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Togo E, Takami M, Ishigaki K. Evaluation of Autonomic Nervous System Function During Sleep by Mindful Breathing Using a Tablet Device: Randomized Controlled Trial. JMIR Nurs 2024; 7:e56616. [PMID: 38865177 DOI: 10.2196/56616] [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: 01/22/2024] [Revised: 04/28/2024] [Accepted: 05/08/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND One issue to be considered in universities is the need for interventions to improve sleep quality and educational systems for university students. However, sleep problems remain unresolved. As a clinical practice technique, a mindfulness-based stress reduction method can help students develop mindfulness skills to cope with stress, self-healing skills, and sleep. OBJECTIVE We aim to verify the effectiveness of mindful breathing exercises using a tablet device. METHODS In total, 18 nursing students, aged 18-22 years, were randomly assigned and divided equally into mindfulness (Mi) and nonmindfulness (nMi) implementation groups using tablet devices. During the 9-day experimental period, cardiac potentials were measured on days 1, 5, and 9. In each sleep stage (sleep with sympathetic nerve dominance, shallow sleep with parasympathetic nerve dominance, and deep sleep with parasympathetic nerve dominance), low frequency (LF) value, high frequency (HF) value, and LF/HF ratios obtained from the cardiac potentials were evaluated. RESULTS On day 5, a significant correlation was observed between sleep duration and each sleep stage in both groups. In comparison to each experimental day, the LF and LF/HF ratios of the Mi group were significantly higher on day 1 than on days 5 and 10. LF and HF values in the nMi group were significantly higher on day 1 than on day 5. CONCLUSIONS The correlation between sleep duration and each sleep stage on day 5 suggested that sleep homeostasis in both groups was activated on day 5, resulting in similar changes in sleep stages. During the experimental period, the cardiac potentials in the nMi group showed a wide range of fluctuations, whereas the LF values and LF/HF ratio in the Mi group showed a decreasing trend over time. This finding suggests that implementing mindful breathing exercises using a tablet device may suppress sympathetic activity during sleep. TRIAL REGISTRATION UMIN-CTR Clinical Trials Registry UMIN000054639; https://tinyurl.com/mu2vdrks.
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Affiliation(s)
- Eiichi Togo
- Department of Nursing, Faculty of Nursing, Hyogo University, Kakogawa City, Japan
| | - Miki Takami
- College of Nursing Art and Science, University of Hyogo, Akasi City, Japan
| | - Kyoko Ishigaki
- College of Nursing Art and Science, University of Hyogo, Akasi City, Japan
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Kinoshita S, Hanashiro S, Tsutsumi S, Shiga K, Kitazawa M, Wada Y, Inaishi J, Kashiwagi K, Fukami T, Mashimo Y, Minato K, Kishimoto T. Assessment of Stress and Well-Being of Japanese Employees Using Wearable Devices for Sleep Monitoring Combined With Ecological Momentary Assessment: Pilot Observational Study. JMIR Form Res 2024; 8:e49396. [PMID: 38696237 PMCID: PMC11099815 DOI: 10.2196/49396] [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: 05/27/2023] [Revised: 10/01/2023] [Accepted: 03/21/2024] [Indexed: 05/04/2024] Open
Abstract
BACKGROUND Poor sleep quality can elevate stress levels and diminish overall well-being. Japanese individuals often experience sleep deprivation, and workers have high levels of stress. Nevertheless, research examining the connection between objective sleep assessments and stress levels, as well as overall well-being, among Japanese workers is lacking. OBJECTIVE This study aims to investigate the correlation between physiological data, including sleep duration and heart rate variability (HRV), objectively measured through wearable devices, and 3 states (sleepiness, mood, and energy) assessed through ecological momentary assessment (EMA) and use of rating scales for stress and well-being. METHODS A total of 40 office workers (female, 20/40, 50%; mean age 40.4 years, SD 11.8 years) participated in the study. Participants were asked to wear a wearable wristband device for 8 consecutive weeks. EMA regarding sleepiness, mood, and energy levels was conducted via email messages sent by participants 4 times daily, with each session spaced 3 hours apart. This assessment occurred on 8 designated days within the 8-week timeframe. Participants' stress levels and perception of well-being were assessed using respective self-rating questionnaires. Subsequently, participants were categorized into quartiles based on their stress and well-being scores, and the sleep patterns and HRV indices recorded by the Fitbit Inspire 2 were compared among these groups. The Mann-Whitney U test was used to assess differences between the quartiles, with adjustments made for multiple comparisons using the Bonferroni correction. Furthermore, EMA results and the sleep and HRV indices were subjected to multilevel analysis for a comprehensive evaluation. RESULTS The EMA achieved a total response rate of 87.3%, while the Fitbit Inspire 2 wear rate reached 88.0%. When participants were grouped based on quartiles of well-being and stress-related scores, significant differences emerged. Specifically, individuals in the lowest stress quartile or highest subjective satisfaction quartile retired to bed earlier (P<.001 and P=.01, respectively), whereas those in the highest stress quartile exhibited greater variation in the midpoint of sleep (P<.001). A multilevel analysis unveiled notable relationships: intraindividual variability analysis indicated that higher energy levels were associated with lower deviation of heart rate during sleep on the preceding day (β=-.12, P<.001), and decreased sleepiness was observed on days following longer sleep durations (β=-.10, P<.001). Furthermore, interindividual variability analysis revealed that individuals with earlier midpoints of sleep tended to exhibit higher energy levels (β=-.26, P=.04). CONCLUSIONS Increased sleep variabilities, characterized by unstable bedtime or midpoint of sleep, were correlated with elevated stress levels and diminished well-being. Conversely, improved sleep indices (eg, lower heart rate during sleep and earlier average bedtime) were associated with heightened daytime energy levels. Further research with a larger sample size using these methodologies, particularly focusing on specific phenomena such as social jet lag, has the potential to yield valuable insights. TRIAL REGISTRATION UMIN-CTR UMIN000046858; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000053392.
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Affiliation(s)
- Shotaro Kinoshita
- Hills Joint Research Laboratory for Future Preventive Medicine and Wellness, Keio University School of Medicine, Tokyo, Japan
- Graduate School of Interdisciplinary Information Studies, The University of Tokyo, Tokyo, Japan
| | - Sayaka Hanashiro
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Shiori Tsutsumi
- Graduate School of Health Management, Keio University, Kanagawa, Japan
| | - Kiko Shiga
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- Department of Clinical Psychology, Faculty of Human Relations, Shigakukan University, Kagoshima, Japan
| | - Momoko Kitazawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Yasuyo Wada
- Center for Preventice Medicine, Keio University Hospital, Tokyo, Japan
- Department of Health Promotion, National Institute of Public Health, Saitama, Japan
| | - Jun Inaishi
- Center for Preventice Medicine, Keio University Hospital, Tokyo, Japan
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kazuhiro Kashiwagi
- Hills Joint Research Laboratory for Future Preventive Medicine and Wellness, Keio University School of Medicine, Tokyo, Japan
- Center for Preventice Medicine, Keio University Hospital, Tokyo, Japan
| | | | | | | | - Taishiro Kishimoto
- Hills Joint Research Laboratory for Future Preventive Medicine and Wellness, Keio University School of Medicine, Tokyo, Japan
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, New York, NY, United States
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
- Department of Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
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Haas A, Chung J, Kent C, Mills B, McCoy M. Vertebral Subluxation and Systems Biology: An Integrative Review Exploring the Salutogenic Influence of Chiropractic Care on the Neuroendocrine-Immune System. Cureus 2024; 16:e56223. [PMID: 38618450 PMCID: PMC11016242 DOI: 10.7759/cureus.56223] [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] [Accepted: 03/15/2024] [Indexed: 04/16/2024] Open
Abstract
In this paper we synthesize an expansive body of literature examining the multifaceted influence of chiropractic care on processes within and modulators of the neuroendocrine-immune (NEI) system, for the purpose of generating an inductive hypothesis regarding the potential impacts of chiropractic care on integrated physiology. Taking a broad, interdisciplinary, and integrative view of two decades of research-documented outcomes of chiropractic care, inclusive of reports ranging from systematic and meta-analysis and randomized and observational trials to case and cohort studies, this review encapsulates a rigorous analysis of research and suggests the appropriateness of a more integrative perspective on the impact of chiropractic care on systemic physiology. A novel perspective on the salutogenic, health-promoting effects of chiropractic adjustment is presented, focused on the improvement of physical indicators of well-being and adaptability such as blood pressure, heart rate variability, and sleep, potential benefits that may be facilitated through multiple neurologically mediated pathways. Our findings support the biological plausibility of complex benefits from chiropractic intervention that is not limited to simple neuromusculoskeletal outcomes and open new avenues for future research, specifically the exploration and mapping of the precise neural pathways and networks influenced by chiropractic adjustment.
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Affiliation(s)
- Amy Haas
- Research, Foundation for Vertebral Subluxation, Kennesaw, USA
| | - Jonathan Chung
- Research, Foundation for Vertebral Subluxation, Kennesaw, USA
| | - Christopher Kent
- Research, Sherman College, Spartanburg, USA
- Research, Foundation for Vertebral Subluxation, Kennesaw, USA
| | - Brooke Mills
- Research, Foundation for Vertebral Subluxation, Kennesaw, USA
| | - Matthew McCoy
- Research, Foundation for Vertebral Subluxation, Kennesaw, USA
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Correia ATL, Forshaw PE, Roden LC, Lipinska G, Rauch HGL, Lambert EV, Layden BT, Reutrakul S, Crowley SJ, Luke A, Dugas LR, Rae DE. Associations between fears related to safety during sleep and self-reported sleep in men and women living in a low-socioeconomic status setting. Sci Rep 2024; 14:3609. [PMID: 38351245 PMCID: PMC10864334 DOI: 10.1038/s41598-024-54032-w] [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: 03/29/2023] [Accepted: 02/07/2024] [Indexed: 02/16/2024] Open
Abstract
South Africans living in low socioeconomic areas have self-reported unusually long sleep durations (approximately 9-10 h). One hypothesis is that these long durations may be a compensatory response to poor sleep quality as a result of stressful environments. This study aimed to investigate whether fear of not being safe during sleep is associated with markers of sleep quality or duration in men and women. South Africans (n = 411, 25-50 y, 57% women) of African-origin living in an urban township, characterised by high crime and poverty rates, participated in this study. Participants are part of a larger longitudinal cohort study: Modelling the Epidemiologic Transition Study (METS)-Microbiome. Customised questions were used to assess the presence or absence of fears related to feeling safe during sleep, and the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index were used to assess daytime sleepiness, sleep quality and insomnia symptom severity respectively. Adjusted logistic regression models indicated that participants who reported fears related to safety during sleep were more likely to report poor sleep quality (PSQI > 5) compared to participants not reporting such fears and that this relationship was stronger among men than women. This is one of the first studies outside American or European populations to suggest that poor quality sleep is associated with fear of personal safety in low-SES South African adults.
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Affiliation(s)
- Arron T L Correia
- Health Through Physical Activity, Lifestyle and Sport (HPALS) Research Centre and Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, 7700, South Africa.
| | - Philippa E Forshaw
- Health Through Physical Activity, Lifestyle and Sport (HPALS) Research Centre and Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, 7700, South Africa
| | - Laura C Roden
- Centre for Health and Life Sciences, Coventry University, Coventry, CV1 2DS, UK
| | - Gosia Lipinska
- Department of Psychology, Humanities Faculty, University of Cape Town, Cape Town, South Africa
| | - H G Laurie Rauch
- Health Through Physical Activity, Lifestyle and Sport (HPALS) Research Centre and Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, 7700, South Africa
| | - Estelle V Lambert
- Health Through Physical Activity, Lifestyle and Sport (HPALS) Research Centre and Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, 7700, South Africa
| | - Brian T Layden
- Division of Endocrinology, Diabetes and Metabolism, University of Illinois Chicago, Chicago, IL, USA
- Jesse Brown Veterans Affairs Medical Center, Chicago, IL, USA
| | - Sirimon Reutrakul
- Division of Endocrinology, Diabetes and Metabolism, University of Illinois Chicago, Chicago, IL, USA
| | - Stephanie J Crowley
- Department of Psychiatry and Behavioral Sciences, Biological Rhythms Research Laboratory, Rush University Medical Center, Chicago, IL, USA
| | - Amy Luke
- Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL, USA
| | - Lara R Dugas
- Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL, USA
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Dale E Rae
- Health Through Physical Activity, Lifestyle and Sport (HPALS) Research Centre and Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, 7700, South Africa
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Associations of social jetlag and insomnia symptoms with depressive symptoms among Chinese adolescents: A large population-based study. Sleep Med 2023; 104:98-104. [PMID: 36917899 DOI: 10.1016/j.sleep.2023.02.024] [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: 12/07/2022] [Revised: 01/31/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023]
Abstract
OBJECTIVE This study aimed to evaluate the associations of social jetlag and insomnia symptoms with depressive symptoms among adolescents. METHODS A total of 37,871 junior high students completed an online survey between May 24th and Jun 5th, 2022. Insomnia symptoms were assessed by three items based on the Diagnostic and Statistical Manual of Mental Disorders criteria. Social jetlag and depressive symptoms were evaluated by the Munich Chronotype Questionnaire and the Patient Health Questionnaire, respectively. Restricted cubic splines were used to explore the relationship between social jetlag and depressive symptoms. Joint effects of social jetlag and insomnia symptoms on depressive symptoms were estimated using additive interaction models. RESULTS The prevalence of depressive symptoms was 13.1%. Depressive symptoms were more common in adolescents with social jetlag ≥2 h (OR: 1.51, 95% CI: 1.39-1.65) and insomnia symptoms (OR: 6.91, 95% CI: 6.41-7.44). There was a J-shaped relationship between social jetlag and depressive symptoms when we took social jetlag as a continuous variable. Moreover, a positive additive interaction of social jetlag ≥2 h and insomnia symptoms on depressive symptoms was found in female adolescents (RERI: 2.30, 95% CI: 0.11-4.49). CONCLUSIONS Our findings suggested that social jetlag ≥2 h and insomnia are related to the occurrence of depressive symptoms in adolescents. Their coexistence additively enhances the strength of the association with depressive symptoms. Early screening and intervention for insomnia, as well as methods to reduce social jetlag, should be comprised as part of preventive strategies for depression in adolescents.
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