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Bonmatí-Carrión MÁ, Santhi N, Atzori G, Mendis J, Kaduk S, Dijk DJ, Archer SN. Effect of 60 days of head down tilt bed rest on amplitude and phase of rhythms in physiology and sleep in men. NPJ Microgravity 2024; 10:42. [PMID: 38553471 PMCID: PMC10980770 DOI: 10.1038/s41526-024-00387-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 03/13/2024] [Indexed: 04/02/2024] Open
Abstract
Twenty-four-hour rhythms in physiology and behaviour are shaped by circadian clocks, environmental rhythms, and feedback of behavioural rhythms onto physiology. In space, 24 h signals such as those associated with the light-dark cycle and changes in posture, are weaker, potentially reducing the robustness of rhythms. Head down tilt (HDT) bed rest is commonly used to simulate effects of microgravity but how HDT affects rhythms in physiology has not been extensively investigated. Here we report effects of -6° HDT during a 90-day protocol on 24 h rhythmicity in 20 men. During HDT, amplitude of light, motor activity, and wrist-temperature rhythms were reduced, evening melatonin was elevated, while cortisol was not affected during HDT, but was higher in the morning during recovery when compared to last session of HDT. During recovery from HDT, time in Slow-Wave Sleep increased. EEG activity in alpha and beta frequencies increased during NREM and REM sleep. These results highlight the profound effects of head-down-tilt-bed-rest on 24 h rhythmicity.
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Affiliation(s)
- María-Ángeles Bonmatí-Carrión
- Surrey Sleep Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
- Chronobiology Laboratory, Department of Physiology, IMIB-Arrixaca, University of Murcia, Murcia, Spain.
- CIBER de Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain.
| | - Nayantara Santhi
- Surrey Sleep Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
- Department of Psychology, Northumbria University, Newcastle Upon Tyne, UK
| | - Giuseppe Atzori
- Surrey Sleep Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Jeewaka Mendis
- Surrey Clinical Trials Unit, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Sylwia Kaduk
- Surrey Sleep Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Derk-Jan Dijk
- Surrey Sleep Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London and the University of Surrey, Guildford, UK
| | - Simon N Archer
- Surrey Sleep Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
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2
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Jiang CS, Chen KM, Belcastro F. Effects of Temperature, Duration, and Heating Height of Foot Thermal Therapy on Sleep Quality of Older Adults: A Systematic Review and Meta-Analysis. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:250-260. [PMID: 37855919 DOI: 10.1089/jicm.2023.0193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
Background: Sleep disturbances, which are common problems in older adults, often lead to cognitive decline and depression and may even increase mortality risk. Foot thermal therapy is a simple and safe approach for improving sleep and is associated with relatively few side effects. However, the effect of different operations of foot thermal therapy on sleep quality in older adults is inconclusive. This study aimed to access the effects of temperature, duration, and heating height of foot thermal therapy (administered through a footbath) on the subjective and objective sleep quality of older adults. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline, eight databases were searched for all relevant articles published up to July 2023, and a rigorous systematic review and meta-analysis was conducted. This study was registered in the PROSPERO database (CRD42022383460). Inclusion criteria were: (1) participants with a mean age ≥60 years; (2) interventions that included foot thermal therapy; (3) a control group that received routine care but no thermal therapy; (4) outcome measurements that assessed sleep quality; and (5) the studies that utilized randomized controlled trials or quasi-experimental studies. Methodological quality was assessed using the Joanna Briggs Institute critical appraisal tools. The meta-analysis was performed using RevMan version 5.4. Results: A total of 11 studies were included. Foot thermal therapy before bedtime improved subjective sleep quality in older adults, with optimal parameters of 40°C temperature (standardized mean difference [SMD] = 0.66, 95% confidence interval [CI]: 0.33 to 0.99), ≤20-min duration (SMD = 0.66, 95% CI: 0.39 to 0.93), and 10 cm heating height (SMD = 0.78, 95% CI: 0.45 to 1.11). Subgroup analyses revealed that a temperature of 41°C-42°C can improve objective sleep latency (SMD = 0.54, 95% CI: 0.09 to 0.99). Conclusions: It is recommended to administer foot thermal therapy (40°C; ≤20 min; 10 cm above the ankle) to older adults 1 h before their bedtime. If they have trouble falling asleep, the temperature can be increased to 41°C-42°C.
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Affiliation(s)
- Cai-Syuan Jiang
- Department of Nursing, Chung-Jen Junior College of Health Sciences and Management, Chia-Yi County, Taiwan
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kuei-Min Chen
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
- Center for Long-Term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Frank Belcastro
- Department of Education and Psychology, University of Dubuque, Dubuque, IA, USA
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龚 明, 唐 桥, 谭 思, 胡 晓. [Research Progress in the Effect of Exercise Intervention on Sleep Disorders and the Mechanisms Involved]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2024; 55:236-242. [PMID: 38322540 PMCID: PMC10839477 DOI: 10.12182/20240160404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Indexed: 02/08/2024]
Abstract
Sleep disorders, a common concern in modern society, seriously affect people's physical and mental health. Reported findings suggest that both acute exercise intervention and long-term regular exercise intervention can improve the disrupted sleep structure and normalize the duration and proportion of the different phases of sleep. Moreover, exercise intervention has a positive effect on the endocrine functions, the metabolic functions, the immune response, the autonomic nervous system, and cardiac functions during sleep. It is a non-medicative therapeutic strategy for improving sleep disorders. The specific type of exercise intervention (aerobic exercise, resistance exercise, or meditative movement) adopted is one of the moderating variables of exercise intervention programs. Different types of exercise improve sleep disorders by way of different mechanisms. Exercise volume and intensity are another moderating variable of exercise intervention programs. The optimal amount and intensity of exercise for different individuals to improve sleep disorders may vary. Exercise interventions implemented at the different times throughout a day can also have varying degrees of impact on sleep disorders and there is no consensus on the optimal exercise time for improving sleep quality at present. Herein, we summarized the mechanisms by which exercise intervention improves sleep disorders from four perspectives, including epigenetics, hyperarousal, human circadian rhythm, and body temperature regulation. In addition, we discussed the current gaps and prospects of research in this field, aiming to provide a theoretical basis for the development of exercise prescriptions for sleep disorders.
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Affiliation(s)
- 明俊 龚
- 天津体育学院 运动训练学院 (天津 301617)Sports Training College, Tianjin University of Sport, Tianjin 301617, China
| | - 桥 唐
- 天津体育学院 运动训练学院 (天津 301617)Sports Training College, Tianjin University of Sport, Tianjin 301617, China
| | - 思洁 谭
- 天津体育学院 运动训练学院 (天津 301617)Sports Training College, Tianjin University of Sport, Tianjin 301617, China
| | - 晓飞 胡
- 天津体育学院 运动训练学院 (天津 301617)Sports Training College, Tianjin University of Sport, Tianjin 301617, China
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Espie CA. Revisiting the Psychobiological Inhibition Model: a conceptual framework for understanding and treating insomnia using cognitive and behavioural therapeutics (CBTx). J Sleep Res 2023; 32:e13841. [PMID: 36747476 DOI: 10.1111/jsr.13841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 01/15/2023] [Indexed: 02/08/2023]
Abstract
Sleep is a biological imperative, so one might wonder "what has psychology got to do with it?" A person's behaviours, thoughts, emotions and interactions with the environment inevitably serve for good, or for ill, as the "setting conditions" for the expression of sleep. Put simply, although sleep is not a psychological phenomenon, sleep has crucial behavioural dependencies. Consequently, the Psychobiological Inhibition Model can embrace numerous, potentially interacting, pathways to the persistence of this ubiquitous disorder, providing an overarching conceptual framework for why and how insomnia develops. The clinical guideline treatment for chronic insomnia is cognitive behavioural therapy. Although typically delivered as "talking therapy", cognitive behavioural therapy is not some form of "psychobabble". Rather, the Psychobiological Inhibition Model framework for insomnia articulates how specific techniques can correct the various ways in which the expression of normal sleep and circadian brain-behaviour relationships have become disrupted. Indeed, cognitive behavioural therapy is best conceived of as an approach to treatment rather than being one specific agent. A shift in emphasis towards a cognitive and behavioural therapeutics formulary would provide improved impetus to understanding of how insomnia develops, and of how it may best be treated in any given patient.
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Affiliation(s)
- Colin A Espie
- Sir Jules Thorn Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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5
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Dressle RJ, Riemann D. Hyperarousal in insomnia disorder: Current evidence and potential mechanisms. J Sleep Res 2023; 32:e13928. [PMID: 37183177 DOI: 10.1111/jsr.13928] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/25/2023] [Accepted: 04/25/2023] [Indexed: 05/16/2023]
Abstract
Insomnia disorder is among the most frequent mental disorders, making research on its aetiology and pathophysiology particularly important. A unifying element of many aetiological and pathophysiological models is that they support or even centre on the role of some form of hyperarousal. In this theoretical review, we aim to summarise the current evidence on hyperarousal in insomnia. Hyperarousal is discussed as a state of relatively increased arousal in physiological, cortical and cognitive-emotional domains. Regarding physiological hyperarousal, there is no conclusive evidence for the involvement of autonomous variables such as heart rate and heart rate variability, whereas recent evidence points to a pathophysiological role of neuroendocrine variables. In addition, current literature supports a central involvement of cortical arousal, that is, high-frequency electroencephalographic activity. An increasingly important focus in the literature is on the role of other microstructural sleep parameters, especially the existence of microarousals during sleep. Beyond that, a broad range of evidence exists supporting the role of cognitive-emotional hyperarousal in the form of insomnia-related thought and worries, and their concomitant emotional symptoms. Besides being a state marker of insomnia, hyperarousal is considered crucial for the predisposition to insomnia and for the development of comorbid mental disorders. Thus, beyond presenting evidence from cross-sectional studies on markers of hyperarousal in insomnia, hypotheses about the mechanisms of hyperarousal are presented. Nevertheless, longitudinal studies are needed to further elucidate the mechanism of hyperarousal throughout the course of the disorder, and future studies should also focus on similarities and differences in hyperarousal across different diagnostic entities.
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Affiliation(s)
- Raphael J Dressle
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Faculty of Medicine, Center for Basics in NeuroModulation (NeuroModulBasics), University of Freiburg, Freiburg, Germany
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Dikeos D, Wichniak A, Ktonas PY, Mikoteit T, Crönlein T, Eckert A, Kopřivová J, Ntafouli M, Spiegelhalder K, Hatzinger M, Riemann D, Soldatos C. The potential of biomarkers for diagnosing insomnia: Consensus statement of the WFSBP Task Force on Sleep Disorders. World J Biol Psychiatry 2023; 24:614-642. [PMID: 36880792 DOI: 10.1080/15622975.2023.2171479] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/30/2022] [Accepted: 01/17/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVES Thus far, the diagnosis of insomnia is based on purely clinical criteria. Although a broad range of altered physiological parameters has been identified in insomniacs, the evidence to establish their diagnostic usefulness is very limited. Purpose of this WFSBP Task Force consensus paper is to systematically evaluate a series of biomarkers as potential diagnostic tools for insomnia. METHODS A newly created grading system was used for assessing the validity of various measurements in establishing the diagnosis of insomnia; these measurements originated from relevant studies selected and reviewed by experts. RESULTS The measurements with the highest diagnostic performance were those derived from psychometric instruments. Biological measurements which emerged as potentially useful diagnostic instruments were polysomnography-derived cyclic alternating pattern, actigraphy, and BDNF levels, followed by heart rate around sleep onset, deficient melatonin rhythm, and certain neuroimaging patterns (mainly for the activity of frontal and pre-frontal cortex, hippocampus and basal ganglia); yet, these findings need replication, as well as establishment of commonly accepted methodology and diagnostic cut-off points. Routine polysomnography, EEG spectral analysis, heart rate variability, skin conductance, thermoregulation, oxygen consumption, HPA axis, and inflammation indices were not shown to be of satisfactory diagnostic value. CONCLUSIONS Apart from psychometric instruments which are confirmed to be the gold standard in diagnosing insomnia, six biomarkers emerge as being potentially useful for this purpose.
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Affiliation(s)
- Dimitris Dikeos
- First Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Adam Wichniak
- Third Department of Psychiatry, Sleep Medicine Center, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Periklis Y Ktonas
- First Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Department of Electrical and Computer Engineering, University of Houston, Houston, TX, USA
| | - Thorsten Mikoteit
- Psychiatric Services Solothurn, Faculty of Medicine, University of Basel, Solothurn, Switzerland
| | - Tatjana Crönlein
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Anne Eckert
- Neurobiology Lab for Brain Aging and Mental Health, Transfaculty Research Platform Molecular & Cognitive Neuroscience (MCN), University of Basel, Basel, Switzerland
| | - Jana Kopřivová
- National Institute of Mental Health, Klecany, Czechia
- Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Maria Ntafouli
- First Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Centre, University of Freiburg, Freiburg, Germany
| | - Martin Hatzinger
- Psychiatric Services Solothurn, Faculty of Medicine, University of Basel, Solothurn, Switzerland
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Centre, University of Freiburg, Freiburg, Germany
| | - Constantin Soldatos
- First Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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7
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Goda T, Umezaki Y, Hamada FN. Molecular and Neural Mechanisms of Temperature Preference Rhythm in Drosophila melanogaster. J Biol Rhythms 2023; 38:326-340. [PMID: 37222551 PMCID: PMC10330063 DOI: 10.1177/07487304231171624] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Temperature influences animal physiology and behavior. Animals must set an appropriate body temperature to maintain homeostasis and maximize survival. Mammals set their body temperatures using metabolic and behavioral strategies. The daily fluctuation in body temperature is called the body temperature rhythm (BTR). For example, human body temperature increases during wakefulness and decreases during sleep. BTR is controlled by the circadian clock, is closely linked with metabolism and sleep, and entrains peripheral clocks located in the liver and lungs. However, the underlying mechanisms of BTR are largely unclear. In contrast to mammals, small ectotherms, such as Drosophila, control their body temperatures by choosing appropriate environmental temperatures. The preferred temperature of Drosophila increases during the day and decreases at night; this pattern is referred to as the temperature preference rhythm (TPR). As flies are small ectotherms, their body temperature is close to that of the surrounding environment. Thus, Drosophila TPR produces BTR, which exhibits a pattern similar to that of human BTR. In this review, we summarize the regulatory mechanisms of TPR, including recent studies that describe neuronal circuits relaying ambient temperature information to dorsal neurons (DNs). The neuropeptide diuretic hormone 31 (DH31) and its receptor (DH31R) regulate TPR, and a mammalian homolog of DH31R, the calcitonin receptor (CALCR), also plays an important role in mouse BTR regulation. In addition, both fly TPR and mammalian BTR are separately regulated from another clock output, locomotor activity rhythms. These findings suggest that the fundamental mechanisms of BTR regulation may be conserved between mammals and flies. Furthermore, we discuss the relationships between TPR and other physiological functions, such as sleep. The dissection of the regulatory mechanisms of Drosophila TPR could facilitate an understanding of mammalian BTR and the interaction between BTR and sleep regulation.
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Affiliation(s)
- Tadahiro Goda
- Department of Neurobiology, Physiology & Behavior, University of California, Davis, Davis, California
| | - Yujiro Umezaki
- Department of Neurobiology, Physiology & Behavior, University of California, Davis, Davis, California
| | - Fumika N. Hamada
- Department of Neurobiology, Physiology & Behavior, University of California, Davis, Davis, California
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8
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Bigalke JA, Cleveland EL, Barkstrom E, Gonzalez JE, Carter JR. Core body temperature changes before sleep are associated with nocturnal heart rate variability. J Appl Physiol (1985) 2023; 135:136-145. [PMID: 37262106 PMCID: PMC10292981 DOI: 10.1152/japplphysiol.00020.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/08/2023] [Accepted: 05/25/2023] [Indexed: 06/03/2023] Open
Abstract
Core body temperature (CBT) reductions occur before and during the sleep period, with the extent of presleep reductions corresponding to sleep onset and quality. Presleep reductions in CBT coincide with increased cardiac parasympathetic activity measured via heart rate variability (HRV), and while this appears to persist into the sleep period, individual differences in presleep CBT decline and nocturnal HRV remain unexplored. The purpose of the current study was to assess the relationship between individual differences in presleep CBT reductions and nocturnal heart rate (HR) and HRV in a population of 15 objectively poor sleeping adults [10 males, 5 females; age, 33 ± 4 yr; body mass index (BMI) 27 ± 1 kg/m2] with the hypothesis that blunted CBT rate of decline would be associated with elevated HR and reduced nocturnal HRV. Following an adaptation night, all participants underwent an overnight, in-laboratory sleep study with simultaneous recording of polysomnographic sleep including electrocardiography (ECG) and CBT recording. Correlations between CBT rate of change before sleep and nocturnal HRV were assessed. Blunted rate of CBT decline was significantly associated with increased heart rate (HR) in stage 2 (N2; R = 0.754, P = 0.001), stage 3 (N3; R = 0.748, P = 0.001), and rapid-eye movement (REM; R = 0.735, P = 0.002). Similarly, blunted rate of CBT decline before sleep was associated with reduced HRV across sleep stages. These findings indicate a relationship between individual differences in presleep thermoregulatory processes and nocturnal cardiac autonomic function in poor sleeping adults.NEW & NOTEWORTHY Core body temperature (CBT) reductions before sleep onset coincide with increases in heart rate variability (HRV) that persist throughout the sleep period. However, the relationship between individual differences in the efficiency of presleep core temperature regulation and nocturnal heart rate variability remains equivocal. The present study reports an association between the magnitude of presleep core body temperature changes and nocturnal parasympathetic activity, highlighting overlap between thermoregulatory processes before sleep and nocturnal cardiac autonomic function.
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Affiliation(s)
- Jeremy A Bigalke
- Department of Health and Human Development, Montana State University, Bozeman, Montana, United States
- Department of Psychology, Montana State University, Bozeman, Montana, United States
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan, United States
| | - Emily L Cleveland
- Microbiology and Cell Biology, Montana State University, Bozeman, Montana, United States
| | - Elyse Barkstrom
- Department of Health and Human Development, Montana State University, Bozeman, Montana, United States
| | - Joshua E Gonzalez
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan, United States
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, Oregon, United States
| | - Jason R Carter
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan, United States
- Robbins College of Health and Human Sciences, Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, United States
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9
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Basner M, Smith MG, Jones CW, Ecker AJ, Howard K, Schneller V, Cordoza M, Kaizi-Lutu M, Park-Chavar S, Stahn AC, Dinges DF, Shou H, Mitchell JA, Bhatnagar A, Smith T, Smith AE, Stopforth CK, Yeager R, Keith RJ. Associations of bedroom PM 2.5, CO 2, temperature, humidity, and noise with sleep: An observational actigraphy study. Sleep Health 2023; 9:253-263. [PMID: 37076419 PMCID: PMC10293115 DOI: 10.1016/j.sleh.2023.02.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 02/20/2023] [Accepted: 02/27/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVE Climate change and urbanization increasingly cause extreme conditions hazardous to health. The bedroom environment plays a key role for high-quality sleep. Studies objectively assessing multiple descriptors of the bedroom environment as well as sleep are scarce. METHODS Particulate matter with a particle size <2.5 µm (PM2.5), temperature, humidity, carbon dioxide (CO2), barometric pressure, and noise levels were continuously measured for 14 consecutive days in the bedroom of 62 participants (62.9% female, mean ± SD age: 47.7 ± 13.2 years) who wore a wrist actigraph and completed daily morning surveys and sleep logs. RESULTS In a hierarchical mixed effect model that included all environmental variables and adjusted for elapsed sleep time and multiple demographic and behavioral variables, sleep efficiency calculated for consecutive 1-hour periods decreased in a dose-dependent manner with increasing levels of PM2.5, temperature, CO2, and noise. Sleep efficiency in the highest exposure quintiles was 3.2% (PM2.5, p < .05), 3.4% (temperature, p < .05), 4.0% (CO2, p < .01), and 4.7% (noise, p < .0001) lower compared to the lowest exposure quintiles (all p-values adjusted for multiple testing). Barometric pressure and humidity were not associated with sleep efficiency. Bedroom humidity was associated with subjectively assessed sleepiness and poor sleep quality (both p < .05), but otherwise environmental variables were not statistically significantly associated with actigraphically assessed total sleep time and wake after sleep onset or with subjectively assessed sleep onset latency, sleep quality, and sleepiness. Assessments of bedroom comfort suggest subjective habituation irrespective of exposure levels. CONCLUSIONS These findings add to a growing body of evidence highlighting the importance of the bedroom environment-beyond the mattress-for high-quality sleep.
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Affiliation(s)
- Mathias Basner
- Unit of Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
| | - Michael G Smith
- Unit of Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Christopher W Jones
- Unit of Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Adrian J Ecker
- Unit of Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Kia Howard
- Unit of Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Victoria Schneller
- Unit of Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Makayla Cordoza
- Unit of Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Marc Kaizi-Lutu
- Unit of Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Sierra Park-Chavar
- Unit of Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Alexander C Stahn
- Unit of Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - David F Dinges
- Unit of Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Haochang Shou
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Jonathan A Mitchell
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA; Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Aruni Bhatnagar
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, USA
| | - Ted Smith
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, USA
| | - Allison E Smith
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, USA
| | - Cameron K Stopforth
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, USA
| | - Ray Yeager
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, USA
| | - Rachel J Keith
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, USA
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10
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Baron P, Hermand É, Bourlois V, Pezé T, Aron C, Lombard R, Hurdiel R. Effect of Aerobic Exercise Training on Sleep and Core Temperature in Middle-Aged Women with Chronic Insomnia: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085452. [PMID: 37107734 PMCID: PMC10138891 DOI: 10.3390/ijerph20085452] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/30/2023] [Accepted: 04/04/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND Exercise represents a viable non-pharmacological intervention to help treating insomnia but the interaction mechanisms between sleep and physical activity still remain poorly understood. The aim of this study was to investigate the effect of a aerobic exercise training intervention on sleep and core temperature. METHODS Twenty-four adult women suffering from insomnia participated in this study. They were randomized into an exercise group and a control group. Aerobic exercise training consisted in moderate to vigorous aerobic exercise training for 12 weeks. Outcome measures included both subjective (Insomnia Severity Index, ISI) and objective (actigraphy recordings) sleep quality assessments, and core body temperature continuously recorded for a minimum 24 h. RESULTS The exercise group showed a decrease in ISI (p < 0.001) and in various objective sleep parameters. The core temperature batyphase value was lowered (p = 0.037) whereas its amplitude was larger (p = 0.002). We also found a tight correlation between the evolution of insomnia and the evolution of mean night-time core temperature and batyphase values. CONCLUSIONS A moderate to vigorous aerobic exercise program appears to be an effective non-drug therapy for improving sleep in women with insomnia. In addition, exercise programs should aim to increase core body temperature during practice to induce sleep-promoting adaptations and rebound.
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Affiliation(s)
- Pauline Baron
- Univ. Littoral Côte d’Opale, Univ. Artois, Univ. Lille, ULR 7369—URePSSS—Unité de Recherche Pluridisciplinaire Sport Santé Société, F-59140 Dunkerque, France
- Correspondence: ; Tel.: +33-6-73-68-11-25
| | - Éric Hermand
- Univ. Littoral Côte d’Opale, Univ. Artois, Univ. Lille, ULR 7369—URePSSS—Unité de Recherche Pluridisciplinaire Sport Santé Société, F-59140 Dunkerque, France
| | - Valentin Bourlois
- Univ. Littoral Côte d’Opale, Univ. Artois, Univ. Lille, ULR 7369—URePSSS—Unité de Recherche Pluridisciplinaire Sport Santé Société, F-59140 Dunkerque, France
| | - Thierry Pezé
- Univ. Littoral Côte d’Opale, Univ. Artois, Univ. Lille, ULR 7369—URePSSS—Unité de Recherche Pluridisciplinaire Sport Santé Société, F-59140 Dunkerque, France
| | - Christophe Aron
- Centre Sommeil Morphée, Polyclinique de Grande Sysnthe, 59760 Grande Synthe, France
| | - Remi Lombard
- Clinique de Flandre, 59210 Coudekerque-Branche, France
| | - Rémy Hurdiel
- Univ. Littoral Côte d’Opale, Univ. Artois, Univ. Lille, ULR 7369—URePSSS—Unité de Recherche Pluridisciplinaire Sport Santé Société, F-59140 Dunkerque, France
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11
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Swanson LM, Raglan GB. Circadian Interventions as Adjunctive Therapies to Cognitive-Behavioral Therapy for Insomnia. Sleep Med Clin 2023; 18:21-30. [PMID: 36764783 PMCID: PMC10015491 DOI: 10.1016/j.jsmc.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
The circadian system plays a key role in the sleep-wake cycle. A mismatch between the behavioral timing of sleep and the circadian timing of sleepiness/alertness can contribute to insomnia. Patients who report primarily difficulty falling asleep or early morning awakenings may benefit from circadian interventions administered adjunctively to cognitive-behavioral therapy for insomnia. Specific circadian interventions that clinicians may consider include bright light therapy, scheduled dim light, blue-blocking glasses, and melatonin. Implementation of these interventions differs depending on the patient's insomnia subtype. Further, careful attention must be paid to the timing of these interventions to ensure they are administered correctly.
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Affiliation(s)
- Leslie M Swanson
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48105, USA.
| | - Greta B Raglan
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48105, USA
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12
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Dressle RJ, Riemann D, Spiegelhalder K, Frase L, Perlis ML, Feige B. On the relationship between EEG spectral analysis and pre-sleep cognitive arousal in insomnia disorder: towards an integrated model of cognitive and cortical arousal. J Sleep Res 2023:e13861. [PMID: 36815625 DOI: 10.1111/jsr.13861] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/06/2022] [Accepted: 02/04/2023] [Indexed: 02/24/2023]
Abstract
According to the hyperarousal model, insomnia is characterised by increased arousal in the cortical, cognitive, and physiological domains. However, the interaction between these arousal domains is poorly understood. The present observational case-control study aimed to investigate cortical arousal during the night, pre-sleep cognitive arousal and the relationship between these two domains. A total of 109 patients with insomnia disorder (ID) and 109 age-and gender matched healthy controls were investigated on two sleep laboratory nights. Electroencephalographic (EEG) spectral power during non-rapid eye movement (NREM) and REM sleep was analysed as a measure of cortical arousal. In addition, patients completed the Pre-Sleep Arousal Scale (PSAS), which consists of two subscales, one for cognitive arousal (PSAS-CA) and one for self-reported somatic arousal (PSAS-SA). The relationship between the subscale scores and EEG spectral power was calculated by multi- and univariate analyses of variance. During NREM and REM sleep, patients with ID showed significantly increased spectral power in the EEG gamma band. In addition, patients with ID showed significantly increased scores on both subscales of the PSAS. The PSAS-CA score was significantly associated with increased NREM and REM gamma power, whereas PSAS-SA was associated with decreases in NREM and REM gamma power. Consistent with our hypothesis, patients with ID showed increased cortical and cognitive arousal. Moreover, there was an association between these two arousal domains, which may indicate that cortical arousal during the night is (at least in part) elicited by pre-sleep worry and rumination.
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Affiliation(s)
- Raphael J Dressle
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Center for Basics in NeuroModulation (NeuroModulBasics), Faculty of Medicine University of Freiburg, Freiburg, Germany
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Lukas Frase
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michael L Perlis
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Bernd Feige
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Center for Basics in NeuroModulation (NeuroModulBasics), Faculty of Medicine University of Freiburg, Freiburg, Germany
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13
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Experiences of Using Weighted Blankets among Children with ADHD and Sleeping Difficulties. Occup Ther Int 2023; 2023:1945290. [PMID: 36824380 PMCID: PMC9943603 DOI: 10.1155/2023/1945290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/14/2022] [Accepted: 02/01/2023] [Indexed: 02/16/2023] Open
Abstract
Introduction Sleeping difficulties are common in children with attention deficit hyperactivity disorder (ADHD). A sleep intervention with weighted blankets was designed to increase current understanding of using weighted blankets to target children's individual needs in connection with sleep and daytime functioning. Aim To explore how children with ADHD and sleeping difficulties experience the use of weighted blankets. Methods An explorative qualitative design in which 26 children with ADHD and sleeping difficulties, 6-15 years old, were interviewed about a sleep intervention with weighted blankets. Four categories emerged from qualitative content analysis. Results Children's experiences revealed that the use of weighted blankets 1) requires a commitment, by adjusting according to needs and preferences and adapting to the environment; 2) improves emotional regulation by feeling calm and feeling safe; 3) changes sleeping patterns by creating new routines for sleep and improving sleep quality; and 4) promotes everyday participation by promoting daily function and balancing activity and sleep. Conclusions Using weighted blankets promoted children's management of daily life with ADHD and sleeping difficulties. Occupational therapists can improve the assessment and delivery of weighted blankets tailored to individual needs based on increased knowledge from the children themselves.
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14
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Idiaquez J, Casar JC, Arnardottir ES, August E, Santin J, Iturriaga R. Hyperhidrosis in sleep disorders - A narrative review of mechanisms and clinical significance. J Sleep Res 2023; 32:e13660. [PMID: 35706374 DOI: 10.1111/jsr.13660] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/10/2022] [Accepted: 05/13/2022] [Indexed: 02/03/2023]
Abstract
Hyperhidrosis is characterized by excessive sweating beyond thermoregulatory needs that affects patients' quality of life. It results from an excessive stimulation of eccrine sweat glands in the skin by the sympathetic nervous system. Hyperhidrosis may be primary or secondary to an underlying cause. Nocturnal hyperhidrosis is associated with different sleep disorders, such as obstructive sleep apnea, insomnia, restless legs syndrome/periodic limb movement during sleep and narcolepsy. The major cause of the hyperhidrosis is sympathetic overactivity and, in the case of narcolepsy type 1, orexin deficiency may also contribute. In this narrative review, we will provide an outline of the possible mechanisms underlying sudomotor dysfunction and the resulting nocturnal hyperhidrosis in these different sleep disorders and explore its clinical relevance.
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Affiliation(s)
- Juan Idiaquez
- Departamento de Neurología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Juan Carlos Casar
- Departamento de Neurología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Erna S Arnardottir
- Reykjavik University Sleep Institute, School of Technology, Reykjavik University, Reykjavik, Iceland.,Internal Medicine Services, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Elias August
- Reykjavik University Sleep Institute, School of Technology, Reykjavik University, Reykjavik, Iceland.,Department of Engineering, School of Technology, Reykjavik University, Reykjavik, Iceland
| | - Julia Santin
- Departamento de Neurología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rodrigo Iturriaga
- Laboratorio de Neurobiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
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15
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Dai Y, Chen B, Chen L, Vgontzas AN, Fernandez-Mendoza J, Karataraki M, Tang X, Li Y. Insomnia with objective short sleep duration is associated with hypertension. J Sleep Res 2023:e13833. [PMID: 36704942 DOI: 10.1111/jsr.13833] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/22/2022] [Accepted: 01/04/2023] [Indexed: 01/28/2023]
Abstract
Insomnia with objective short sleep duration has been proposed as the most biologically severe phenotype of the disorder associated with cardiometabolic morbidity in population-based samples. In this study, we investigated the association between insomnia with objective short sleep duration and hypertension in a large clinical sample. We studied 348 patients diagnosed with chronic insomnia disorder based on International Classification of Sleep Disorders Third Edition criteria and 150 normal sleepers. Objective short sleep duration was defined by the median total sleep time of the sample (< 7 hr) measured with 1-night polysomnography. Hypertension was defined based on blood pressure levels, antihypertensive medication use and/or a physician diagnosis. After adjusting for potential confounders, patients with chronic insomnia disorder who slept < 7 hr were associated with 2.8-fold increased odds of hypertension compared with normal sleepers who slept ≥ 7 hr (odds ratio = 2.81, 95% confidence interval = 1.068-7.411) or < 7 hr (odds ratio = 2.75, 95% confidence interval = 1.005-7.542), whereas patients with chronic insomnia disorder who slept ≥ 7 hr (odds ratio = 1.52, 95% confidence interval = 0.537-4.285) or normal sleepers who slept < 7 hr (odds ratio = 1.07, 95% confidence interval = 0.294-3.904) were not significantly associated with increased odds of hypertension compared with normal sleepers who slept ≥ 7 hr. Linear regression analyses showed that, for every hour decrease in total sleep time, systolic and diastolic blood pressure increased by 1.014 mmHg (p = 0.045) and 0.923 mmHg (p = 0.015), respectively, in patients with chronic insomnia disorder but not in normal sleepers. Our findings further support that insomnia with objective short sleep duration is a risk factor for hypertension, and objective short sleep duration may be a useful marker of the biological severity of chronic insomnia disorder in clinical practice.
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Affiliation(s)
- Yanyuan Dai
- Department of Sleep Medicine, Shantou University Mental Health Center, Shantou University Medical College, Shantou, Guangdong, China
- Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Baixin Chen
- Department of Sleep Medicine, Shantou University Mental Health Center, Shantou University Medical College, Shantou, Guangdong, China
- Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Le Chen
- Department of Sleep Medicine, Shantou University Mental Health Center, Shantou University Medical College, Shantou, Guangdong, China
- Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Alexandros N Vgontzas
- Sleep Research and Treatment Center, Department of Psychiatry and Behavioral Health, Pennsylvania State University, College of Medicine, Hershey, Pennsylvania, USA
| | - Julio Fernandez-Mendoza
- Sleep Research and Treatment Center, Department of Psychiatry and Behavioral Health, Pennsylvania State University, College of Medicine, Hershey, Pennsylvania, USA
| | - Maria Karataraki
- Department of Psychiatry and Behavioral Sciences, University of Crete, Heraklion, Greece
| | - Xiangdong Tang
- Sleep Medicine Center, Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yun Li
- Department of Sleep Medicine, Shantou University Mental Health Center, Shantou University Medical College, Shantou, Guangdong, China
- Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China
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16
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Geng YJ, Smolensky M, Sum-Ping O, Hermida R, Castriotta RJ. Circadian rhythms of risk factors and management in atherosclerotic and hypertensive vascular disease: Modern chronobiological perspectives of an ancient disease. Chronobiol Int 2023; 40:33-62. [PMID: 35758140 PMCID: PMC10355310 DOI: 10.1080/07420528.2022.2080557] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 05/12/2022] [Accepted: 05/16/2022] [Indexed: 12/13/2022]
Abstract
Atherosclerosis, a chronic inflammatory disease of the arteries that appears to have been as prevalent in ancient as in modern civilizations, is predisposing to life-threatening and life-ending cardiac and vascular complications, such as myocardial and cerebral infarctions. The pathogenesis of atherosclerosis involves intima plaque buildup caused by vascular endothelial dysfunction, cholesterol deposition, smooth muscle proliferation, inflammatory cell infiltration and connective tissue accumulation. Hypertension is an independent and controllable risk factor for atherosclerotic cardiovascular disease (CVD). Conversely, atherosclerosis hardens the arterial wall and raises arterial blood pressure. Many CVD patients experience both atherosclerosis and hypertension and are prescribed medications to concurrently mitigate the two disease conditions. A substantial number of publications document that many pathophysiological changes caused by atherosclerosis and hypertension occur in a manner dependent upon circadian clocks or clock gene products. This article reviews progress in the research of circadian regulation of vascular cell function, inflammation, hemostasis and atherothrombosis. In particular, it delineates the relationship of circadian organization with signal transduction and activation of the renin-angiotensin-aldosterone system as well as disturbance of the sleep/wake circadian rhythm, as exemplified by shift work, metabolic syndromes and obstructive sleep apnea (OSA), as promoters and mechanisms of atherogenesis and risk for non-fatal and fatal CVD outcomes. This article additionally updates advances in the clinical management of key biological processes of atherosclerosis to optimally achieve suppression of atherogenesis through chronotherapeutic control of atherogenic/hypertensive pathological sequelae.
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Affiliation(s)
- Yong-Jian Geng
- The Center for Cardiovascular Biology and Atherosclerosis Research, Division of Cardiovascular Medicine, Department of Internal Medicine, McGovern School of Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Michael Smolensky
- The Center for Cardiovascular Biology and Atherosclerosis Research, Division of Cardiovascular Medicine, Department of Internal Medicine, McGovern School of Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
- Department of Biomedical Engineering, Cockrell School of Engineering, The University of Texas at Austin, Austin, TX, USA
| | - Oliver Sum-Ping
- The Center for Sleep Sciences and Medicine, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, USA
| | - Ramon Hermida
- Bioengineering & Chronobiology Laboratories, Atlantic Research Center for Telecommunication Technologies (atlanTTic), University of Vigo, Vigo, Spain
| | - Richard J. Castriotta
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Keck Medical School, University of Southern California, Los Angeles, CA, USA
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17
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Støre SJ, Tillfors M, Wästlund E, Angelhoff C, Andersson G, Norell‐Clarke A. The effects of a sleep robot intervention on sleep, depression and anxiety in adults with insomnia—A randomized waitlist‐controlled trial. J Sleep Res 2022; 32:e13758. [PMID: 36285420 DOI: 10.1111/jsr.13758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/01/2022] [Accepted: 09/24/2022] [Indexed: 11/29/2022]
Abstract
The study objective was to assess if a 3-week intervention with the Somnox sleep robot had effects on symptoms of insomnia, somatic arousal, and/or concurrent symptoms of depression and anxiety in adults with insomnia, compared with a waitlist-control group. The participants (n = 44) were randomized to a 3-week intervention with the sleep robot (n = 22), or to a waitlist-control group (n = 22). The primary outcome measure was the Insomnia Severity Index administered at baseline, mid-intervention, post-intervention and at 1-month follow-up. Secondary outcome measures were the Pre-Sleep Arousal Scale, and the Hospital Anxiety and Depression Scale. Additionally, sleep-onset latency, wake time after sleep onset, total sleep time and sleep efficiency were measured the week prior to and the last week of the intervention, both subjectively with the Consensus Sleep Diary and objectively with wrist actigraphy. Mixed-effects models were used to analyse data. The effect of the sleep robot on the participants' insomnia severity was not statistically significant. The differences between the intervention group and the control group on the measures of arousal, anxiety and depression were also not statistically significant, and neither were the sleep diary and actigraphy variables. In conclusion, a 3-week intervention with daily at-home use of the robot was not found to be an effective method to relieve the symptom burden in adults with insomnia.
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Affiliation(s)
- Siri Jakobsson Støre
- Department of Social and Psychological Studies Karlstad University Karlstad Sweden
| | - Maria Tillfors
- Department of Social and Psychological Studies Karlstad University Karlstad Sweden
| | - Erik Wästlund
- Department of Social and Psychological Studies Karlstad University Karlstad Sweden
| | - Charlotte Angelhoff
- Crown Princess Victoria's Child and Youth Hospital and Department of Biomedical and Clinical Sciences (BKV) Linköping University Linköping Sweden
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences Linköping University Linköping Sweden
- Department of Clinical Neuroscience Karolinska Institute Stockholm Sweden
| | - Annika Norell‐Clarke
- Department of Social and Psychological Studies Karlstad University Karlstad Sweden
- Faculty of Health Sciences Kristianstad University Kristianstad Sweden
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18
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Abstract
Sleep is a fundamental, evolutionarily conserved, plastic behavior that is regulated by circadian and homeostatic mechanisms as well as genetic factors and environmental factors, such as light, humidity, and temperature. Among environmental cues, temperature plays an important role in the regulation of sleep. This review presents an overview of thermoreception in animals and the neural circuits that link this process to sleep. Understanding the influence of temperature on sleep can provide insight into basic physiologic processes that are required for survival and guide strategies to manage sleep disorders.
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19
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Tracy EL, Zhang J, Wilckens K, Krafty RT, Hasler BP, Hall MH, Buysse DJ. Homeostatic response to sleep deprivation and circadian rhythmicity are intact in older adults with insomnia. Sleep 2022; 45:zsac162. [PMID: 35878753 PMCID: PMC9453614 DOI: 10.1093/sleep/zsac162] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 03/20/2022] [Indexed: 07/27/2023] Open
Abstract
STUDY OBJECTIVES We examined whether homeostatic sleep drive and circadian rhythmicity differ in older adults with insomnia (OAI) compared to older good sleepers (GS). METHODS OAI (n = 37) and GS (n = 30) participated in a 60-h in-lab study with sleep deprivation and constant routine paradigms. Homeostatic sleep drive was assessed by examining the effect of sleep deprivation on delta EEG power and theta EEG power, and repeated sleep latency tests. Circadian rhythm was assessed with salivary melatonin (phase and amplitude), core body temperature (phase, amplitude, and mesor), and sleep latency during a constant routine paradigm. Mixed models were used to assess interactions of group (OAS vs GS) with homeostatic sleep and circadian effects. RESULTS Compared to GS, OAI showed a greater linear increase in waking theta power during sleep deprivation, but the two groups did not show differential responses to sleep deprivation in delta EEG, or in repeated sleep latency tests. The two groups did not differ in circadian phase or amplitude of melatonin or core body temperature rhythms. OAI had a significantly elevated core body temperature mesor compared to GS. CONCLUSIONS Homeostatic response to sleep deprivation was intact in OAI compared to GS; theta EEG power suggested a greater homeostatic response in OAI. Circadian rhythm amplitude and phase were similar in OAI compared to GS. Elevated body temperature mesor in OAI may indicate elevated physiological arousal. These findings suggest that effective treatments for insomnia in older adults may leverage intact sleep and circadian regulatory mechanisms, rather than repair defective sleep and circadian regulation.
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Affiliation(s)
| | | | - Kristine Wilckens
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Robert T Krafty
- Department of Biostatics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Daniel J Buysse
- Corresponding author. Daniel J. Buysse, Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O’Hara St. Pittsburgh, PA, 15213, USA.
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20
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Miyazaki K, Itoh N, Saiki P, Kuroki Y. Supplementation with Eurycoma longifolia Extract Modulates Diurnal Body Temperature Fluctuation and Sleep Rhythm in Mice. J Nutr Sci Vitaminol (Tokyo) 2022; 68:342-347. [PMID: 36047106 DOI: 10.3177/jnsv.68.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Eurycoma longifolia (Tongkat Ali; TA) is a traditional medicinal herb, commonly known as Malaysian ginseng. The root tea has been traditionally applied to treat fevers, aches, sexual dysfunction and other ailments. We evaluated the effects of TA extract supplementation on diurnal core body temperature (BT) and sleep architecture in model mice. Dietary supplementation with TA extract for 4 wk resulted in significantly and moderately reduced BT during the rest and active phases, respectively. A high dose delayed the onset of BT elevation at the start of the active phase, indicating that the effect was dose-dependent. Electroencephalography findings revealed that dietary supplementation with TA extract changed sleep rhythms and delta power during the inactive phase of NREM sleep, indicating improved sleep quality. Our findings suggested that dietary TA extract could be a promising natural aid that alleviates sleep problems via thermoregulation.
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Affiliation(s)
- Koyomi Miyazaki
- Cellular and Molecular Biotechnology Research Institute, National Institute of Advanced Industrial Science and Technology
| | - Nanako Itoh
- Cellular and Molecular Biotechnology Research Institute, National Institute of Advanced Industrial Science and Technology
| | - Papawee Saiki
- Cellular and Molecular Biotechnology Research Institute, National Institute of Advanced Industrial Science and Technology
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21
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Irwin MR. Sleep disruption induces activation of inflammation and heightens risk for infectious disease: Role of impairments in thermoregulation and elevated ambient temperature. Temperature (Austin) 2022; 10:198-234. [PMID: 37332305 PMCID: PMC10274531 DOI: 10.1080/23328940.2022.2109932] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/25/2022] [Accepted: 07/30/2022] [Indexed: 10/15/2022] Open
Abstract
Thermoregulation and sleep are tightly coordinated, with evidence that impairments in thermoregulation as well as increases in ambient temperature increase the risk of sleep disturbance. As a period of rest and low demand for metabolic resources, sleep functions to support host responses to prior immunological challenges. In addition by priming the innate immune response, sleep prepares the body for injury or infection which might occur the following day. However when sleep is disrupted, this phasic organization between nocturnal sleep and the immune system becomes misaligned, cellular and genomic markers of inflammation are activated, and increases of proinflammatory cytokines shift from the nighttime to the day. Moreover, when sleep disturbance is perpetuated due to thermal factors such as elevated ambient temperature, the beneficial crosstalk between sleep and immune system becomes further imbalanced. Elevations in proinflammatory cytokines have reciprocal effects and induce sleep fragmentation with decreases in sleep efficiency, decreases in deep sleep, and increases in rapid eye movement sleep, further fomenting inflammation and inflammatory disease risk. Under these conditions, sleep disturbance has additional potent effects to decrease adaptive immune response, impair vaccine responses, and increase vulnerability to infectious disease. Behavioral interventions effectively treat insomnia and reverse systemic and cellular inflammation. Further, insomnia treatment redirects the misaligned inflammatory- and adaptive immune transcriptional profiles with the potential to mitigate risk of inflammation-related cardiovascular, neurodegenerative, and mental health diseases, as well as susceptibility to infectious disease.
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Affiliation(s)
- Michael R. Irwin
- University of California, Los Angeles – Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Los Angeles, California, USA
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22
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He C, Kim H, Hashizume M, Lee W, Honda Y, Kim SE, Kinney PL, Schneider A, Zhang Y, Zhu Y, Zhou L, Chen R, Kan H. The effects of night-time warming on mortality burden under future climate change scenarios: a modelling study. Lancet Planet Health 2022; 6:e648-e657. [PMID: 35932785 DOI: 10.1016/s2542-5196(22)00139-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The health impacts of climate warming are usually quantified based on daily average temperatures. However, extra health risks might result from hot nights. We project the future mortality burden due to hot nights. METHODS We selected the hot night excess (HNE) to represent the intensity of night-time heat, which was calculated as the excess sum of high temperature during night time. We collected historical mortality data in 28 cities from three east Asian countries, from 1981 to 2010. The associations between HNE and mortality in each city were firstly examined using a generalised additive model in combination with a distributed lag non-linear model over lag 0-10 days. We then pooled the cumulative associations using a univariate meta-regression model at the national or regional levels. Historical and future hourly temperature series were projected under two scenarios of greenhouse-gas emissions from 1980-2099, with ten general circulation models. We then projected the attributable fraction of mortality due to HNE under each scenario. FINDINGS Our dataset comprised 28 cities across three countries (Japan, South Korea, and China), including 9 185 598 deaths. The time-series analyses showed the HNE was significantly associated with increased mortality risks, the relative mortality risk on days with hot nights could be 50% higher than on days with non-hot nights. Compared with the rise in daily mean temperature (lower than 20%), the frequency of hot nights would increase more than 30% and the intensity of hot night would increase by 50% by 2100s. The attributable fraction of mortality due to hot nights was projected to be 3·68% (95% CI 1·20 to 6·17) under a strict emission control scenario (SSP126). Under a medium emission control scenario (SSP245), the attributable fraction of mortality was projected to increase up to 5·79% (2·07 to 9·52), which is 0·95% (-0·39 to 2·29) more than the attributable fraction of mortality due to daily mean temperature. INTERPRETATION Our study provides evidence for significant mortality risks and burden in association with night-time warming across Japan, South Korea, and China. Our findings suggest a growing role of night-time warming in heat-related health effects in a changing climate. FUNDING The National Natural Science Foundation of China, Shanghai International Science and Technology Partnership Project.
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Affiliation(s)
- Cheng He
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Ho Kim
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Whanhee Lee
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, South Korea; Institute of Ewha-SCL for Environmental Health, College of Medicine, Ewha Womans University, Seoul, South Korea
| | - Yasushi Honda
- Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Japan; Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Satbyul Estella Kim
- Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Japan; Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | | | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Yuqiang Zhang
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Durham, NC, USA
| | - Yixiang Zhu
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Lu Zhou
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China.
| | - Haidong Kan
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China; Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China.
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23
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Kuderer S, Vagedes K, Szöke H, Kohl M, Joos S, Gündling PW, Vagedes J. Do ginger footbaths improve symptoms of insomnia more than footbaths with warm water only? - A randomized controlled study. Complement Ther Med 2022; 67:102834. [PMID: 35439548 DOI: 10.1016/j.ctim.2022.102834] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 04/13/2022] [Accepted: 04/15/2022] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES To compare the effects between warm water (WW) and ginger footbaths (WW+ginger) on sleep quality and warmth regulation in adults with self-reported insomnia symptoms. METHODS A prospective randomized-controlled study in which 28 participants (mean age 50.9 years, 64.3% women, insomnia symptom duration 11.4 years) were randomized to receive WW (n = 13) or WW+ginger (n = 15) daily for 2 weeks. Treatment involved nightly footbaths (12 liters of 38-42 °C warm tap water, maximum duration 20 min) with and without topical ginger (80 g of powdered ginger rhizomes). MAIN OUTCOME MEASURES The primary outcome measure was self-reported sleep quality (global score from Pittsburgh Sleep Quality Index, PSQI) at 2 weeks. Secondary outcomes included measures of insomnia severity (Insomnia Severity Index, ISI) and warmth regulation (Herdecke Warmth Perception Questionnaire, HWPQ and 24-hour distal-proximal skin temperature gradient, DPG). RESULTS WW+ginger had no greater effect on PSQI (mean between-difference 0.0 [95% CI -3.0 to 2.9], Cohen's d=0.0) or ISI (-0.2 [-3.9 to 3.4], 0.0) than WW. Nor were there any significant differences in HWPQ perceived warmth (0.1 ≥d≥0.5) or DPG (0.1 ≥d≥0.4) between WW and WW+ginger. Both groups improved over time in PSQI (WW+ginger: d=0.7, WW: d=1.3) and ISI (WW+ginger: d=0.8, WW: d=1.0). Perceived warmth of the feet increased only in WW+ginger over time (d=0.6, WW: d=0.0). CONCLUSIONS This dose of ginger (6.67 g/liter) did not have greater effects on sleep quality, insomnia severity or warmth regulation than WW. Considering effect sizes, costs and risks, the use of WW would be recommended over WW+ginger in this patient population.
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Affiliation(s)
- Silja Kuderer
- Research Department, ARCIM Institute (Academic Research in Complementary and Integrative Medicine), Im Haberschlai 7, 70794 Filderstadt, Germany
| | - Katrin Vagedes
- Research Department, ARCIM Institute (Academic Research in Complementary and Integrative Medicine), Im Haberschlai 7, 70794 Filderstadt, Germany
| | - Henrik Szöke
- Department of Integrative Medicine, University of Pécs, Vörösmarty utca 3, 7623 Pécs, Hungary
| | - Matthias Kohl
- Institute of Precision Medicine, University Furtwangen, Jakob-Kienzle-Straße 17, 78054 VS-Schwenningen, Germany
| | - Stefanie Joos
- Institute for General Practice and Interprofessional Care, University Hospital Tübingen, Osianderstraße 5, 72076 Tübingen, Germany
| | - Peter W Gündling
- Hochschule Fresenius, University of Applied Sciences, Limburger Str. 2, 65510 Idstein, Germany
| | - Jan Vagedes
- Research Department, ARCIM Institute (Academic Research in Complementary and Integrative Medicine), Im Haberschlai 7, 70794 Filderstadt, Germany; Department of Neonatology, University Hospital Tübingen, Calwerstraße 7, 72076 Tübingen, Germany; Department of Pediatrics, Filderklinik, Im Haberschlai 7, 70794 Filderstadt, Germany.
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24
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Haghayegh S, Khoshnevis S, Smolensky MH, Hermida RC, Castriotta RJ, Schernhammer E, Diller KR. Novel
temperature‐controlled
sleep system to improve sleep: a p
roof‐of‐concept
study. J Sleep Res 2022; 31:e13662. [DOI: 10.1111/jsr.13662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 04/14/2022] [Accepted: 05/13/2022] [Indexed: 01/08/2023]
Affiliation(s)
- Shahab Haghayegh
- Channing Division of Network Medicine Brigham and Women's Hospital and Harvard Medical School Boston Massachusetts USA
- Department of Biomedical Engineering Cockrell School of Engineering, The University of Texas at Austin Austin Texas USA
| | - Sepideh Khoshnevis
- 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 Cardiology McGovern School of Medicine, The University of Texas Health Science Center at Houston Houston 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 Telecommunication 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
| | - Eva Schernhammer
- Channing Division of Network Medicine Brigham and Women's Hospital and Harvard Medical School Boston Massachusetts USA
- Department of Epidemiology Center for Public Health, Medical University of Vienna Vienna Austria
- Department of Epidemiology Harvard TH Chan School of Public Health Boston Massachusetts 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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25
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Approches thérapeutiques des troubles du sommeil et des rythmes chez l’enfant avec TSA. Encephale 2022; 48:294-303. [DOI: 10.1016/j.encep.2021.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 07/12/2021] [Accepted: 08/20/2021] [Indexed: 12/27/2022]
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26
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Rösler L, van der Lande G, Leerssen J, Vandegriffe AG, Lakbila-Kamal O, Foster-Dingley JC, Albers ACW, van Someren EJW. Combining cardiac monitoring with actigraphy aids nocturnal arousal detection during ambulatory sleep assessment in insomnia. Sleep 2022; 45:zsac031. [PMID: 35554586 PMCID: PMC9113014 DOI: 10.1093/sleep/zsac031] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 10/15/2021] [Indexed: 11/29/2022] Open
Abstract
STUDY OBJECTIVES The objective assessment of insomnia has remained difficult. Multisensory devices collecting heart rate (HR) and motion are regarded as the future of ambulatory sleep monitoring. Unfortunately, reports on altered average HR or heart rate variability (HRV) during sleep in insomnia are equivocal. Here, we evaluated whether the objective quantification of insomnia improves by assessing state-related changes in cardiac measures. METHODS We recorded electrocardiography, posture, and actigraphy in 33 people without sleep complaints and 158 patients with mild to severe insomnia over 4 d in their home environment. At the microscale, we investigated whether HR changed with proximity to gross (body) and small (wrist) movements at nighttime. At the macroscale, we calculated day-night differences in HR and HRV measures. For both timescales, we tested whether outcome measures were related to insomnia diagnosis and severity. RESULTS At the microscale, an increase in HR was often detectable already 60 s prior to as well as following a nocturnal chest, but not wrist, movement. This increase was slightly steeper in insomnia and was associated with insomnia severity, but future EEG recordings are necessary to elucidate whether these changes occur prior to or simultaneously with PSG-indicators of wakefulness. At the macroscale, we found an attenuated cardiac response to sleep in insomnia: patients consistently showed smaller day-night differences in HR and HRV. CONCLUSIONS Incorporating state-related changes in cardiac features in the ambulatory monitoring of sleep might provide a more sensitive biomarker of insomnia than the use of cardiac activity averages or actigraphy alone.
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Affiliation(s)
- Lara Rösler
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, The Netherlands
| | - Glenn van der Lande
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, The Netherlands
| | - Jeanne Leerssen
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, The Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU University, Amsterdam, The Netherlands
| | - Austin G Vandegriffe
- Department of Mathematics and Statistics, Missouri University of Science and Technology, Rolla, MO,USA
| | - Oti Lakbila-Kamal
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, The Netherlands
| | - Jessica C Foster-Dingley
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, The Netherlands
| | - Anne C W Albers
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, The Netherlands
| | - Eus J W van Someren
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, The Netherlands
- Department of Integrative Neurophysiology and Psychiatry, Center for Neurogenomics and Cognitive Research, VU University, Amsterdam UMC, Amsterdam Neuroscience, Amsterdam, The Netherlands
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27
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Chen SC, Tang X, Goda T, Umezaki Y, Riley AC, Sekiguchi M, Yoshii T, Hamada FN. Dorsal clock networks drive temperature preference rhythms in Drosophila. Cell Rep 2022; 39:110668. [PMID: 35417715 PMCID: PMC9109596 DOI: 10.1016/j.celrep.2022.110668] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 09/21/2021] [Accepted: 03/22/2022] [Indexed: 11/24/2022] Open
Abstract
Animals display a body temperature rhythm (BTR). Little is known about the mechanisms by which a rhythmic pattern of BTR is regulated and how body temperature is set at different times of the day. As small ectotherms, Drosophila exhibit a daily temperature preference rhythm (TPR), which generates BTR. Here, we demonstrate dorsal clock networks that play essential roles in TPR. Dorsal neurons 2 (DN2s) are the main clock for TPR. We find that DN2s and posterior DN1s (DN1ps) contact and the extent of contacts increases during the day and that the silencing of DN2s or DN1ps leads to a lower temperature preference. The data suggest that temporal control of the microcircuit from DN2s to DN1ps contributes to TPR regulation. We also identify anterior DN1s (DN1as) as another important clock for TPR. Thus, we show that the DN networks predominantly control TPR and determine both a rhythmic pattern and preferred temperatures.
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Affiliation(s)
- Shyh-Chi Chen
- Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Xin Tang
- Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Tadahiro Goda
- Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA; Department of Neurobiology, Physiology and Behavior, University of California, Davis, Davis, CA 95616, USA
| | - Yujiro Umezaki
- Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA; Department of Neurobiology, Physiology and Behavior, University of California, Davis, Davis, CA 95616, USA
| | - Abigail C Riley
- Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Manabu Sekiguchi
- Graduate School of Natural Science and Technology, Okayama University, Okayama 700-8530, Japan
| | - Taishi Yoshii
- Graduate School of Natural Science and Technology, Okayama University, Okayama 700-8530, Japan
| | - Fumika N Hamada
- Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA; Department of Neurobiology, Physiology and Behavior, University of California, Davis, Davis, CA 95616, USA.
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28
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Qi X, Ye J, Wen Y, Liu L, Cheng B, Cheng S, Yao Y, Zhang F. Evaluating the Effects of Diet-Gut Microbiota Interactions on Sleep Traits Using the UK Biobank Cohort. Nutrients 2022; 14:1134. [PMID: 35334789 PMCID: PMC8951611 DOI: 10.3390/nu14061134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 12/11/2022] Open
Abstract
Previous studies showed that diet and gut microbiota had a correlation with sleep. However, the potential interaction effects of diet and gut microbiota on sleep are still unclear. The phenotypic data of insomnia (including 374,505 subjects) and sleep duration (including 372,805 subjects) were obtained from the UK Biobank cohort. The Single Nucleotide Polymorphisms (SNPs) associated with 114 gut microbiota, 84 dietary habits, and 4 dietary compositions were derived from the published Genome-wide Association Study (GWAS). We used Linkage Disequilibrium Score Regression (LDSC) to estimate the genetic correlation and colocalization analysis to assess whether dietary habits and insomnia/sleep duration shared a causal variant in a region of the genome. Using UK Biobank genotype data, the polygenetic risk score of gut microbiota, dietary habits, and dietary compositions were calculated for each subject. Logistic regression and linear regression models were used to assess the potential effects of diet-gut microbiota interactions on sleep phenotypes, including insomnia and sleep duration. Insomnia and sleep duration were used as dependent variables, and sex, age, the Townsend Deprivation Index scores, and smoking and drinking habits were selected as covariates in the regression analysis. All statistical analyses were conducted using R-3.5.1 software. Significant genetic correlations were discovered between insomnia/sleep duration and dietary habits. Further, we found several significant dietary compositions-gut microbiota interactions associated with sleep, such as fat × G_Collinsella_RNT (p = 1.843 × 10-2) and protein × G_Collinsella_HB (p = 7.11 × 10-3). Besides, multiple dietary habits-gut microbiota interactions were identified for sleep, such as overall beef intake × G_Desulfovibrio_RNT (p = 3.26 × 10-4), cups of coffee per day × G_Escherichia_Shigella_RNT (p = 1.14 × 10-3), and pieces of dried fruit per day × G_Bifidobacterium_RNT (p = 5.80 × 10-3). This study reported multiple diet-gut microbiota interactions associated with sleep, which may provide insights into the biological mechanisms of diet and gut microbiota affecting sleep.
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Affiliation(s)
- Xin Qi
- Precision Medicine Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China;
| | - Jing Ye
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China; (J.Y.); (Y.W.); (L.L.); (B.C.); (S.C.); (Y.Y.)
| | - Yan Wen
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China; (J.Y.); (Y.W.); (L.L.); (B.C.); (S.C.); (Y.Y.)
| | - Li Liu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China; (J.Y.); (Y.W.); (L.L.); (B.C.); (S.C.); (Y.Y.)
| | - Bolun Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China; (J.Y.); (Y.W.); (L.L.); (B.C.); (S.C.); (Y.Y.)
| | - Shiqiang Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China; (J.Y.); (Y.W.); (L.L.); (B.C.); (S.C.); (Y.Y.)
| | - Yao Yao
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China; (J.Y.); (Y.W.); (L.L.); (B.C.); (S.C.); (Y.Y.)
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China; (J.Y.); (Y.W.); (L.L.); (B.C.); (S.C.); (Y.Y.)
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29
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Namisnak LH, Haghayegh S, Khoshnevis S, Diller KR. Bioheat Transfer Basis of Human Thermoregulation: Principles and Applications. JOURNAL OF HEAT TRANSFER 2022; 144:031203. [PMID: 35833149 PMCID: PMC8823203 DOI: 10.1115/1.4053195] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 12/06/2021] [Indexed: 05/29/2023]
Abstract
Thermoregulation is a process that is essential to the maintenance of life for all warm-blooded mammalian and avian species. It sustains a constant core body temperature in the face of a wide array of environmental thermal conditions and intensity of physical activities that generate internal heat. A primary component of thermoregulatory function is the movement of heat between the body core and the surface via the circulation of blood. The peripheral vasculature acts as a forced convection heat exchanger between blood and local peripheral tissues throughout the body enabling heat to be convected to the skin surface where is may be transferred to and from the environment via conduction, convection, radiation, and/or evaporation of water as local conditions dictate. Humans have evolved a particular vascular structure in glabrous (hairless) skin that is especially well suited for heat exchange. These vessels are called arteriovenous anastomoses (AVAs) and can vasodilate to large diameters and accommodate high flow rates. We report herein a new technology based on a physiological principle that enables simple and safe access to the thermoregulatory control system to allow manipulation of thermoregulatory function. The technology operates by applying a small amount of heating local to control tissue on the body surface overlying the cerebral spine that upregulates AVA perfusion. Under this action, heat exchangers can be applied to glabrous skin, preferably on the palms and soles, to alter the temperature of elevated blood flow prior to its return to the core. Therapeutic and prophylactic applications are discussed.
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Affiliation(s)
- Laura H Namisnak
- Department of Biomedical Engineering, Cockrell School of Engineering, University of Texas at Austin, Austin, TX 78712
| | - Shahab Haghayegh
- Department of Biomedical Engineering, Cockrell School of Engineering, University of Texas at Austin, Austin, TX 78712; Department of Biostatics, T.H. Chan School of Public Health, Harvard Medical School, Boston, MA 02138
| | - Sepideh Khoshnevis
- Department of Biomedical Engineering, Cockrell School of Engineering, University of Texas at Austin, Austin, TX 78712
| | - Kenneth R Diller
- Department of Biomedical Engineering, Cockrell School of Engineering, University of Texas at Austin, Austin, TX 78712
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30
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McCabe SM, Abbiss CR, Libert JP, Bach V. Functional links between thermoregulation and sleep in children with neurodevelopmental and chronic health conditions. Front Psychiatry 2022; 13:866951. [PMID: 36451768 PMCID: PMC9703054 DOI: 10.3389/fpsyt.2022.866951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 10/24/2022] [Indexed: 11/16/2022] Open
Abstract
The bi-directional relationship between sleep and wake is recognized as important for all children. It is particularly consequential for children who have neurodevelopmental disorders (NDDs) or health conditions which challenge their sleep and biological rhythms, and their ability to maintain rhythms of participation in everyday activities. There are many studies which report the diverse reasons for disruption to sleep in these populations. Predominantly, there is focus on respiratory, pharmaceutical, and behavioral approaches to management. There is, however, little exploration and explanation of the important effects of body thermoregulation on children's sleep-wake patterns, and associated behaviors. Circadian patterns of sleep-wake are dependent on patterns of body temperature change, large enough to induce sleep preparedness but remaining within a range to avoid sleep disturbances when active thermoregulatory responses against heat or cold are elicited (to maintain thermoneutrality). Additionally, the subjective notion of thermal comfort (which coincides with the objective concept of thermoneutrality) is of interest as part of general comfort and associated behavioral responses for sleep onset and maintenance. Children's thermoregulation and thermal comfort are affected by diverse biological functions, as well as their participation in everyday activities, within their everyday environments. Hence, the aforementioned populations are additionally vulnerable to disruption of their thermoregulatory system and their capacity for balance of sleep and wakefulness. The purpose of this paper is to present hitherto overlooked information, for consideration by researchers and clinicians toward determining assessment and intervention approaches to support children's thermoregulation functions and promote their subjective thermal comfort, for improved regulation of their sleep and wake functions.
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Affiliation(s)
- Susan M McCabe
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Chris R Abbiss
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | | | - Véronique Bach
- PeriTox UMR_I 01, University of Picardie Jules Verne, Amiens, France
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31
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Korman P, Kusy K, Kantanista A, Straburzyńska-Lupa A, Zieliński J. Temperature and creatine kinase changes during a 10d taper period in sprinters. Physiol Meas 2021; 42. [PMID: 34823228 DOI: 10.1088/1361-6579/ac3d76] [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] [Received: 04/05/2021] [Accepted: 11/25/2021] [Indexed: 01/20/2023]
Abstract
Objective.The aim of this prospective cohort study, performed during a 10 d training camp, was to analyze the effect of a series of successive speed-power training sessions on the concurrent circadian changes in resting leg skin temperature and blood creatine kinase (CK) levels and to determine the correlation between them.Approach. Seventeen elite sprinters, aged 22-31 years, were examined. Every morning and evening, capillary blood samples were drawn to assay CK levels. Lower limb skin temperature was measured simultaneously, and thermal images were taken using an infrared camera.Main results. From the first day of the training camp, the base temperature levels began to drop to obtain a significant reduction from the 6th day (male) and from the 8th day (female) to the end of the camp. Simultaneously, CK levels increased in the male group from 8th to the end of the camp, but it did not change significantly in females. Regarding the circadian rhythm, the CK levels always rose during the day and declined during the night. The temperature decreased during the day and increased during the night until the 6th day. After that, the temperature changed oppositely till the end of camp, i.e. it increased during the day and decreased during the night. This could suggest that the training microcycle should last about a week because after this time there may be a disturbance in the temperature circadian rhythm and a significant CK accumulationSignificance. Multi-day speed-power training induced a progressive reduction in resting skin temperature and an elevation in CK levels. It also altered the circadian rhythm of the body skin temperature, which may indicate that after about 6 d of regular exercise, physiological deregulation may occur.
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Affiliation(s)
- Paweł Korman
- Chair of Physical Therapy and Sports Recovery, Poznan University of Physical Education, Poland
| | - Krzysztof Kusy
- Department of Athletics, Strength and Conditioning, Poznan University of Physical Education, Poland
| | - Adam Kantanista
- Department of Physical Education and Lifelong Sports, Poznan University of Physical Education, Poland
| | - Anna Straburzyńska-Lupa
- Chair of Physical Therapy and Sports Recovery, Poznan University of Physical Education, Poland
| | - Jacek Zieliński
- Department of Athletics, Strength and Conditioning, Poznan University of Physical Education, Poland
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32
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Lechat B, Scott H, Naik G, Hansen K, Nguyen DP, Vakulin A, Catcheside P, Eckert DJ. New and Emerging Approaches to Better Define Sleep Disruption and Its Consequences. Front Neurosci 2021; 15:751730. [PMID: 34690688 PMCID: PMC8530106 DOI: 10.3389/fnins.2021.751730] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 09/16/2021] [Indexed: 01/07/2023] Open
Abstract
Current approaches to quantify and diagnose sleep disorders and circadian rhythm disruption are imprecise, laborious, and often do not relate well to key clinical and health outcomes. Newer emerging approaches that aim to overcome the practical and technical constraints of current sleep metrics have considerable potential to better explain sleep disorder pathophysiology and thus to more precisely align diagnostic, treatment and management approaches to underlying pathology. These include more fine-grained and continuous EEG signal feature detection and novel oxygenation metrics to better encapsulate hypoxia duration, frequency, and magnitude readily possible via more advanced data acquisition and scoring algorithm approaches. Recent technological advances may also soon facilitate simple assessment of circadian rhythm physiology at home to enable sleep disorder diagnostics even for “non-circadian rhythm” sleep disorders, such as chronic insomnia and sleep apnea, which in many cases also include a circadian disruption component. Bringing these novel approaches into the clinic and the home settings should be a priority for the field. Modern sleep tracking technology can also further facilitate the transition of sleep diagnostics from the laboratory to the home, where environmental factors such as noise and light could usefully inform clinical decision-making. The “endpoint” of these new and emerging assessments will be better targeted therapies that directly address underlying sleep disorder pathophysiology via an individualized, precision medicine approach. This review outlines the current state-of-the-art in sleep and circadian monitoring and diagnostics and covers several new and emerging approaches to better define sleep disruption and its consequences.
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Affiliation(s)
- Bastien Lechat
- Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia
| | - Hannah Scott
- Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia
| | - Ganesh Naik
- Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia
| | - Kristy Hansen
- Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia
| | - Duc Phuc Nguyen
- Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia
| | - Andrew Vakulin
- Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia
| | - Peter Catcheside
- Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia
| | - Danny J Eckert
- Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia
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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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Spiegelhalder K, Benz F, Feige B, Riemann D. Subtypen der Insomnie – exemplarische Ansätze und offene Fragen. SOMNOLOGIE 2021. [DOI: 10.1007/s11818-021-00327-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
ZusammenfassungVerschiedene Autorinnen und Autoren nehmen an, dass es klinisch nützlich und wissenschaftlich erkenntnisbringend sein könnte, Subtypen der Insomnie zu identifizieren, um diese spezifisch und damit möglicherweise effektiver zu behandeln, als dies derzeit geschieht. Im vorliegenden Beitrag werden folgende exemplarisch ausgewählte Ansätze zur Einteilung der Insomnie in Subtypen vorgestellt: 1) Einteilungen nach klinischen Symptomen; 2) Primäre vs. sekundäre Insomnie; 3) Subtypen nach ICSD‑2; 4) Insomnie mit und ohne objektiv messbare kurze Schlafdauer; 5) Subtypen aus der Netherlands Sleep Registry. Anschließend werden die Stabilität der Zuordnung von einzelnen Patienten zu den verschiedenen Subtypen sowie die klinische Relevanz der Einteilungen kritisch diskutiert.
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Rothhaas R, Chung S. Role of the Preoptic Area in Sleep and Thermoregulation. Front Neurosci 2021; 15:664781. [PMID: 34276287 PMCID: PMC8280336 DOI: 10.3389/fnins.2021.664781] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 05/28/2021] [Indexed: 12/18/2022] Open
Abstract
Sleep and body temperature are tightly interconnected in mammals: warming up our body helps to fall asleep and the body temperature in turn drops while falling asleep. The preoptic area of the hypothalamus (POA) serves as an essential brain region to coordinate sleep and body temperature. Understanding how these two behaviors are controlled within the POA requires the molecular identification of the involved circuits and mapping their local and brain-wide connectivity. Here, we review our current understanding of how sleep and body temperature are regulated with a focus on recently discovered sleep- and thermo-regulatory POA neurons. We further discuss unresolved key questions including the anatomical and functional overlap of sleep- and thermo-regulatory neurons, their pathways and the role of various signaling molecules. We suggest that analysis of genetically defined circuits will provide novel insights into the mechanisms underlying the coordinated regulation of sleep and body temperature in health and disease.
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Affiliation(s)
- Rebecca Rothhaas
- Department of Neuroscience, Perelman School of Medicine, Chronobiology and Sleep Institute, University of Pennsylvania, Philadelphia, PA, United States
| | - Shinjae Chung
- Department of Neuroscience, Perelman School of Medicine, Chronobiology and Sleep Institute, University of Pennsylvania, Philadelphia, PA, United States
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36
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Hoyniak CP, McQuillan MM, Bates JE, Staples AD, Schwichtenberg A, Honaker SM. Presleep Arousal and Sleep in Early Childhood. J Genet Psychol 2021; 182:236-251. [PMID: 33870880 PMCID: PMC8684049 DOI: 10.1080/00221325.2021.1905596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 01/26/2021] [Indexed: 10/21/2022]
Abstract
Research suggests that arousal during the transition to sleep-presleep arousal-is associated with sleep disturbances. Although a robust literature has examined the role of presleep arousal in conferring risk for sleep disturbances in adults, substantially less research has examined the developmental origins of presleep arousal in early childhood. The authors examined presleep arousal using parent report and psychophysiological measures in a sample of preschoolers to explore the association between different measures of presleep arousal, and to examine how nightly presleep arousal is associated with sleep. Participants included 29 children assessed at 54 months of age. Presleep arousal was measured using parent reports of child arousal each night at bedtime and using a wearable device that took minute-by-minute recordings of heart rate, peripheral skin temperature, and electrodermal activity each night during the child's bedtime routine. This yielded a dataset with 4,550 min of ambulatory recordings across an average of 3.52 nights per child (SD = 1.84 nights per child; range = 1-8 nights). Sleep was estimated using actigraphy. Findings demonstrated an association between parent-reported and psychophysiological arousal, including heart rate, peripheral skin temperature, and skin conductance responses during the child's bedtime routine. Both the parent report and psychophysiological measures of presleep arousal showed some associations with poorer sleep, with the most robust associations occurring between presleep arousal and sleep onset latency. Behavioral and biological measures of hyperarousal at bedtime are associated with poorer sleep in young children. Findings provide early evidence of the utility of wearable devices for assessing individual differences in presleep arousal in early childhood.
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Affiliation(s)
- Caroline P. Hoyniak
- Department of Psychiatry, Washington University in St. Louis School of Medicine, USA
| | | | - John E. Bates
- Department of Psychological and Brain Sciences, Indiana University – Bloomington, USA
| | | | | | - Sarah M. Honaker
- Department of Pediatrics, Indiana University School of Medicine, USA
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Sweetman A, Lack L, McEvoy RD, Smith S, Eckert DJ, Osman A, Carberry JC, Wallace D, Nguyen PD, Catcheside P. Bi-directional relationships between co-morbid insomnia and sleep apnea (COMISA). Sleep Med Rev 2021; 60:101519. [PMID: 34229295 DOI: 10.1016/j.smrv.2021.101519] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 06/06/2021] [Accepted: 06/11/2021] [Indexed: 02/07/2023]
Abstract
Insomnia and obstructive sleep apnea (OSA) commonly co-occur. Approximately 30-50% of patients with OSA report clinically significant insomnia symptoms, and 30-40% of patients with chronic insomnia fulfil diagnostic criteria for OSA. Compared to either insomnia or OSA alone, co-morbid insomnia and sleep apnea (COMISA) is associated with greater morbidity for patients, complex diagnostic decisions for clinicians, and reduced response to otherwise effective treatment approaches. Potential bi-directional causal relationships between the mechanisms and manifestations of insomnia and OSA could play an integral role in the development and management of COMISA. A greater understanding of these relationships is required to guide personalized diagnostic and treatment approaches for COMISA. This review summarizes the available evidence of bi-directional relationships between COMISA, including epidemiological research, case studies, single-arm treatment studies, randomized controlled treatment trials, and objective sleep study data. This evidence is integrated into a conceptual model of COMISA to help refine the understanding of potential bi-directional causal relationships between the two disorders. This theoretical framework is essential to help guide future research, improve diagnostic tools, determine novel therapeutic targets, and guide tailored sequenced and multi-faceted treatment approaches for this common, complex, and debilitating condition.
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Affiliation(s)
- Alexander Sweetman
- The Adelaide Institute for Sleep Health: A Centre of Research Excellence, Flinders Health and Medical Research Institute: Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, Australia.
| | - Leon Lack
- The Adelaide Institute for Sleep Health: A Centre of Research Excellence, Flinders Health and Medical Research Institute: Sleep Health, College of Education Psychology and Social Work, Flinders University, Adelaide, Australia.
| | - R Doug McEvoy
- The Adelaide Institute for Sleep Health: A Centre of Research Excellence, Flinders Health and Medical Research Institute: Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, Australia.
| | - Simon Smith
- Institute for Social Science Research (ISSR), The University of Queensland, Brisbane, 4027, Australia.
| | - Danny J Eckert
- The Adelaide Institute for Sleep Health: A Centre of Research Excellence, Flinders Health and Medical Research Institute: Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, Australia.
| | - Amal Osman
- The Adelaide Institute for Sleep Health: A Centre of Research Excellence, Flinders Health and Medical Research Institute: Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, Australia.
| | - Jayne C Carberry
- The Adelaide Institute for Sleep Health: A Centre of Research Excellence, Flinders Health and Medical Research Institute: Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, Australia; University College Dublin, School of Medicine, Dublin, Ireland.
| | - Douglas Wallace
- Department of Neurology, Sleep Medicine Division, University of Miami Miller School of Medicine, Miami, FL, USA; Neurology Service, Bruce W. Carter Department of Veterans Affairs Medical Center, Miami, FL, USA.
| | - Phuc D Nguyen
- The Adelaide Institute for Sleep Health: A Centre of Research Excellence, Flinders Health and Medical Research Institute: Sleep Health, College of Science and Engineering, Flinders University, Adelaide, Australia.
| | - Peter Catcheside
- The Adelaide Institute for Sleep Health: A Centre of Research Excellence, Flinders Health and Medical Research Institute: Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, Australia.
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Min KB, Lee S, Min JY. High and low ambient temperature at night and the prescription of hypnotics. Sleep 2021; 44:6016156. [PMID: 33442740 DOI: 10.1093/sleep/zsaa262] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 10/04/2020] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES This study investigated the association between ambient nighttime temperature and sleep problems assessed by the prescription dose of sleeping pills in South Korean adults. METHODS We used the 2002-2015 National Health Insurance Service-National Sample Cohort. A total of 711,079 adults who were 20 years old or older were included, wherein 42,858 adults (~6%) had been prescribed hypnotic medications including zolpidem (N05CF02) and triazolam (N05CD05). Ambient temperature data was calculated as the mean highest temperature of nighttime (23:00-07:00) for every month from January to December. We combined the drug-prescribed date with the administrative districts-level daily nighttime temperature between 2002 and 2015. RESULTS We found that a non-linear, U-shaped relationship between nighttime temperature and hypnotic medication prescription. With an increase per 1°C temperature or an increase in a square per 1°C, the prescription dose of sleeping pills was significantly increased (both p < 0.05). At each 5°C nighttime temperature, subjects belonging to low (≤0°C and 0-5°C) or high (20-25°C and ≥25°C) temperature categories had significantly higher doses of sleeping pills than those at the reference temperature (10-15°C). Changes in nighttime temperature had a significant non-linear effect on the prescribed dosage of hypnotic medications for both adults (p < 0.0001) and the elderly (p = 0.0006). CONCLUSION We found that either a high or low nighttime temperature was significantly associated with a high daily dose of hypnotic medications in the Korean population.
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Affiliation(s)
- Kyoung-Bok Min
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Sohyae Lee
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Jin-Young Min
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul, Republic of Korea
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Charest J, Marois A, Bastien CH. Can a tDCS treatment enhance subjective and objective sleep among student-athletes? JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:378-389. [PMID: 31724914 DOI: 10.1080/07448481.2019.1679152] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 09/06/2019] [Accepted: 10/06/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Previous studies have shown that student-athletes suffer from sleep difficulties. This study explored the impact of tDCS on sleep parameters among student-athletes. METHOD Thirty student-athletes (15 females, 15 males, age 21.1 ± 2.1 years) were recruited. All participants underwent a series of questions to rule out depressive and anxiety disorders or any specific tDCS exclusion criteria. All participants were advised to maintain their usual sleep schedule. RESULTS Compared polysomnographic and Psychomotor Vigilance Task data analyses did not show any improvement after experimental tDCS. Regardless of groups, PVT mean reaction time was decreased. Regarding the questionnaires, data analyses showed improvement on the PSQI (p < .001), ISI (p < .001) and ASSQ (p < .007) scores after tDCS. DISCUSSION tDCS appears to increase total sleep time and should be further explored. Improvements in subjective sleep suggest that tDCS bears interesting possibilities into the enhancement of sleep among student-athletes.
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Murphy CJ, Hartescu I, Roberts IE, Leicht CA, Goosey-Tolfrey VL. Sleep Characteristics of Highly Trained Wheelchair Rugby Athletes With and Without a Cervical Spinal Cord Injury During the Competitive Season. Front Sports Act Living 2021; 3:643233. [PMID: 33997778 PMCID: PMC8118075 DOI: 10.3389/fspor.2021.643233] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/17/2021] [Indexed: 01/06/2023] Open
Abstract
Sleep behaviors although significantly relevant to exercise recovery are poorly characterized in Para-sport athletes. Therefore, the main aims of this study were to describe sleep quality and quantity of highly trained wheelchair rugby (WR) athletes during the competitive season, and to investigate whether impairment type or attending a training camp influenced sleep outcomes. Eighteen male WR athletes (mean ± SD; age: 30 ± 5 years) with cervical spinal cord injuries (n = 11) (CSCI) and without (n = 7) (NON-SCI) wore an activity monitor over a 16-day period to objectively quantify sleep parameters, while the Pittsburgh Sleep Quality Index (PSQI) and nightly sleep diary entries were used as subjective means. A sub-sample of the athletes (n = 11) had their sleep monitored during a 3-night training camp to assess the impact of environmental change on sleep. Furthermore, as an additional exploratory measure core temperature was measured for a single night-time period using ingestible telemetry capsules. The athletes had total sleep times and sleep efficiency scores of 7.06 (1.30) h.min [median (interquartile range)] and 81 (9)%, respectively. Sleep onset latency and wake after sleep onset were 13 (24) min and 1.11 (0.45) h.min, respectively. No significant differences were found in objective sleep variables between the impairment groups despite the CSCI group being significantly more likely to report a poorer night's sleep (p = 0.04). Furthermore, attending the training camp caused a significant reduction in total sleep time for both groups [Δ38 ± 33 min; (95% CI: 18–60 min) p < 0.01]. This study highlights suboptimal sleep characteristics that are present in both CSCI and NON-SCI wheelchair athletes, as defined by the National Sleep Foundation. Although objective scores did not differ between groups, athletes with a CSCI rated their sleep worse. Furthermore, the disruption of sleep during training camp reflects an additional risk factor that is important to recognize for those working with wheelchair athletes.
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Affiliation(s)
- Conor J Murphy
- The Peter Harrison Centre for Disability Sport, School of Sport and Exercise Sciences, Loughborough University, Loughborough, United Kingdom.,National Centre of Sport and Exercise Medicine (NCSEM), School of Sport and Exercise Sciences, Loughborough University, Loughborough, United Kingdom
| | - Iuliana Hartescu
- National Centre of Sport and Exercise Medicine (NCSEM), School of Sport and Exercise Sciences, Loughborough University, Loughborough, United Kingdom
| | - Ifan E Roberts
- National Centre of Sport and Exercise Medicine (NCSEM), School of Sport and Exercise Sciences, Loughborough University, Loughborough, United Kingdom
| | - Christof A Leicht
- The Peter Harrison Centre for Disability Sport, School of Sport and Exercise Sciences, Loughborough University, Loughborough, United Kingdom.,National Centre of Sport and Exercise Medicine (NCSEM), School of Sport and Exercise Sciences, Loughborough University, Loughborough, United Kingdom
| | - Vicky L Goosey-Tolfrey
- The Peter Harrison Centre for Disability Sport, School of Sport and Exercise Sciences, Loughborough University, Loughborough, United Kingdom.,National Centre of Sport and Exercise Medicine (NCSEM), School of Sport and Exercise Sciences, Loughborough University, Loughborough, United Kingdom
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Boots RJ, Mead G, Garner N, Rawashdeh O, Bellapart J, Townsend S, Paratz J, Clement P, Oddy D, Leong M, Zappala C. Temperature rhythms and ICU sleep: the TRIS study. Minerva Anestesiol 2021; 87:794-802. [PMID: 33853269 DOI: 10.23736/s0375-9393.21.15232-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Core body temperature (CBT) patterns associated with sleep have not been described in the critically ill. This study aimed to characterize night-time sleep and its relationship to CBT in ICU patients. METHODS A prospective study was performed in a 27-bed tertiary adult intensive care unit of 20 mechanically ventilated patients in the weaning stage of their critical illness. The study assessed sleep by polysomnography (PSG) during the evening between 21:00-7:00 hours, nursing interventions using the Therapeutic Intervention Scoring System (TISS), illness severity using SOFA and APACHE II scores and CBT 24-hour pattern. RESULTS Patients were awake for approximately half the study period (45.04%, IQR 13.81-77-17) with no REM (0%, IQR 0-0.04%) and median arousals of 19.5/hour (IQR 7.1-40.9). The 24-hour CBT had a rhythmic pattern in 13 (65%) patients with a highly variable phase of median peak time at 17:35 hours (IQR 12:40-19:39). No significant associations were found between CBT rhythmicity, sleep stages, sleep EEG frequency density, illness severity scores or TISS on the day of PSG. There was no relationship between time awake and CBT rhythmicity (P=0.48) or CBT peak time (P=0.82). The relationship between circadian rhythms and sleep patterns in the critically ill is complex. CONCLUSIONS Patients recovering in ICU commonly have CBT loss of rhythmicity or a significant phase shift with loss of normal night-time patterns of sleep architecture. Appropriate care plans to promote sleep and circadian rhythm require further investigation of contributing factors such as environment, clinical care routines, illness type and severity.
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Affiliation(s)
- Rob J Boots
- Department of Thoracic Medicine, Royal Brisbane and Women's Hospital, Herston, Australia - .,Faculty of Medicine, University of Queensland, Herston, Australia - .,Department of Burns, Trauma and Critical Care, University of Queensland, Herston, Australia - .,Department of Intensive Care, Bundaberg Base Hospital, Bundaberg, Australia -
| | - Gabrielle Mead
- School of Biomedical Sciences, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Nicholas Garner
- School of Biomedical Sciences, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Oliver Rawashdeh
- School of Biomedical Sciences, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Judith Bellapart
- Department of Burns, Trauma and Critical Care, University of Queensland, Herston, Australia.,Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Shane Townsend
- Department of Burns, Trauma and Critical Care, University of Queensland, Herston, Australia.,Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Jenny Paratz
- Department of Burns, Trauma and Critical Care, University of Queensland, Herston, Australia
| | - Pierre Clement
- Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Herston, Australia
| | - David Oddy
- Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Matthew Leong
- Department of Thoracic Medicine, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Christopher Zappala
- Department of Thoracic Medicine, Royal Brisbane and Women's Hospital, Herston, Australia
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The effects of exercise on sleep in unipolar depression: A systematic review and network meta-analysis. Sleep Med Rev 2021; 59:101452. [PMID: 33667885 DOI: 10.1016/j.smrv.2021.101452] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/11/2020] [Accepted: 12/26/2020] [Indexed: 12/31/2022]
Abstract
Insomnia predicts the onset, course, and reoccurrence of unipolar depression. However, systematic reviews of treatment options for insomnia in unipolar depression are lacking. After screening 7725 records, 17 trials comprising 1645 patients randomized to 13 treatments were included for quantitative synthesis. Network meta-analysis showed that compared to a passive control condition, all exercise interventions except moderate aerobic exercise alone resulted in significantly better sleep outcomes. Compared with treatment as usual, mind-body exercise plus treatment as usual (SMD: -0.46; 95% CI: -0.80, -0.12) and vigorous strength exercise (SMD: -0.61; 95% CI: -1.12, -0.10) were significantly more effective. Pairwise meta-analyses showed that mind-body exercise (SMD: -0.54; 95% CI: -0.85, -0.23) had beneficial effects compared to passive control. The network meta-analysis is statistically very robust with low heterogeneity, incoherence, and indirectness. However, confidence in the findings was moderate to very low, primarily due to within-study bias. This is the first network meta-analysis to assess exercise's efficacy to improve sleep quality in patients with depression. The findings confirm the benefits of exercise as an add-on treatment for depression. This consolidation of the current state of evidence can help clinicians make evidence-based decisions.
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The association of insomnia disorder characterised by objective short sleep duration with hypertension, diabetes and body mass index: A systematic review and meta-analysis. Sleep Med Rev 2021; 59:101456. [PMID: 33640704 DOI: 10.1016/j.smrv.2021.101456] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 12/07/2020] [Accepted: 01/04/2021] [Indexed: 01/26/2023]
Abstract
Insomnia disorder with objective short sleep duration (less than 6 h of objective sleep or sleep efficiency less than 85%) has been considered as a biologically severe subtype of insomnia associated with a higher risk of cardiometabolic disease morbidity. This systematic review and meta-analysis firstly compared insomnia disorder with objective short and normal sleep duration, and subsequently, objective short sleep duration with and without insomnia disorder, and their associations with hypertension, type 2 diabetes and body mass index. A systematic search of five databases yielded 2345 non-duplicated articles, of which 11 individual studies were used for the qualitative review and 10 individual studies for the meta-analysis. The sample size varied from 30 to 4994 participants. A higher risk of hypertension (RR 1.54, 95% CI: [1.30; 1.82] p < 0.0001) and type 2 diabetes (RR 1.63 [1.37; 1.94], p < 0.0001) was associated with insomnia disorder with objective short sleep compared to normal sleep duration, but not for body mass index. Comparisons between insomnia disorder with objective short sleep and objective short sleep without insomnia disorder showed no significant differences. However, the majority of these studies were cross-sectional, and there is a need for more cohort study data.
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Youngstedt SD, Ito W, Passos GS, Santana MG, Youngstedt JM. Testing the sleep hygiene recommendation against nighttime exercise. Sleep Breath 2021; 25:2189-2196. [DOI: 10.1007/s11325-020-02284-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/02/2020] [Accepted: 12/21/2020] [Indexed: 10/22/2022]
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von Salis S, Ehlert U, Fischer S. Altered Experienced Thermoregulation in Depression-No Evidence for an Effect of Early Life Stress. Front Psychiatry 2021; 12:620656. [PMID: 34366905 PMCID: PMC8333702 DOI: 10.3389/fpsyt.2021.620656] [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: 10/23/2020] [Accepted: 06/28/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives: Accumulating evidence suggests that individuals with depression are characterised by difficulties in thermoregulatory cooling. The aim of this study was to investigate, for the first time, whether depressed individuals are aware of these alterations, what their physical consequences are and whether they may be rooted in early life stress. Methods: A total of N = 672 medically healthy individuals from the general population were recruited to participate in an online survey. Participants were divided into depressed vs. non-depressed using the Patient Health Questionnaire. Experienced autonomic and behavioural thermoregulation as well as vigilance problems in response to temperature increases were assessed by the Experienced Temperature Sensitivity and Regulation Survey. The Childhood Trauma Questionnaire was administered to assess early life stress. Results: Controlling for age, sex, body mass index, and physical activity, depressed vs. non-depressed individuals did not differ in their experienced autonomic and behavioural responses to temperature increases. However, the depressed individuals reported comparably greater difficulties in concentrating and drowsiness/fatigue in warm environments (p = 0.029), during physical exertion (p = 0.029), and during stress (p < 0.001). There were no differences in the experienced thermoregulation between depressed individuals with vs. without early life stress. Conclusions: Depressed individuals experienced more severe physical impairments (i.e., greater vigilance problems) in response to intense warmth when compared to non-depressed individuals. These differences were not attributable to comorbid illnesses, the intake of medication, or physical deconditioning. Further enquiries in clinical populations are warranted to investigate to what extent the observed alterations map onto specific symptoms of depression (e.g., sleep disturbances).
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Affiliation(s)
- Sarina von Salis
- Clinical Psychology and Psychotherapy, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | - Susanne Fischer
- Clinical Psychology and Psychotherapy, Institute of Psychology, University of Zurich, Zurich, Switzerland
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Vagedes J, Kuderer S, Vagedes K, Hiller S, Beissner F, Szőke H, Joos S, Wolf U. Increasing Warmth in Oncological Patients: A Randomized Controlled Cross-Over Pilot Trial Examining the Efficacy of Mustard and Ginger Footbaths. Integr Cancer Ther 2021; 20:15347354211058449. [PMID: 34814768 PMCID: PMC8647243 DOI: 10.1177/15347354211058449] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/09/2021] [Accepted: 10/21/2021] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To analyze the thermogenic effects of footbaths with medicinal powders in oncological patients (ON) and healthy controls (HC). INTERVENTION AND OUTCOMES Thirty-six participants (23 ON, 13 HC; 24 females; 49.9 ± 13.3 years) received 3 footbaths in a random order with cross-over design: warm water only (WA), warm water plus mustard (MU, Sinapis nigra), and warm water plus ginger (GI, Zingiber officinale). Warmth perception of the feet (Herdecke Warmth Perception Questionnaire, HeWEF) at the follow-up (10 minutes after completion of footbaths, t2) was assessed as the primary outcome measure. Secondary outcome measures included overall warmth as well as self-reported warmth (HeWEF) and measured skin temperature (high resolution thermography) of the face, hands and feet at baseline (t0), post immersion (t1), and follow-up (t2). RESULTS With respect to the warmth perception of the feet, GI and MU differed significantly from WA (P's < .05) with the highest effect sizes at t1 (WA vs GI, d = 0.92, WA vs MU, d = 0.73). At t2, perceived warmth tended to be higher with GI compared to WA (d = 0.46). No differences were detected between ON and HC for self-reported warmth. With respect to skin temperatures, face and feet skin temperatures of ON were colder (at t0 and t1, 0.42 ≥ d ≥ 0.68) and tended to have diametrical response patterns than HC (ON vs HC: colder vs warmer after MU). CONCLUSION Among adult oncological patients and healthy controls, footbaths with mustard and ginger increased warmth perception of the feet longer than with warm water only. The potential impact of regularly administered thermogenic footbaths over extended periods merits further investigation for the recovery of cancer-related sense of cold.
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Affiliation(s)
- Jan Vagedes
- ARCIM Institute, Filderstadt,
Germany
- University Hospital Tuebingen,
Tuebingen, Germany
- Filderklinik, Filderstadt,
Germany
| | | | | | | | - Florian Beissner
- Insula Institute for Integrative
Therapy Research, Hannover, Germany
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Kim SJ, Lim YC, Suh IB, Lee JH. Disrupted sleep maintenance is associated with altered circadian phase and phase angle in community-dwelling adults. Sleep Med 2020; 73:250-256. [DOI: 10.1016/j.sleep.2020.02.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 10/12/2019] [Accepted: 02/17/2020] [Indexed: 12/01/2022]
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Van Someren EJW. Brain mechanisms of insomnia: new perspectives on causes and consequences. Physiol Rev 2020; 101:995-1046. [PMID: 32790576 DOI: 10.1152/physrev.00046.2019] [Citation(s) in RCA: 170] [Impact Index Per Article: 42.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
While insomnia is the second most common mental disorder, progress in our understanding of underlying neurobiological mechanisms has been limited. The present review addresses the definition and prevalence of insomnia and explores its subjective and objective characteristics across the 24-hour day. Subsequently, the review extensively addresses how the vulnerability to develop insomnia is affected by genetic variants, early life stress, major life events, and brain structure and function. Further supported by the clear mental health risks conveyed by insomnia, the integrated findings suggest that the vulnerability to develop insomnia could rather be found in brain circuits regulating emotion and arousal than in circuits involved in circadian and homeostatic sleep regulation. Finally, a testable model is presented. The model proposes that in people with a vulnerability to develop insomnia, the locus coeruleus is more sensitive to-or receives more input from-the salience network and related circuits, even during rapid eye movement sleep, when it should normally be sound asleep. This vulnerability may ignite a downward spiral of insufficient overnight adaptation to distress, resulting in accumulating hyperarousal, which, in turn, impedes restful sleep and moreover increases the risk of other mental health adversity. Sensitized brain circuits are likely to be subjectively experienced as "sleeping with one eye open". The proposed model opens up the possibility for novel intervention studies and animal studies, thus accelerating the ignition of a neuroscience of insomnia, which is direly needed for better treatment.
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Affiliation(s)
- Eus J W Van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands; Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit University Amsterdam, Amsterdam, The Netherlands; and Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
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Redeker NS, Conley S, Anderson G, Cline J, Andrews L, Mohsenin V, Jacoby D, Jeon S. Effects of Cognitive Behavioral Therapy for Insomnia on Sleep, Symptoms, Stress, and Autonomic Function Among Patients With Heart Failure. Behav Sleep Med 2020; 18:190-202. [PMID: 30461315 PMCID: PMC6529289 DOI: 10.1080/15402002.2018.1546709] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background: Insomnia is common among patients with stable heart failure (HF) and associated with inflammation and altered autonomic function. Purpose: The purposes of this study were to examine the effects of cognitive behavioral therapy for insomnia (CBT-I) on the Hypothalamic Pituitary (HPA) Axis, autonomic function, inflammation, and circadian rhythmicity and the associations between these biomarkers and insomnia, sleep characteristics, symptoms, functional performance, and sleep-related cognitions. Methods: We conducted a subanalysis of a pilot randomized controlled trial (RCT, NCT02827799) whose primary aim was to test the effects of CBT-I on insomnia. We randomized 51 patients with stable Class II-IV HF to CBT-I (n = 30) or attention control (n = 21). Participants completed wrist actigraphy and self-reported insomnia severity, sleep characteristics, sleep-related cognitions, daytime symptoms, and functional performance. We measured day and nighttime urinary free cortisol, melatonin sulfate, epinephrine, and norepinephrine at baseline, and two weeks after CBT-I and computed general linear models and partial correlations. Results: CBT-I had no effects on the biomarkers, but there were statistically significant negative cross-sectional correlations between the ratio of day and night urinary free cortisol and sleep disturbance, anxiety, fatigue, depression, and negative sleep cognitions. Increases in the ratio between day and night cortisol were associated with statistically significant improvements in fatigue, depression, sleep duration, and sleep-related cognitions. Conclusions: Biomarkers of stress and autonomic function are associated with sleep, sleep-related symptoms, and cognitions among people with chronic HF. Future studies are needed to identify potential causal relationships and the impact of sleep interventions.
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Affiliation(s)
- Nancy S Redeker
- Beatrice Renfield Term Professor of Nursing, Yale School of Nursing, West Haven, Connecticut
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