indian youth, it may be helpful to consider sleep patterns as part of a comprehensive assessment process for youth who have or are at risk for depression and suicide.
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Affiliation(s)
| | | | | | - Alfred Bryant
- Georgia Health Sciences University, Augusta, GA, USA
| | - Ronny Bell
- University of North Carolina at Pembroke, NC, USA
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Borsook D, Maleki N, Becerra L, McEwen B. Understanding migraine through the lens of maladaptive stress responses: a model disease of allostatic load. Neuron 2012; 73:219-34. [PMID: 22284178 DOI: 10.1016/j.neuron.2012.01.001] [Citation(s) in RCA: 250] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2012] [Indexed: 12/12/2022]
Abstract
The brain and body respond to potential and actual stressful events by activating hormonal and neural mediators and modifying behaviors to adapt. Such responses help maintain physiological stability ("allostasis"). When behavioral or physiological stressors are frequent and/or severe, allostatic responses can become dysregulated and maladaptive ("allostatic load"). Allostatic load may alter brain networks both functionally and structurally. As a result, the brain's responses to continued/subsequent stressors are abnormal, and behavior and systemic physiology are altered in ways that can, in a vicious cycle, lead to further allostatic load. Migraine patients are continually exposed to such stressors, resulting in changes to central and peripheral physiology and function. Here we review how changes in brain states that occur as a result of repeated migraines may be explained by a maladaptive feedforward allostatic cascade model and how understanding migraine within the context of allostatic load model suggests alternative treatments for this often-debilitating disease.
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Affiliation(s)
- David Borsook
- Center for Pain and the Brain, McLean, Massachusetts General, and Children's Hospitals, Harvard Medical School, Boston, MA 02115, USA.
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Hart SL, Albiani JJ, Crangle CJ, Torbit LA, Varma MG. Development and assessment of the constipation-related disability scale. Aliment Pharmacol Ther 2012; 35:183-92. [PMID: 22093056 DOI: 10.1111/j.1365-2036.2011.04910.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Abstract
BACKGROUND Chronic constipation is associated with impaired quality of life and physical discomfort. Although inability to engage in day-to-day activities has been significantly associated with psychological distress, limited research has examined this relationship in constipated samples. AIM To develop and validate the Constipation-Related Disability Scale (CRDS), which assesses the extent of disability caused by constipation. METHODS A total of 240 constipated participants and 103 healthy controls completed the CRDS. Reliability was measured with Cronbach's coefficient alpha and test-retest reliability was assessed with intraclass correlation coefficients. Convergent, divergent and predictive validity were assessed. RESULTS Component and factor analyses were used to derive two factors: Work/Leisure Activities and Activities of Daily Living, as well as a total CRDS score. Good reliability was found, with alphas ≥ 0.87 and intraclass correlation coefficients ≥ 0.85. All scales were negatively correlated with the physical health subscales of the SF-36 (P < 0.001) and were not significantly correlated with the Epworth Sleepiness Scale and Social Desirability Scale, providing support for convergent and divergent validity, respectively. Evidence of predictive validity was supported by associations between the total CRDS with number of physician visits per year (P < 0.01), missed work in the last year (odds ratio [OR = 1.11, 95% confidence interval [CI] = 1.06-1.19, P < 0.001) and ER visits in the last year (OR = 1.08, 95% CI = 1.00-1.16, P < 0.05). CONCLUSIONS The Constipation-Related Disability Scale is the first instrument that assesses the impact of constipation on daily activities. There is evidence of strong reliability and validity of the instrument.
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Affiliation(s)
- S L Hart
- Department of Psychology, Ryerson University, Toronto, ON, Canada.
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Sandberg JC, Grzywacz JG, Talton JW, Quandt SA, Chen H, Chatterjee AB, Arcury TA. A cross-sectional exploration of excessive daytime sleepiness, depression, and musculoskeletal pain among migrant farmworkers. J Agromedicine 2012; 17:70-80. [PMID: 22191505 PMCID: PMC3297680 DOI: 10.1080/1059924x.2012.626750] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
In this study the authors estimated the prevalence of elevated daytime sleepiness, depressive symptoms, and musculoskeletal pain among Latino migrant farmworkers, and examined the relationship among these symptoms. Data are from a cross-sectional survey of migrant farmworkers (N = 300) conducted in eastern North Carolina in 2009. Eleven percent of Latino farmworkers reported elevated levels of daytime sleepiness, 28% reported elevated levels of depressive symptoms, and 5% reported moderate to severe musculoskeletal pain on a daily or weekly basis. Depressive symptoms and daytime sleepiness were positively associated. Depression and daytime sleepiness may increase risk of injury; further research regarding sleep issues is warranted.
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Affiliation(s)
- Joanne C. Sandberg
- Department of Family and Community Medicine, Wake Forest School of Medicine, Center for Worker Health, Wake Forest School of Medicine
| | - Joseph G. Grzywacz
- Department of Family and Community Medicine, Wake Forest School of Medicine, Center for Worker Health, Wake Forest School of Medicine
| | - Jennifer W. Talton
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine
| | - Sara A. Quandt
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Center for Worker Health, Wake Forest School of Medicine
| | - Haiying Chen
- Department of Pulmonary, Critical Care, Allergy, and Immunologic Medicine, Wake Forest School of Medicine, Center for Worker Health, Wake Forest School of Medicine
| | - Arjun B. Chatterjee
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Center for Worker Health, Wake Forest School of Medicine
| | - Thomas A. Arcury
- Department of Family and Community Medicine, Wake Forest School of Medicine, Center for Worker Health, Wake Forest School of Medicine
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Kamdar BB, Nandkumar P, Krishnan V, Gamaldo CE, Collop NA. Self-reported sleep and breathing disturbances in Joubert syndrome. Pediatr Neurol 2011; 45:395-9. [PMID: 22115003 DOI: 10.1016/j.pediatrneurol.2011.09.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2011] [Accepted: 09/12/2011] [Indexed: 10/15/2022]
Abstract
Joubert syndrome is a rare autosomal recessive disease characterized by malformations of the cerebellar vermis, hypotonia, developmental delay, and respiratory variability. Because little is known about sleep and ventilatory dysregulation in this patient population, a questionnaire was distributed at the Joubert Syndrome and Related Disorders Foundation Conference. This questionnaire addressed respiratory and sleep abnormalities, and included the Pediatric Sleep Questionnaire. Parents or proxies completed questionnaires for patients unable to do so themselves because of young age or neurologic problems. Twenty surveys were collected. The median age was 8.3 years, and 45% were female. Seven patients (35%) reported existing episodic tachypnea, four (20%) reported apnea, and three (15%) reported both. Snoring was reported by 10 patients (50%), of whom four snored nightly and five had coexisting daytime tachypnea. Six of 14 (43%) Pediatric Sleep Questionnaire responders had scores suggestive of sleep-related breathing disorder. These results suggest that episodic tachypnea, apnea, snoring, and Pediatric Sleep Questionnaire scores suggestive of sleep-related breathing disorder are common in Joubert syndrome. Early detection and improved understanding of sleep and breathing abnormalities may contribute to improved outcomes for patients with Joubert syndrome.
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Affiliation(s)
- Biren B Kamdar
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA
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Pecotic R, Dodig IP, Valic M, Ivkovic N, Dogas Z. The evaluation of the Croatian version of the Epworth sleepiness scale and STOP questionnaire as screening tools for obstructive sleep apnea syndrome. Sleep Breath 2011; 16:793-802. [DOI: 10.1007/s11325-011-0578-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Revised: 07/26/2011] [Accepted: 08/15/2011] [Indexed: 02/01/2023]
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Abstract
PURPOSE OF REVIEW Recently published literature indicates that sleep disorders present with medical comorbidities quite frequently. The coexistence of a sleep disorder with a medical disorder has a substantial impact for both the patient and the health system. RECENT FINDINGS Insomnia and hypersomnia are highly comorbid with medical conditions, such as chronic pain and diabetes, as well as with various cardiovascular, respiratory, gastrointestinal, urinary and neurological disorders. Restless legs syndrome and periodic leg movement syndrome have been associated with iron deficiency, kidney disease, diabetes, and neurological, autoimmune, cardiovascular and respiratory disorders. Rapid eye movement behaviour disorder has been described as an early manifestation of serious central nervous system diseases; thus, close neurological monitoring of patients referring with this complaint is indicated. SUMMARY Identification and management of any sleep disorder in medical patients is important for optimizing the course and prognosis. Of equal importance is the search for undetected medical disorder in patients presenting with sleep disorders.
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