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Arnison T, Evans B, Schrooten MGS, Persson J, Palermo TM. Adolescent Girls' Musculoskeletal Pain is More Affected by Insomnia Than Boys, and Through Different Psychological Pathways. THE JOURNAL OF PAIN 2024; 25:104571. [PMID: 38763259 DOI: 10.1016/j.jpain.2024.104571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 05/21/2024]
Abstract
Prior research has established that insomnia is predictive of pain in adolescents and that psychological mechanisms have a crucial role in this relationship. Adolescent girls report more insomnia and pain than boys, yet little is known of gender differences in how insomnia influences pain. This study assessed gender differences in levels and trajectories of insomnia and pain during adolescence, and whether rumination and negative mood mediated the effect of insomnia on pain. Longitudinal survey data measured on 5 annual occasions (Nbaseline = 2,767) were analyzed in a multigroup longitudinal serial mediation model. A final model was generated with insomnia as the predictor, rumination and depressed mood as mediators, pain as the outcome, and gender as the grouping variable. The results showed that insomnia predicted pain in adolescents, with an effect 3.5 times larger in girls than boys. Depressed mood was the main mediator in boys. In girls, rumination was the only significant mediator. There were significant gender differences in the effects of insomnia on rumination and pain, and in the effects of rumination on depressed mood and pain, with stronger effects in girls. These results highlight that girls and boys should be considered separately when studying the relationship between insomnia and pain. PERSPECTIVE: Levels of insomnia and pain are progressively higher in adolescent girls than boys, across adolescence. The predictive strength of insomnia symptoms for future pain is 3.5 times greater in girls, with distinct gender-specific underlying pathways: rumination partially mediates this effect in girls, while depressed mood does so in boys.
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Affiliation(s)
- Tor Arnison
- Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Örebro County, Sweden; School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Örebro County, Sweden.
| | - Brittany Evans
- School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Örebro County, Sweden
| | - Martien G S Schrooten
- School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Örebro County, Sweden
| | - Jonas Persson
- School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Örebro County, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Stockholm County, Sweden
| | - Tonya M Palermo
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington; Department of Anesthesiology, Pediatrics & Psychiatry, University of Washington School of Medicine, Seattle, Washington
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Honaker SM, Simon SL, Byars KC, Simmons DM, Williamson AA, Meltzer LJ. Advancing Patient-Centered Care: An International Survey of Adolescent Perspectives on Insomnia. Behav Sleep Med 2024; 22:571-592. [PMID: 38488114 DOI: 10.1080/15402002.2024.2322519] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2024]
Abstract
OBJECTIVE The study objective was to inform patient-centered care for adolescent insomnia by describing adolescents' perspectives on insomnia. Specific constructs of interest included: 1) factors that contributed to insomnia development or maintenance, 2) impact of insomnia on day-to-day life, 3) recommended research priorities, and 4) overall experience living with insomnia. METHOD A convenience sample of adolescents (ages 13-18 years) self-identifying with insomnia symptoms was recruited through social media. Respondents (n = 3,014) completed an online survey. Responses to an open-ended item assessing patient experience were coded using thematic analysis. RESULTS Participants identified as 70.8% White non-Hispanic, 77.0% female, and lived in one of five English-speaking countries (United States, United Kingdom, Canada, Australia, or New Zealand). Most (87.5%) met DSM-V diagnostic criteria for insomnia. The most common contributory factors to insomnia endorsed were stress (72.1%) and depressed mood (63.6%), while common impact areas were mood (72.2%), focus (61.0%), and pain (49.7%). Patient-centered research priorities were identifying insomnia causes (66.4%) and early detection (66.1%). Common adolescent experiences included high distress levels, feelings of invalidation, and helplessness about their insomnia. CONCLUSIONS Adolescents with insomnia offer a unique perspective that should inform patient-centered research and care. There is a need for heightened screening and awareness about insomnia as a condition that causes significant distress and impairment for adolescents. To provide validating care, providers should recognize the multifaceted causes of insomnia.
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Affiliation(s)
- Sarah M Honaker
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Stacey L Simon
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, CO, USA
| | - Kelly C Byars
- Divisions of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Danielle M Simmons
- Divisions of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Ariel A Williamson
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Lisa J Meltzer
- Department of Pediatrics, National Jewish Health, Denver, CO, USA
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3
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Prodi T, Dragogna F, Benatti B, Varinelli A, Vanzetto S, Gianfelice L, Dell'Osso B. COVID-19 and psychiatric disorders among young people: a cross-sectional study. Int Clin Psychopharmacol 2024:00004850-990000000-00148. [PMID: 39120982 DOI: 10.1097/yic.0000000000000565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/11/2024]
Abstract
During the COVID-19 pandemic, a significant rise in mental health issues was observed. Particularly, children and adolescents have shown a higher risk of developing mental disorders than adults. This study aimed to describe the evolving features of the requests for psychiatric emergency interventions during the COVID-19 pandemic in young people. We conducted a cross-sectional study comparing the number, characteristics, and symptoms of people aged between 12 and 18 years old attending one Emergency Department (ED) for psychiatric issues, considering three different periods: T0 (8 March 2019-7 March 2020), T1 (8 March 2020-7 March 2021), and T2 (8 March 2021-7 March 2022). Total admissions were 220: 99 (45%) during T0, 40 (18.1%) for T1, and 81 (36.8%) for T2 ( P < 0.001). A significant decrease in the mean age from T0 to T1 was found ( P < 0.01). Admissions for psychomotor agitation decreased, while admission due to anxiety disorder and nonsuicidal self-injury raised significantly ( P < 0.05), as for first psychiatric presentation ( P < 0.01). Regarding substance use, a significant reduction was observed ( P < 0.05). The rates of eating disorders ( P < 0.001) and early insomnia ( P < 0.01) increased from T0. These findings highlight the worsening of psychiatric symptoms in the young population during the COVID-19 pandemic.
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Affiliation(s)
- Tiziano Prodi
- Department of Mental Health, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan
| | - Filippo Dragogna
- Department of Mental Health, Psychiatry 1 Unit, Fatebenefratelli Hospital, Milan
| | - Beatrice Benatti
- Department of Mental Health, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan
| | - Alberto Varinelli
- Department of Mental Health, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan
| | | | - Letizia Gianfelice
- Department of Mental Health, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan
| | - Bernardo Dell'Osso
- Department of Mental Health, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan
- Department of Mental Health, Psychiatry 1 Unit, Fatebenefratelli Hospital, Milan
- "Aldo Ravelli" Center for Nanotechnology and Neurostimulation, University of Milan, Milan, Italy
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
- Centro per lo studio dei meccanismi molecolari alla base delle patologie neuro-psico-geriatriche, University of Milan, Milan, Italy
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4
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Al-Mamun F, Mamun MA, Hasan ME, ALmerab MM, Gozal D. Exploring Sleep Duration and Insomnia Among Prospective University Students: A Study with Geographical Data and Machine Learning Techniques. Nat Sci Sleep 2024; 16:1235-1251. [PMID: 39184950 PMCID: PMC11344553 DOI: 10.2147/nss.s481786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Accepted: 08/14/2024] [Indexed: 08/27/2024] Open
Abstract
Background Sleep disruptions among prospective university students are increasingly recognized for their potential ramifications on academic achievement and psychological well-being. But, information regarding sleep issues among students preparing for university entrance exams is unknown. Thus, this study aimed to investigate the prevalence and factors associated with sleep duration and insomnia among university entrance test-takers in Bangladesh, utilizing both traditional statistical analyses and advanced geographic information system and machine learning techniques for enhanced predictive capability. Methods A cross-sectional study was conducted in June 2023 among 1496 entrance test-takers at Jahangirnagar University, Dhaka. Structured questionnaires collected data on demographics, academic information, and mental health assessments. Statistical analyses, including chi-square tests and logistic regression, were performed using SPSS, while machine learning models were applied using Python and Google Colab. Results Approximately 62.9% of participants reported abnormal sleep duration (<7 hours/night or >9 hours/night), with 25.5% experiencing insomnia. Females and those dissatisfied with mock tests were more likely to report abnormal sleep duration, while repeat test-takers, those with unsatisfactory mock test results, or anxiety symptoms had a higher risk of insomnia. Machine learning identified satisfaction with previous mock tests as the most significant predictor of sleep disturbances, while higher secondary school certificate GPA had the least influence. The CatBoost model achieved maximum accuracy rates of 61.27% and 73.46%, respectively, for predicting sleep duration and insomnia, with low log loss values indicating robust predictive performance. Geographic analysis revealed regional variations in sleep disturbances, with higher insomnia prevalence in some southern districts and abnormal sleep duration in northern and eastern districts. Conclusion Sleep disturbances are prevalent among prospective university students and are associated with various factors including gender, test-taking status, mock test satisfaction, and anxiety. Targeted interventions, including sleep education and psychological support, hold promise in ameliorating sleep health and overall well-being among students, potentially enhancing entrance test performance.
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Affiliation(s)
- Firoj Al-Mamun
- CHINTA Research Bangladesh, Savar, Dhaka, Bangladesh
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
- Department of Public Health, University of South Asia, Dhaka, Bangladesh
| | - Mohammed A Mamun
- CHINTA Research Bangladesh, Savar, Dhaka, Bangladesh
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
- Department of Public Health, University of South Asia, Dhaka, Bangladesh
| | - Md Emran Hasan
- CHINTA Research Bangladesh, Savar, Dhaka, Bangladesh
- Software College, Northeastern University, Shenyang, 110169, People’s Republic of China
| | - Moneerah Mohammad ALmerab
- Department of Psychology, College of Education and Human Development, Princess Nourah Bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - David Gozal
- Department of Pediatrics and Office of the Dean, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, 25701, USA
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Bruni O, Angriman M, Miano S, DelRosso LM, Spruyt K, Mogavero MP, Ferri R. Individualized approaches to pediatric chronic insomnia: Advancing precision medicine in sleep disorders. Sleep Med Rev 2024; 76:101946. [PMID: 38735089 DOI: 10.1016/j.smrv.2024.101946] [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: 12/27/2023] [Revised: 02/25/2024] [Accepted: 05/02/2024] [Indexed: 05/14/2024]
Abstract
The manifestations of chronic insomnia undergo age-related changes. In younger infants and children, behavioral insomnia emerges as the most prevalent form and typically responds to behavioral interventions. However, distinct clusters of clinical presentations suggest the presence of various phenotypes, potentially implicating the primary involvement of specific neurotransmitters. These conceptualizations, coupled with genetic studies on pleiotropy and polygenicity, may aid in identifying individuals at risk of persistent insomnia into adulthood and shed light on novel treatment options. In school-age children, the predominant presentation is sleep-onset insomnia, often linked with nighttime fears, anxiety symptoms, poor sleep hygiene, limit-setting issues, and inadequate sleep duration. The manifestations of insomnia in adolescence correlate with the profound changes occurring in sleep architecture, circadian rhythms, and homeostatic processes. The primary symptoms during adolescence include delayed sleep onset, sleep misperception, persistent negative thoughts about sleep, and physiological hyperarousal-paralleling features observed in adult insomnia. An approach centered on distinct presentations may provide a framework for precision-based treatment options. Enhanced comprehension of insomnia's manifestations across diverse developmental stages can facilitate accurate assessment. Efforts to subtype insomnia in childhood align with this objective, potentially guiding the selection of appropriate treatments tailored to individual neurobiological, clinical, and familial features.
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Affiliation(s)
- Oliviero Bruni
- Developmental and Social Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185, Rome, Italy.
| | - Marco Angriman
- Child Neurology and Neurorehabilitation Unit, Bolzano Hospital, Via Guncina 54, 39100, Bolzano, Italy
| | - Silvia Miano
- Sleep Medicine Unit, Neurocenter of Southern Switzerland, Ospedale Civico, Via Tesserete 46, 6900, Lugano, Switzerland
| | - Lourdes M DelRosso
- University of California San Francisco, Fresno, 2625 E. Divisadero St. Fresno, CA, 93721, USA
| | - Karen Spruyt
- Université de Paris, NeuroDiderot Inserm, Academic Hospital Robert Debré Ap-Hp in the Building Bingen, 48 Bd Sérurier, 75019, Paris, France
| | - Maria P Mogavero
- Vita-Salute San Raffaele University, Via Olgettina, 58, 20132, Milan, Italy; Sleep Disorders Center, Division of Neuroscience, San Raffaele Scientific Institute, Via Stamira d'Ancona, 20, 20127, Milan, Italy
| | - Raffaele Ferri
- Sleep Research Centre, Oasi Research Institute - IRCCS, Via C. Ruggero 73, 94018, Troina, Italy
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Clegg I, Notebaert L, Richardson C. Negative attention bias and attentional control as mechanisms in the association between insomnia and depression in young people. Behav Res Ther 2024; 179:104569. [PMID: 38761556 DOI: 10.1016/j.brat.2024.104569] [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: 03/05/2024] [Revised: 04/30/2024] [Accepted: 05/10/2024] [Indexed: 05/20/2024]
Abstract
Evidence supports a causal role of insomnia in the development and maintenance of depression, yet mechanisms underlying this association in young people are not well established. Attention biases have been implicated separately in the sleep and depression fields and represents an important candidate mechanism. Poor sleep may lead to a negative attention bias (characteristic of depression) by impacting attentional control. This study assessed the hypothesis that attentional control and negative attention bias would sequentially mediate the relationship between insomnia and depressive symptoms in an unselected sample of young people (17-24 years). Concerns have been raised regarding the psychometric properties of tasks used to measure attention bias, and a Dual-Probe Task is emerging as a more reliable measure. Participants (N = 275, Male = 59, Mage = 19.40) completed the Dual-Probe Task, a behavioural measure of attentional control, and self-report measures of insomnia and depression. Participants completed a one-week sleep diary. Results were consistent with negative attention bias, but not attentional control, as a mechanism which partially accounts for the relationship between sleep (i.e., insomnia severity, sleep duration, sleep efficiency, sleep latency) and depression. This study highlights sleep and negative attention bias as potentially modifiable risk factors to reduce depressive symptoms in young people.
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Affiliation(s)
- Isabel Clegg
- Center for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, 35 Stirling Highway, Crawley, 6009, WA, Australia; Center for Sleep Science, School of Psychological Science, University of Western Australia, 35 Stirling Highway, Crawley, 6009, WA, Australia.
| | - Lies Notebaert
- Center for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, 35 Stirling Highway, Crawley, 6009, WA, Australia.
| | - Cele Richardson
- Center for Sleep Science, School of Psychological Science, University of Western Australia, 35 Stirling Highway, Crawley, 6009, WA, Australia.
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Scahill L, Lecavalier L, Edwards MC, Wenzell ML, Barto LM, Mulligan A, Williams AT, Ousley O, Sinha CB, Taylor CA, Youn Kim S, Johnson LM, Gillespie SE, Johnson CR. Toward better outcome measurement for insomnia in children with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241255814. [PMID: 39075748 DOI: 10.1177/13623613241255814] [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: 07/31/2024]
Abstract
LAY ABSTRACT Insomnia, trouble falling asleep or staying asleep, is common in autistic children. In a previous report, we described the results of focus groups with parents of autistic children toward the development of the Pediatric Autism Insomnia Rating Scale. In this article, we report on the steps taken to complete the Pediatric Autism Insomnia Rating Scale. With help from the Simons Foundation registry, we collected information from parents on 1185 children with autism spectrum disorder to test the new measure. These results were evaluated using standard statistical methods such as factor analysis. To confirm the validity of the new measure, we enrolled a separate sample of 134 autistic children for a detailed assessment by video conference. This step showed that the Pediatric Autism Insomnia Rating Scale is clearly measuring symptoms of insomnia in children with autism spectrum disorder and not related problems such as hyperactivity, repetitive behavior, or anxiety. We also showed that the total score on the Pediatric Autism Insomnia Rating Scale is stable when repeated over a brief period of time. This is important because a measure that is not stable over a brief period of time would not be suitable as an outcome measure. In summary, the Pediatric Autism Insomnia Rating Scale is a brief and valid measure of insomnia in children with autism spectrum disorder that provides reliable scores.
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Affiliation(s)
| | | | | | | | - Leah M Barto
- Case Western Reserve University, USA
- Cleveland Clinic, USA
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Yang J, Zhao Y. Examining bidirectional relations between sleep problems and non-suicidal self-injury/suicidal behavior in adolescents: emotion regulation difficulties and externalizing problems as mediators. Eur Child Adolesc Psychiatry 2024; 33:2397-2411. [PMID: 38150149 DOI: 10.1007/s00787-023-02334-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 11/28/2023] [Indexed: 12/28/2023]
Abstract
Based on previous empirical evidences and theoretical framework, sleep problems and non-suicidal self-injury (NSSI)/suicidal behavior may bidirectionally related to one another. However, this still needs to be examined through longitudinal research. Moreover, the mediating mechanisms accounting for their potential bidirectional relations have yet to be fully investigated. This study thus aimed to evaluate whether sleep problems and NSSI/suicidal behavior promoted each other directly or indirectly through the mediating roles of emotion regulation difficulties (ERD) and externalizing problems. A total of 1648 Chinese adolescents (48.12% boys; Mage = 13.69; SD = 0.82; Age range = 11-16 years old at T1) completed self-report measures on 3-time points across 1 year. Cross-lagged panel models were used to examine the focal longitudinal associations. Results revealed a predictive effect of sleep problems on NSSI and a positive bidirectional relation between sleep problems and suicidal behavior. Moreover, sleep problems exerted an indirect effect on NSSI through ERD, and vice versa. Additionally, both ERD and externalizing problems served as mediators in the pathway from suicidal behavior to sleep problems. This study disentangled the differential mediating roles of ERD and externalizing problems in the longitudinal associations between sleep problems and NSSI/suicidal behavior, which may help provide a more holistic theoretical framework through which to precisely identify key targets for early prevention and intervention of sleep problems and NSSI/suicidal behavior in adolescents.
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Affiliation(s)
- Jiaping Yang
- Department of Psychology, Guangzhou University, 230 Wai Huan Xi Rd, 510006, Guangzhou, China.
| | - Yinqiu Zhao
- School of Psychology, South China Normal University, 510631, Guangzhou, People's Republic of China
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Fan X, Ma Y, Zhang J, Lin X, Sun B, Rosenheck R, He H. Sleep disturbance and suicidal ideation among youth with depression. J Affect Disord 2024; 354:232-238. [PMID: 38461901 DOI: 10.1016/j.jad.2024.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/30/2024] [Accepted: 03/07/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Sleep disturbance may exacerbate the risk of suicide among youth with depression, but whether this association is independent of psychopathology requires further study. METHODS This cross-sectional study included 576 youths (13-25 years old) recruited from January 2022 to May 2023. The patients were first divided into two groups by the presence of suicidal ideation according to the Columbia-Suicide Severity Scale (C-SSRS). Sleep quality was assessed by the Athens Insomnia Scale (AIS) and mental health with the Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA). Logistic regression was conducted to analyze the association between sleep disturbance and suicidal ideation, adjusted for depressive symptoms severity. RESULTS The suicidal ideation group exhibited more severe sleep disturbances, anxiety symptoms, and depressive symptoms than the non-suicidal ideation group. Pearson correlation showed that sleep disturbance (AIS) was significantly correlated with the severity of anxiety symptoms, depressive symptoms, and suicidal ideation. Logistic regression analysis revealed that the AIS factor "daytime dysfunction" (β = 0.145; OR = 1.156, 95 % CI: 1.02, 1.309; p = 0.023) was significantly associated with suicidal ideation after adjusting for demographic characteristics and depressive symptoms severity. LIMITATIONS Due to the cross-sectional nature of the data, no causal inference can be made regarding the observed associations between sleep disturbance and suicidal ideation. CONCLUSION Sleep disturbance, particularly in the realm of daytime dysfunction, is associated with increased suicidal ideation among depressed youth. Clinicians need to assess and manage sleep disturbance in the context of suicidal ideation for young depression patients.
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Affiliation(s)
- Xuefei Fan
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; The 3rd People Hospital of Foshan, Foshan, China
| | - Yarong Ma
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jie Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaoming Lin
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Bin Sun
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Robert Rosenheck
- Department of Psychiatry, Yale Medical School, New Haven, CT, USA
| | - Hongbo He
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.
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Berey BL, Meisel S, Pielech M, Parnes J, Padovano HT, Miranda R. A test of competing mediators linking trouble sleeping to cannabis use in adolescents and emerging adults. Exp Clin Psychopharmacol 2024; 32:316-328. [PMID: 38127518 PMCID: PMC11098684 DOI: 10.1037/pha0000693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
This study examined day-level associations between trouble sleeping and three cannabis-use indices (likelihood/quantity of use and impaired control). We evaluated behavioral and cognitive mediators of the association between trouble sleeping and cannabis outcomes. Youth (N = 86, ages 15-24, 48.8% female, 58.8% White, 18.6% Latine) who regularly used cannabis were recruited for an intervention study. This preregistered secondary data analysis leveraged data from a 1-week ecological momentary assessment (EMA) study completed prior to intervention. Trouble sleeping, cannabis use, and impaired control over use were assessed each morning; negative affect, risk-taking propensity, and cannabis craving were assessed multiple times and aggregated to create a daily average. Multilevel structural equation modeling evaluated hypothesized temporally sequenced associations and putative mechanisms at the day (i.e., within) and person (i.e., between) level. In bivariate analyses at the person level, there were large-effect associations between trouble sleeping and craving and negative affect, and between craving and cannabis-use likelihood and quantity (rs from .34 to .48). In multilevel analyses at the day level, participants were less likely to use cannabis the next day after reporting more trouble sleeping (β = -.65, p < .001). Trouble sleeping was not directly associated with subsequent cannabis-use quantity or impaired control, or indirectly via negative affect, risk-taking propensity, or craving. Trouble sleeping had differential relations with cannabis-use indices at the day and person levels. To promote youth health and reduce cannabis use, future research may consider the unique, person- and situation-driven mechanistic processes at play. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Benjamin L. Berey
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
| | - Samuel Meisel
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
- E.P. Bradley Hospital, Riverside, RI
| | - Melissa Pielech
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
- Department of Psychiatry and Human Behavior, Brown University
| | - Jamie Parnes
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
| | - Hayley Treloar Padovano
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
- Department of Behavioral and Social Sciences, Brown University School of Public Health
| | - Robert Miranda
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
- Department of Behavioral and Social Sciences, Brown University School of Public Health
- Department of Psychiatry and Human Behavior, Brown University
- E.P. Bradley Hospital, Riverside, RI
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11
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Que J, Chen S, Chan NY, Wu S, Zhang L, Chen Y, Liu J, Chen M, Chen L, Li SX, Lin D, Liu F, Wing YK. Associations of evening-type and insomnia symptoms with depressive symptoms among youths. Sleep Med 2024; 118:81-87. [PMID: 38626648 DOI: 10.1016/j.sleep.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/23/2024] [Accepted: 04/06/2024] [Indexed: 04/18/2024]
Abstract
BACKGROUND Evening-type and insomnia symptoms are significantly related to each other and independently associated with depressive symptoms, yet few studies have examined the potential interaction between these two conditions. Therefore, we aimed to examine the associations of evening-type and insomnia symptoms with depressive symptoms among Chinese youths, with a specific focus on the joint effects of the two conditions on depressive symptoms. METHODS Participants aged between 12 and 25 were invited to participate in an online survey from December 15, 2022, to May 26, 2023. Multivariate logistic regression models and additive interaction models were used to examine the independent and joint effects of chronotypes and insomnia symptoms on depressive symptoms, respectively. RESULTS Of the 6145 eligible youths, the prevalence of evening-type and insomnia symptoms were 24.9 % and 29.6 %, respectively. Both evening-type (adjusted OR, [AdjOR]: 3.21, 95 % CI: 2.80-3.67) and insomnia symptoms (AdjOR: 10.53, 95 % CI: 9.14-12.12) were associated with an increased risk of depressive symptoms. In addition, the additive interaction models showed that there is an enhanced risk of depression related to interaction between evening-type and insomnia symptoms (relative excess risk due to interaction, [RERI]: 11.66, 95 % CI: 7.21-16.11). CONCLUSIONS The present study provided additional evidence demonstrating the presence of interaction between evening-type and insomnia symptoms, which can lead to a higher risk of depressive symptoms. Our findings argue the need for addressing both sleep and circadian factors in the management of depressive symptoms in young people.
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Affiliation(s)
- Jianyu Que
- Xiamen Xianyue Hospital, Xianyue Hospital Affiliated with Xiamen Medical College, Fujian Psychiatric Center, Fujian Clinical Research Center for Mental Disorders, Fujian, China
| | - Sijing Chen
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China; Centre de Recherche CERVO/Brain Research Center, École de Psychologie, Université Laval, Quebec City, Quebec, Canada
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Suying Wu
- Xiamen Xianyue Hospital, Xianyue Hospital Affiliated with Xiamen Medical College, Fujian Psychiatric Center, Fujian Clinical Research Center for Mental Disorders, Fujian, China
| | - Li Zhang
- Inner Mongolia Autonomous Region Mental Health Center, Hohhot, Inner Mongolia, China
| | - Yaoyi Chen
- Xiamen Xianyue Hospital, Xianyue Hospital Affiliated with Xiamen Medical College, Fujian Psychiatric Center, Fujian Clinical Research Center for Mental Disorders, Fujian, China
| | - Jingrou Liu
- Xiamen University of Technology, Xiamen, Fujian, China
| | | | - Lixia Chen
- Inner Mongolia Autonomous Region Mental Health Center, Hohhot, Inner Mongolia, China
| | - Shirley Xin Li
- Department of Psychology, The University of Hong Kong, Hong Kong Special Administrative Region of China; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Duoduo Lin
- Xiamen Xianyue Hospital, Xianyue Hospital Affiliated with Xiamen Medical College, Fujian Psychiatric Center, Fujian Clinical Research Center for Mental Disorders, Fujian, China.
| | - Farong Liu
- Xiamen Xianyue Hospital, Xianyue Hospital Affiliated with Xiamen Medical College, Fujian Psychiatric Center, Fujian Clinical Research Center for Mental Disorders, Fujian, China.
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
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12
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Calazans de Lira CT, Santiago LDCS, Henrique RDS, Rangel-Junior JFLB, Campello CP, Santos MAM. Examining the Effects of Strength Training with Load Progression on Sleep Parameters and Mental Health in College Students. Sleep Sci 2024; 17:e134-e142. [PMID: 38846591 PMCID: PMC11152631 DOI: 10.1055/s-0043-1777781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/02/2023] [Indexed: 06/09/2024] Open
Abstract
Objective To compare the effects of strength training with load progression after 4 weeks on sleep parameters and mental health in college students. Methods A total of 17 university students (11 women, 6 men), ranging from 18 to 21 years old, were randomized into a strength training group (STG) and a control group (CG). The Pittsburgh sleep quality index (PSQI), insomnia severity questionnaire, hospital anxiety and depression (HAD) scale, profile of mood states (POMS), and chronotype were used to evaluate the main outcomes. Training consisted of 60 minute·d -1 (2 times/week, for 4-weeks), with 3 sets of 10 to 12 repetitions, and a 1-minute rest interval between sets and exercises. Baseline and postintervention differences were analyzed using generalized estimating equations (GEE). Results After 4 weeks of ST, a significant time effect on the chronotype (β: 1.33; p < 0.05) was observed in the STG. Additionally, there was a significant time and group effect in the reduction of tension (β: 5.00; p < 0.05), depression (β: 15.41; p < 0.05), anger (β: 8.00; p < 0.05), and confusion (β: 6.50; p < 0.05). For fatigue (β: 2.66; p < 0.05), there was a significant time effect difference in its reduction. Vigor was meaningfully increased in the STG group (β: -1.75; p < 0.05). Furthermore, a significant positive relationship was observed between sleep quality and anxiety (r = 0.54; p = 0.03). Finally, insomnia was positively related with an increase in confusion (r = 0.70; p = 0.04) and anxiety (r = 0.52; p = 0.04), as well as with a decrease in vigor (r = -0.71; p = 0.03). Discussion Short-term strength training for 4 weeks was effective for improving mental health, helping achieve characteristics of a positive mood profile, that is, low values for negative factors and a high value for the positive factor.
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Affiliation(s)
- Camila Tenório Calazans de Lira
- Department of Physical Education, Associate Graduate Program in Physical Education, University of Pernambuco, Recife, Pernambuco, Brazil
- Department of Physical Education, Uninovo University Center, Olinda, Pernambuco, Brazil
| | - Ladyodeyse da Cunha Silva Santiago
- Department of Physical Education, Associate Graduate Program in Physical Education, University of Pernambuco, Recife, Pernambuco, Brazil
| | | | - João Francisco Lins Brayner Rangel-Junior
- Department of Dentistry, Graduate Hebiatrics Program: Health Determinants in Adolescence, University of Pernambuco, Recife, Pernambuco, Brazil
- Department of Physical Education, School of Physical Education, University of Pernambuco, Recife, Pernambuco, Brazil
| | - Camilla Porto Campello
- Department of Dentistry, Graduate Hebiatrics Program: Health Determinants in Adolescence, University of Pernambuco, Recife, Pernambuco, Brazil
- Department of Physical Education, Division of Research in Adolescents Mental Health and Sleep Problems, Institutional Project in Natural Disasters, Sanitary, and Social Emergencies, University of Pernambuco, Recife, Pernambuco, Brazil
- Department of Dentistry, Graduate Program in Global Health and Health Diplomacy, National School of Public Health Sérgio Arouca, Oswaldo Cruz Foundation, Fiocruz, Ministry of Health, Rio de Janeiro, Brazil
| | - Marcos André Moura Santos
- Department of Physical Education, Associate Graduate Program in Physical Education, University of Pernambuco, Recife, Pernambuco, Brazil
- Department of Dentistry, Graduate Hebiatrics Program: Health Determinants in Adolescence, University of Pernambuco, Recife, Pernambuco, Brazil
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13
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Chen SJ, Li SX, Zhang J, Lam SP, Chan JWY, Chan KCC, Li AM, Morin CM, Wing YK, Chan NY. Subtyping at-risk adolescents for predicting response toward insomnia prevention program. J Child Psychol Psychiatry 2024; 65:764-775. [PMID: 37803887 DOI: 10.1111/jcpp.13904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/25/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Previous study has shown that a brief cognitive-behavioral prevention insomnia program could reduce 71% risk of developing insomnia among at-risk adolescents. This study aimed to evaluate the differential response to insomnia prevention in subgroups of at-risk adolescents. METHODS Adolescents with a family history of insomnia and subthreshold insomnia symptoms were randomly assigned to a 4-week insomnia prevention program or nonactive control group. Assessments were conducted at baseline, 1 week, and 6- and 12-month after the intervention. Baseline sleep, daytime, and mood profiles were used to determine different subgroups by using latent class analysis (LCA). Analyses were conducted based on the intention-to-treat approach. RESULTS LCA identified three subgroups: (a) insomnia symptoms only, (b) insomnia symptoms with daytime sleepiness and mild anxiety, and (c) insomnia symptoms with daytime sleepiness, mild anxiety, and depression. The incidence rate of insomnia disorder over the 12-month follow-up was significantly reduced for adolescents receiving intervention in subgroup 3 compared with the controls (hazard ratio [HR] = 0.37; 95% confidence interval [CI]: 0.13-0.99; p = .049) and marginally for subgroup 2 (HR = 0.14; 95% CI: 0.02-1.08; p = .059). In addition, adolescents who received intervention in subgroups 2 and 3 had a reduced risk of excessive daytime sleepiness (subgroup 2: adjusted OR [AdjOR] = 0.45, 95% CI: 0.23-0.87; subgroup 3: AdjOR = 0.32, 95% CI: 0.13-0.76) and possible anxiety (subgroup 2: AdjOR = 0.47, 95% CI: 0.27-0.82; subgroup 3: AdjOR = 0.33, 95% CI: 0.14-0.78) compared with the controls over the 12-month follow-up. CONCLUSIONS Adolescents at risk for insomnia can be classified into different subgroups according to their psychological profiles, which were associated with differential responses to the insomnia prevention program. These findings indicate the need for further phenotyping and subgrouping at-risk adolescents to develop personalized insomnia prevention.
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Affiliation(s)
- Si-Jing Chen
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Shirley Xin Li
- Department of Psychology, The University of Hong Kong, Hong Kong, SAR, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, SAR, China
| | - Jihui Zhang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Siu Ping Lam
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Joey Wing Yan Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Kate Ching-Ching Chan
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
- Laboratory for Paediatric Respiratory Research, Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Albert Martin Li
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
- Laboratory for Paediatric Respiratory Research, Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Charles M Morin
- School of Psychology, Université Laval and Centre de recherche CERVO, Quebec City, QC, Canada
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
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14
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Sun M, Scherffius A, Sun M, Chen C, Wang D. Insomnia symptoms as a mediator between school connectedness and suicidal ideation in Chinese adolescents: A three-wave longitudinal model. Early Interv Psychiatry 2024. [PMID: 38783351 DOI: 10.1111/eip.13579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 04/02/2024] [Accepted: 05/12/2024] [Indexed: 05/25/2024]
Abstract
AIM School connectedness is related to suicidal ideation (SI) in adolescents. However, little is known about the mediating role of insomnia symptoms in the school connectedness-SI link. This study aimed to examine the longitudinal mediating effect of insomnia symptoms on the relationship between school connectedness and SI as well as the moderating effect of sex using a three-wave longitudinal design. METHODS A total of 3110 adolescents completed three online surveys. Data were collected over the course of 1 year, in three waves 6 months apart. Participants completed the School Connectedness Scale, Youth Self-Rating Insomnia Scale, Self-rating Idea of Suicide Scale, Beck Depression Inventory and a self-compiled demographic questionnaire. Linear regressions and mediation analyses were performed to examine the associations between school connectedness, insomnia symptoms and SI. RESULTS School connectedness had a significant mediating effect on SI through insomnia symptoms (βa×b = -.03, 95% confidence interval = -0.04, -0.02) after controlling for demographics and depressive symptoms. Mediation analyses showed that insomnia symptoms accounted for 23.1% of the total effects in the entire sample, with 13.3% in males and 27.3% in females. Sex had no significant moderating effect on the school connectedness-SI link association. CONCLUSIONS The association between school connectedness and SI appears to be mediated by insomnia symptoms. Assessing and promoting school connectedness, as well as intervening and treating distress associated with insomnia, may have important clinical implications for reducing the risk of SI in adolescents.
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Affiliation(s)
- Mingze Sun
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Andrew Scherffius
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Meng Sun
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Chunping Chen
- Institute of Education, Xiamen University, Xiamen, China
| | - Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
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15
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Rossouw J, Suliman S, Nothling J, Lombard C, Bröcker E, Hewett M, Simmons C, Shorter GW, Seedat S, Milanak ME, Armour C. A pilot randomised control study to investigate the effect of the South African Adolescence Group Sleep Intervention (SAASI) on adolescent sleep and PTSD. Eur J Psychotraumatol 2024; 15:2350217. [PMID: 38774992 PMCID: PMC11123447 DOI: 10.1080/20008066.2024.2350217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 04/11/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Trauma exposure prevalence and consequent post-traumatic stress disorder among South African adolescents are significant. Sleep disturbances are among the most frequently reported difficulties faced by those dealing with PTSD. The current study examined the feasibility and preliminary efficacy of the South African Adolescence Group Sleep Intervention on PTSD symptom severity and sleep disturbance.Method: Sixty-one adolescents with PTSD diagnoses and sleep disturbance were randomly assigned (1:1) to one individual and four group sessions of a sleep intervention (SAASI) or a control group. Participants completed the Child PTSD symptom scale for DSM5 (CPSS-5) and the Pittsburgh Sleep Quality Index (PSQI) among other sleep and psychiatric measures. The trial was registered on the Pan African Trial Registry (PACTR202208559723690).Results: There was a significant but similar decrease in PSQI scores in both groups over time indicating no overall intervention effect (Wald test = -2.18, p = .029), mean slope = -0.2 (95% CI: -0.37 to -0.02) (p = .583). On the CPSS-5, interaction between groups was also not significant (p = .291). Despite this overall finding, the mean difference in CPSS-SR-5 scores increased over time, with the difference between groups post-treatment -9.10 (95%CI: -18.00 to -0.21), p = .045 and the 1-month follow-up contrast - 11.22 (95%CI: -22.43 to -0.03), p = .049 suggesting that PTSD symptom severity decreased more in the intervention group than the control group. The dropout rate was higher than expected for both the intervention (n = 10; 32%) and control (n = 8; 26.7%) groups. Dropout were mostly school commitments or travel related.Conclusions: Early findings suggest a trend towards dual improvement in sleep quality and PTSD symptom severity in adolescents with a sleep disturbance and PTSD receiving a group sleep intervention (SAASI). Further investigation in a properly powered RCT with detailed retention planning is indicated.
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Affiliation(s)
- Jaco Rossouw
- Faculty of Medicine and Health Sciences, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Sharain Suliman
- Faculty of Medicine and Health Sciences, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- Faculty of Medicine and Health Sciences, South African Medical Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Jani Nothling
- Faculty of Medicine and Health Sciences, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Carl Lombard
- South African Medical Research Council – Biostatistics Unit, Cape Town, South Africa
| | - Erine Bröcker
- Faculty of Medicine and Health Sciences, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Maryke Hewett
- Faculty of Medicine and Health Sciences, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Candice Simmons
- Faculty of Medicine and Health Sciences, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Gillian W. Shorter
- School of Psychology, David Keir Building, Queen’s University Belfast, Belfast, Northern Ireland
| | - Soraya Seedat
- Faculty of Medicine and Health Sciences, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- Faculty of Medicine and Health Sciences, South African Medical Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Melissa E. Milanak
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Cherie Armour
- Faculty of Medicine and Health Sciences, South African Medical Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
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16
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Bushnell G, Ivanenko A, Horton DB, Lunsford-Avery JR, Posner J, Gerhard T, Suarez E, Olfson M. Psychiatric comorbidities and prescribing tendencies of sleep medications and related medications in young people with insomnia: a United States commercial claims-based analysis. Sleep 2024; 47:zsae057. [PMID: 38430553 PMCID: PMC11082474 DOI: 10.1093/sleep/zsae057] [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: 08/28/2023] [Revised: 02/05/2024] [Indexed: 03/04/2024] Open
Abstract
STUDY OBJECTIVES To characterize children and youth newly diagnosed with insomnia and to describe their use of sleep and other related prescription medications. METHODS Within a commercial claims database (January 1, 2016-December 31, 2021), we identified children and youth (2-24 years) with a newly recorded insomnia diagnosis (G47.0x; F51.0x) and examined psychiatric diagnoses in the prior 6 months. We evaluated sleep and related prescription medications dispensed in the week after new insomnia diagnoses (i.e. trazodone, other antidepressants, hydroxyzine, alpha-agonists, benzodiazepines, non-benzodiazepine hypnotics "z-drugs," antipsychotics, and others). Analyses were stratified by age and psychiatric comorbidities. RESULTS Among 68 698 children and 108 118 older youth (18-24 years) with a new insomnia diagnosis, three-quarters had a diagnosed comorbid psychiatric condition; anxiety disorders, depression, and ADHD were the most common. Among those without comorbid psychiatric diagnoses, 20.2% of children and 37.4% of older youth had a sleep or related medication dispensed in the following week. In children without a comorbid psychiatric diagnosis, alpha-agonists, hydroxyzine, and trazodone were the most common medications; in older youth, trazodone was the most common medication followed by hydroxyzine, z-drugs, and SSRIs. Sleep and related prescription medications were more commonly dispensed to those with psychiatric comorbidities. From 2017 to 2021, there was an increase in hydroxyzine prescriptions following a new insomnia diagnosis and decline in z-drug and benzodiazepine prescriptions. CONCLUSIONS Our findings from a nationwide sample of young people with insomnia highlight the high prevalence of psychiatric comorbidities and variety of sleep and related medications they receive. Characterizing prescribing tendencies informs guideline development and future research.
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Affiliation(s)
- Greta Bushnell
- Center for Pharmacoepidemiology and Treatment Sciences, Institute for Health, Health Care Policy and Aging Research; Rutgers University; New Brunswick, NJ, USA
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health; Piscataway, NJ, USA
| | - Anna Ivanenko
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine; Chicago, IL, USA
| | - Daniel B Horton
- Center for Pharmacoepidemiology and Treatment Sciences, Institute for Health, Health Care Policy and Aging Research; Rutgers University; New Brunswick, NJ, USA
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health; Piscataway, NJ, USA
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School; New Brunswick, NJ, USA
| | - Jessica R Lunsford-Avery
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine; Durham, NC, USA
| | - Jonathan Posner
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine; Durham, NC, USA
| | - Tobias Gerhard
- Center for Pharmacoepidemiology and Treatment Sciences, Institute for Health, Health Care Policy and Aging Research; Rutgers University; New Brunswick, NJ, USA
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health; Piscataway, NJ, USA
- Pharmacy Practice and Administration, Ernest Mario School of Pharmacy, Rutgers University; New Brunswick, NJ, USA
| | - Elizabeth Suarez
- Center for Pharmacoepidemiology and Treatment Sciences, Institute for Health, Health Care Policy and Aging Research; Rutgers University; New Brunswick, NJ, USA
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health; Piscataway, NJ, USA
| | - Mark Olfson
- Department of Psychiatry, Columbia University Irving Medical Center; New York, NY, USA
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Singh R, Atha R, Lenker KP, Calhoun SL, Liao J, He F, Vgontzas AN, Liao D, Bixler EO, Jackson CL, Fernandez-Mendoza J. Racial/ethnic disparities in the trajectories of insomnia symptoms from childhood to young adulthood. Sleep 2024; 47:zsae021. [PMID: 38270531 PMCID: PMC11082472 DOI: 10.1093/sleep/zsae021] [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: 11/08/2023] [Revised: 01/03/2024] [Indexed: 01/26/2024] Open
Abstract
STUDY OBJECTIVES To examine differences in the longitudinal prevalence of childhood insomnia symptoms across black/African American, Hispanic/Latinx, and non-Hispanic white groups. METHODS Participants were 519 children from the Penn State Child Cohort (baseline [V1] from 2000-2005) who were followed up 8 years later as adolescents (V2) and 15 years later as young adults (S3). Mean age at S3 was 24.1 ± 2.7 years. Approximately, 76.5% identified as non-Hispanic white, 12.9% as black/African American, 7.1% as Hispanic/Latinx, and 3.5% as "other" race/ethnicity. Insomnia symptoms were defined as parent-reported (childhood) or self-reported (adolescence and young adulthood) moderate-to-severe difficulties initiating/maintaining sleep. Longitudinal trajectories of insomnia symptoms were identified across three-time points and the odds of each trajectory were compared between racial/ethnic groups, adjusting for sex, age, overweight, sleep apnea, periodic limb movements, psychiatric/behavioral disorders, and psychotropic medication use. RESULTS Black/African Americans compared to non-Hispanic whites were at significantly higher odds of having a childhood-onset persistent trajectory through young adulthood (OR = 2.58, 95% CI [1.29, 5.14]), while Hispanics/Latinx were at nonsignificantly higher odds to have the same trajectory (OR = 1.81, 95% CI [0.77, 4.25]). No significant racial/ethnic differences were observed for remitted and waxing-and-waning trajectories since childhood or incident/new-onset trajectories in young adulthood. CONCLUSIONS The results indicate that disparities in insomnia symptoms among black/African American and, to a lesser extent, Hispanic/Latinx groups start early in childhood and persist into young adulthood. Identifying and intervening upon upstream determinants of racial/ethnic insomnia disparities are warranted to directly address these disparities and to prevent their adverse health sequelae. CLINICAL TRIAL INFORMATION N/A; Not a clinical trial.
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Affiliation(s)
- Rupsha Singh
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Department of Health and Human Services, Baltimore, MD, USA
| | - Raegan Atha
- Sleep Research and Treatment Center, Department of Psychiatry and Behavioral Health, Penn State Health Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA, USA
| | - Kristina P Lenker
- Sleep Research and Treatment Center, Department of Psychiatry and Behavioral Health, Penn State Health Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA, USA
| | - Susan L Calhoun
- Sleep Research and Treatment Center, Department of Psychiatry and Behavioral Health, Penn State Health Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA, USA
| | - Jiangang Liao
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Fan He
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Alexandros N Vgontzas
- Sleep Research and Treatment Center, Department of Psychiatry and Behavioral Health, Penn State Health Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA, USA
| | - Duanping Liao
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Edward O Bixler
- Sleep Research and Treatment Center, Department of Psychiatry and Behavioral Health, Penn State Health Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA, USA
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Julio Fernandez-Mendoza
- Sleep Research and Treatment Center, Department of Psychiatry and Behavioral Health, Penn State Health Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA, USA
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18
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Tamura N, Okamura K. Longitudinal course and outcome of social jetlag in adolescents: A 1-year follow-up study of the adolescent sleep health epidemiological cohorts. J Sleep Res 2024; 33:e14042. [PMID: 37697814 DOI: 10.1111/jsr.14042] [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: 04/05/2023] [Revised: 08/19/2023] [Accepted: 08/25/2023] [Indexed: 09/13/2023]
Abstract
The discrepancy in sleep timing between weekdays and weekends - social jetlag (SJL) - is known to negatively affect student quality of life (QOL). However, the association between social jetlag and physical/mental QOL among adolescents and the precise effect of social jetlag on depressive symptoms and daytime sleepiness remains unknown. This study investigated the longitudinal course, risk factors, and effects of social jetlag, a circadian misalignment, in a school-based cohort. The participants were 427 students (13.3 ± 0.6 years, 45.2% girls) from five junior high schools. We performed a baseline survey in 2019 and a 1-year follow-up survey in 2020. Depressive symptoms, QOL, and daytime sleepiness were assessed using the Birleson Depression Self-Rating Scale for Children, Paediatric Quality of Life Inventory, and Paediatric Daytime Sleepiness Scale. In the baseline survey, 49.6% of the students reported SJL ≥1 h, and 17.1% reported SJL ≥2 h. Among them, 37.2% and 6.8% reported persistent SJL at follow-up, respectively. New incidences of SJL ≥1 h were associated with older age, non-attainment of menarche or voice changes, and longer duration of smartphone use, whereas its persistence was associated with a later chronotype. Persistence of SJL ≥1 h and ≥2 h predicted depressive symptoms and daytime sleepiness at follow-up, whereas new incidences of SJL ≥2 h predicted lower QOL. In conclusion, social jetlag has a persistent course, and daytime functioning can deteriorate as social jetlag becomes chronic. Our findings suggest the need for intensive interventions for social jetlag among adolescents.
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Affiliation(s)
- Norihisa Tamura
- Department of Psychology, Graduate School of Humanities and Social Sciences, Hiroshima University, Hiroshima, Japan
- Centre for Brain, Mind and Kansei Sciences Research, Hiroshima University, Hiroshima, Japan
| | - Kayoko Okamura
- Osaka Municipal Nanko Kita Junior High School, Osaka, Japan
- Department of Clinical Psychology, Graduate School of Education, Hyogo University of Teacher Education, Hyogo, Japan
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19
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Thompson L, Baker A, Almeida I, Slavish D, Blumenthal H. Disengagement coping and sleep problems among trauma-exposed adolescents. ANXIETY, STRESS, AND COPING 2024; 37:379-393. [PMID: 38093577 PMCID: PMC10990797 DOI: 10.1080/10615806.2023.2292180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 12/03/2023] [Indexed: 04/05/2024]
Abstract
BACKGROUND The formation of healthy sleep patterns is a critical component of positive adolescent development. Dysregulated sleep habits can put youth at risk for the development of a multitude of inimical outcomes, particularly among those who are exposed to a traumatic event. DESIGN AND METHODS The present study investigated the links between voluntary disengagement coping (e.g., avoidance, denial, wishful thinking) and sleep outcomes among 86 trauma-exposed and non-exposed adolescents between the ages of 12-17 (Mage = 15.44, SD = 1.51; 41.9% female). RESULTS The relationship between voluntary disengagement coping and sleep outcomes was significant only among trauma-exposed adolescents, such that greater use of voluntary disengagement strategies was associated with greater sleep disturbances and greater daytime dysfunction. CONCLUSIONS Targeting disengagement coping may be an important strategy to improve sleep health among trauma-exposed adolescents. Continued efforts in improving the efficacy of trauma-exposed adolescent intervention strategies are needed.
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Affiliation(s)
- Linda Thompson
- University of North Texas, Department of Psychology, 1155 Union Circle #311280, Denton, TX, 76203, United States
| | - Alexandria Baker
- University of Rochester, Department of Psychology, Rochester, NY, United States
| | - Isamar Almeida
- University of North Texas, Department of Psychology, 1155 Union Circle #311280, Denton, TX, 76203, United States
| | - Danica Slavish
- University of North Texas, Department of Psychology, 1155 Union Circle #311280, Denton, TX, 76203, United States
| | - Heidemarie Blumenthal
- University of North Texas, Department of Psychology, 1155 Union Circle #311280, Denton, TX, 76203, United States
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20
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Lunsford-Avery JR, Bidopia T, Jackson L, Sloan JS. Behavioral Treatment of Insomnia and Sleep Disturbances in School-Aged Children and Adolescents. Psychiatr Clin North Am 2024; 47:103-120. [PMID: 38302200 DOI: 10.1016/j.psc.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Insomnia and related sleep disturbances are prevalent among youth and are associated with adverse consequences, including poorer psychiatric functioning. Behavioral sleep interventions, ranging from brief educational interventions to behavioral therapies (cognitive behavior therapy-insomnia), are associated with positive outcomes for pediatric sleep health. In addition, sleep interventions may improve psychiatric health for children and adolescents with neurodevelopmental and internalizing disorders. Additional research is necessary to clarify the efficacy of these interventions over the long-term and across demographic groups; however, evidence suggests incorporating behavioral sleep strategies may prove beneficial to pediatric patients with sleep disturbances and related psychiatric complaints.
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Affiliation(s)
- Jessica R Lunsford-Avery
- Department of Psychiatry, Duke University School of Medicine, 2400 Pratt Street, Office 7036, 7th Floor, North Pavilion, Durham, NC 27705, USA.
| | - Tatyana Bidopia
- Department of Psychology, Fordham University, Bronx, NY, USA
| | - Leah Jackson
- HRC Behavioral Health & Psychiatry, PA, Chapel Hill, NC, USA
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21
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Madrid-Valero JJ, Barclay NL, Gregory AM. The interaction between polygenic risk and environmental influences: A direct test of the 3P model of insomnia in adolescents. J Child Psychol Psychiatry 2024; 65:308-315. [PMID: 37792459 PMCID: PMC10922170 DOI: 10.1111/jcpp.13895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/07/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND Stress is a universal phenomenon and one of the most common precipitants of insomnia. However, not everyone develops insomnia after experiencing a stressful life event. This study aims to test aspects of Spielman's '3P model of insomnia' (during adolescence) by exploring the extent to which: (a) insomnia symptoms are predicted by polygenic scores (PGS); (b) life events predict insomnia symptoms; (c) the interaction between PGS and life events contribute to the prediction of insomnia symptoms; (d) gene-environment interaction effects remain after controlling for sex. METHODS The sample comprised 4,629 twins aged 16 from the Twin Early Development Study who reported on their insomnia symptoms and life events. PGS for insomnia were calculated. In order to test the main hypothesis of this study (a significant interaction between PGS and negative life events), we fitted a series of mixed effect regressions. RESULTS The best fit was provided by the model including sex, PGS for insomnia, negative life events, and their interactions (AIC = 26,158.7). Our results show that the association between insomnia symptoms and negative life events is stronger for those with a higher genetic risk for insomnia. CONCLUSIONS This work sheds light on the complex relationship between genetic and environmental factors implicated for insomnia. This study has tested for the first time the interaction between genetic predisposition (PGS) for insomnia and environmental stressors (negative life events) in adolescents. This work represents a direct test of components of Spielman's 3P model for insomnia which is supported by our results.
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Affiliation(s)
- Juan J Madrid-Valero
- Department of Health Psychology, Faculty of Health Sciences, University of Alicante, Alicante, Spain
- Department of Human Anatomy and Psychobiology, University of Murcia, Murcia, Spain
| | - Nicola L Barclay
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Alice M Gregory
- Department of Psychology, Goldsmiths, University of London, London, United Kingdom
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22
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Zhong L, Han X, Li M, Gao S. Modifiable dietary factors in adolescent sleep: A systematic review and meta-analysis. Sleep Med 2024; 115:100-108. [PMID: 38350307 DOI: 10.1016/j.sleep.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/29/2024] [Accepted: 02/01/2024] [Indexed: 02/15/2024]
Abstract
OBJECTIVE Sleep problems are prevalent during adolescence, and modifying dietary factors may contribute to better sleep outcomes in adolescents. This systematic review and meta-analysis aimed to evaluate the impact of modifiable dietary factors on sleep health among adolescents. METHODS A systematic search of records from six databases including MEDLINE, PubMed, Embase, Scopus, CINAHL, and the CENTRAL from inception up to November 2023, identified 33 peer-reviewed publications that assessed the relationship between modifiable dietary factors and sleep outcomes in adolescents aged 12-18 years. The NIH Quality Assessment Tools were used to assess the quality of the included studies. Meta-analysis was performed on a sub-group of studies (n = 6) to ascertain the effect of dietary factors on sleep health. RESULTS Although the included studies were predominantly cross-sectional and exhibited heterogeneity, relying mainly on self-reported measures, it was observed that consumption of healthy foods was consistently linked with improved sleep outcomes among adolescents, whereas higher intake of fat-rich or sugar-rich foods and red meats or processed food was associated with poorer sleep features. The meta-analysis further substantiated that adolescents with higher caffeine intake faced increased odds of sleep problems (OR = 1.67, 95% CI: 1.28-2.17), while alcohol consumption was significantly associated with insomnia (OR = 1.17, 95% CI: 1.07-1.27). CONCLUSION Overall, despite high heterogeneity among studies, this systematic review underscores the promising role of healthy dietary factors in enhancing both the quality and quantity of sleep in adolescents. The meta-analysis results also highlight that reducing caffeine and alcohol intake holds potential for supporting better sleep in this population. However, further validation through intervention studies is warranted.
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Affiliation(s)
- Ling Zhong
- Department of Endocrinology, National Health Commission (NHC) Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Xuan Han
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Ming Li
- Department of Endocrinology, National Health Commission (NHC) Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
| | - Shan Gao
- Department of Endocrinology, Xuan Wu Hospital, Capital Medical University, Beijing, 100053, China
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23
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Yang X, Liu L, Tian Y, Yang C, Ling C, Liu H. Insomnia and Alexithymia in Chinese Adolescents with Major Depressive Disorder: A Cross-Sectional Study of Sex Differences and Associations. Psychol Res Behav Manag 2024; 17:615-625. [PMID: 38404923 PMCID: PMC10893783 DOI: 10.2147/prbm.s446788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/29/2024] [Indexed: 02/27/2024] Open
Abstract
Purpose Insomnia is related to alexithymia in adults, but the relationship between insomnia and alexithymia in adolescents with major depressive disorder remains unclear. This study aimed to investigate the sex differences and the association between insomnia and alexithymia in adolescents with major depressive disorder. Patients and Methods From October 2020 to April 2022, adolescent patients with major depressive disorder were recruited from psychiatric departments of seven hospitals in Anhui Province, China. Their general demographic and clinical information were collected. The 20-item Toronto Alexithymia Scale, the Center for Epidemiologic Studies of Depression Scale, and the Insomnia Severity Index Scale were used to assess their alexithymia, depression, and insomnia symptoms, respectively. The analysis of variance (ANOVA), Student's t-test and Mann-Whitney U-test were used for continuous variables and chi-square tests for categorical variables. Pearson's correlation analysis and Spearman correlation analysis were used to examine the correlation between ISI and demographic and clinical variables. Multiple binary logistic regression analyses with the "Enter" method were carried out to explore the correlations of insomnia. Results The prevalence of insomnia in female adolescent patients was similar to that of male patients (χ2=1.84, p = 0.175). Compared with those without insomnia, patients with insomnia had worse family relationships (F = 7.71, p = 0.021), perceived heavier academic stress (F = 6.32, p = 0.012), more likely to take sedative-hypnotics (F = 5.51, p = 0.019), had higher levels of depression (F = 81.57, p < 0.001) and alexithymia (F = 28.57, p < 0.001). Correlation analysis showed that alexithymia was significantly associated with insomnia in adolescent patients (r = 0.360, p < 0.01). Binary logistic regression analyses showed that, alexithymia was significantly associated with insomnia in female patients (OR = 1.050, p < 0.05) but not male patients. Conclusion In female adolescent patients, alexithymia is a risk factor of insomnia, which is of great importance in the understanding of the psychopathological mechanisms, treatments and psychological interventions of insomnia in adolescents with major depressive disorder.
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Affiliation(s)
- Xiaoxue Yang
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, People's Republic of China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
| | - Lewei Liu
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, People's Republic of China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
| | - Yinghan Tian
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, People's Republic of China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
| | - Cheng Yang
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, People's Republic of China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
| | - Chen Ling
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, People's Republic of China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
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Han Y, Song Z, Li W, Ke P, Wu X. Analysis of the correlation between immune cell characteristics and insomnia: a Mendelian randomization study. J Neurophysiol 2024; 131:176-186. [PMID: 38117913 DOI: 10.1152/jn.00429.2023] [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: 11/18/2023] [Revised: 12/11/2023] [Accepted: 12/19/2023] [Indexed: 12/22/2023] Open
Abstract
Insomnia, recognized as a prevalent sleep disorder, has garnered extensive attention within the realm of public health. Recent studies indicate a close interaction between the immune system and sleep; however, the specific mechanism remains not yet fully understood. Based on the publicly available Genome-Wide Association Study (GWAS) data, we used two-sample Mendelian randomization (MR) analyses to investigate the associations between 731 immune cell traits and insomnia risk. Five MR analysis methods and a comprehensive sensitivity analysis were used to evaluate the reliability of the results. In this study, we identified that 14 immune characteristics among four immune profiles [median fluorescence intensity (MFI), relative cell count (RC), absolute cell count (AC), and morphological parameters (MP)] demonstrated a significant causal association with insomnia. Specifically, eight immune cell characteristics were associated with an increased risk of insomnia, including CD11c+ monocyte% (P < 0.001), CD11c+ HLA DR++ monocyte% (P = 0.004), CD86+ plasmoid dendritic cell (DC) AC (P < 0.001), CD33br HLA DR+ CD14dim AC (P < 0.001), CD8dim AC (P = 0.002), CCR2 on CD14+ CD16- monocyte (P < 0.001), CD39 on monocyte (P < 0.001), and SSC-A on myeloid DC (P < 0.001). Six immune cell characteristics demonstrated protective effects against insomnia, including PB/PC %B cell (P < 0.001), CM CD4+% CD4+ (P < 0.001), T-cell AC (P < 0.001), BAFF-R on IgD- CD38br (P < 0.001), CD16-CD56 on HLA DR+ NK cells (P < 0.001), and CD14 on CD33br HLA DR+ CD14dim (P < 0.001). Our study established the correlation between immune cell characteristics and insomnia, offering a novel theoretical foundation for the concept of sleep-immune cross talk.NEW & NOTEWORTHY This study investigated the association between 731 immune cell characteristics and insomnia using Mendelian randomization, revealing that 14 immune cell characteristics across four groups of immune traits (MFI, RC, AC, and MP) have a significant and causal association with insomnia risk. Our results contribute to the understanding of the sleep-immune cross talk doctrine and offer a new theoretical basis for immune modulation in treating insomnia.
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Affiliation(s)
- Yupeng Han
- Department of Anesthesiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Zhiwei Song
- Department of Neurology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Wangyu Li
- Department of Pain Management, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Peng Ke
- Department of Anesthesiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Xiaodan Wu
- Department of Anesthesiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
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25
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Zhao J, Wang X, Xu S, Yan W, Wang J, Wang E, Liu T, Hao M. The influence of lifestyle habits on levels of depression among rural middle school students in Northeastern China. Front Public Health 2024; 12:1293445. [PMID: 38347930 PMCID: PMC10859412 DOI: 10.3389/fpubh.2024.1293445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/15/2024] [Indexed: 02/15/2024] Open
Abstract
Background Depression rates among adolescents have risen dramatically over the past decade. Therefore, preventing depression among adolescents is particularly important. Differences in lifestyle habits may play a role in depression. Purpose This study aimed to explore the influence of living habits on depression levels among rural middle school students in Northeast China and to provide a theoretical basis for developing interventions to reduce depression levels in middle school students. Methods A total of 296 middle school students aged 13-15 years from Benxi City, Northeast China completed the anthropometric measurements, Physical Activity Scale-3 (PARS-3), and the Self-Rating Depression Scale (SDS). Their average screen time in the most recent week, parents' education level, and monthly family income were collected through a questionnaire. Results Females had higher depression scores than males (41.0 ± 6.9 vs. 37.9 ± 8.0). Physical activity (β = -0.38, t = -7.06, P < 0.01), family income (β = -0.20, t = -4.07, P < 0.01), screen time (β = 0.16, t = 3.34, P < 0.01), age (β = 0.15, t = 3.16, P < 0.01), sex (β = -0.13, t = -2.74, P < 0.01), and sleep quality (β = -0.08, t = -1.87, P < 0.01) are important factors related to depression levels. Conclusion The preliminary analysis results showed that among middle school students in rural Northeast China, the depression level of females was significantly higher than that of males. Poor quality sleep, low levels of physical activity, low household income, and long screen time were positively associated with depression. Therefore, strengthening physical activity, improving sleep quality, and reducing screen time are of clinical relevance in preventing and reducing depression.
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Affiliation(s)
- JunCheng Zhao
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Xiaoyin Wang
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Shiliang Xu
- College of Electronics and Information Engineering, Liaoning Institute of Science and Technology, Benxi, Liaoning, China
| | - Wenjing Yan
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Jingzhe Wang
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Ende Wang
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Tao Liu
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Ming Hao
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
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26
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Nordström EEL, Kaltiala R, Kristensen P, Thimm JC. Somatic symptoms and insomnia among bereaved parents and siblings eight years after the Utøya terror attack. Eur J Psychotraumatol 2024; 15:2300585. [PMID: 38214224 PMCID: PMC10791101 DOI: 10.1080/20008066.2023.2300585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/27/2023] [Indexed: 01/13/2024] Open
Abstract
Background: Levels of prolonged grief symptoms (PGS) and post-traumatic stress symptoms (PTSS) can be high, many years following bereavement after terror, but knowledge concerning somatic health is scarce. Terrorism is a serious public health challenge, and increased knowledge about long-term somatic symptoms and insomnia is essential for establishing follow-up interventions after terrorism bereavement.Objective: To study the prevalence of somatic symptoms and insomnia and their association with PGS, PTSS, and functional impairment among terrorism-bereaved parents and siblings.Methods: A cross-sectional quantitative study included 122 bereaved individuals from the Utøya terror attack in Norway in 2011. The sample comprised 88 parents and 34 siblings aged 19 years and above (Mage = 49.7 years, SDage = 13.8 years, 59.8% females). The participants completed questionnaires 8 years after the attack assessing somatic symptoms (Children's Somatic Symptoms Inventory) and insomnia (Bergen Insomnia Scale) along with measures of PGS (Inventory of Complicated Grief), PTSS (Impact of Event Scale-Revised), and functional impairment (Work and Social Adjustment Scale).Results: Fatigue was the most frequently reported somatic symptom (88% of females and 65% of males). Females reported statistically significantly more somatic symptoms than males. In total, 68% of the bereaved individuals scored above the cut-off for insomnia. There were no statistically significant gender differences for insomnia. Female gender, intrusion, and arousal were associated with somatic symptoms. Intrusion and somatic symptoms were associated with insomnia. Somatic symptoms, avoidance, and hyperarousal were associated with functional impairment.Conclusion: Many bereaved parents and siblings report somatic symptoms and insomnia eight years after the terror attack. Somatic symptoms are associated with functional impairment. Long-term follow-up and support after traumatic bereavement should focus on somatic symptoms and insomnia.
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Affiliation(s)
| | - Riittakerttu Kaltiala
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Adolescent Psychiatry, Tampere University Hospital, Tampere, Finland
- Vanha Vaasa Hospital, Vaasa, Finland
| | - Pål Kristensen
- Center for Crisis Psychology, University of Bergen, Bergen, Norway
| | - Jens C. Thimm
- Center for Crisis Psychology, University of Bergen, Bergen, Norway
- Department of Psychology, UiT The Arctic University of Norway, Tromsø, Norway
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Crevits L, Silva C, Bat-Pitault F. Preliminary study: cognitive behavioural therapy for insomnia in adolescents with anorexia nervosa. Eat Weight Disord 2024; 29:3. [PMID: 38177892 PMCID: PMC10766733 DOI: 10.1007/s40519-023-01634-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/13/2023] [Indexed: 01/06/2024] Open
Abstract
PURPOSE Insomnia and anorexia nervosa (AN) are frequently comorbid, negatively affecting the evolution and the prognosis of AN. Within this framework, the management of sleep disorders appears as critical. The aim of this retrospective study is to assess, for the first time, the efficacy of cognitive and behavioural therapy for insomnia (CBT-I) on sleep disturbances in adolescents with AN. To do so, we investigated the impact of CBT-I on sleep disturbances and sleep-related outcomes, in BMI, AN symptoms, anxiety and depressive symptoms, emotionality and quality of life. These features were compared between two groups of patients with AN, one following CBT-I, and the other receiving the regular treatment at the psychiatric unit. METHODS Data collection occurred between January and May 2022. The study included 42 adolescents in-treatment at the Eating Disorders care specialised unit at Salvator Hospital in Marseille. They were randomly assigned to the CBT-I group (N = 31) or the control group (N = 11). Several clinical elements were assessed using sleep diaries and self-report questionnaires. RESULTS Participants undergoing CBT-I showed a significant improvement in sleep latency, total wake time and sleep efficacy, as well as in physical well-being. No significant effects were found regarding AN symptoms. CONCLUSION These preliminary findings provide support for CBT-I effectiveness in adolescents with AN, as shown by significant improvements in several sleep parameters, as well as in physical well-being. These promising results, underline the relevance of this topic and its potential benefits for a more appropriate treatment for adolescents with AN. LEVEL OF EVIDENCE Level V, retrospective study.
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Affiliation(s)
- Léna Crevits
- Child and Adolescent Psychopathology Unit, Salvator University Hospital, Public Assistance-Marseille Hospitals, Aix-Marseille University, 249 Boulevard Sainte-Marguerite, 13009, Marseille, France
- Adult Psychopathology Unit, Valvert Hospital, 78 Boulevard des Libérateurs, 13011, Marseille, France
| | - Catarina Silva
- Child and Adolescent Psychopathology Unit, Salvator University Hospital, Public Assistance-Marseille Hospitals, Aix-Marseille University, 249 Boulevard Sainte-Marguerite, 13009, Marseille, France
- Institute of Neuroscience Timone, CNRS, Aix-Marseille University, Marseille, France
| | - Flora Bat-Pitault
- Child and Adolescent Psychopathology Unit, Salvator University Hospital, Public Assistance-Marseille Hospitals, Aix-Marseille University, 249 Boulevard Sainte-Marguerite, 13009, Marseille, France.
- Institute of Neuroscience Timone, CNRS, Aix-Marseille University, Marseille, France.
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28
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Kelmanson IA. [Trait and state anxiety, symptoms of insomnia and their influence on daytime functioning in adolescent girls]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:66-71. [PMID: 38934668 DOI: 10.17116/jnevro202412405266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
OBJECTIVE To investigate the relationship between symptoms of trait anxiety, state anxiety and symptoms of insomnia and the degree of their influence on daytime functioning disorders in adolescent girls. MATERIAL AND METHODS The study included 50 healthy adolescent girls, senior school students, aged 15-17 years, selected as simple random sample. Insomnia symptoms and their impact on daytime functioning were assessed using the SLEEP-50 (S-50) questionnaire. Trait and state anxiety were assessed using the Spielberger questionnaire. The method of path analysis was used to identify significant associations. RESULTS There was a positive association of the severity of daytime functioning disorders with the severity of insomnia symptoms (β=0.45; p<0.001) and the level of trait anxiety (β=0.34; p=0.004). Trait anxiety was also a significant predictor of state anxiety (p<0.001), with a direct relationship between these parameters (β=0.62). Positive covariation of insomnia symptoms severity and state anxiety was found (β=0.53; p<0.001). CONCLUSION Improving sleep quality and daytime functioning in adolescents with insomnia symptoms should take into account personality characteristics. High levels of trait anxiety increase the negative effects of insomnia on the impaired daytime functioning.
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Affiliation(s)
- I A Kelmanson
- Almazov National Medical Research Centre, St. Petersburg, Russia
- Saint-Petersburg State Institute for Psychology and Social Work, St. Petersburg, Russia
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29
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Liu W, Wang D, Fan Y, Ye H, Bu L, Fan F. Changes in sleep disturbance among Chinese adolescents: A population-based online survey. J Psychosom Res 2023; 175:111515. [PMID: 37856932 DOI: 10.1016/j.jpsychores.2023.111515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/17/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVE Sleep disturbance is prevalent among adolescents but little is known about the short-term changes among Chinese adolescents. The study aimed to explore the prevalence and change patterns of sleep disturbance and identify its risk and protective factors. METHODS Data were collected online from April 21st to May 12th, 2021 (Time 1, T1) and December 17th to 26th, 2021 (Time 2, T2). The final sample comprised 34,260 adolescents. Self-administrated questionnaires were used to assess socio-demographic variables, sleep disturbance, depression, anxiety, life events, family function, and resilience. RESULTS The prevalence of sleep disturbance was 12.0% at T1 and 11.8% at T2, with higher rates in females than males. Four groups of sleep disturbance change patterns were identified: non-sleep disturbance group (80.4%), persistent group (4.2%), new-onset group (7.6%), and remission group (7.8%). Risk factors for new-onset sleep disturbance included being in junior high school (AOR = 1.26, 95%CI = 1.15-1.38), family history of mental disorders (AOR = 1.49, 95%CI = 1.03-2.15), and moderate (AOR = 1.24, 95%CI = 1.13-1.36) and severe (AOR = 1.48, 95%CI = 1.27-1.72) family dysfunction. Risk factors for persistent sleep disturbance included being in junior (AOR = 1.25, 95%CI = 1.08-1.45) and senior (AOR = 1.53, 95%CI = 1.15-2.03) high school, parental currently unmarried status (AOR = 1.34, 95%CI = 1.05-1.73), moderate (AOR = 1.19, 95%CI = 1.02-1.39) and severe (AOR = 1.28, 95%CI = 1.06-1.55) family dysfunction. Medium (AOR = 0.48, 95%CI = 0.43-0.53) and high (AOR = 0.34, 95%CI = 0.29-0.40) levels of resilience were protective factors against new-onset sleep disturbance, as well as against persistent sleep disturbance (medium level: AOR = 0.51, 95%CI = 0.43-0.60; high level: AOR = 0.32, 95%CI = 0.25-0.43). CONCLUSIONS Interventions aimed at promoting family functions and enhancing resilience may improve sleep disturbance among adolescents.
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Affiliation(s)
- Wenxu Liu
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Yunge Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Haoxian Ye
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Luowei Bu
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Fang Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China.
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Gorovoy SB, Tubbs AS, Grandner MA. Sleep disorders symptoms in children, adolescents, and emerging adults: Reducing mortality and population health burden through improved identification, referral, and treatment. Sleep Health 2023; 9:991-992. [PMID: 37648647 PMCID: PMC11041109 DOI: 10.1016/j.sleh.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/12/2023] [Accepted: 07/18/2023] [Indexed: 09/01/2023]
Affiliation(s)
- Suzanne B Gorovoy
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine - Tucson, Tucson, Arizona, USA.
| | - Andrew S Tubbs
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine - Tucson, Tucson, Arizona, USA
| | - Michael A Grandner
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine - Tucson, Tucson, Arizona, USA
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Alzueta E, Baker FC. The Menstrual Cycle and Sleep. Sleep Med Clin 2023; 18:399-413. [PMID: 38501513 DOI: 10.1016/j.jsmc.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
Aspects of sleep change across the menstrual cycle in some women. Poorer sleep quality in the premenstrual phase and menstruation is common in women with premenstrual symptoms or painful menstrual cramps. Although objective sleep continuity remains unchanged across the regular, asymptomatic menstrual cycle, activity in the sleep electroencephalogram varies, with a prominent increase in sleep spindle activity in the postovulatory luteal phase, when progesterone is present, relative to the follicular phase. Menstrual cycle phase, reproductive stage, and menstrual-related disorders should be considered when assessing women's sleep complaints.
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Affiliation(s)
- Elisabet Alzueta
- Human Sleep Research Program, SRI International, Menlo Park, CA, USA
| | - Fiona C Baker
- Human Sleep Research Program, SRI International, Menlo Park, CA, USA; Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa.
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Kiss O, Nagata JM, de Zambotti M, Dick AS, Marshall AT, Sowell ER, Van Rinsveld A, Guillaume M, Pelham WE, Gonzalez MR, Brown SA, Dowling GJ, Lisdahl KM, Tapert SF, Baker FC. Effects of the COVID-19 pandemic on screen time and sleep in early adolescents. Health Psychol 2023; 42:894-903. [PMID: 36972087 PMCID: PMC10522787 DOI: 10.1037/hea0001251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
OBJECTIVE During the COVID-19 pandemic, adolescents and families have turned to online activities and social platforms more than ever to maintain well-being, connect remotely with friends and family, and online schooling. However, excessive screen use can have negative effects on health (e.g., sleep). This study examined changes in sleep habits and recreational screen time (social media, video gaming), and their relationship, before and across the first year of the pandemic in adolescents in the Adolescent Brain Cognitive Development (ABCD) Study. METHOD Mixed-effect models were used to examine associations between self-reported sleep and screen time using longitudinal data of 5,027 adolescents in the ABCD Study, assessed before the pandemic (10-13 years) and across six time points between May 2020 and March 2021 (pandemic). RESULTS Time in bed varied, being higher during May-August 2020 relative to pre-pandemic, partially related to the school summer break, before declining in October 2020 to levels lower than pre-pandemic. Screen time steeply increased and remained high across all pandemic time points relative to pre-pandemic. Higher social media use and video gaming were associated with shorter time in bed, later bedtimes, and longer sleep onset latency. CONCLUSIONS Sleep behavior and screen time changed during the pandemic in early adolescents. More screen time was associated with poorer sleep behavior, before and during the pandemic. While recreational screen usage is an integral component of adolescent's activities, especially during the pandemic, excessive use can have negative effects on essential health behaviors, highlighting the need to promote balanced screen usage. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Orsolya Kiss
- Center for Health Sciences, SRI International, 333 Ravenswood Ave, Menlo Park, CA 94025, USA
| | - Jason M. Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California San Francisco, San Francisco, California, CA 94158, USA
| | | | - Anthony Steven Dick
- Department of Psychology, Florida International University, Miami, FL 33199 USA
| | - Andrew T. Marshall
- Division of Research on Children, Youth and Families, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA, 90027, USA
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033
| | - Elizabeth R. Sowell
- Division of Research on Children, Youth and Families, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA, 90027, USA
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033
| | | | - Mathieu Guillaume
- Graduate School of Education, Stanford University, Stanford, CA 94305, USA
| | - William E. Pelham
- Department of Psychiatry, University of California, San Diego, 9500 S Gilman Dr., La Jolla, CA 92093, USA
| | - Marybel R. Gonzalez
- Department of Psychiatry, University of California, San Diego, 9500 S Gilman Dr., La Jolla, CA 92093, USA
| | - Sandra A. Brown
- Department of Psychiatry, University of California, San Diego, 9500 S Gilman Dr., La Jolla, CA 92093, USA
| | - Gayathri J. Dowling
- Division of Extramural Research, National Institute on Drug Abuse, Rockville, MD 20852, USA
| | - Krista M. Lisdahl
- Department of Psychology, University of Wisconsin at Milwaukee, Milwaukee, WI 53201, USA
| | - Susan F. Tapert
- Department of Psychiatry, University of California, San Diego, 9500 S Gilman Dr., La Jolla, CA 92093, USA
| | - Fiona C. Baker
- Center for Health Sciences, SRI International, 333 Ravenswood Ave, Menlo Park, CA 94025, USA
- School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
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Stangeland H, Handal M, Skurtveit SO, Aakvaag HF, Dyb G, Wentzel-Larsen T, Baumann-Larsen M, Zwart JA, Storheim K, Stensland SØ. Killing pain?: a population-based registry study of the use of prescription analgesics, anxiolytics, and hypnotics among all children, adolescents and young adults in Norway from 2004 to 2019. Eur Child Adolesc Psychiatry 2023; 32:2259-2270. [PMID: 36030342 PMCID: PMC9419914 DOI: 10.1007/s00787-022-02066-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 08/05/2022] [Indexed: 11/03/2022]
Abstract
The ongoing opioid epidemic has been a global concern for years, increasingly due to its heavy toll on young people's lives and prospects. Few studies have investigated trends in use of the wider range of drugs prescribed to alleviate pain, psychological distress and insomnia in children, adolescents and young adults. Our aim was to study dispensation as a proxy for use of prescription analgesics, anxiolytics and hypnotics across age groups (0-29 years) and sex over the last 15 years in a large, representative general population. The study used data from a nationwide prescription database, which included information on all drugs dispensed from any pharmacy in Norway from 2004 through 2019. Age-specific trends revealed that the prevalence of use among children and adolescents up to age 14 was consistently low, with the exception of a substantial increase in use of melatonin from age 5. From age 15-29, adolescents and young adults used more prescription drugs with increasing age at all time points, especially analgesics and drugs with higher potential for misuse. Time trends also revealed that children from age 5 were increasingly dispensed melatonin over time, while adolescents from age 15 were increasingly dispensed analgesics, including opioids, gabapentinoids and paracetamol. In contrast, use of benzodiazepines and z-hypnotics slightly declined in young adults over time. Although trends were similar for both sexes, females used more prescription drugs than their male peers overall. The upsurge in use of prescription analgesics, anxiolytics and hypnotics among young people is alarming.Trial registration The study is part of the overarching Killing Pain project. The rationale behind the Killing Pain research was pre-registered through ClinicalTrials.gov on April 7, 2020. Registration number NCT04336605; https://clinicaltrials.gov/ct2/show/record/NCT04336605 .
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Affiliation(s)
- Helle Stangeland
- Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Gullhaugveien 1, 0484, Oslo, Norway.
- Division of Clinical Neuroscience, Department of Research and Innovation, Oslo University Hospital, Oslo, Norway.
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Marte Handal
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | - Svetlana Ondrasova Skurtveit
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | - Helene Flood Aakvaag
- Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Gullhaugveien 1, 0484, Oslo, Norway
| | - Grete Dyb
- Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Gullhaugveien 1, 0484, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tore Wentzel-Larsen
- Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Gullhaugveien 1, 0484, Oslo, Norway
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Monica Baumann-Larsen
- Division of Clinical Neuroscience, Department of Research and Innovation, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - John Anker Zwart
- Division of Clinical Neuroscience, Department of Research and Innovation, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kjersti Storheim
- Division of Clinical Neuroscience, Department of Research and Innovation, Oslo University Hospital, Oslo, Norway
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Synne Øien Stensland
- Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Gullhaugveien 1, 0484, Oslo, Norway
- Division of Clinical Neuroscience, Department of Research and Innovation, Oslo University Hospital, Oslo, Norway
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Xiao L, Voutsas G, Ryan CM, Katz SL, Narang I. The association between sleep quality and obstructive sleep apnea with health-related quality of life in children with obesity. J Clin Sleep Med 2023; 19:1877-1883. [PMID: 37409497 PMCID: PMC10620665 DOI: 10.5664/jcsm.10706] [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: 03/23/2023] [Revised: 06/27/2023] [Accepted: 06/27/2023] [Indexed: 07/07/2023]
Abstract
STUDY OBJECTIVES Obstructive sleep apnea (OSA) and poor sleep quality are highly prevalent in children with obesity, but their individual associations with health-related quality of life (HRQOL) are unknown in this population. The primary objective was to describe the independent association of OSA and sleep quality with HRQOL in children with obesity. METHODS This was a cross-sectional study of children with obesity at 2 tertiary care centers. Sleep quality and HRQOL were measured with the Pittsburgh Sleep Quality Index and Pediatric Quality of Life Inventory questionnaires, respectively. Multivariable regression models were created to evaluate associations between OSA and sleep quality with HRQOL. RESULTS There were 98 children (median age 15.0 years, median body mass index z-score 3.8, 44% females). Among the study population, 49/98 (50%) children reported poor sleep quality, 41/98 (42%) children had OSA, and 52/98 (53%) children reported impaired HRQOL. Self-reported poor sleep quality was independently associated with reduced HRQOL, whereas the presence of OSA was not. Children with poor sleep quality had a reduced Pediatric Quality of Life Inventory score by 8.8 compared to children with good sleep quality (95% confidence interval, 2.6-14.9; P = .006), when adjusting for age, sex, body mass index z-score, attention-deficit/hyperactivity disorder, mood/anxiety disorder, and study site. CONCLUSIONS In the current study of children with obesity, we found that HRQOL was more strongly associated with the self-reported experience of sleep than the presence of OSA. Clinicians should assess and optimize sleep quality as part of the evaluation for OSA in children with obesity. CITATION Xiao L, Voutsas G, Ryan CM, Katz SL, Narang I. The association between sleep quality and obstructive sleep apnea with health-related quality of life in children with obesity. J Clin Sleep Med. 2023;19(11):1877-1883.
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Affiliation(s)
- Lena Xiao
- Division of Respiratory Medicine, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Giorge Voutsas
- Division of Respiratory Medicine, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Clodagh M. Ryan
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Respirology, Department of Medicine, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Sherri Lynne Katz
- Division of Respiratory Medicine, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Indra Narang
- Division of Respiratory Medicine, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
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Gao T, Tao Y, Wang Q, Liu J, Du Z, Xing Y, Chen F, Mei J. A bibliometric analysis of insomnia in adolescent. Front Psychiatry 2023; 14:1246808. [PMID: 37965363 PMCID: PMC10641400 DOI: 10.3389/fpsyt.2023.1246808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 10/10/2023] [Indexed: 11/16/2023] Open
Abstract
Background The negative effects of insomnia on adolescents' development, academic performance, and quality of life place a burden on families, schools, and society. As one of the most important research directions for insomnia, adolescent insomnia has significant research value, social value, and practical significance. Unfortunately, there is no bibliometric analysis in this field of study. This study aims to analyze published articles using bibliometrics, summarize the current research progress and hot topics in this field systematically and exhaustively, and predict the future direction and trend of research. Methods For this study, the Web of Science Core Collection (WoSCC) database was searched between 2002 and 2022 for publications related to adolescent insomnia. The R-bibliometrix, VOSViewer, and CiteSpace software were utilized for bibliometric analysis. Results This investigation included 2468 publications from 3102 institutions in 87 countries, led by China and the United States. This field of research has entered a period of rapid development since 2017. The journal with the most publications on adolescent insomnia is Sleep, which is also the most co-cited journal. American Journal of Psychology has the highest impact factor among the top 10 journals. These papers were written by 10605 authors; notably, Liu Xianchen emerged as the author with the highest frequency of publications, while Mary A. Carskadon was the most frequently co-cited author. Mental health and comorbid diseases were the main research directions in this field. "Depression," "anxiety," "mental health," "COVID-19," "stress," "quality of life," "heart rate variability," and "attention-deficit hyperactivity disorder" were hot spots and trends in this field at the current moment. Conclusion The research on adolescent insomnia has social value, research value, and research potential; its development is accelerating, and an increasing number of researchers are focusing on it. This study summarized and analyzed the development process, hot spots, and trends of adolescent insomnia research using bibliometric analysis, which identified the current hot topics in this field and predicted the development trend for the future.
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Affiliation(s)
- Tianci Gao
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- First Affiliated Hospital, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Yulei Tao
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- First Affiliated Hospital, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Qianfei Wang
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- First Affiliated Hospital, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Jiayi Liu
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Zekun Du
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - YueYi Xing
- School of Basic Medicine, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Fenqiao Chen
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- First Affiliated Hospital, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Jianqiang Mei
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- First Affiliated Hospital, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
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Tatar D, Dębski P, Bocian B, Bąkowska M, Będkowska J, Tropiejko M, Główczyński P, Badura-Brzoza K. How do teenagers sleep? Analysis of factors related to sleep disorders in a group of Polish high school students. BMC Pediatr 2023; 23:498. [PMID: 37784108 PMCID: PMC10544440 DOI: 10.1186/s12887-023-04327-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/24/2023] [Indexed: 10/04/2023] Open
Abstract
Insomnia is the most common sleep disorder in the adolescent population. Resulting from a complex interplay of genetic, biological, social, and environmental factors, it affects disturbances in everyday functioning in many aspects of life. The aim of the study was to analyze the factors related to the occurrence of insomnia among high school students. MATERIAL The study was conducted among 2364 high school students aged between 14 and 19 years old (the average age 17.92 ± 1.10), of which there were 2068 girls and 295 boys. METHOD Athens Insomnia Scale (AIS) and authorial demographic data questionnaire involved questions about physical activity during the day, smoking, frequency of upper respiratory tract infections, problems with concentration and memory, school achievements, and the use of mobile devices at bedtime were used to assess examined parameters. The scale and questionnaires were shared on-line via social media. RESULTS Analyzing the results obtained in the study group, the average score of 8.42 ± 4.16 was obtained in the AIS, which allows the assessment of sleep disorders bordering on normal. After division into groups of girls and boys, 8.38 ± 4.56 points were obtained, respectively for girls and 8.43 ± 4.27pts. for boys - the difference was not statistically significant. Similarly, statistically significant differences were not found when dividing the groups into the one in which adolescents used the phone just before bedtime and the one that did not use it. The act of sleeping alone or with another person in the room also did not differentiate the groups statistically, as well as the place of residence. Statistically significant worse results in the AIS scale were obtained by people who declared worse physical activity during the day and smoking cigarettes, as well as those who reported more frequent problems with concentration and memory, had worse school performance and suffered from upper respiratory infections more often. CONCLUSIONS 1). Sleep disorders may be related to factors such as smoking cigarettes or lack of physical activity, as well as difficulties in concentrating attention, memory disorders or worse academic performance and a tendency to contract upper respiratory tract infections. 2). Elimination of factors that may adversely affect the quality of sleep is particularly important in the group of adolescents, in whom the developing structures of the central nervous system may be particularly sensitive to deficiencies in this area. 3). Exploration of the interplay of study duration, screen time, and semester-specific stressors on sleep quality could yield further insights.
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Affiliation(s)
- Dominika Tatar
- Clinical ward, Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Ul. Pyskowicka 47, Katowice, Tarnowskie Góry, 42-600, Poland
| | - Paweł Dębski
- Clinical ward, Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Ul. Pyskowicka 47, Katowice, Tarnowskie Góry, 42-600, Poland
- Institute of Psychology, Humanitas University, Sosnowiec, Poland
| | - Bogusława Bocian
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Students' Scientific Association, Katowice, Poland
| | - Małgorzata Bąkowska
- Department of Endocrinology and Metabolic Diseases, Regional Specialist Hospital No. 3, Rybnik, Poland
| | - Joanna Będkowska
- Department of Rheumatology and Autoimmune Diseases, Rheumatology Center, Ustroń, Poland
| | | | - Patryk Główczyński
- Clinical ward, Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Ul. Pyskowicka 47, Katowice, Tarnowskie Góry, 42-600, Poland.
| | - Karina Badura-Brzoza
- Clinical ward, Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Ul. Pyskowicka 47, Katowice, Tarnowskie Góry, 42-600, Poland
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Zhai S, Li T, Zhang D, Qu Y, Xie Y, Wu X, Zou L, Tao F, Tao S. Insomnia trajectories predict chronic inflammation over 2 years at the transition to adulthood. J Sleep Res 2023; 32:e13906. [PMID: 37062708 DOI: 10.1111/jsr.13906] [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: 08/25/2022] [Revised: 03/01/2023] [Accepted: 03/29/2023] [Indexed: 04/18/2023]
Abstract
Insomnia in adolescents is an important public health concern, as its impacts on both their current and future physical and mental health has been discussed. However, few longitudinal studies have examined insomnia and chronic inflammation at the transition from adolescence to adulthood. This study aimed to examine the predictive effects of insomnia and insomnia trajectories on inflammation in college students by using a prospective design. Using data from the College Student Behaviour and Health Cohort Study, which was conducted between April 2019 and April 2021, with an interval of 6 months. We investigated the associations between insomnia trajectories from Year 1 to Year 3 and five inflammatory biomarkers (C-reactive protein [CRP], tumour necrosis factor [TNF]-α, interleukin [IL]-6, IL-1β, IL-10) at Year 3. The association of insomnia symptoms at baseline, Wave 1 or Wave 2 with inflammatory biomarkers at Wave 4 were also assessed. A total of 312 college students (males: 51.6%) aged 16-26 years (mean [SD] 18.82 [1.22] years) were analysed. We identified two insomnia trajectory classes: increasing insomnia (n = 63 [20.2%]) and decreasing insomnia (n = 249 [79.8%]). Generalised linear model analysis revealed that insomnia symptoms at Wave 1 were associated with significantly elevated CRP and TNF-α levels at Wave 4. Increasing insomnia trajectories predicted consistently higher levels of CRP, TNF-α and IL-10. However, after adjusting for potential confounders, these associations were significantly attenuated. Overall, the findings suggest that insomnia symptoms affect chronic inflammation at the transition to adulthood. Our study needs to be replicated in larger cohorts to further explore how inflammation interacts with insomnia to increase the susceptibility to adverse health conditions.
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Affiliation(s)
- Shuang Zhai
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Tingting Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Dan Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Yang Qu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Yang Xie
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Xiaoyan Wu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, People's Republic of China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, Anhui, People's Republic of China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Liwei Zou
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, Anhui, People's Republic of China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, People's Republic of China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, Anhui, People's Republic of China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Shuman Tao
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, Anhui, People's Republic of China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, People's Republic of China
- Department of Ophthalmology, The Second Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
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Albinni B, Baker FC, Javitz H, Hasler BP, Franzen PL, Clark DB, de Zambotti M. Morning perception of sleep, stress, and mood, and its relationship with overnight physiological sleep: findings from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study. J Sleep Res 2023; 32:e13886. [PMID: 36941027 PMCID: PMC10509318 DOI: 10.1111/jsr.13886] [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: 08/31/2022] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 03/23/2023]
Abstract
This cross-sectional study investigated objective-subjective sleep discrepancies and the physiological basis for morning perceptions of sleep, mood, and readiness, in adolescents. Data collected during a single in-laboratory polysomnographic assessment from 137 healthy adolescents (61 girls; age range: 12-21 years) in the United States National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study were analysed. Upon awakening, participants completed questionnaires assessing sleep quality, mood, and readiness. We evaluated the relationship between overnight polysomnographic, electroencephalographic, sleep autonomic nervous system functioning measures, and next morning self-reported indices. Results showed that older adolescents reported more awakenings, yet they perceived their sleep to be deeper and less restless than younger adolescents. Prediction models including sleep physiology measures (polysomnographic, electroencephalographic, and sleep autonomic nervous system) explained between 3% and 29% of morning sleep perception, mood, and readiness indices. The subjective experience of sleep is a complex phenomenon with multiple components. Distinct physiological sleep processes contribute to the morning perception of sleep and related measures of mood and readiness. More than 70% of the variance (based on a single observation per person) in the perception of sleep, mood, and morning readiness is not explained by overnight sleep-related physiological measures, suggesting that other factors are important for the subjective sleep experience.
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Affiliation(s)
- Benedetta Albinni
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
- Department of Psychology, University of Campania “Luigi Vanvitelli”
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
- Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Harold Javitz
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Brant P. Hasler
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Peter L. Franzen
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Duncan B. Clark
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Bliddal M, Kildegaard H, Rasmussen L, Ernst M, Jennum PJ, Mogensen SH, Pottegård A, Wesselhoeft R. Melatonin use among children, adolescents, and young adults: a Danish nationwide drug utilization study. Eur Child Adolesc Psychiatry 2023; 32:2021-2029. [PMID: 35792937 DOI: 10.1007/s00787-022-02035-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/20/2022] [Indexed: 11/03/2022]
Abstract
We aimed to provide a detailed description of the use of melatonin in Danish children, adolescents, and young adults during 2012-2019. We identified melatonin users 0-24 years of age (n = 43,652; median age 16 years) via the Danish nationwide health registers. Melatonin is a prescription drug in Denmark. The incidence of melatonin use increased from 2.4 to 3.9/1000 person-years during 2012 to 2019. Among 6,557 incident users in 2019, 53% filled only a single prescription within the first 6 months. Long-term use was most common among the younger age groups, with 17% of 5-9-year-olds and 14% of 10-13-year-olds being in continued treatment (no treatment breaks) 12 months after their first melatonin prescription. Disregarding treatment breaks, 3 in 10 were using melatonin 12 months after their first melatonin prescription and this proportion was also highest among 5-9-year-olds (63%) and 10-13-year-olds (51%). Psychopathology was common among melatonin users with 75% registered with either a psychiatric disorder diagnosis (54%), a filled prescription for another psychotropic (58%), or a contact to a private practice psychiatrist (15%) within ± 12 months of treatment initiation. General practitioners authorized melatonin prescriptions to almost half of all new users (48%), while psychiatric specialists authorized 37% of first prescriptions. In conclusion, the incidence of melatonin use increased in Denmark from 2012 to 2019. A substantial proportion of users had concurrent psychopathology most likely explaining their use of melatonin. Long-term melatonin use was more common among the youngest age groups, which should be a focus of interest due to limited safety data.
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Affiliation(s)
- Mette Bliddal
- Research Unit OPEN, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark.
| | - Helene Kildegaard
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Lotte Rasmussen
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Martin Ernst
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Poul Jørgen Jennum
- Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet, Glostrup, Denmark
| | | | - Anton Pottegård
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Rikke Wesselhoeft
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Child and Adolescent Mental Health Odense, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
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Liu X, Han M, Lv T, Li J, Zhang X. TBSS analysis of white matter fasciculus in chronic insomnia and the relationship with sleep quality and cognitive function. Sleep Biol Rhythms 2023; 21:467-470. [PMID: 38476185 PMCID: PMC10899946 DOI: 10.1007/s41105-023-00468-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/21/2023] [Indexed: 03/14/2024]
Abstract
Eighty patients with chronic insomnia and 50 normal controls were selected. Evaluation scales included Pittsburgh Sleep Quality Index, Dysfunctional Beliefs and Attitudes about Sleep, Montreal Cognitive Assessment, Self-Rating Anxiety Scale, Self-Rating Depression Scale, Ruminative Responses Scale and Social Disability Screening Schedule. All patients and controls underwent whole-brain DTI scanning and Tract-Based Spatial Statistics (TBSS) analysis was performed. Chronic insomnia patients are mainly accompanied by white matter lesions of right posterior thalamic radiation, right sagittal tract, and right upper longitudinal tract. TBSS is helpful in the diagnosis of chronic insomnia and can reflect the changes of cognitive function.
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Affiliation(s)
- Xiaoran Liu
- School of Nursing, Binzhou Medical University, Yantai, China
| | - Mingxing Han
- Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China
| | - Tongyu Lv
- School of Nursing, Binzhou Medical University, Yantai, China
| | - Jun Li
- Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China
| | - Xueyan Zhang
- School of Nursing, Binzhou Medical University, Yantai, China
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Miller MB, Park A. Bidirectional associations between sleep and addiction across populations: Introduction to the special issue. Addict Behav 2023; 144:107722. [PMID: 37084566 PMCID: PMC10461131 DOI: 10.1016/j.addbeh.2023.107722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Affiliation(s)
- Mary Beth Miller
- University of Missouri, 1 Hospital Drive DC067.00, Columbia, MO 65212, USA.
| | - Aesoon Park
- Syracuse University, 430 Huntington Hall, Syracuse, NY 13244, USA
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Larsen M, He F, Kawasawa YI, Berg A, Vgontzas AN, Liao D, Bixler EO, Fernandez-Mendoza J. Objective and subjective measures of sleep initiation are differentially associated with DNA methylation in adolescents. Clin Epigenetics 2023; 15:136. [PMID: 37634000 PMCID: PMC10464279 DOI: 10.1186/s13148-023-01553-2] [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: 01/19/2023] [Accepted: 08/14/2023] [Indexed: 08/28/2023] Open
Abstract
INTRODUCTION The onset of puberty is associated with a shift in the circadian timing of sleep, leading to delayed sleep initiation [i.e., later sleep onset time (SOT)] due to later bedtimes and/or longer sleep onset latency (SOL). Several genome-wide association studies (GWAS) have identified genes that may be involved in the etiology of sleep phenotypes. However, circadian rhythms are also epigenetically regulated; therefore, epigenetic biomarkers may provide insight into the physiology of the pubertal sleep onset shift and the pathophysiology of prolonged or delayed sleep initiation. RESULTS The gene-wide analysis indicated differential methylation within or around 1818 unique genes across the sleep initiation measurements using self-report, actigraphy (ACT), and polysomnography (PSG), while GWAS-informed analysis yielded 67 genes. Gene hits were identified for bedtime (PSG), SOL (subjective, ACT and PSG) and SOT (subjective and PSG). DNA methylation within 12 genes was associated with both subjective and PSG-measured SOL, 31 with both ACT- and PSG-measured SOL, 19 with both subjective and ACT-measured SOL, and one gene (SMG1P2) had methylation sites associated with subjective, ACT- and PSG-measured SOL. CONCLUSIONS Objective and subjective sleep initiation in adolescents is associated with altered DNA methylation in genes previously identified in adult GWAS of sleep and circadian phenotypes. Additionally, our data provide evidence for a potential epigenetic link between habitual (subjective and ACT) SOL and in-lab SOT and DNA methylation in and around genes involved in circadian regulation (i.e., RASD1, RAI1), cardiometabolic disorders (i.e., FADS1, WNK1, SLC5A6), and neuropsychiatric disorders (i.e., PRR7, SDK1, FAM172A). If validated, these sites may provide valuable targets for early detection and prevention of disorders involving prolonged or delayed SOT, such as insomnia, delayed sleep phase, and their comorbidity.
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Affiliation(s)
- Michael Larsen
- Sleep Research and Treatment Center, Department of Psychiatry & Behavioral Health, The Pennsylvania State University College of Medicine, Hershey, PA, 17033, USA
| | - Fan He
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, 17033, USA
| | - Yuka Imamura Kawasawa
- Departments of Biochemistry and Molecular Biology and Pharmacology, Institute for Personalized Medicine, The Pennsylvania State University College of Medicine, Hershey, PA, 17033, USA
| | - Arthur Berg
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, 17033, USA
| | - Alexandros N Vgontzas
- Sleep Research and Treatment Center, Department of Psychiatry & Behavioral Health, The Pennsylvania State University College of Medicine, Hershey, PA, 17033, USA
| | - Duanping Liao
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, 17033, USA
| | - Edward O Bixler
- Sleep Research and Treatment Center, Department of Psychiatry & Behavioral Health, The Pennsylvania State University College of Medicine, Hershey, PA, 17033, USA
| | - Julio Fernandez-Mendoza
- Sleep Research and Treatment Center, Department of Psychiatry & Behavioral Health, The Pennsylvania State University College of Medicine, Hershey, PA, 17033, USA.
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Pan R, Zhang G, Deng F, Lin W, Pan J. Effects of red light on sleep and mood in healthy subjects and individuals with insomnia disorder. Front Psychiatry 2023; 14:1200350. [PMID: 37692298 PMCID: PMC10484593 DOI: 10.3389/fpsyt.2023.1200350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/04/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction This study aimed to determine the influence of red light on objective sleep and the relationship between mood and sleep among individuals with insomnia disorder (ID). Method 57 individuals with insomnia symptoms and 57 healthy participants were randomly divided into three groups (red- and white-light groups, and the black control group), which received different light treatments for 1 h before bedtime. The emotions and subjective alertness of participants were evaluated using Positive and Negative Affect Schedule scales (PANAS) and Karolinska Sleepiness Scale (KSS), their sleeping data were recorded using polysomnography (PSG). Result The negative emotion scores were higher in the healthy subject-red light (HS-RL) group than in the HS-white light (WL) and HS-black control (BC) groups (p < 0.001). The anxiety and negative emotion scores were higher in the ID-RL group than in the ID-WL and ID-BC groups (p = 0.007 and p < 0.001, respectively). The KSS scores were lower in the RL group than in the WL and BC groups for both HS and ID group (both p < 0.001). The SOL was shorter in the HS-RL group than in HS-WL group (p = 0.019). Compared with the HS-BC group, the HS-RL group had an increase in microarousal index (MAI) and N1% (p = 0.034 and p = 0.021, respectively), while the total sleep time (TST) and sleep efficiency (SE) decreased (p = 0.001 and p < 0.001, respectively). Compared with the ID-WL group, the SOL was shorter in the ID-RL group (p = 0.043), while TST, SE, number of microarousals (NMA), and numbers of cycles of REM period were increased (p = 0.016, p = 0.046, p = 0.001, and p = 0.041, respectively). Compared with the ID-BC group, the ID-RL group had increases in the SOL, WASO, and the numbers of cycles and NMA in REM period (p = 0.038, p = 0.005, p = 0.045, and p = 0.033, respectively), and a decrease in SE (p = 0.014). The effects of ID-WL (vs. ID-RL group) and ID-BC (vs. ID-RL group) on SOL were mediated by negative emotions (mediating effects were - 37.626 and - 33.768, respectively). Conclusion Red light can increase subjective alertness, anxiety, and negative emotions in both healthy subjects and people with ID, which can affect sleep directly or indirectly via the mediating effect of negative emotions.
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Affiliation(s)
- Rong Pan
- Department of Psychology, The Third People’s Hospital of Zhaoqing, Zhaoqing, Guangdong Province, China
| | - Guimei Zhang
- Department of Psychiatry, Sleep Medicine Center, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
| | - Fangyi Deng
- Department of Psychiatry, Sleep Medicine Center, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
| | - Weifeng Lin
- Department of Neurology, Dongguan People’s Hospital (Affiliated Dongguan People’s Hospital, Southern Medical University), Guangzhou, Guangdong Province, China
| | - Jiyang Pan
- Department of Psychiatry, Sleep Medicine Center, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
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Çelikkol Sadiç Ç, Gerçek HG, Kara A, Özkan Y. Problematic internet use and sleep quality in adolescents with major depressive disorder. Chronobiol Int 2023; 40:1049-1058. [PMID: 37638644 DOI: 10.1080/07420528.2023.2249557] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/01/2023] [Accepted: 08/14/2023] [Indexed: 08/29/2023]
Affiliation(s)
- Çağla Çelikkol Sadiç
- Department of Child and Adolescent Psychiatry, Afyonkarahisar Health Sciences University Faculty of Medicine, Afyonkarahisar, Turkey
| | - Hacer Gizem Gerçek
- Department of Child and Adolescent Psychiatry, Afyonkarahisar Health Sciences University Faculty of Medicine, Afyonkarahisar, Turkey
| | - Aziz Kara
- Department of Child and Adolescent Psychiatry, Afyonkarahisar Health Sciences University Faculty of Medicine, Afyonkarahisar, Turkey
| | - Yekta Özkan
- Department of Child and Adolescent Psychiatry, Afyonkarahisar Health Sciences University Faculty of Medicine, Afyonkarahisar, Turkey
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Reynolds AM, Spaeth AM, Hale L, Williamson AA, LeBourgeois MK, Wong SD, Hartstein LE, Levenson JC, Kwon M, Hart CN, Greer A, Richardson CE, Gradisar M, Clementi MA, Simon SL, Reuter-Yuill LM, Picchietti DL, Wild S, Tarokh L, Sexton-Radek K, Malow BA, Lenker KP, Calhoun SL, Johnson DA, Lewin D, Carskadon MA. Pediatric sleep: current knowledge, gaps, and opportunities for the future. Sleep 2023; 46:zsad060. [PMID: 36881684 PMCID: PMC10334737 DOI: 10.1093/sleep/zsad060] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/19/2023] [Indexed: 03/09/2023] Open
Abstract
This White Paper addresses the current gaps in knowledge, as well as opportunities for future studies in pediatric sleep. The Sleep Research Society's Pipeline Development Committee assembled a panel of experts tasked to provide information to those interested in learning more about the field of pediatric sleep, including trainees. We cover the scope of pediatric sleep, including epidemiological studies and the development of sleep and circadian rhythms in early childhood and adolescence. Additionally, we discuss current knowledge of insufficient sleep and circadian disruption, addressing the neuropsychological impact (affective functioning) and cardiometabolic consequences. A significant portion of this White Paper explores pediatric sleep disorders (including circadian rhythm disorders, insomnia, restless leg and periodic limb movement disorder, narcolepsy, and sleep apnea), as well as sleep and neurodevelopment disorders (e.g. autism and attention deficit hyperactivity disorder). Finally, we end with a discussion on sleep and public health policy. Although we have made strides in our knowledge of pediatric sleep, it is imperative that we address the gaps to the best of our knowledge and the pitfalls of our methodologies. For example, more work needs to be done to assess pediatric sleep using objective methodologies (i.e. actigraphy and polysomnography), to explore sleep disparities, to improve accessibility to evidence-based treatments, and to identify potential risks and protective markers of disorders in children. Expanding trainee exposure to pediatric sleep and elucidating future directions for study will significantly improve the future of the field.
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Affiliation(s)
| | - Andrea M Spaeth
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ, USA
| | - Lauren Hale
- Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Ariel A Williamson
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Monique K LeBourgeois
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Sachi D Wong
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Lauren E Hartstein
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Jessica C Levenson
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Misol Kwon
- Division of Sleep Medicine, University of Pennsylvania Perelman School of Medicine, PA, USA
| | - Chantelle N Hart
- The Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, USA
- The Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Ashley Greer
- The Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Cele E Richardson
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | | | - Michelle A Clementi
- Clinical Sciences, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Stacey L Simon
- Clinical Sciences, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lilith M Reuter-Yuill
- Comprehensive Speech and Therapy Center, Western Michigan University, Kalamazoo, MI, USA
| | - Daniel L Picchietti
- University of Illinois School of Medicine, Carle Illinois College of Medicine, Carle Foundation Hospital, and University of Illinois School of Medicine, Urbana, IL, USA
| | - Salome Wild
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Leila Tarokh
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | | | - Beth A Malow
- Departments of Neurology and Pediatrics, Burry Chair in Cognitive Childhood Development, Vanderbilt University Medical Center, Nashville, TN, USA
- Sleep Disorders Division, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kristina P Lenker
- Department of Psychiatry and Behavioral Health, Penn State Health Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA, USA
| | - Susan L Calhoun
- Department of Psychiatry and Behavioral Health, Penn State Health Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA, USA
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Daniel Lewin
- Department of Pulmonary and Sleep Medicine, Children’s National Hospital, Washington, DC, USA
| | - Mary A Carskadon
- Bradley Hospital Sleep Lab, Warren Alpert Medical School, Brown University, Providence, RI, USA
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Alghamdi AA, Alghamdi AM, Alshareef MA, AlGhamdi AA, Alghamdi RA, AlAmri AA, Alzahrani GT. Assessment of Sleep Quality Among Adolescents and Adults With Self-Diagnosed Irritable Bowel Syndrome, in Jeddah, Saudi Arabia. Cureus 2023; 15:e42778. [PMID: 37663979 PMCID: PMC10469519 DOI: 10.7759/cureus.42778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2023] [Indexed: 09/05/2023] Open
Abstract
Background The frequency of irritable bowel syndrome (IBS) has increased significantly in the last ten years. Few studies were done in Saudi Arabia to assess the relationship between sleep quality and IBS. This study aims to assess the prevalence of IBS and its association with sleep quality among adolescents and adults in Saudi Arabia. Methods A cross-sectional study was done on 651 participants aged 15-65 years. An online questionnaire was used to collect data, including demographics; the Rome IV criteria (R4DQ) was used in the diagnosis of IBS, the IBS symptoms severity scale (IBS-SSS) assessed IBS symptoms and severity, and the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Results Based on the Rome IV criteria, 25.7% of the participants had IBS. Among them, 23.3%, 17.9%, 47.3%, and 11.5% had IBS types constipation (C), diarrhea (D), mixed bowel habits (M), and undefined subtype (U), respectively. Mild, moderate, and severe IBS were found among 43.1%, 39.5%, and 17.4% of IBS cases, respectively. About 46% had poor sleep quality, which was significantly higher among those with younger mean age, females, and students. Patients with IBS exhibited a considerably greater prevalence of poor sleep quality, and IBS-C had the highest prevalence. Conclusion A correlation was found between poor sleep quality and the positive status of IBS diagnosis among adolescents and adults. An evaluation of specific sleep disorders among IBS patients is needed.
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Levenson JC, Williamson AA. Bridging the gap: leveraging implementation science to advance pediatric behavioral sleep interventions. J Clin Sleep Med 2023; 19:1321-1336. [PMID: 36722616 PMCID: PMC10315605 DOI: 10.5664/jcsm.10476] [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: 08/25/2022] [Revised: 01/05/2023] [Accepted: 01/05/2023] [Indexed: 02/02/2023]
Abstract
STUDY OBJECTIVES This review synthesizes the pediatric behavioral sleep intervention (BSI) evidence base, summarizes challenges in translating BSIs from research to practice, and provides recommendations for integrating implementation science methods to advance pediatric BSI research. METHODS We briefly review the common behavioral sleep disturbances among youth, discuss the pediatric BSIs with well-established evidence, and identify gaps in pediatric BSI research. We then identify contributors to the dearth of research evaluating pediatric BSIs in accessible settings and present a model for applying implementation science strategies to address identified gaps across the continuum of translational research. RESULTS Relatively few BSI trials include older children and adolescents. Similarly, there is limited research evaluating BSIs among racially and ethnically minoritized children and families and/or those of lower socioeconomic status backgrounds. Access to scalable and easily disseminable tools to treat pediatric sleep disturbances early in their development is crucial for promoting positive child outcomes. To address these gaps, researchers should apply implementation science theories, models, and frameworks to design new interventions for implementation, adapt existing interventions with end users and settings in mind, conduct hybrid effectiveness-implementation trials, and test implementation strategies. CONCLUSIONS Given the prevalence and consequences of poor sleep across developmental periods, pediatric BSIs must be effective as well as adaptable, scalable, and easily disseminable. Implementation science theories, models, and frameworks can enhance access to, engagement in, and the implementation and dissemination of scalable BSIs across diverse pediatric care settings and heterogeneous populations. CITATION Levenson JC, Williamson AA. Bridging the gap: leveraging implementation science to advance pediatric behavioral sleep interventions. J Clin Sleep Med. 2023;19(7):1321-1336.
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Affiliation(s)
- Jessica C. Levenson
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Ariel A. Williamson
- Sleep Center, Division of Pulmonary and Sleep Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
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Chen J, Li Y, Yin X, Man J, Zhang X, Zhang T, Yang X, Lu M. Dose-response association of polycyclic aromatic hydrocarbon with self-reported trouble sleeping in adults: evidence from the National Health and Nutrition Examination Survey. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023:10.1007/s11356-023-28218-0. [PMID: 37330443 DOI: 10.1007/s11356-023-28218-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/07/2023] [Indexed: 06/19/2023]
Abstract
Previous epidemiological evidence from large population-based studies on the association between polycyclic aromatic hydrocarbons (PAH) exposure and the risk of sleep disorders is inadequate. To comprehensively examine the relationship between independent and combined PAHs and trouble sleeping, we analyzed data from 8194 participants from the National Health and Nutrition Survey (NHANES) cycles. Multivariate adjusted logistic regression and restricted cubic spline models were applied to assess the relationship between PAH exposure and the risk of trouble sleeping. Bayesian kernel machine regression and weighted quantile sum regression models were used to estimate the combined association of urinary PAHs with trouble sleeping. In the single-exposure analyses, compared with the lowest level, the respective adjusted odds ratios (ORs) for trouble sleeping among subjects from the highest quartile were 1.34 (95% CI, 1.15, 1.56), 1.23 (95% CI, 1.05, 1.44), 1.31 (95% CI, 1.11, 1.54), 1.35 (95% CI, 1.15, 1.58), and 1.29 (95% CI, 1.08, 1.53) for 1-hydroxynaphthalene (1-NAP), 2-hydroxynaphthalene (2-NAP), 3-hydroxyfluorene (3-FLU), 2-hydroxyfluorene(2-FLU), and 1-hydroxypyrene(1-PYR). An overall positive correlation between the PAH mixture and trouble sleeping was observed when the mixture was at the 50th percentile or higher. The current study reveals that PAH metabolites (1-NAP, 2-NAP, 3-FLU, 2-FLU, and 1-PYR) may be detrimental to trouble sleeping. PAH mixture exposure was positively associated with trouble sleeping. The results suggested the potential impacts of PAHs and expressed concerns regarding the potential impact of PAHs on health. More intensive research and monitoring of environmental pollutants in the future will contribute to preventing environmental hazards.
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Affiliation(s)
- Jiaqi Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yufei Li
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xiaolin Yin
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Jinyu Man
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xuening Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Tongchao Zhang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Shandong, 250012, Jinan, China
- Clinical Research Center of Shandong University, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Department of Gastroenterology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xiaorong Yang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Shandong, 250012, Jinan, China
- Clinical Research Center of Shandong University, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Department of Gastroenterology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Ming Lu
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Shandong, 250012, Jinan, China.
- Clinical Research Center of Shandong University, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
- Department of Gastroenterology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
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Fucà E, Costanzo F, Celestini L, Galassi P, Villani A, Valentini D, Vicari S. Sleep and behavioral problems in Down syndrome: differences between school age and adolescence. Front Psychiatry 2023; 14:1193176. [PMID: 37363163 PMCID: PMC10288521 DOI: 10.3389/fpsyt.2023.1193176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/16/2023] [Indexed: 06/28/2023] Open
Abstract
Background Individuals with Down syndrome (DS) are at risk of developing sleep problems. In spite of the well-established knowledge on the presence of sleep difficulties in DS individuals and the associated emotional and behavioral problems, less is known about the possible differences in the kind of associations between sleep and emotional/behavioral problems across different age ranges. Methods In this retrospective study, we included 289 participants with DS aged 6-18 years with the aims to explore differences in the distribution of sleep problems between specific age groups (school age vs. adolescence) and to identify specific age-based associations between sleep problems and emotional/behavioral problems. Results Some differences in the distribution of sleep problems have emerged between age groups. Moreover, differences in the patterns of association between emotional/behavioral difficulties and sleep problems-in particular, sleep-related breathing difficulties and parasomnias-have been observed. However, sleep-wake transition disorders and excessive daily somnolence appear to be related to emotional and behavioral problems (both internalizing and externalizing), in general, across school age and adolescence. Discussion These results remark the importance of appropriate neuropsychiatric and psychological evaluation taking into account the age-specific needs and features of individuals with DS.
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Affiliation(s)
- Elisa Fucà
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Floriana Costanzo
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Laura Celestini
- Pediatric Unit, Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Paolo Galassi
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Alberto Villani
- Pediatric Unit, Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Diletta Valentini
- Pediatric Unit, Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Department of Life Science and Public Health, Catholic University of the Sacred Heart, Rome, Italy
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Arnison T. Prevention is better than cure: why early interventions for insomnia and chronic pain during adolescence should be a priority. Front Psychol 2023; 14:1206977. [PMID: 37359854 PMCID: PMC10285456 DOI: 10.3389/fpsyg.2023.1206977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
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