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Michielsen M, Böhmer MN, Vermeulen RCH, Vlaanderen JJ, Beekman ATF, Kooij JJS. ADHD, sleep, chronotype and health in a large cohort of Dutch nurses. J Psychiatr Res 2024; 174:159-164. [PMID: 38636152 DOI: 10.1016/j.jpsychires.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/05/2024] [Accepted: 04/02/2024] [Indexed: 04/20/2024]
Affiliation(s)
- M Michielsen
- PsyQ, Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR, The Hague, the Netherlands.
| | - M N Böhmer
- PsyQ, Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR, The Hague, the Netherlands
| | - R C H Vermeulen
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Jenalaan 18d, 3584 CK, Utrecht, Utrecht, the Netherlands
| | - J J Vlaanderen
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Jenalaan 18d, 3584 CK, Utrecht, Utrecht, the Netherlands
| | - A T F Beekman
- Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam University Medical Center/VUmc, Oldenaller 1, 1081 HL, Amsterdam, the Netherlands
| | - J J S Kooij
- PsyQ, Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR, The Hague, the Netherlands; Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam University Medical Center/VUmc, Oldenaller 1, 1081 HL, Amsterdam, the Netherlands
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Estivill-Domènech C, Rodriguez-Morilla B, Estivill E, Madrid JA. Case report: Diagnosis and intervention of a non-24-h sleep-wake disorder in a sighted child with a psychiatric disorder. Front Psychiatry 2024; 14:1129153. [PMID: 38250267 PMCID: PMC10797120 DOI: 10.3389/fpsyt.2023.1129153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Circadian rhythm sleep-wake disorders (CRSWD) are sleep dysfunctions related to circadian functioning. They are characterized by symptoms of insomnia or excessive sleepiness that occur because the intrinsic circadian pacemaker is not entrained to a 24-h light/dark cycle. Affected individuals with a free-running disorder or hypernycthemeral syndrome (N24SWD) have a longer sleep-wake cycle that produces a sleep pattern that typically delays each day. The disorder is seen in 70% of blind people, and among people with healthy vision, it is a rare pathology. Among sighted cases, 80% are young men and 28% have a psychiatric disorder. The patient was a 14-year-old boy with a psychiatric pathology diagnosed with a PANDAS syndrome (pediatric autoimmune neuropsychiatric disorders associated with streptococci), a sudden acute and debilitating onset of intense anxiety and mood lability accompanied by obsessive compulsive-like issues and/or tics, in association with a streptococcal A infection that occurs immediately prior to the symptoms. As a comorbidity, he exhibited severe insomnia due to an irregular sleep pattern that strongly delayed his sleep schedule day to day. It affected his daily routines, as he was not going to school, and aggravated, furthermore, the psychiatric symptoms. He was referred for sleep consultation, where the case was explored by ambulatory circadian monitoring (ACM) using the novel system Kronowise® (Chronolab, University of Murcia) and diagnosed with a non-24-h sleep-wake disorder (N24SWD). The first treatment approach for the patient was focused on improving symptoms during the acute infection and psychiatric symptoms. Additionally, sleep pathology was treated by light therapy and melatonin. After 8 months and different trials, it was possible to establish a treatment to normalize the symptoms and fix his sleep rhythm in a normal schedule as well as to reduce anxious symptoms during the day. The association of PANDAS and N24SWD has not previously been reported in the literature.
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Affiliation(s)
| | | | | | - Juan Antonio Madrid
- Chronobiology Lab, Department of Physiology, College of Biology, University of Murcia, IUIE, IMIB, Murcia, Spain
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3
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Wu A. Updates and confounding factors in delayed sleep-wake phase disorder. Sleep Biol Rhythms 2023; 21:279-287. [PMID: 37363638 PMCID: PMC9979143 DOI: 10.1007/s41105-023-00454-4] [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: 10/09/2022] [Accepted: 02/09/2023] [Indexed: 03/06/2023]
Abstract
Delayed sleep-wake phase disorder (DSWPD) is a circadian rhythm sleep disorder characterised by a delay in the main sleep period, with patients experiencing difficulty getting to sleep and waking up at socially appropriate times. This often causes insomnia and compromised sleep, results in impairment to daytime function and is associated with a range of comorbidities. Besides interventions aimed at ameliorating symptoms, there is good evidence supporting successful phase advancement with bright light therapy or melatonin administration. However, no treatment to date addresses the tendency to phase delay, which is a common factor amongst the various contributing causes of DSWPD. Circadian phase markers such as core body temperature and circulating melatonin typically correlate well with sleep timing in healthy patients, but numerous variations exist in DSWPD patients that can make these unpredictable for use in diagnostics. There is also increasing evidence that, on top of problems with the circadian cycle, sleep homeostatic processes actually differ in DSWPD patients compared to controls. This naturally has ramifications for management but also for the current approach to the pathogenesis itself in which DSWPD is considered a purely circadian disorder. This review collates what is known on the causes and treatments of DSWPD, addresses the pitfalls in diagnosis and discusses the implications of current data on modified sleep homeostasis, making clinical recommendations and directing future research.
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Affiliation(s)
- Alexandra Wu
- Division of Biosciences, University College London, Gower Street, London, WC1E 6BT UK
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4
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Futenma K, Takaesu Y, Komada Y, Shimura A, Okajima I, Matsui K, Tanioka K, Inoue Y. Delayed sleep-wake phase disorder and its related sleep behaviors in the young generation. Front Psychiatry 2023; 14:1174719. [PMID: 37275982 PMCID: PMC10235460 DOI: 10.3389/fpsyt.2023.1174719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/08/2023] [Indexed: 06/07/2023] Open
Abstract
Delayed sleep-wake phase disorder (DSWPD) is a sleep disorder in which the habitual sleep-wake timing is delayed, resulting in difficulty in falling asleep and waking up at the desired time. Patients with DSWPD frequently experience fatigue, impaired concentration, sleep deprivation during weekdays, and problems of absenteeism, which may be further complicated by depressive symptoms. DSWPD is typically prevalent during adolescence and young adulthood. Although there are no studies comparing internationally, the prevalence of DSWPD is estimated to be approximately 3% with little racial differences between Caucasians and Asians. The presence of this disorder is associated with various physiological, genetic and psychological as well as behavioral factors. Furthermore, social factors are also involved in the mechanism of DSWPD. Recently, delayed sleep phase and prolonged sleep duration in the young generation have been reported during the period of COVID-19 pandemic-related behavioral restrictions. This phenomenon raises a concern about the risk of a mismatch between their sleep-wake phase and social life that may lead to the development of DSWPD after the removal of these restrictions. Although the typical feature of DSWPD is a delay in circadian rhythms, individuals with DSWPD without having misalignment of objectively measured circadian rhythm markers account for approximately 40% of the cases, wherein the psychological and behavioral characteristics of young people, such as truancy and academic or social troubles, are largely involved in the mechanism of this disorder. Recent studies have shown that DSWPD is frequently comorbid with psychiatric disorders, particularly mood and neurodevelopmental disorders, both of which have a bidirectional association with the pathophysiology of DSWPD. Additionally, patients with DSWPD have a strong tendency toward neuroticism and anxiety, which may result in the aggravation of insomnia symptoms. Therefore, future studies should address the effectiveness of cognitive-behavioral approaches in addition to chronobiological approaches in the treatment of DSWPD.
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Affiliation(s)
- Kunihiro Futenma
- Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
| | - Yoshikazu Takaesu
- Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
| | - Yoko Komada
- Institute for Liberal Arts, Tokyo Institute of Technology, Tokyo, Japan
| | - Akiyoshi Shimura
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
- Department of Psychiatry, Tokyo Medical University, Tokyo, Japan
| | - Isa Okajima
- Department of Psychological Counseling, Faculty of Humanities, Tokyo Kasei University, Tokyo, Japan
| | - Kentaro Matsui
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
- Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kosuke Tanioka
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
| | - Yuichi Inoue
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
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Alam MS, Kim JK, Choi J. Multifunctional Wearable System for Mapping Body Temperature and Analyzing Sweat. ACS Sens 2023; 8:1980-1988. [PMID: 37098135 DOI: 10.1021/acssensors.3c00098] [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: 04/27/2023]
Abstract
Integrated wearable bioelectronic health monitoring systems have revealed new possibilities for collecting personalized physiological information. Wearable sweat sensors have the potential to noninvasively measure valuable biomarkers. Mapping sweat and skin-temperature throughout the body can provide detailed information on the human body. However, existing wearable systems cannot evaluate such data. Here, we report a multifunctional wearable platform that can wirelessly measure local sweat loss, sweat chloride concentration, and skin temperature. The approach combines a reusable electronics module to monitor skin temperature and a microfluidic module for monitoring sweat loss and sweat chloride concentration. The miniaturized electronic system takes temperature measurements from the skin and wirelessly transmits the obtained data to a user device using Bluetooth technology. In contrast, the microfluidic system provides accurate colorimetric analysis of the chloride concentration and sweat loss. Thus, this integrated wearable system has great application potential in individualized health management systems for sports researchers and competitors and can also be applied in clinical settings.
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Affiliation(s)
- Md Sajjad Alam
- Department of Mechanical Engineering, Kookmin University, Seoul 02707, Republic of Korea
| | - Jung Kyung Kim
- School of Mechanical Engineering and Department of Integrative Biomedical Science and Engineering, Kookmin University, Seoul 02707, Republic of Korea
| | - Jungil Choi
- Department of Mechanical Engineering, Ajou University, Suwon 16499, Republic of Korea
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6
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Sun SY, Chen GH. Treatment of Circadian Rhythm Sleep-Wake Disorders. Curr Neuropharmacol 2022; 20:1022-1034. [PMID: 34493186 PMCID: PMC9886819 DOI: 10.2174/1570159x19666210907122933] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/09/2021] [Accepted: 09/05/2021] [Indexed: 11/22/2022] Open
Abstract
Circadian rhythm sleep-wake disorders (CRSWDs) are a distinct class of sleep disorders caused by alterations to the circadian time-keeping system, its entrainment mechanisms, or a mismatch between the endogenous circadian rhythm and the external environment. The main clinical manifestations are insomnia and excessive daytime sleepiness that often lead to clinically meaningful distress or cause mental, physical, social, occupational, educational, or other functional impairment. CRSWDs are easily mistaken for insomnia or early waking up, resulting in inappropriate treatment. CRSWDs can be roughly divided into two categories, namely, intrinsic CRSWDs, in which sleep disturbances are caused by alterations to the endogenous circadian rhythm system due to chronic changes in the regulation or capture mechanism of the biological clock, and extrinsic circadian rhythm sleep-wake disorders, in which sleep disorders, such as jet lag or shift-work disorder, result from environmental changes that cause a mismatch between sleep-wakefulness times and internal circadian rhythms. Sleep diaries, actigraphy, and determination of day and night phase markers (dim light melatonin onset and core body temperature minimum) have all become routine diagnostic methods for CRSWDs. Common treatments for CRSWD currently include sleep health education, time therapy, light therapy, melatonin, and hypnotic drug therapy. Here, we review the progress in the epidemiology, etiology, diagnostic evaluation, diagnostic criteria, and treatment of intrinsic CRSWD, with emphasis on the latter, in the hope of bolstering the clinical diagnosis and treatment of CRSWDs.
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Affiliation(s)
- Shi-Yu Sun
- Department of Neurology, First Affiliated Hospital of Anhui University of Science and Technology, First People's Hospital of Huainan, Huainan 232007, Anhui, People's Republic of China
| | - Gui-Hai Chen
- Department of Neurology (Sleep Disorders), the Affiliated Chaohu Hospital of Anhui Medical University, Hefei 238000, Anhui Province, P.R. China;,Address correspondence to this author at the Department of Neurology (Sleep Disorders), the Affiliated Chaohu Hospital of Anhui Medical University, Hefei 238000, Anhui Province, P.R. China; Tel/Fax:+86-551-82324252; E-mail:
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7
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Yuhas PT. Non-24-Hour Sleep–Wake Disorder and Tasimelteon: A Review for Practitioners Who Work with Blind People. JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS 2022. [DOI: 10.1177/0145482x211072521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction This narrative review summarizes the biology of human circadian rhythms; details the epidemiology, clinical manifestation, and diagnosis of non-24-hour sleep–wake disorder (N24SWD); and reviews the efficacy of possible treatments. Methods Searches of targeted phrases, such as “non-24-hour sleep–wake disorder” and “tasimelteon,” were conducted on PubMed between December 2016 and March 2020. Results As the world’s population ages, health practitioners frequently work with people who are blind. Damage to the retinal ganglion cells that signal environmental irradiance levels to the suprachiasmatic nucleus prevents many of these individuals from synchronizing their internal clocks to the 24-hour day. As a result, they experience a condition called N24SWD, where the body’s circadian rhythms fall in and out of phase with the solar cycle. The ability to fall asleep and remain asleep is a complex process that depends on many variables, including the release of the neurohormone melatonin. Melatonin is produced at night and is a key regulator of regular sleep cycles. Periods of interrupted sleep, increased sleep latency, and reduced total sleep time occur when melatonin production peaks during daytime. Thus, many persons with N24SWD have difficulty maintaining normal schedules due in part to the mistimed release of melatonin. Randomized clinical trials have shown that melatonin receptor agonist tasimelteon is an effective therapy for individuals with N24SWD. Other treatments have varying efficacy profiles. Conclusions Although rare, N24SWD is a serious condition that can impair quality of life for blind persons. Tasimelteon appears to be a safe and efficacious treatment option. Implications for practitioners Practitioners can use this information to better understand why blind persons often report difficulties sleeping and to realize that therapeutic options are available to these individuals.
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Affiliation(s)
- Phillip T. Yuhas
- College of Optometry, the Ohio State University, Columbus, OH, USA
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Eo YJ, Park J, Kim S, Lee KN, Lee SM, Kim DH, Kim C, Do YR. Estimation of melatonin level and core body temperature: heart rate and heart rate variability as circadian rhythm markers. BIOL RHYTHM RES 2022. [DOI: 10.1080/09291016.2021.2024408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Yun Jae Eo
- Department of Chemistry, Kookmin University, Seoul, Republic of Korea
| | - Jingyu Park
- School of Electrical Engineering, Kookmin University, Seoul, Republic of Korea
| | - Seohyeon Kim
- School of Electrical Engineering, Kookmin University, Seoul, Republic of Korea
| | - Keyong Nam Lee
- Department of Chemistry, Kookmin University, Seoul, Republic of Korea
| | - Seung Min Lee
- School of Electrical Engineering, Kookmin University, Seoul, Republic of Korea
- Circadian ICT Research Center, Kookmin University, Seoul, Republic of Korea
| | - Dae Hwan Kim
- School of Electrical Engineering, Kookmin University, Seoul, Republic of Korea
- Circadian ICT Research Center, Kookmin University, Seoul, Republic of Korea
| | - Changwook Kim
- Circadian ICT Research Center, Kookmin University, Seoul, Republic of Korea
| | - Young Rag Do
- Department of Chemistry, Kookmin University, Seoul, Republic of Korea
- Circadian ICT Research Center, Kookmin University, Seoul, Republic of Korea
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9
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Hirose M, Nakamura T, Watanabe A, Esaki Y, Koike S, Yamamoto Y, Iwata N, Kitajima T. Altered distribution of resting periods of daily locomotor activity in patients with delayed sleep phase disorder. Front Psychiatry 2022; 13:933690. [PMID: 36311503 PMCID: PMC9606617 DOI: 10.3389/fpsyt.2022.933690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 09/12/2022] [Indexed: 11/30/2022] Open
Abstract
Delayed sleep phase disorder (DSPD) and mood disorders have a close relationship. However, the shared mechanisms by DSPD and mood disorders have not been well-elucidated. We previously found that micro-fluctuations in human behaviors are organized by robust statistical laws (behavioral organization), where the cumulative distributions of resting and active period durations take a power-law distribution form and a stretched exponential functional form, respectively. Further, we found that the scaling exponents of resting period distributions significantly decreased in major depressive disorder (MDD). In this study, we hypothesized that DSPD had similar characteristics of the altered behavioral organization to that of MDD. Locomotor activity data were acquired for more than 1 week from 17 patients with DSPD and 17 age- and gender-matched healthy participants using actigraphy. We analyzed the cumulative distributions of resting and active period durations in locomotor activity data and subsequently derived fitting parameters of those distributions. Similar to patients with MDD, we found that resting period distributions took a power-law form over the range of 2-100 min, with significantly lower values of scaling exponents γ in patients with DSPD compared with healthy participants. The shared alteration in γ suggests the existence of similar pathophysiology between DSPD and MDD.
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Affiliation(s)
- Marina Hirose
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - Toru Nakamura
- Graduate School of Engineering Science, Osaka University, Osaka, Japan
| | - Akiko Watanabe
- Department of Sleep Medicine, Toyohashi Mates Sleep Disorders Center, Toyohashi, Japan
| | - Yuichi Esaki
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - Shigefumi Koike
- Department of Sleep Medicine, Toyohashi Mates Sleep Disorders Center, Toyohashi, Japan
| | - Yoshiharu Yamamoto
- Educational Physiology Laboratory, Graduate School of Education, University of Tokyo, Tokyo, Japan
| | - Nakao Iwata
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - Tsuyoshi Kitajima
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
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10
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Tamura N, Komada Y, Inoue Y, Tanaka H. Social jetlag among Japanese adolescents: Association with irritable mood, daytime sleepiness, fatigue, and poor academic performance. Chronobiol Int 2021; 39:311-322. [PMID: 34732101 DOI: 10.1080/07420528.2021.1996388] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Social jetlag, a form of circadian misalignment, has been suggested to induce several clinical symptoms such as mental/physical health problems. However, evidence on the association of social jetlag with general daytime functioning (e.g., school life) is limited. This cross-sectional study aimed to 1) estimate the distribution of social jetlag exceeding one hour and 2) comprehensively explore the associations between social jetlag and irritable mood, daytime sleepiness, and poor academic performance among Japanese adolescents. The study included 4,782 students aged 12-15 years, from 13 junior high schools, who completed a self-administered questionnaire. Social jetlag was calculated as the difference in the midpoint of sleep between weekdays and weekends and was categorized as follow: negative, <1 h, 1-2 h, or ≥2 h. Outcomes were irritable mood, daytime sleepiness, and academic performance, which were analyzed with generalized linear mixed models to examine the relations with social jetlag, with adjustments for potential confounders like sleep quality. The distribution of social jetlag of ≥1 h was 51.1%, including 1-2 h (35.8%) and ≥2 h (15.3%). Its most frequently observed duration was 0 to <1 h (41.0%), followed by negative social jetlag (7.9%). The full adjusted model revealed that social jetlag of ≥1 h was associated with elevated risk of irritable mood, daytime sleepiness, and poor academic performance, while negative social jetlag was associated only with poor academic performance. Social jetlag was highly prevalent among Japanese adolescents and could be a major risk factor for irritable mood, daytime sleepiness, and poor academic performance.Abbreviations: BMI, Body mass index; DLMO, Dim light melatonin onset; CIs, Confidence intervals; MSF, The midpoints of sleep on free days; MSFsc, Sleep-corrected MSF; MSW, The midpoints of sleep on weekdays; PDSS, The Pediatric Daytime Sleepiness Scale.
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Affiliation(s)
- Norihisa Tamura
- Graduate School of Humanities and Social Sciences, Department of Psychology, Hiroshima University, Hiroshima, Japan
| | - Yoko Komada
- Faculty of Liberal Arts, Meiji Pharmaceutical University, Tokyo, Japan
| | - Yuichi Inoue
- Department of Somnology, Tokyo Medical University, Tokyo, Japan.,Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
| | - Hideki Tanaka
- Department of Psychology, Faculty of Health and Wellness Sciences, Hiroshima International University, Hiroshima, Japan
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11
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Haghayegh S, Smolensky MH, Khoshnevis S, Hermida RC, Castriotta RJ, Diller KR. The Circadian Rhythm of Thermoregulation Modulates both the Sleep/Wake Cycle and 24 h Pattern of Arterial Blood Pressure. Compr Physiol 2021; 11:2645-2658. [PMID: 34636410 DOI: 10.1002/cphy.c210008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Borbély proposed an interacting two-component model of sleep regulation comprising a homeostatic Process S and a circadian Process C. The model has provided understanding of the association between core body temperature (CBT) as a key element of Process C that is deterministic of sleep onset and offset. However, it additionally provides a new perspective of the importance of the thermoregulatory mechanisms of Process C in modulating the circadian rhythm of arterial blood pressure (ABP). Herein, we examine the circadian physiology of thermoregulation, including at the end of the activity span the profound redistribution of cardiac output from the systemic circulation to the arteriovenous anastomoses of the glabrous skin that markedly enhances convective transfer of heat from the body to the environment to cause (i) decrease of the CBT as a pathway to sleep onset and (ii) attenuation of the asleep ABP mean and augmentation of the ABP decline (dipping) from the wake-time mean, in combination the strongest predictors of the risk for blood vessel and organ pathology and morbid and mortal cardiovascular disease events. We additionally review the means by which blood perfusion to the glabrous skin can be manipulated on demand by selective thermal stimulation, that is, mild warming, on the skin of the cervical spinal cord to intensify Process C as a way to facilitate sleep induction and promote healthy asleep ABP. © 2021 American Physiological Society. Compr Physiol 11:1-14, 2021.
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Affiliation(s)
- Shahab Haghayegh
- Department of Biostatics, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.,Department of Biomedical Engineering, Cockrell School of Engineering, The University of Texas at Austin, Austin, Texas, USA
| | - Michael H Smolensky
- Department of Biomedical Engineering, Cockrell School of Engineering, The University of Texas at Austin, Austin, Texas, USA.,Department of Internal Medicine, Division of Pulmonary and Sleep Medicine, McGovern School of Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Sepideh Khoshnevis
- Department of Biomedical Engineering, Cockrell School of Engineering, The University of Texas at Austin, Austin, Texas, USA
| | - Ramon C Hermida
- Department of Biomedical Engineering, Cockrell School of Engineering, The University of Texas at Austin, Austin, Texas, USA.,Bioengineering and Chronobiology Laboratories, Atlantic Research Center for Information and Communication Technologies, University of Vigo, Vigo, Spain
| | - Richard J Castriotta
- Division of Pulmonary, Critical Care and Sleep Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Kenneth R Diller
- Department of Biomedical Engineering, Cockrell School of Engineering, The University of Texas at Austin, Austin, Texas, USA
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12
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Kolberg E, Hjetland GJ, Thun E, Pallesen S, Nordhus IH, Husebo BS, Flo-Groeneboom E. The effects of bright light treatment on affective symptoms in people with dementia: a 24-week cluster randomized controlled trial. BMC Psychiatry 2021; 21:377. [PMID: 34320937 PMCID: PMC8317398 DOI: 10.1186/s12888-021-03376-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 07/10/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The majority of people with dementia have behavioral and psychological symptoms of dementia (BPSD), including depression, anxiety and agitation. These may be elicited or aggravated by disrupted circadian rhythms. Bright light treatment (BLT) is a promising non-pharmacological approach to the management of BPSD, but previous research has yielded mixed results. METHODS Eight nursing home dementia units (1 unit = 1 cluster) with 78 patients were invited to participate in a cluster randomized controlled trial from September 2017 to April 2018 investigating the effects of BLT on sleep and circadian rhythms (primary outcome) and BPSD (secondary outcome). Ceiling mounted LED-panels were installed in the intervention group (four units), providing light at 1000 lx and 6000 K (vertically at 1.2 m) between 10 a.m. and 3 p.m., with lower values in the mornings and evenings. Standard indoor light was used in the control group (four units). BPSD were assessed with The Cornell Scale for Depression in Dementia (CSDD) and the Neuropsychiatric Inventory Nursing Home Version (NPI-NH). Data collection took place at baseline and after 8, 16 and 24 weeks. Multilevel regression models with and without false discovery rate correction were used for the analysis, with baseline values and dementia stage entered as covariates. RESULTS Sixty-nine patients were included in the study at baseline. Compared to the control group, the intervention group had a larger reduction on the composite scores of both the CSDD (95% CI = - 6.0 - - 0.3) and the NPI-NH (95% CI = - 2.2 - - 0.1), as well as on the NPI-NH Affect sub-syndrome, and the CSDD Mood related signs sub-scale at follow-up after 16 weeks. With FDR correction, the group difference was significant on the CSDD Mood related signs sub-scale (95% CI = - 2.7 - - 0.8) and the NPI-NH Affect sub-syndrome (95% CI = - 1.6 - - 0.2). No differences were found between conditions at weeks 8 or 24. CONCLUSION Compared to the control condition, affective symptoms were reduced after 16 weeks in the group receiving BLT, suggesting BLT may be beneficial for nursing home patients with dementia. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03357328 . Retrospectively registered on November 29, 2017.
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Affiliation(s)
- Eirin Kolberg
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen (UiB), Aarstadveien 17, 5009, Bergen, Norway.
| | - Gunnhild Johnsen Hjetland
- grid.7914.b0000 0004 1936 7443Department of Clinical Psychology, Faculty of Psychology, University of Bergen (UiB), Aarstadveien 17, 5009 Bergen, Norway ,City Department of Health and Care, City of Bergen, Norway
| | - Eirunn Thun
- grid.7914.b0000 0004 1936 7443Department of Clinical Psychology, Faculty of Psychology, University of Bergen (UiB), Aarstadveien 17, 5009 Bergen, Norway
| | - Ståle Pallesen
- grid.7914.b0000 0004 1936 7443Department of Psychosocial Science, Faculty of Psychology, University of Bergen (UiB) Christies gate 12, 5015 Bergen, Bergen, Norway ,grid.412008.f0000 0000 9753 1393Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway ,Optentia, the Vaal Triangle Campus of the North-West University, Vanderbijlpark, South Africa
| | - Inger Hilde Nordhus
- grid.7914.b0000 0004 1936 7443Department of Clinical Psychology, Faculty of Psychology, University of Bergen (UiB), Aarstadveien 17, 5009 Bergen, Norway ,grid.5510.10000 0004 1936 8921Department of Behavioral Medicine, Faculty of Medicine, University of Oslo, (UiO), Oslo, Norway
| | - Bettina S. Husebo
- grid.7914.b0000 0004 1936 7443Centre for Elderly and Nursing Home Medicine (SEFAS), Department of Global Public Health and Primary Care, University of Bergen (UiB), Aarstadveien 17, 5009 Bergen, Norway
| | - Elisabeth Flo-Groeneboom
- grid.7914.b0000 0004 1936 7443Department of Clinical Psychology, Faculty of Psychology, University of Bergen (UiB), Aarstadveien 17, 5009 Bergen, Norway
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13
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Frangopoulos F, Nicolaou I, Zannetos S, Economou NT, Adamide T, Georgiou A, Nikolaidis PT, Rosemann T, Knechtle B, Trakada G. Setting Objective Clinical Assessment Tools for Circadian Rhythm Sleep-Wake Disorders - A Community-Based Cross-Sectional Epidemiological Study. Nat Sci Sleep 2021; 13:791-802. [PMID: 34163273 PMCID: PMC8215907 DOI: 10.2147/nss.s308917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 05/22/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Circadian rhythm sleep-wake disorder (CRSWD) is an often-misdiagnosed group of sleep disturbances with limited data concerning diagnostic and therapeutic algorithms in the general population. Therefore, reported prevalence varies in the literature due to different case definitions, methodological, and environmental factors. OBJECTIVES The purpose of our cross-sectional study was to estimate the prevalence of CRSWD in the general population of Cyprus and to suggest clinical parameters for the assessment of atypical sleep schedules. The estimation was carried out by introducing normal preset sleep time limits, according to the imposed local environment and by administering well-established questionnaires for symptoms and consequence dysfunction, as objective evaluation tools. METHODS In a nationwide epidemiological survey, 4118 Cypriot adult participants, selected and stratified to represent the general population, were interviewed on sleep habits and complaints by computer-assisted telephone interviewing (CATI). In the second stage, 250 adults were randomly selected from the initial representative sample, for a CRSWD assessment. According to the proposed diagnostic criteria, patients were interviewed about sleepiness and/or insomnia, and daytime dysfunction (fatigue, anxiety, and depression). They were also assessed by a weekly sleep diary for sleep schedules. Finally, all participants underwent a Type III Sleep Study, to rule out obstructive sleep apnea. RESULTS From 195 enrolled participants (response rate 78%), 25 individuals (12.8%) met the criteria for CRSWD. The two most prevalent disorders were delayed sleep-wake phase disorder (DSWPD) (10pts, 5.1%) and shift work sleep disorder (SWD) (13, 6.7%). Less prevalent disorders included irregular sleep-wake rhythm disorder (ISWRD) (1, 0.5%) and advanced sleep-wake phase disorder (ASWPD) (1, 0.5%). CONCLUSIONS According to our data, CRSWDs are common in the general population of Cyprus, especially DSWPD and SWD. Affected individuals usually suffer from sleep deprivation and complain about insomnia, sleepiness and depression.
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Affiliation(s)
| | - Ivi Nicolaou
- Respiratory Department, Nicosia General Hospital, Nicosia, Cyprus
| | - Savvas Zannetos
- Health Economics and Statistics, Neapolis University, Paphos, Cyprus
| | - Nicholas-Tiberio Economou
- Division of Pulmonology, Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Alexandra Hospital, Athens, Greece
| | - Tonia Adamide
- Respiratory Department, Nicosia General Hospital, Nicosia, Cyprus
| | - Andreas Georgiou
- Respiratory Department, Nicosia General Hospital, Nicosia, Cyprus
| | | | - Thomas Rosemann
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Georgia Trakada
- Division of Pulmonology, Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Alexandra Hospital, Athens, Greece
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14
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Kudo N, Shinohara H, Kagabu S, Kodama H. Evaluation of salivary melatonin concentrations as a circadian phase maker of morning awakening and their association with depressive mood in postpartum mothers. Chronobiol Int 2021; 38:1409-1420. [PMID: 34100322 DOI: 10.1080/07420528.2021.1930028] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The disruption of circadian rhythm is closely related to mood disorders in night-shift workers, and a similar situation may occur in postpartum mothers. However, the situations of postpartum mothers remain largely unknown because of a lack of an appropriate circadian phase marker in the clinical setting. This study aimed to evaluate whether salivary melatonin concentration at awakening can identify misalignment between awakening time and the biological clock system, which might be associated with depressive mood in some mothers. Ninety-eight healthy mothers who were currently the primary parental caregivers were recruited at 1 month after delivery. All mothers completed the Edinburgh Postnatal Depression Scale (EPDS) and wore an actigraphy watch at home for 3 consecutive days to determine nocturnal sleep variables. While wearing the actigraphy watch, they also collected saliva samples during the awakening period for a melatonin concentration assay. The results indicated that daily salivary melatonin levels after 30 min of awakening (hereafter, melatonin levels) were positively correlated with sleep onset time and negatively correlated with sleep offset time and total sleep time. Six mothers with an EPDS score of ≥9 (the cutoff value for Japanese women at high risk for postnatal depression) had an average melatonin level of either <4 pg/ml or >16 pg/ml for 3 d. Mothers with melatonin levels <4 pg/ml or >16 pg/ml tended to have elevated EPDS scores (4.93 ± 2.95 or 4.20 ± 2.93, mean ± standard deviation) compared with mothers with melatonin levels between 4 and 16 pg/ml (3.00 ± 2.12, p = .053). Mothers whose melatonin levels were >16 pg/ml had relatively later sleep onset time and shorter nocturnal sleep duration. Backward stepwise regression demonstrated that such high/low levels of melatonin were a significant predictor of EPDS scores. These results suggest that elevated melatonin levels after 30 min of awakening could identify a phase-delayed circadian rhythm in postpartum mothers, and that relatively higher or lower melatonin levels could be associated with increased depressive mood.
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Affiliation(s)
- Naoko Kudo
- Department of Maternity Nursing, Akita University Graduate School of Medicine and Faculty of Medicine, School of Health Science, Akita-shi, Japan
| | - Hitomi Shinohara
- Department of Maternity Nursing, Akita University Graduate School of Medicine and Faculty of Medicine, School of Health Science, Akita-shi, Japan
| | | | - Hideya Kodama
- Department of Maternity Nursing, Akita University Graduate School of Medicine and Faculty of Medicine, School of Health Science, Akita-shi, Japan
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15
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Micic G, Lovato N, Ferguson SA, Burgess HJ, Lack L. Circadian tau differences and rhythm associations in delayed sleep-wake phase disorder and sighted non-24-hour sleep-wake rhythm disorder. Sleep 2021; 44:5867108. [PMID: 32619243 DOI: 10.1093/sleep/zsaa132] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 06/19/2020] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES We investigated biological and behavioral rhythm period lengths (i.e. taus) of delayed sleep-wake phase disorder (DSWPD) and non-24-hour sleep-wake rhythm disorder (N24SWD). Based on circadian phase timing (temperature and dim light melatonin onset), DSWPD participants were dichotomized into a circadian-delayed and a circadian non-delayed group to investigate etiological differences. METHODS Participants with DSWPD (n = 26, 17 m, age: 21.85 ± 4.97 years), full-sighted N24SWD (n = 4, 3 m, age: 25.75 ± 4.99 years) and 18 controls (10 m, age: 23.72 ± 5.10 years) participated in an 80-h modified constant routine. An ultradian protocol of 1-h "days" in dim light, controlled conditions alternated 20-min sleep/dark periods with 40-min enforced wakefulness/light. Subjective sleepiness ratings were recorded prior to every sleep/dark opportunity and median reaction time (vigilance) was measured hourly. Obtained sleep (sleep propensity) was derived from 20-min sleep/dark opportunities to quantify hourly objective sleepiness. Hourly core body temperature was recorded, and salivary melatonin assayed to measure endogenous circadian rhythms. Rhythm data were curved using the two-component cosine model. RESULTS Patients with DSWPD and N24SWD had significantly longer melatonin and temperature taus compared to controls. Circadian non-delayed DSWPD had normally timed temperature and melatonin rhythms but were typically sleeping at relatively late circadian phases compared to those with circadian-delayed DSWPD. CONCLUSIONS People with DSWPD and N24SWD exhibit significantly longer biological circadian rhythm period lengths compared to controls. Approximately half of those diagnosed with DSWPD do not have abnormally delayed circadian rhythm timings suggesting abnormal phase relationship between biological rhythms and behavioral sleep period or potentially conditioned sleep-onset insomnia.
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Affiliation(s)
- Gorica Micic
- Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia
| | - Nicole Lovato
- Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia
| | - Sally A Ferguson
- Appleton Institute, Central Queensland University, Adelaide, South Australia
| | - Helen J Burgess
- Sleep and Circadian Research Laboratory, Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan
| | - Leon Lack
- Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia.,College of Education, Psychology and Social Work, Flinders University, Bedford Park, South Australia
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16
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McGowan NM, Saunders KEA. The Emerging Circadian Phenotype of Borderline Personality Disorder: Mechanisms, Opportunities and Future Directions. Curr Psychiatry Rep 2021; 23:30. [PMID: 33835306 PMCID: PMC8035096 DOI: 10.1007/s11920-021-01236-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/23/2021] [Indexed: 01/22/2023]
Abstract
PURPOSE OF REVIEW We review the recent evidence suggesting that circadian rhythm disturbance is a common unaddressed feature of borderline personality disorder (BPD); amelioration of which may confer substantial clinical benefit. We assess chronobiological BPD studies from a mechanistic and translational perspective and highlight opportunities for the future development of this hypothesis. RECENT FINDINGS The emerging circadian phenotype of BPD is characterised by a preponderance of comorbid circadian rhythm sleep-wake disorders, phase delayed and misaligned rest-activity patterns and attenuated amplitudes of usually well-characterised circadian rhythms. Such disturbances may exacerbate symptom severity, and specific maladaptive personality dimensions may produce a liability towards extremes in chronotype. Pilot studies suggest intervention may be beneficial, but development is limited. Endogenous and exogenous circadian rhythm disturbances appear to be common in BPD. The interface between psychiatry and chronobiology has led previously to novel efficacious strategies for the treatment of psychiatric disorders. We believe that better characterisation of the circadian phenotype in BPD will lead to a directed biological target for treatment in a condition where there is a regrettable paucity of accessible therapies.
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Affiliation(s)
- Niall M McGowan
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK.
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK.
| | - Kate E A Saunders
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
- NIHR Oxford Health Biomedical Research Centre, Oxford, UK
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17
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Nishimon S, Nishino N, Nishino S. Advances in the pharmacological management of non-24-h sleep-wake disorder. Expert Opin Pharmacother 2021; 22:1039-1049. [PMID: 33618599 DOI: 10.1080/14656566.2021.1876665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Introduction: Melatonin, a hormone that regulates circadian rhythms and the sleep-wake cycle, is produced mainly during the dark period in the pineal gland and is suppressed by light exposure. Patients with non-24-h sleep-wake disorder (non-24) fail to entrain the master clock with the 24-h light-dark cycle due to the lack of light perception to the suprachiasmatic nucleus typically in totally blind individuals or other organic disorders in sighted individuals, causing a progressive delay in the sleep-wake cycle and periodic insomnia and daytime sleepiness.Areas covered: Herein, the authors review the pharmacological therapies including exogenous melatonin and melatonin receptor agonists for the management of non-24. They introduce a historical report about the effects of melatonin on the phase shift and entrainment for blind individuals with the free-running circadian rhythm.Expert opinion: Orally administered melatonin entrains the endogenous circadian rhythm and improves nighttime sleep and daytime alertness for non-24. Currently, tasimelteon is the only approved medication for non-24 by the US Food and Drug Administration and the European Medicines Agency. Treatments that focus only on sleep problems are insufficient for the treatment of non-24, and aids to entrain the free-running rhythm with the light-dark cycle are needed.
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Affiliation(s)
- Shohei Nishimon
- Sleep and Circadian Neurobiology Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, USA.,Department of Psychiatry and Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Naoya Nishino
- Sleep and Circadian Neurobiology Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, USA
| | - Seiji Nishino
- Sleep and Circadian Neurobiology Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, USA
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18
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Abstract
The circadian clock coordinates daily rhythmicity of biochemical, physiologic, and behavioral functions in humans. Gene expression, cell division, and DNA repair are modulated by the clock, which gives rise to the hypothesis that clock dysfunction may predispose individuals to cancer. Although the results of many epidemiologic and animal studies are consistent with there being a role for the clock in the genesis and progression of tumors, available data are insufficient to conclude that clock disruption is generally carcinogenic. Similarly, studies have suggested a circadian time-dependent efficacy of chemotherapy, but clinical trials of chronochemotherapy have not demonstrated improved outcomes compared with conventional regimens. Future hypothesis-driven and discovery-oriented research should focus on specific interactions between clock components and carcinogenic mechanisms to realize the full clinical potential of the relationship between clocks and cancer.
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Affiliation(s)
- Aziz Sancar
- Department of Biochemistry and Biophysics, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA.
| | - Russell N Van Gelder
- Departments of Ophthalmology, Biological Structure, and Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA 98104, USA.
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19
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Kim J. Networks and near-field communication: up-close but far away. Digit Health 2021. [DOI: 10.1016/b978-0-12-818914-6.00019-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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20
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Han S, Kim J, Won SM, Ma Y, Kang D, Xie Z, Lee KT, Chung HU, Banks A, Min S, Heo SY, Davies CR, Lee JW, Lee CH, Kim BH, Li K, Zhou Y, Wei C, Feng X, Huang Y, Rogers JA. Battery-free, wireless sensors for full-body pressure and temperature mapping. Sci Transl Med 2019; 10:10/435/eaan4950. [PMID: 29618561 DOI: 10.1126/scitranslmed.aan4950] [Citation(s) in RCA: 129] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 02/13/2018] [Indexed: 01/13/2023]
Abstract
Thin, soft, skin-like sensors capable of precise, continuous measurements of physiological health have broad potential relevance to clinical health care. Use of sensors distributed over a wide area for full-body, spatiotemporal mapping of physiological processes would be a considerable advance for this field. We introduce materials, device designs, wireless power delivery and communication strategies, and overall system architectures for skin-like, battery-free sensors of temperature and pressure that can be used across the entire body. Combined experimental and theoretical investigations of the sensor operation and the modes for wireless addressing define the key features of these systems. Studies with human subjects in clinical sleep laboratories and in adjustable hospital beds demonstrate functionality of the sensors, with potential implications for monitoring of circadian cycles and mitigating risks for pressure-induced skin ulcers.
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Affiliation(s)
- Seungyong Han
- Department of Materials Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.,Department of Mechanical Engineering, Ajou University, San 5, Woncheon-Dong, Yeongtong-Gu, Suwon 16499, Republic of Korea
| | - Jeonghyun Kim
- Department of Materials Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.,Department of Electronics Convergence Engineering, Kwangwoon University, Seoul, Republic of Korea
| | - Sang Min Won
- Department of Materials Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Yinji Ma
- Applied Mechanics Laboratory, Department of Engineering Mechanics, Center for Mechanics and Materials, Tsinghua University, Beijing 100084, China.,Department of Civil and Environmental Engineering, Mechanical Engineering, and Materials Science and Engineering, Northwestern University, Evanston, IL 60208, USA
| | - Daeshik Kang
- Department of Mechanical Engineering, Ajou University, San 5, Woncheon-Dong, Yeongtong-Gu, Suwon 16499, Republic of Korea
| | - Zhaoqian Xie
- Applied Mechanics Laboratory, Department of Engineering Mechanics, Center for Mechanics and Materials, Tsinghua University, Beijing 100084, China.,Department of Civil and Environmental Engineering, Mechanical Engineering, and Materials Science and Engineering, Northwestern University, Evanston, IL 60208, USA
| | - Kyu-Tae Lee
- Department of Materials Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Ha Uk Chung
- Departments of Materials Science and Engineering, Biomedical Engineering, Neurological Surgery, Chemistry, Mechanical Engineering, Electrical Engineering and Computer Science; Center for Bio-Integrated Electronics; Simpson Querrey Institute for Nano/Biotechnology; Northwestern University, Evanston, IL 60208, USA
| | - Anthony Banks
- Department of Materials Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Seunghwan Min
- Department of Materials Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Seung Yun Heo
- Departments of Materials Science and Engineering, Biomedical Engineering, Neurological Surgery, Chemistry, Mechanical Engineering, Electrical Engineering and Computer Science; Center for Bio-Integrated Electronics; Simpson Querrey Institute for Nano/Biotechnology; Northwestern University, Evanston, IL 60208, USA
| | - Charles R Davies
- Neurology and Sleep Medicine Carle Physician Group, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Jung Woo Lee
- Department of Materials Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.,School of Materials Science and Engineering, Pusan National University, Busan 609-735, Republic of Korea
| | - Chi-Hwan Lee
- Weldon School of Biomedical Engineering, School of Mechanical Engineering, Center for Implantable Devices, Birck Nanotechnology Center, Purdue University, West Lafayette, IN 47907, USA
| | - Bong Hoon Kim
- Departments of Materials Science and Engineering, Biomedical Engineering, Neurological Surgery, Chemistry, Mechanical Engineering, Electrical Engineering and Computer Science; Center for Bio-Integrated Electronics; Simpson Querrey Institute for Nano/Biotechnology; Northwestern University, Evanston, IL 60208, USA
| | - Kan Li
- Department of Civil and Environmental Engineering, Mechanical Engineering, and Materials Science and Engineering, Northwestern University, Evanston, IL 60208, USA
| | - Yadong Zhou
- Department of Civil and Environmental Engineering, Mechanical Engineering, and Materials Science and Engineering, Northwestern University, Evanston, IL 60208, USA.,Department of Engineering Mechanics, Southeast University, Nanjing 210096, China
| | - Chen Wei
- Department of Civil and Environmental Engineering, Mechanical Engineering, and Materials Science and Engineering, Northwestern University, Evanston, IL 60208, USA
| | - Xue Feng
- Applied Mechanics Laboratory, Department of Engineering Mechanics, Center for Mechanics and Materials, Tsinghua University, Beijing 100084, China
| | - Yonggang Huang
- Department of Civil and Environmental Engineering, Mechanical Engineering, and Materials Science and Engineering, Northwestern University, Evanston, IL 60208, USA.
| | - John A Rogers
- Department of Materials Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA. .,Departments of Materials Science and Engineering, Biomedical Engineering, Neurological Surgery, Chemistry, Mechanical Engineering, Electrical Engineering and Computer Science; Center for Bio-Integrated Electronics; Simpson Querrey Institute for Nano/Biotechnology; Northwestern University, Evanston, IL 60208, USA
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21
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Nishimon S, Nishimon M, Nishino S. Tasimelteon for treating non-24-h sleep-wake rhythm disorder. Expert Opin Pharmacother 2019; 20:1065-1073. [DOI: 10.1080/14656566.2019.1603293] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Shohei Nishimon
- Sleep and Circadian Neurobiology Laboratory, Psychiatry and Behavior Sciences, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Mari Nishimon
- Sleep and Circadian Neurobiology Laboratory, Psychiatry and Behavior Sciences, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Seiji Nishino
- Sleep and Circadian Neurobiology Laboratory, Psychiatry and Behavior Sciences, Stanford University School of Medicine, Palo Alto, CA, USA
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22
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Kim SH, Goh S, Han K, Kim JW, Choi M. Numerical study of entrainment of the human circadian system and recovery by light treatment. Theor Biol Med Model 2018; 15:5. [PMID: 29743086 PMCID: PMC5944165 DOI: 10.1186/s12976-018-0077-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 04/23/2018] [Indexed: 11/26/2022] Open
Abstract
Background While the effects of light as a zeitgeber are well known, the way the effects are modulated by features of the sleep-wake system still remains to be studied in detail. Methods A mathematical model for disturbance and recovery of the human circadian system is presented. The model combines a circadian oscillator and a sleep-wake switch that includes the effects of orexin. By means of simulations, we characterize the period-locking zone of the model, where a stable 24-hour circadian rhythm exists, and the occurrence of circadian disruption due to both insufficient light and imbalance in orexin. We also investigate how daily bright light treatments of short duration can recover the normal circadian rhythm. Results It is found that the system exhibits continuous phase advance/delay at lower/higher orexin levels. Bright light treatment simulations disclose two optimal time windows, corresponding to morning and evening light treatments. Among the two, the morning light treatment is found effective in a wider range of parameter values, with shorter recovery time. Conclusions This approach offers a systematic way to determine the conditions under which circadian disruption occurs, and to evaluate the effects of light treatment. In particular, it could potentially offer a way to optimize light treatments for patients with circadian disruption, e.g., sleep and mood disorders, in clinical settings.
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Affiliation(s)
- Soon Ho Kim
- Department of Physics and Center for Theoretical Physics, Seoul National University, Gwanak-ro 1, Seoul, 08826, Korea
| | - Segun Goh
- Institut für Theoretische Physik II - Soft Matter, Heinrich-Heine- Universität Düsseldorf, Düsseldorf, D-40225, Germany
| | - Kyungreem Han
- Laboratory of Computational Biology, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, 20892, USA
| | - Jong Won Kim
- Department of Healthcare Information Technology, Inje University, Gimhae, 50834, Korea.
| | - MooYoung Choi
- Department of Physics and Center for Theoretical Physics, Seoul National University, Gwanak-ro 1, Seoul, 08826, Korea
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23
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Omori Y, Kanbayashi T, Sagawa Y, Imanishi A, Tsutsui K, Takahashi Y, Takeshima M, Takaki M, Nishino S, Shimizu T. Low dose of aripiprazole advanced sleep rhythm and reduced nocturnal sleep time in the patients with delayed sleep phase syndrome: an open-labeled clinical observation. Neuropsychiatr Dis Treat 2018; 14:1281-1286. [PMID: 29849459 PMCID: PMC5965391 DOI: 10.2147/ndt.s158865] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Delayed sleep phase syndrome (DSPS) is a chronic dysfunction of circadian rhythm of the subject that impairs functioning in social, occupational, or other spheres. High rate of depression is found among DSPS patients. Aripiprazole (APZ), a second-generation antipsychotic, is effective in treatment of depression as well as schizophrenia. Recently, few case reports show the effectiveness of APZ in treating DSPS and non-24-hour sleep-wake rhythm disorder. Therefore, we tried to treat DSPS with depression using APZ. METHODS Twelve subjects (including four women) aged 19-64 years were included. The subjects were prescribed initially 0.5-3 mg of APZ once a day with subsequent dose adjustments. RESULTS Sleep onset, midpoint of sleep, and sleep offset were significantly advanced by 1.1, 1.8, and 2.5 hours, respectively. Unexpectedly, sleep duration became significantly shorter by 1.3 hours after treatment. Their depressive moods showed an unremarkable change. CONCLUSION Low dose of APZ advanced the sleep rhythm and reduced nocturnal sleep time in the subjects with DSPS. Since it is not easy for physicians to treat prolonged sleep duration often associated with DSPS, this medication would become a new therapeutic option for these patients.
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Affiliation(s)
- Yuki Omori
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
| | - Takashi Kanbayashi
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan.,International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
| | - Yohei Sagawa
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
| | - Aya Imanishi
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
| | - Ko Tsutsui
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
| | - Yuya Takahashi
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
| | - Masahiro Takeshima
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
| | - Manabu Takaki
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Seiji Nishino
- Department of Psychiatry and Behavioral Sciences, Sleep and Circadian Neurobiology Laboratory & Center for Narcolepsy, Stanford University School of Medicine, Stanford, CA, USA
| | - Tetsuo Shimizu
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan.,International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
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24
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Hida A, Ohsawa Y, Kitamura S, Nakazaki K, Ayabe N, Motomura Y, Matsui K, Kobayashi M, Usui A, Inoue Y, Kusanagi H, Kamei Y, Mishima K. Evaluation of circadian phenotypes utilizing fibroblasts from patients with circadian rhythm sleep disorders. Transl Psychiatry 2017; 7:e1106. [PMID: 28440811 PMCID: PMC5416712 DOI: 10.1038/tp.2017.75] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Revised: 02/12/2017] [Accepted: 03/08/2017] [Indexed: 12/11/2022] Open
Abstract
We evaluated the circadian phenotypes of patients with delayed sleep-wake phase disorder (DSWPD) and non-24-hour sleep-wake rhythm disorder (N24SWD), two different circadian rhythm sleep disorders (CRSDs) by measuring clock gene expression rhythms in fibroblast cells derived from individual patients. Bmal1-luciferase (Bmal1-luc) expression rhythms were measured in the primary fibroblast cells derived from skin biopsy samples of patients with DSWPD and N24SWD, as well as control subjects. The period length of the Bmal1-luc rhythm (in vitro period) was distributed normally and was 22.80±0.47 (mean±s.d.) h in control-derived fibroblasts. The in vitro periods in DSWPD-derived fibroblasts and N24SWD-derived fibroblasts were 22.67±0.67 h and 23.18±0.70 h, respectively. The N24SWD group showed a significantly longer in vitro period than did the control or DSWPD group. Furthermore, in vitro period was associated with response to chronotherapy in the N24SWD group. Longer in vitro periods were observed in the non-responders (mean±s.d.: 23.59±0.89 h) compared with the responders (mean±s.d.: 22.97±0.47 h) in the N24SWD group. Our results indicate that prolonged circadian periods contribute to the onset and poor treatment outcome of N24SWD. In vitro rhythm assays could be useful for predicting circadian phenotypes and clinical prognosis in patients with CRSDs.
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Affiliation(s)
- A Hida
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Y Ohsawa
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - S Kitamura
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - K Nakazaki
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - N Ayabe
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Y Motomura
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - K Matsui
- Yoyogi Sleep Disorder Center, Tokyo, Japan
| | - M Kobayashi
- Yoyogi Sleep Disorder Center, Tokyo, Japan
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
| | - A Usui
- Yoyogi Sleep Disorder Center, Tokyo, Japan
| | - Y Inoue
- Yoyogi Sleep Disorder Center, Tokyo, Japan
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
| | - H Kusanagi
- Department of Neuropsychiatry, Bioregulatory Medicine, Akita University, Graduate School of Medicine, Akita, Japan
| | - Y Kamei
- Department of Laboratory Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - K Mishima
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
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25
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Micic G, Lovato N, Gradisar M, Lack LC. Personality differences in patients with delayed sleep–wake phase disorder and non-24-h sleep–wake rhythm disorder relative to healthy sleepers. Sleep Med 2017; 30:128-135. [DOI: 10.1016/j.sleep.2016.04.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 03/31/2016] [Accepted: 04/04/2016] [Indexed: 10/21/2022]
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26
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Adams RJ, Appleton SL, Taylor AW, Gill TK, Lang C, McEvoy RD, Antic NA. Sleep health of Australian adults in 2016: results of the 2016 Sleep Health Foundation national survey. Sleep Health 2017; 3:35-42. [DOI: 10.1016/j.sleh.2016.11.005] [Citation(s) in RCA: 159] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 10/06/2016] [Accepted: 11/15/2016] [Indexed: 11/29/2022]
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27
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Keijzer H, Snitselaar MA, Smits MG, Spruyt K, Zee PC, Ehrhart F, Curfs LM. Precision medicine in circadian rhythm sleep-wake disorders: current state and future perspectives. Per Med 2017; 14:171-182. [PMID: 29754559 DOI: 10.2217/pme-2016-0079] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
In circadian rhythm sleep-wake disorders precision medicine is less developed than in other medical disciplines mainly because homeostatic sleep and circadian timing have a very complex phenotype with multiple genetic regulation mechanisms. However, biomarkers, phenotyping and psychosocial characteristics are increasingly used. Devices for polysomnography, actigraphy and sleep-tracking applications in mobile phones and other consumer devices with eHealth technologies are increasingly used. Also sleep-related questionnaires and the assessment of co-morbidities influencing sleep in circadian rhythm sleep-wake disorders are major contributors to precision sleep medicine. To further strengthen the (pharmaco-)genetic and biomarker pillar, technology needs to be evolved further. Routinely measuring treatment results using patient-reported outcome measures and clinical neurophysiological instruments will boost precision sleep medicine.
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Affiliation(s)
- Henry Keijzer
- Governor Kremers Centre, University Maastricht, Maastricht, The Netherlands.,Department of Clinical Chemistry & Hematology, Rijnstate Hospital, Arnhem, The Netherlands
| | - Mark A Snitselaar
- Centre for Sleep-Wake Disturbances & Chronobiology, Gelderse Vallei Hospital, Ede, The Netherlands.,Pro Persona Mental Health Care, Ede, The Netherlands
| | - Marcel G Smits
- Governor Kremers Centre, University Maastricht, Maastricht, The Netherlands.,Centre for Sleep-Wake Disturbances & Chronobiology, Gelderse Vallei Hospital, Ede, The Netherlands
| | - Karen Spruyt
- Rett Expertise Centre, University Maastricht, Maastricht, The Netherlands.,Faculty of Psychology & Educational Sciences, Vrije Universiteit Brussel, Belgium.,Department of Developmental & Behavioral Pediatrics, Shanghai Children's Medical Centre affiliated with Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Phyllis C Zee
- Center for Circadian & Sleep Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Friederike Ehrhart
- Governor Kremers Centre, University Maastricht, Maastricht, The Netherlands.,Rett Expertise Centre, University Maastricht, Maastricht, The Netherlands.,Department of Bioinformatics, Maastricht University, Maastricht, The Netherlands
| | - Leopold Mg Curfs
- Governor Kremers Centre, University Maastricht, Maastricht, The Netherlands.,Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, The Netherlands
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28
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Aubin S, Kupers R, Ptito M, Jennum P. Melatonin and cortisol profiles in the absence of light perception. Behav Brain Res 2017; 317:515-521. [DOI: 10.1016/j.bbr.2016.09.060] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 09/18/2016] [Accepted: 09/22/2016] [Indexed: 11/28/2022]
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29
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Tamura N, Sasai-Sakuma T, Morita Y, Okawa M, Inoue S, Inoue Y. A Nationwide Cross-Sectional Survey of Sleep-Related Problems in Japanese Visually Impaired Patients: Prevalence and Association with Health-Related Quality of Life. J Clin Sleep Med 2016; 12:1659-1667. [PMID: 27655465 DOI: 10.5664/jcsm.6354] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 08/08/2016] [Indexed: 01/31/2023]
Abstract
STUDY OBJECTIVES This questionnaire-based cross-sectional study was conducted (1) to estimate the prevalence of sleep-related problems, and (2) to explore factors associated with lower physical/mental quality of life (QOL), particularly addressing sleep-related problems among Japanese visually impaired people. METHODS This nationwide questionnaire-based survey was administered to visually impaired individuals through the Japan Federation of the Blind. Visually impaired individuals without light perception (LP) (n = 311), those with LP (n = 287), and age-matched and gender-matched controls (n = 615) were eligible for this study. Study questionnaires elicited demographic information, and information about visual impairment status, sleep-related problems, and health-related quality of life. RESULTS Visually impaired individuals with and without LP showed higher prevalence rates of irregular sleep-wake patterns and difficulty maintaining sleep than controls (34.7% and 29.4% vs. 15.8%, 60.1% and 46.7% vs. 26.8%, respectively; p < 0.001). These sleep-related problems were observed more frequently in visually impaired individuals without LP than in those with LP. Non-restorative sleep or excessive daytime sleepiness was associated with lower mental/physical QOL in visually impaired individuals with LP and in control subjects. However, visually impaired individuals without LP showed irregular sleep-wake pattern or difficulty waking up at the desired time, which was associated with lower mental/physical QOL. CONCLUSIONS Sleep-related problems were observed more frequently in visually impaired individuals than in controls. Moreover, the rates of difficulties were higher among subjects without LP. Sleep-related problems, especially circadian rhythm-related ones, can be associated with lower mental/physical QOL in visually impaired individuals without LP.
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Affiliation(s)
- Norihisa Tamura
- Department of Somnology, Tokyo Medical University, Tokyo, Japan.,Yoyogi Sleep Disorder Center, Tokyo, Japan
| | - Taeko Sasai-Sakuma
- Department of Somnology, Tokyo Medical University, Tokyo, Japan.,Department of Life Sciences and Bio-informatics, Division of Biomedical Laboratory Sciences, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuko Morita
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
| | - Masako Okawa
- Department of Somnology, Tokyo Medical University, Tokyo, Japan.,Yoyogi Sleep Disorder Center, Tokyo, Japan.,Japan Foundation for Neuroscience and Mental Health, Tokyo, Japan
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Japan
| | - Yuichi Inoue
- Department of Somnology, Tokyo Medical University, Tokyo, Japan.,Yoyogi Sleep Disorder Center, Tokyo, Japan.,Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
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30
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Aubin S, Gacon C, Jennum P, Ptito M, Kupers R. Altered sleep–wake patterns in blindness: a combined actigraphy and psychometric study. Sleep Med 2016; 24:100-108. [DOI: 10.1016/j.sleep.2016.07.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Revised: 07/17/2016] [Accepted: 07/18/2016] [Indexed: 10/21/2022]
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31
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Paprocka J, Kijonka M, Pęcka M, Sokół M. Melatonin in Epilepsy: A New Mathematical Model of Diurnal Secretion. Int J Endocrinol 2016; 2016:3861461. [PMID: 27478439 PMCID: PMC4961834 DOI: 10.1155/2016/3861461] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 06/05/2016] [Accepted: 06/13/2016] [Indexed: 02/07/2023] Open
Abstract
Purpose. The main objective of the study was to create a mathematical model that describes the melatonin circadian secretion and, then the functionality of the model was tested by a comparison of the melatonin secretions in children with and without epilepsy. Material and Methods. The patients were divided into the epilepsy group (EG, n = 52) and the comparison group (CG, n = 30). The melatonin level was assessed by a radioimmunoassay method. The diurnal melatonin secretion was described using a nonlinear least squares method. Spearman's rank correlation coefficient was chosen to estimate the dependence of the acquired data. The model reproduces blood concentration profiles and its parameters were statistically analyzed using the Mann-Whitney-Wilcoxon test and logistic regression. Results. The correlation analysis performed for the EG and CG groups showed moderate correlations between age and the melatonin secretion model parameters. Patients with epilepsy are characterized by an increased phase shift of melatonin release.
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Affiliation(s)
- Justyna Paprocka
- Department of Paediatrics and Developmental Age Neurology, School of Medicine in Katowice, Medical University of Silesia, Ulica Medyków 16, 40-752 Katowice, Poland
- *Justyna Paprocka:
| | - Marek Kijonka
- Department of Medical Physics, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Ulica Wybrzeże Armii Krajowej 15, 44-101 Gliwice, Poland
| | - Marcin Pęcka
- Faculty of Automatic Control, Electronics and Computer Science Biomedical Engineering, Silesian University of Technology, Ulica Akademicka 2A, 44-100 Gliwice, Poland
| | - Maria Sokół
- Department of Medical Physics, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Ulica Wybrzeże Armii Krajowej 15, 44-101 Gliwice, Poland
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32
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Uchiyama M, Lockley SW. Non–24-Hour Sleep–Wake Rhythm Disorder in Sighted and Blind Patients. Sleep Med Clin 2015; 10:495-516. [DOI: 10.1016/j.jsmc.2015.07.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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33
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Pace-Schott EF, Rubin ZS, Tracy LE, Spencer RM, Orr SP, Verga PW. Emotional trait and memory associates of sleep timing and quality. Psychiatry Res 2015; 229:999-1010. [PMID: 26257092 PMCID: PMC4568156 DOI: 10.1016/j.psychres.2015.05.069] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 05/07/2015] [Accepted: 05/20/2015] [Indexed: 10/23/2022]
Abstract
Poor ability to remember the extinction of conditioned fear, elevated trait anxiety, and delayed or disrupted nocturnal sleep are reported in anxiety disorders. The current study examines the interrelationship of these factors in healthy young-adult males. Skin-conductance response was conditioned to two differently colored lamps. One color but not the other was then extinguished. After varying delays, both colors were presented to determine extinction recall and generalization. Questionnaires measured sleep quality, morningness-eveningness, neuroticism and trait anxiety. A subset produced a mean 7.0 nights of actigraphy and sleep diaries. Median split of mean sleep midpoint defined early- and late-"sleep timers". Extinction was more rapidly learned in the morning than evening only in early timers who also better generalized extinction recall. Extinction recall was greater with higher sleep efficiency. Sleep efficiency and morningness were negatively associated with neuroticism and anxiety. However, neuroticism and anxiety did not predict extinction learning, recall or generalization. Therefore, neuroticism/anxiety and deficient fear extinction, although both associated with poor quality and late timing of sleep, are not directly associated with each other. Elevated trait anxiety, in addition to predisposing directly to anxiety disorders, may thus also indirectly promote such disorders by impairing sleep and, consequently, extinction memory.
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Affiliation(s)
- Edward F. Pace-Schott
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA,Corresponding Author: Edward F. Pace-Schott, Ph.D.. Harvard Medical School, Massachusetts General Hospital – East. CNY 149 13th Street Room 2510, Charlestown, MA 02129. Phone: 508-523-4288. Fax: 617-726-4078,
| | - Zoe S. Rubin
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Lauren E. Tracy
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | | | - Scott P. Orr
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Patrick W. Verga
- Department of Psychology, University of Massachusetts, Amherst, MA, USA
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34
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Circadian Modulation of 8-Oxoguanine DNA Damage Repair. Sci Rep 2015; 5:13752. [PMID: 26337123 PMCID: PMC4559719 DOI: 10.1038/srep13752] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 08/04/2015] [Indexed: 11/08/2022] Open
Abstract
The DNA base excision repair pathway is the main system involved in the removal of oxidative damage to DNA such as 8-Oxoguanine (8-oxoG) primarily via the 8-Oxoguanine DNA glycosylase (OGG1). Our goal was to investigate whether the repair of 8-oxoG DNA damage follow a circadian rhythm. In a group of 15 healthy volunteers, we found a daily variation of Ogg1 expression and activity with higher levels in the morning compared to the evening hours. Consistent with this, we also found lower levels of 8-oxoG in morning hours compared to those in the evening hours. Lymphocytes exposed to oxidative damage to DNA at 8:00 AM display lower accumulation of 8-oxoG than lymphocytes exposed at 8:00 PM. Furthermore, altered levels of Ogg1 expression were also observed in a group of shift workers experiencing a deregulation of circadian clock genes compared to a control group. Moreover, BMAL1 knockdown fibroblasts with a deregulated molecular clock showed an abolishment of circadian variation of Ogg1 expression and an increase of OGG1 activity. Our results suggest that the circadian modulation of 8-oxoG DNA damage repair, according to a variation of Ogg1 expression, could render humans less susceptible to accumulate 8-oxoG DNA damage in the morning hours.
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35
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Micic G, Lovato N, Gradisar M, Ferguson SA, Burgess HJ, Lack LC. The etiology of delayed sleep phase disorder. Sleep Med Rev 2015; 27:29-38. [PMID: 26434674 DOI: 10.1016/j.smrv.2015.06.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 05/14/2015] [Accepted: 06/23/2015] [Indexed: 12/27/2022]
Abstract
According to classification manuals for sleep disorders, nine disorders are directly related to biological clock timing misalignments. Of all, delayed sleep phase disorder (DSPD) is the most commonly diagnosed, predominantly affecting adolescents, young adults, and insomnia patients. It is a persistent inability to fall asleep at earlier, more desirable and socially conventional times, coupled with extreme difficulty awakening in the morning. Considerable evidence shows a delay in the circadian clock to be associated with DSPD. Therefore, treatments have mainly focused on advancing the biological clock and sleep timing through pharmacotherapy, phototherapy and behavioral therapies. The clinical evidence indicates that these treatments are efficacious, at least in the short term. However, follow up studies show frequent patient relapse, leading researchers to speculate that alternative etiologies may be contributing to sleep and circadian clock delays in DSPD. The aim of the present paper is to review and collate current literature related to DSPD etiology in order to outline gaps in current knowledge and suggest future research.
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Affiliation(s)
- Gorica Micic
- Flinders University of South Australia, Australia.
| | | | | | | | | | - Leon C Lack
- Flinders University of South Australia, Australia
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36
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Sletten TL, Segal AY, Flynn-Evans EE, Lockley SW, Rajaratnam SMW. Inter-Individual Differences in Neurobehavioural Impairment following Sleep Restriction Are Associated with Circadian Rhythm Phase. PLoS One 2015; 10:e0128273. [PMID: 26043207 PMCID: PMC4456409 DOI: 10.1371/journal.pone.0128273] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 04/23/2015] [Indexed: 11/18/2022] Open
Abstract
Although sleep restriction is associated with decrements in daytime alertness and neurobehavioural performance, there are considerable inter-individual differences in the degree of impairment. This study examined the effects of short-term sleep restriction on neurobehavioural performance and sleepiness, and the associations between individual differences in impairments and circadian rhythm phase. Healthy adults (n = 43; 22 M) aged 22.5 ± 3.1 (mean ± SD) years maintained a regular 8:16 h sleep:wake routine for at least three weeks prior to laboratory admission. Sleep opportunity was restricted to 5 hours time-in-bed at home the night before admission and 3 hours time-in-bed in the laboratory, aligned by wake time. Hourly saliva samples were collected from 5.5 h before until 5 h after the pre-laboratory scheduled bedtime to assess dim light melatonin onset (DLMO) as a marker of circadian phase. Participants completed a 10-min auditory Psychomotor Vigilance Task (PVT), the Karolinska Sleepiness Scale (KSS) and had slow eye movements (SEM) measured by electrooculography two hours after waking. We observed substantial inter-individual variability in neurobehavioural performance, particularly in the number of PVT lapses. Increased PVT lapses (r = -0.468, p < 0.01), greater sleepiness (r = 0.510, p < 0.0001), and more slow eye movements (r = 0.375, p = 0.022) were significantly associated with later DLMO, consistent with participants waking at an earlier circadian phase. When the difference between DLMO and sleep onset was less than 2 hours, individuals were significantly more likely to have at least three attentional lapses the following morning. This study demonstrates that the phase of an individual’s circadian system is an important variable in predicting the degree of neurobehavioural performance impairment in the hours after waking following sleep restriction, and confirms that other factors influencing performance decrements require further investigation.
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Affiliation(s)
- Tracey L. Sletten
- Sleep and Circadian Medicine Laboratory, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- * E-mail:
| | - Ahuva Y. Segal
- Sleep and Circadian Medicine Laboratory, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Erin E. Flynn-Evans
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Steven W. Lockley
- Sleep and Circadian Medicine Laboratory, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Shantha M. W. Rajaratnam
- Sleep and Circadian Medicine Laboratory, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
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37
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Abstract
Delayed sleep phase syndrome (DSPS) comprises a persistent or recurrent pattern of sleep disturbances, sleep disruption that leads to insomnia and/or excessive daytime sleepiness, and impaired functioning in social, occupational, or other spheres. Aripiprazole (APZ), a second-generation antipsychotic, manifests a novel mechanism of action by serving as a partial agonist of both D2 and serotonergic 5-HT1A receptors and antagonist of 5-HT2A receptors. We have used APZ to treat DSPS. One reason it was effective may be that the insomnia induced by daytime APZ was effective in treating the patient's daytime sleepiness. Another reason may be APZ increases histamine release which controls sleep-wake cycles. Thus, APZ may be therapeutic for DSPS.
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38
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Difficult morning awakening from rapid eye movement sleep and impaired cognitive function in delayed sleep phase disorder patients. Sleep Med 2014; 15:1264-8. [DOI: 10.1016/j.sleep.2014.05.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 04/18/2014] [Accepted: 05/29/2014] [Indexed: 11/23/2022]
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39
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Hida A, Kitamura S, Katayose Y, Kato M, Ono H, Kadotani H, Uchiyama M, Ebisawa T, Inoue Y, Kamei Y, Okawa M, Takahashi K, Mishima K. Screening of clock gene polymorphisms demonstrates association of a PER3 polymorphism with morningness-eveningness preference and circadian rhythm sleep disorder. Sci Rep 2014; 4:6309. [PMID: 25201053 PMCID: PMC4158573 DOI: 10.1038/srep06309] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 08/19/2014] [Indexed: 01/01/2023] Open
Abstract
A system of self-sustained biological clocks controls the 24-h rhythms of behavioral and physiological processes such as the sleep-wake cycle. The circadian clock system is regulated by transcriptional and translational negative feedback loops of multiple clock genes. Polymorphisms in circadian clock genes have been associated with morningness-eveningness (diurnal) preference, familial advanced sleep phase type (ASPT), and delayed sleep phase type (DSPT). We genotyped single-nucleotide polymorphisms in circadian clock genes in 182 DSPT individuals, 67 free-running type (FRT) individuals, and 925 controls. The clock gene polymorphisms were tested for associations with diurnal preference and circadian rhythm sleep disorder (CRSD) phenotypes. The PER3 polymorphism (rs228697) was significantly associated with diurnal preference and the FRT phenotype. The minor allele of rs228697 was more prevalent in evening types than in morning types (sex-adjusted odds ratio (OR), 2.483, Bonferroni-corrected P = 0.012) and in FRT individuals compared with the controls (age- and sex-adjusted OR, 2.021, permutated P = 0.017). Our findings support the notion that PER3 polymorphisms could be a potential genetic marker for an individual's circadian and sleep phenotypes.
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Affiliation(s)
- Akiko Hida
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo 187-8553, Japan
| | - Shingo Kitamura
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo 187-8553, Japan
| | - Yasuko Katayose
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo 187-8553, Japan
| | - Mie Kato
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo 187-8553, Japan
| | - Hiroko Ono
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo 187-8553, Japan
| | - Hiroshi Kadotani
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Makoto Uchiyama
- Department of Psychiatry, Nihon University School of Medicine, Itabashi, Tokyo 173-8610, Japan
| | - Takashi Ebisawa
- Department of Psychiatry, Tokyo Metropolitan Police Hospital, Nakano, Tokyo 164-8541, Japan
| | - Yuichi Inoue
- Department of Somnology, Tokyo Medical University, Shinjuku, Tokyo 160-8402, Japan
- Yoyogi Sleep Disorder Center, Shibuya, Tokyo 151-0053, Japan
| | - Yuichi Kamei
- Department of Laboratory Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo 187-8551, Japan
| | - Masako Okawa
- Japan Foundation for Neuroscience and Mental Health, Kodaira, Tokyo 187-8551, Japan
| | - Kiyohisa Takahashi
- Japan Foundation for Neuroscience and Mental Health, Kodaira, Tokyo 187-8551, Japan
| | - Kazuo Mishima
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo 187-8553, Japan
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40
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Bonacci JM, Venci JV, Gandhi MA. Tasimelteon (Hetlioz™): A New Melatonin Receptor Agonist for the Treatment of Non-24-Hour Sleep-Wake Disorder. J Pharm Pract 2014; 28:473-8. [PMID: 25092604 DOI: 10.1177/0897190014544792] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In January 2014, the US Food and Drug Administration approved tasimelteon (Hetlioz™), a melatonin-receptor agonist for the treatment of non-24-hour sleep-wake disorder. This article provides an overview of the mechanism of action, pharmacokinetic properties, as well as the clinical efficacy, safety, and tolerability of tasimelteon. Relevant information was identified through a comprehensive literature search of several databases using the key words tasimelteon, Non-24-hour Sleep-Wake disorder, Non-24, and melatonin. Further information was obtained from the tasimelteon package insert, fda.gov, clinicaltrials.gov, briefing materials provided by Vanda Pharmaceuticals, and posters from scientific meetings.
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Affiliation(s)
- Janene M Bonacci
- St John Fisher College Wegmans School of Pharmacy, Rochester, NY, USA
| | - Jineane V Venci
- Center for Primary Care, University of Rochester Medical Center, Rochester, NY, USA
| | - Mona A Gandhi
- St John Fisher College Wegmans School of Pharmacy, Rochester, NY, USA
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Yanagihara M, Nakamura M, Usui A, Nishida S, Ito E, Okawa M, Inoue Y. The Melatonin Receptor Agonist Is Effective for Free-Running Type Circadian Rhythm Sleep Disorder: Case Report on Two Sighted Patients. TOHOKU J EXP MED 2014; 234:123-8. [DOI: 10.1620/tjem.234.123] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Mariko Yanagihara
- Japan Somnology Center, Neuropsychiatric Research Institute
- Yoyogi Sleep Disorder Center
- First Department of Internal Medicine, Tokyo Medical University
| | - Masaki Nakamura
- Japan Somnology Center, Neuropsychiatric Research Institute
- Yoyogi Sleep Disorder Center
- Department of Somnology, Tokyo Medical University
| | - Akira Usui
- Japan Somnology Center, Neuropsychiatric Research Institute
- Yoyogi Sleep Disorder Center
- Department of Somnology, Tokyo Medical University
| | - Shingo Nishida
- Japan Somnology Center, Neuropsychiatric Research Institute
- Yoyogi Sleep Disorder Center
- Department of Somnology, Tokyo Medical University
| | - Eiki Ito
- Japan Somnology Center, Neuropsychiatric Research Institute
- Yoyogi Sleep Disorder Center
- Department of Somnology, Tokyo Medical University
| | - Masako Okawa
- Japan Somnology Center, Neuropsychiatric Research Institute
- Yoyogi Sleep Disorder Center
- Department of Somnology, Tokyo Medical University
- Japan Foundation for Neuroscience and Mental Health
| | - Yuichi Inoue
- Japan Somnology Center, Neuropsychiatric Research Institute
- Yoyogi Sleep Disorder Center
- Department of Somnology, Tokyo Medical University
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42
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In vitro circadian period is associated with circadian/sleep preference. Sci Rep 2013; 3:2074. [PMID: 23797865 PMCID: PMC3691610 DOI: 10.1038/srep02074] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 06/07/2013] [Indexed: 11/24/2022] Open
Abstract
Evaluation of circadian phenotypes is crucial for understanding the pathophysiology of diseases associated with disturbed biological rhythms such as circadian rhythm sleep disorders (CRSDs). We measured clock gene expression in fibroblasts from individual subjects and observed circadian rhythms in the cells (in vitro rhythms). Period length of the in vitro rhythm (in vitro period) was compared with the intrinsic circadian period, τ, measured under a forced desynchrony protocol (in vivo period) and circadian/sleep parameters evaluated by questionnaires, sleep log, and actigraphy. Although no significant correlation was observed between the in vitro and in vivo periods, the in vitro period was correlated with chronotype, habitual sleep time, and preferred sleep time. Our data demonstrate that the in vitro period is significantly correlated with circadian/sleep preference. The findings suggest that fibroblasts from individual patients can be utilized for in vitro screening of therapeutic agents to provide personalized therapeutic regimens for CRSD patients.
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Bromundt V, Wirz-Justice A, Kyburz S, Opwis K, Dammann G, Cajochen C. Circadian sleep-wake cycles, well-being, and light therapy in borderline personality disorder. J Pers Disord 2013; 27:680-96. [PMID: 22928852 DOI: 10.1521/pedi_2012_26_057] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Individuals with borderline personality disorder (BPD) frequently suffer from sleep disturbances. The authors investigated circadian rhythms, sleep, and well-being in women with BPD in their habitual life conditions during 3 weeks with morning light therapy (LT) and 3 weeks without LT (oLT). Sleep-wake cycles were measured using wrist actimetry, proximal skin temperature as an indirect index of relaxation, as well as weekly salivary melatonin to document the internal circadian rhythm phase. Questionnaires assessed clinical state throughout the 6-week protocol. Ten matched healthy women followed the same 6-week protocol without light treatment. Women with BPD had significantly worse subjective sleep quality and reduced daytime alertness compared to controls. Sleep-wake cycles in BPD ranged from highly disturbed to extremely regular patterns. Melatonin and proximal skin temperature profiles revealed appropriate synchronization of the circadian system with the sleep-wake cycle in most BPD women and in all controls. Morning LT significantly phase-advanced activity in BPD compared to oLT, shortened sleep duration, decreased movement time, and increased skin temperature during sleep (a marker of relaxation). Although general depression scores and borderline symptoms did not change, daytime alertness improved with morning LT, and atypical depression scores were attenuated. Morning LT is a potential adjunct treatment for BPD.
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Chung KF, Kan KKK, Yeung WF. Sleep duration, sleep–wake schedule regularity, and body weight in Hong Kong Chinese adolescents. BIOL RHYTHM RES 2013. [DOI: 10.1080/09291016.2012.656247] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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45
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Golombek DA, Casiraghi LP, Agostino PV, Paladino N, Duhart JM, Plano SA, Chiesa JJ. The times they're a-changing: effects of circadian desynchronization on physiology and disease. ACTA ACUST UNITED AC 2013; 107:310-22. [PMID: 23545147 DOI: 10.1016/j.jphysparis.2013.03.007] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Circadian rhythms are endogenous and need to be continuously entrained (synchronized) with the environment. Entrainment includes both coupling internal oscillators to external periodic changes as well as synchrony between the central clock and peripheral oscillators, which have been shown to exhibit different phases and resynchronization speed. Temporal desynchronization induces diverse physiological alterations that ultimately decrease quality of life and induces pathological situations. Indeed, there is a considerable amount of evidence regarding the deleterious effect of circadian dysfunction on overall health or on disease onset and progression, both in human studies and in animal models. In this review we discuss the general features of circadian entrainment and introduce diverse experimental models of desynchronization. In addition, we focus on metabolic, immune and cognitive alterations under situations of acute or chronic circadian desynchronization, as exemplified by jet-lag and shiftwork schedules. Moreover, such situations might lead to an enhanced susceptibility to diverse cancer types. Possible interventions (including light exposure, scheduled timing for meals and use of chronobiotics) are also discussed.
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Affiliation(s)
- Diego A Golombek
- Laboratory of Chronobiology, National University of Quilmes/CONICET, Buenos Aires, Argentina.
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Mars 520-d mission simulation reveals protracted crew hypokinesis and alterations of sleep duration and timing. Proc Natl Acad Sci U S A 2013; 110:2635-40. [PMID: 23297197 DOI: 10.1073/pnas.1212646110] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The success of interplanetary human spaceflight will depend on many factors, including the behavioral activity levels, sleep, and circadian timing of crews exposed to prolonged microgravity and confinement. To address the effects of the latter, we used a high-fidelity ground simulation of a Mars mission to objectively track sleep-wake dynamics in a multinational crew of six during 520 d of confined isolation. Measurements included continuous recordings of wrist actigraphy and light exposure (4.396 million min) and weekly computer-based neurobehavioral assessments (n = 888) to identify changes in the crew's activity levels, sleep quantity and quality, sleep-wake periodicity, vigilance performance, and workload throughout the record-long 17 mo of mission confinement. Actigraphy revealed that crew sedentariness increased across the mission as evident in decreased waking movement (i.e., hypokinesis) and increased sleep and rest times. Light exposure decreased during the mission. The majority of crewmembers also experienced one or more disturbances of sleep quality, vigilance deficits, or altered sleep-wake periodicity and timing, suggesting inadequate circadian entrainment. The results point to the need to identify markers of differential vulnerability to hypokinesis and sleep-wake changes during the prolonged isolation of exploration spaceflight and the need to ensure maintenance of circadian entrainment, sleep quantity and quality, and optimal activity levels during exploration missions. Therefore, successful adaptation to such missions will require crew to transit in spacecraft and live in surface habitats that instantiate aspects of Earth's geophysical signals (appropriately timed light exposure, food intake, exercise) required for temporal organization and maintenance of human behavior.
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Evans JA, Davidson AJ. Health consequences of circadian disruption in humans and animal models. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2013; 119:283-323. [PMID: 23899601 DOI: 10.1016/b978-0-12-396971-2.00010-5] [Citation(s) in RCA: 193] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Daily rhythms in behavior and physiology are programmed by a hierarchical collection of biological clocks located throughout the brain and body, known as the circadian system. Mounting evidence indicates that disruption of circadian regulation is associated with a wide variety of adverse health consequences, including increased risk for premature death, cancer, metabolic syndrome, cardiovascular dysfunction, immune dysregulation, reproductive problems, mood disorders, and learning deficits. Here we review the evidence for the pervasive effects of circadian disruption in humans and animal models, drawing from both environmental and genetic studies, and identify questions for future research.
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Affiliation(s)
- Jennifer A Evans
- Department of Neurobiology, Morehouse School of Medicine, Atlanta, Georgia, USA
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Grandner MA, Kripke DF, Elliott J, Cole R. Short wavelength light administered just prior to waking: a pilot study. BIOL RHYTHM RES 2013; 44:13-32. [PMID: 23275686 DOI: 10.1080/09291016.2011.632578] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Bright light in the blue-green range, administered in the early morning hours (prior to waking) may be particularly effective in shifting circadian rhythms and may increase gonadotropin production. Accordingly, we tested the feasibility and utility of a mask that emits bright blue/green light (compared to a similar mask that emitted a dim red light) towards the end of sleep in a randomized, placebo-controlled pilot study. The study included a 3-day baseline period, immediately followed by a 12-day intervention period. Subjects were 30 healthy young men with minimal-mild depression. The bright light masks were well-tolerated and demonstrated adequate safety and feasibility. Following the intervention, those who wore the bright light mask demonstrated altered sleep timing suggestive of an earlier sleep period, and excreted a slight increase in follicle-stimulating hormone. Overall, light masks may prove useful in future studies of bright light therapy.
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Affiliation(s)
- Michael A Grandner
- Center for Sleep and Circadian Neurobiology, Division of Sleep Medicine, University of Pennsylvania, Philadelphia, PA, USA
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49
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Intrinsic circadian period of sighted patients with circadian rhythm sleep disorder, free-running type. Biol Psychiatry 2013; 73:63-9. [PMID: 22846439 DOI: 10.1016/j.biopsych.2012.06.027] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 06/26/2012] [Accepted: 06/26/2012] [Indexed: 01/31/2023]
Abstract
BACKGROUND Circadian rhythm sleep disorder, free-running type (FRT), is an intractable sleep disorder in which sleep and wake times progressively delay each day even in normal living environments. This disorder severely affects the social functioning of patients because of periodic nighttime insomnia, excessive daytime sleepiness, and a high rate of comorbid psychiatric disorders. Although abnormal regulation of the biological clock is suspected, the pathophysiology of FRT has yet to be elucidated. In this study, the endogenous circadian period, τ, of FRT patients with normal vision was compared with that of healthy individuals whose circadian rhythms are entrained to a 24-hour cycle. METHODS Six FRT patients and 17 healthy individuals (9 intermediate chronotypes and 8 evening chronotypes) were subjected to a 7-day, 28-hour sleep-wake schedule according to the forced desynchrony protocol. Phase shifts in melatonin rhythm were measured under constant routine conditions to calculate τ. RESULTS In FRT patients, τ was significantly longer than in intermediate chronotypes, whereas in evening chronotypes, it ranged widely and was not significantly different from that in FRT patients. Moreover, τ of melatonin rhythm in FRT patients showed no significant correlation with τ of sleep-wake cycles measured before the study. CONCLUSIONS The findings suggest that although a prolongation of τ may be involved in the onset mechanism of FRT, a prolonged τ is not the only factor involved. It appears that several factors including abnormal entrainment of circadian rhythms are involved in the onset of FRT in a multilayered manner.
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Watanabe M, Hida A, Kitamura S, Enomoto M, Ohsawa Y, Katayose Y, Nozaki K, Moriguchi Y, Aritake S, Higuchi S, Tamura M, Kato M, Mishima K. Rhythmic expression of circadian clock genes in human leukocytes and beard hair follicle cells. Biochem Biophys Res Commun 2012; 425:902-7. [PMID: 22902636 DOI: 10.1016/j.bbrc.2012.08.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 08/02/2012] [Indexed: 11/18/2022]
Abstract
Evaluating individual circadian rhythm traits is crucial for understanding the human biological clock system. The present study reports characterization of physiological and molecular parameters in 13 healthy male subjects under a constant routine condition, where interfering factors were kept to minimum. We measured hormonal secretion levels and examined temporal expression profiles of circadian clock genes in peripheral leukocytes and beard hair follicle cells. All 13 subjects had prominent daily rhythms in melatonin and cortisol secretion. Significant circadian rhythmicity was found for PER1 in 9 subjects, PER2 in 3 subjects, PER3 in all 13 subjects, and BMAL1 in 8 subjects in leukocytes. Additionally, significant circadian rhythmicity was found for PER1 in 5 of 8 subjects tested, PER2 in 2 subjects, PER3 in 6 subjects, and BMAL1 in 3 subjects in beard hair follicle cells. The phase of PER1 and PER3 rhythms in leukocytes correlated significantly with that of physiological rhythms. Our results demonstrate that leukocytes and beard hair follicle cells possess an endogenous circadian clock and suggest that PER1 and PER3 expression would be appropriate biomarkers and hair follicle cells could be a useful tissue source for the evaluation of biological clock traits in individuals.
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Affiliation(s)
- Makiko Watanabe
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8553, Japan
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