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Saifeldin H, Negm IM. Assessing the immediate impact of Twin-block appliance insertion on adolescents' sleep using a wearable device. Orthod Craniofac Res 2024; 27:598-605. [PMID: 38426595 DOI: 10.1111/ocr.12773] [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] [Accepted: 02/18/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE This prospective clinical study aimed to evaluate the immediate impact of Twin-block appliance insertion on the sleep of adolescents using a wearable device. MATERIALS AND METHODS A total of 24 girls, aged 11-13 years, with Class II division 1 molar relationship, skeletal class 2 malocclusion (ANB ≥5) and overjet measuring ≥5 mm were selected. Exclusion criteria included a history of previous orthodontic treatment, systemic disease, irregular sleep pattern, obstructive sleep apnea, medical history of breathing disorders, or concurrent use of medications. Participants wore a wearable device to measure sleep parameters, including deep sleep, light sleep, minutes awake during sleep, wake-up times, bedtimes and total sleep times. The participants wore the device for 10 days prior to Twin-block insertion and sleep data were collected for another 10 days after insertion. RESULTS Following the insertion of the Twin-block appliance, there was a highly statistically significant shift in bedtime and wake-up time to later hours (P < .001). All participants experienced a highly significant delay in bedtime compared to the recommended 10 pm time (P < .001). Additionally, there was a significant increase in the duration of light sleep (P < .05). However, the effect on deep sleep, minutes awake during sleep and sleep duration was not statistically significant. None of the sleep parameters tested showed statistically significant changes between the first 5 days after Twin-block insertion with the subsequent 5 days. CONCLUSION The immediate insertion of the Twin-block appliance disrupts sleep onset, wake-up time and light sleep during the specified period of 10 days.
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Affiliation(s)
- Hatem Saifeldin
- Orthodontic Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Ibrahim M Negm
- Orthodontic Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
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Gauld C, Hartley S, Micoulaud-Franchi JA, Royant-Parola S. Sleep Health Analysis Through Sleep Symptoms in 35,808 Individuals Across Age and Sex Differences: Comparative Symptom Network Study. JMIR Public Health Surveill 2024; 10:e51585. [PMID: 38861716 PMCID: PMC11200043 DOI: 10.2196/51585] [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: 08/04/2023] [Revised: 11/28/2023] [Accepted: 05/14/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND Sleep health is a multidimensional construct that includes objective and subjective parameters and is influenced by individual sleep-related behaviors and sleep disorders. Symptom network analysis allows modeling of the interactions between variables, enabling both the visualization of relationships between different factors and the identification of the strength of those relationships. Given the known influence of sex and age on sleep health, network analysis can help explore sets of mutually interacting symptoms relative to these demographic variables. OBJECTIVE This study aimed to study the centrality of symptoms and compare age and sex differences regarding sleep health using a symptom network approach in a large French population that feels concerned about their sleep. METHODS Data were extracted from a questionnaire provided by the Réseau Morphée health network. A network analysis was conducted on 39 clinical variables related to sleep disorders and sleep health. After network estimation, statistical analyses consisted of calculating inferences of centrality, robustness (ie, testifying to a sufficient effect size), predictability, and network comparison. Sleep clinical variable centralities within the networks were analyzed by both sex and age using 4 age groups (18-30, 31-45, 46-55, and >55 years), and local symptom-by-symptom correlations determined. RESULTS Data of 35,808 participants were obtained. The mean age was 42.7 (SD 15.7) years, and 24,964 (69.7%) were women. Overall, there were no significant differences in the structure of the symptom networks between sexes or age groups. The most central symptoms across all groups were nonrestorative sleep and excessive daytime sleepiness. In the youngest group, additional central symptoms were chronic circadian misalignment and chronic sleep deprivation (related to sleep behaviors), particularly among women. In the oldest group, leg sensory discomfort and breath abnormality complaint were among the top 4 central symptoms. Symptoms of sleep disorders thus became more central with age than sleep behaviors. The high predictability of central nodes in one of the networks underlined its importance in influencing other nodes. CONCLUSIONS The absence of structural difference between networks is an important finding, given the known differences in sleep between sexes and across age groups. These similarities suggest comparable interactions between clinical sleep variables across sexes and age groups and highlight the implication of common sleep and wake neural circuits and circadian rhythms in understanding sleep health. More precisely, nonrestorative sleep and excessive daytime sleepiness are central symptoms in all groups. The behavioral component is particularly central in young people and women. Sleep-related respiratory and motor symptoms are prominent in older people. These results underscore the importance of comprehensive sleep promotion and screening strategies tailored to sex and age to impact sleep health.
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Affiliation(s)
| | - Sarah Hartley
- Sleep Center, APHP Hôpital Raymond Poincaré, Université de Versailles Saint-Quentin en Yvelines, Garches, France
- Réseau Morphée, Garches, France
| | - Jean-Arthur Micoulaud-Franchi
- Services of Functional Exploration of the Nervous System, University Sleep Clinic, University Hospital of Bordeaux, Bordeaux, France
- Unité Sommeil, Addiction, Neuropsychiatrie, Centre national de la recherche scientifique Unité Mixte de Recherche-6033, Bordeaux, France
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Diogo FMC, Bessa ZCM, Galina SD, Oliveira MLCD, Silva-Júnior ELRD, Valdez P, Azevedo CVMD. Sex Differences in Temporal Sleep Patterns, Social Jetlag, and Attention in High School Adolescents. Sleep Sci 2024; 17:e125-e133. [PMID: 38846590 PMCID: PMC11152636 DOI: 10.1055/s-0043-1777831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 08/02/2023] [Indexed: 06/09/2024] Open
Abstract
Insufficient sleep and irregular sleep hours are common in adolescents, who experience a delayed sleep phase due to biopsychosocial changes associated with puberty, resulting in later sleep times. However, early morning class hours shorten sleep duration on weekdays. This condition is harmful to cognitive performance, which may be accentuated in girls due to a greater sleep need and less resistance to sleep deprivation. In this study, we evaluated sex differences concerning temporal sleep patterns, social jetlag, and attention in high school adolescents attending morning classes. Students ( n = 146 - F: 73-16.1 ± 0.8 years; M: 73-16.2 ± 0.9 years) completed a Health and Sleep questionnaire, kept a sleep diary for 10 days, which incorporated a Maldonado Sleepiness Scale, and performed a Continuous Performance Task. Girls went to bed earlier and woke up on weekends, and spent more time in bed at night and in 24 h on weekdays and weekends, while they also had a greater irregularity in wake-up times ( p < 0.05). There were no differences between sexes in terms of social jetlag, sleep debt, and sleepiness upon awakening ( p > 0.05). Regarding attention, the girls had a longer reaction time in phasic alertness ( p < 0.01) and a tendency to have fewer errors in selective attention ( p = 0.06). These results persisted when controlled for sleep parameters. Therefore, we suggest that girls have a greater sleep need and less resistance to sleep deprivation, while the differences in attention performance could be due to different strategies, the girls could be making a trade, increasing reaction time in favor of better accuracy, while the boys could be prioritizing a faster response time.
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Affiliation(s)
- Fernanda Mayara Crispim Diogo
- Department of Physiology and Behavior, Laboratório de Cronobiologia e Comportamento, Postgraduate Program on Psychobiology, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Zoelia Camila Moura Bessa
- Department of Physiology and Behavior, Laboratório de Cronobiologia e Comportamento, Postgraduate Program on Psychobiology, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Sabinne Danielle Galina
- Department of Physiology and Behavior, Laboratório de Cronobiologia e Comportamento, Postgraduate Program on Psychobiology, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Maria Luiza Cruz de Oliveira
- Department of Physiology and Behavior, Laboratório de Cronobiologia e Comportamento, Postgraduate Program on Psychobiology, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Emanuel Linegley Ribeiro da Silva-Júnior
- Department of Physiology and Behavior, Laboratório de Cronobiologia e Comportamento, Postgraduate Program on Psychobiology, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Pablo Valdez
- Laboratorio de Psicofisiología, Faculty of Psychology, Universidade Autónoma de Nuevo Léon, Monterrey, NL, Mexico
| | - Carolina Virginia Macêdo de Azevedo
- Department of Physiology and Behavior, Laboratório de Cronobiologia e Comportamento, Postgraduate Program on Psychobiology, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
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Yang WL, Wang Q, Wang Y, Sun S, Shen Y, Yu LM. Long-term gastrointestinal symptoms and sleep quality sequelae in adolescents after COVID-19: a retrospective study. Front Public Health 2024; 12:1323820. [PMID: 38835614 PMCID: PMC11148350 DOI: 10.3389/fpubh.2024.1323820] [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: 10/18/2023] [Accepted: 05/09/2024] [Indexed: 06/06/2024] Open
Abstract
Objective To evaluate the long-term gastrointestinal (GI) symptoms and sleep quality sequelae in adolescents with COVID-19. Methods Between June and July 2023, an online survey was done in Xiaoshan District, Hangzhou City, Zhejiang Province, China, using the GI Symptom Rating Scale (GSRS) and the Pittsburgh Sleep Quality Inventory (PSQI). Results GI symptoms in COVID-19 patients increased by 11.86% compared to before infection, while sleep quality decreased by 10.9%. Over time, there was a significant increase in the cumulative incidence rate of GI symptoms and sleep disorders (p < 0.001). Follow-up of COVID-19 positive patients within 6 months of infection showed that GI symptoms and sleep quality began to ease starting from the first month after infection. Further analysis indicated a significant linear relationship between the severity of GI symptoms and sleep quality (R > 0.5, p < 0.001). Moreover, females, older age, and higher education were identified as risk factors influencing the long-term effects of COVID-19. Conclusion SARS-CoV-2 affects GI symptoms and sleep quality in adolescents during both the acute phase and post-infection periods. Over time, these symptoms gradually alleviate. A significant correlation exists between GI symptoms and sleep quality.
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Affiliation(s)
- Wei-Lin Yang
- Department of Gastroenterology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Zhejiang Province, China
- Department of Gastroenterology, Anji County Hospital of TCM, Huzhou, Zhejiang, China
| | - Qi Wang
- Department of Neurology, Hangzhou TCM Hospital of Zhejiang Chinese Medical University (Hangzhou Hospital of Traditional Chinese Medicine), Hangzhou, Zhejiang, China
| | - Ying Wang
- Key Laboratory of Digestive Pathophysiology of Zhejiang Province, The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Shaopeng Sun
- Key Laboratory of Digestive Pathophysiology of Zhejiang Province, The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yan Shen
- Department of Gastroenterology, The Second Affiliated Hospital of Zhejiang Chinese Medical University (Xinhua Hospital of Zhejiang Province), Hangzhou, Zhejiang, China
| | - Lei-Min Yu
- Department of Gastroenterology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Zhejiang Province, China
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Thompson MJ, Gillis BT, Hinnant JB, Erath SA, Buckhalt JA, El-Sheikh M. Trajectories of Actigraphy-Derived Sleep Duration, Quality, and Variability from Childhood to Adolescence: Downstream Effects on Mental Health. Sleep 2024:zsae112. [PMID: 38758702 DOI: 10.1093/sleep/zsae112] [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: 02/05/2024] [Indexed: 05/19/2024] Open
Abstract
STUDY OBJECTIVES We examined growth trajectories of four actigraphy-derived sleep parameters (sleep minutes, sleep efficiency, and variability in sleep minutes and efficiency across a week of assessments) across childhood and adolescence and examined individual differences in trajectories according to participants' race/ethnicity and sex. We also assessed the predictive effect of growth trajectories of sleep parameters on growth trajectories of mental health outcomes and moderation by race and sex. METHOD Youth (N=199, 49% female, 65% White, 32% Black, 3% biracial) and their parents participated in five waves of data (M ages were 9, 10, 11, 17, and 18 across waves). Participants were from a diverse range of socioeconomic backgrounds. RESULTS Across participants, sleep minutes, sleep efficiency, and variability in sleep minutes and efficiency demonstrated significant linear change across childhood and adolescence. Whereas sleep duration shortened over time, sleep efficiency improved. Youth exhibited increases in night-to-night variability in sleep minutes and reductions in night-to-night variability in sleep efficiency. Highlighting the importance of individual differences, some race- and sex-related effects emerged. Black youth and male youth experienced steeper declines in their sleep duration across development relative to their respective counterparts. Black youth also demonstrated smaller improvements in sleep efficiency and greater variability in sleep efficiency compared to White youth. Finally, trajectories of sleep efficiency and variability in sleep minutes predicted trajectories of internalizing symptoms and externalizing behaviors. CONCLUSIONS Findings showed significant changes in developmental trajectories of four sleep parameters across childhood and adolescence. We discuss empirical and translational implications of the findings.
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de Mello GT, Minatto G, Costa RM, Leech RM, Cao Y, Lee RE, Silva KS. Clusters of 24-hour movement behavior and diet and their relationship with health indicators among youth: a systematic review. BMC Public Health 2024; 24:1080. [PMID: 38637757 PMCID: PMC11027390 DOI: 10.1186/s12889-024-18364-6] [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: 09/28/2023] [Accepted: 03/15/2024] [Indexed: 04/20/2024] Open
Abstract
Movement-related behaviors (physical activity [PA], sedentary behavior [SB], and sleep) and diet interact with each other and play important roles in health indicators in youth. This systematic review aimed to investigate how PA, SB, sleep, and diet cluster in youth by biological sex; and to examine which cluster are associated with health indicators. This study was registered in PROSPERO (number: CRD42018094826). Five electronic databases were assessed. Eligibility criteria allowed studies that included youth (aged 19 years and younger), and only the four behaviors {PA, SB, sleep, and diet (ultra-processed foods [UPF]; fruits and vegetables [FV])} analyzed by applying data-based cluster procedures. From 12,719 articles screened; 23 were included. Of these, four investigated children, and ten identified clusters by biological sex. Sixty-six mixed cluster were identified including, 34 in mixed-sex samples, 10 in boys and 11 in girls. The most frequent clusters in mixed-sex samples were "High SB UPF Low Sleep", "Low PA High SB Satisfactory Sleep", and "High PA". The main difference in profiles according to sex was that girls' clusters were characterized by high sleep duration, whereas boys' clusters by high PA. There were a few associations found between cluster types and health indicators, highlighting that youth assigned to cluster types with low PA exhibited higher adiposity. In conclusion, the youth presented a range of clusters of behaviors, typically exhibiting at least one unhealthy behavior. Similar patterns were observed in both sexes with the biggest difference in time of sleep for girls and PA for boys. These findings underscore the importance of intervention strategies targeting multiple behaviors simultaneously to enhance health risk profiles and indicators in children and adolescents.
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Affiliation(s)
- Gabrielli T de Mello
- Research Center for Physical Activity and Health, Federal University of Santa Catarina, Florianópolis, Brazil.
| | - Giseli Minatto
- Research Center for Physical Activity and Health, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Rafael M Costa
- Research Center for Physical Activity and Health, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Rebecca M Leech
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Melbourne, Australia
| | - Yingting Cao
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Rebecca E Lee
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, USA
| | - Kelly S Silva
- Research Center for Physical Activity and Health, Federal University of Santa Catarina, Florianópolis, Brazil
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Leduc T, El Alami H, Bougadir K, Bélanger-Nelson E, Mongrain V. Neuroligin-2 shapes individual slow waves during slow-wave sleep and the response to sleep deprivation in mice. Mol Autism 2024; 15:13. [PMID: 38570872 PMCID: PMC10993465 DOI: 10.1186/s13229-024-00594-5] [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: 11/28/2023] [Accepted: 03/18/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Sleep disturbances are a common comorbidity to most neurodevelopmental disorders and tend to worsen disease symptomatology. It is thus crucial to understand mechanisms underlying sleep disturbances to improve patients' quality of life. Neuroligin-2 (NLGN2) is a synaptic adhesion protein regulating GABAergic transmission. It has been linked to autism spectrum disorders and schizophrenia in humans, and deregulations of its expression were shown to cause epileptic-like hypersynchronized cerebral activity in rodents. Importantly, the absence of Nlgn2 (knockout: KO) was previously shown to alter sleep-wake duration and quality in mice, notably increasing slow-wave sleep (SWS) delta activity (1-4 Hz) and altering its 24-h dynamics. This type of brain oscillation is involved in memory consolidation, and is also a marker of homeostatic sleep pressure. Sleep deprivation (SD) is notably known to impair cognition and the physiological response to sleep loss involves GABAergic transmission. METHODS Using electrocorticographic (ECoG) recordings, we here first aimed to verify how individual slow wave (SW; 0.5-4 Hz) density and properties (e.g., amplitude, slope, frequency) contribute to the higher SWS delta activity and altered 24-h dynamics observed in Nlgn2 KO mice. We further investigated the response of these animals to SD. Finally, we tested whether sleep loss affects the gene expression of Nlgn2 and related GABAergic transcripts in the cerebral cortex of wild-type mice using RNA sequencing. RESULTS Our results show that Nlgn2 KO mice have both greater SW amplitude and density, and that SW density is the main property contributing to the altered 24-h dynamics. We also found the absence of Nlgn2 to accelerate paradoxical sleep recovery following SD, together with profound alterations in ECoG activity across vigilance states. Sleep loss, however, did not modify the 24-h distribution of the hypersynchronized ECoG events observed in these mice. Finally, RNA sequencing confirmed an overall decrease in cortical expression of Nlgn2 and related GABAergic transcripts following SD in wild-type mice. CONCLUSIONS This work brings further insight into potential mechanisms of sleep duration and quality deregulation in neurodevelopmental disorders, notably involving NLGN2 and GABAergic neurotransmission.
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Affiliation(s)
- Tanya Leduc
- Department of Neuroscience, Université de Montréal, Montreal, QC, Canada
- Centre d'études avancées en médecine du sommeil (CÉAMS), Recherche - Centre intégré universitaire de santé et services sociaux du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada
- Centre de recherche du Centre hospitalier de l'Université de Montréal, 900, St-Denis street, Tour Viger Montréal, Montreal, QC, H2X 0A9, Canada
| | - Hiba El Alami
- Department of Neuroscience, Université de Montréal, Montreal, QC, Canada
- Centre d'études avancées en médecine du sommeil (CÉAMS), Recherche - Centre intégré universitaire de santé et services sociaux du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Khadija Bougadir
- Department of Neuroscience, Université de Montréal, Montreal, QC, Canada
- Centre d'études avancées en médecine du sommeil (CÉAMS), Recherche - Centre intégré universitaire de santé et services sociaux du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Erika Bélanger-Nelson
- Centre d'études avancées en médecine du sommeil (CÉAMS), Recherche - Centre intégré universitaire de santé et services sociaux du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada
- Pfizer Canada ULC, Montreal, QC, Canada
| | - Valérie Mongrain
- Department of Neuroscience, Université de Montréal, Montreal, QC, Canada.
- Centre d'études avancées en médecine du sommeil (CÉAMS), Recherche - Centre intégré universitaire de santé et services sociaux du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada.
- Centre de recherche du Centre hospitalier de l'Université de Montréal, 900, St-Denis street, Tour Viger Montréal, Montreal, QC, H2X 0A9, Canada.
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Thieux M, Zhang M, Guignard‐Perret A, Mazza S, Plancoulaine S, Guyon A, Franco P. Does the brain sleep differently depending on intellectual abilities? CNS Neurosci Ther 2024; 30:e14378. [PMID: 37485816 PMCID: PMC10848103 DOI: 10.1111/cns.14378] [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: 04/08/2023] [Revised: 06/05/2023] [Accepted: 07/12/2023] [Indexed: 07/25/2023] Open
Abstract
AIMS To compare the children's sleep electroencephalogram according to their intellectual profile. METHODS Children were grouped according to their Wechsler Intelligence Scale for Children (WISC) scores (17 with normal intelligence quotient [IQ, NIQ] and 24 with high IQ [HIQ]). Comparisons of spectral power between groups and its relationship with WISC scores were assessed using analyses of variance and linear regression models, adjusted for age and sex. RESULTS Children with HIQ had more rapid eye movement (REM) sleep, especially late at night, and more power in slow-frequency bands during REM sleep than those with NIQ. There were also positive associations between the processing speed index and the spectral power in β bands in NREM sleep, and with the spectral power in α, σ, β, and γ bands in REM sleep, with different associations between groups. CONCLUSION The enhanced power in slow bands during REM sleep in children with HIQ overlaps with that of typical REM sleep oscillations thought to be involved in emotional memory consolidation. The dissimilar relationships between spectral power and WISC scores in NIQ and HIQ groups may underlie functional differences in brain activity related to cognitive efficiency, questioning the direction of the relationship between sleep and cognitive functioning.
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Affiliation(s)
- Marine Thieux
- INSERM U1028, CNRS UMR5292Lyon Neuroscience Research CenterLyonFrance
| | - Min Zhang
- INSERM U1028, CNRS UMR5292Lyon Neuroscience Research CenterLyonFrance
| | - Anne Guignard‐Perret
- Pediatric Sleep Unit, Department of Pediatric Clinical Epileptology, Sleep Disorders and Functional Neurology, Hôpital Femme Mère EnfantHospices Civils de LyonLyonFrance
| | - Stéphanie Mazza
- Research on Healthcare Performance RESHAPE, INSERM U1290Université Claude Bernard Lyon 1LyonFrance
| | - Sabine Plancoulaine
- INSERM U1028, CNRS UMR5292Lyon Neuroscience Research CenterLyonFrance
- Inserm, INRAE, Center for Research in Epidemiology and Statistics (CRESS)Université Paris Cité and Université Sorbonne Paris NordParisFrance
| | - Aurore Guyon
- Pediatric Sleep Unit, Department of Pediatric Clinical Epileptology, Sleep Disorders and Functional Neurology, Hôpital Femme Mère EnfantHospices Civils de LyonLyonFrance
| | - Patricia Franco
- INSERM U1028, CNRS UMR5292Lyon Neuroscience Research CenterLyonFrance
- Pediatric Sleep Unit, Department of Pediatric Clinical Epileptology, Sleep Disorders and Functional Neurology, Hôpital Femme Mère EnfantHospices Civils de LyonLyonFrance
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Yoshida M, Ikeda A, Adachi H. Contributions of the light environment and co-sleeping to sleep consolidation into nighttime in early infants: A pilot study. Early Hum Dev 2024; 189:105923. [PMID: 38218083 DOI: 10.1016/j.earlhumdev.2023.105923] [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: 08/28/2023] [Revised: 12/18/2023] [Accepted: 12/18/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND Sleep consolidation into nighttime is considered the primary goal of sleep development in early infants. However, factors contributing to sleep consolidation into nighttime remain unclear. AIM To clarify the influences of the light environment and nighttime co-sleeping on sleep consolidation into nighttime in early infants. STUDY DESIGN Cross-sectional study. SUBJECTS AND METHODS Sleep-wake time and light stimulation were measured in infants for 4 consecutive days using actigraphy. The infants' mothers were asked to complete a sleep events diary and a questionnaire about childcare, including "co-sleeping", defined as when the infant and mother slept on the same surface throughout the night. OUTCOME MEASURES The data were analyzed with a focus on daytime and nighttime sleep parameters. RESULTS Daytime light stimulation reduced daytime "active sleep", tended to reduce daytime sleep, and increased daytime waking. Nighttime light stimulation reduced nighttime "quiet sleep" and nighttime sleep and increased nighttime waking. Co-sleeping reduced nighttime waking, and, as a result, nighttime sleep time and sleep efficiency increased. Co-sleeping reduced daytime sleep and tended to increase daytime waking. Consequently, co-sleeping tended to increase the ratio of nighttime sleep to daytime sleep. CONCLUSIONS The present findings suggest that an appropriate light environment promotes daytime waking and nighttime sleep in early infants, but it does not contribute to sleep consolidation into nighttime by itself. On the other hand, co-sleeping may promote sleep consolidation into nighttime. Therefore, further methods for safe co-sleeping need to be established while avoiding risk factors for sudden unexpected death in infancy/sudden infant death syndrome.
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Affiliation(s)
- Michiko Yoshida
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5, Kita-ku, Sapporo, Hokkaido 060-0812, Japan; Department of Maternity Child Nursing, Akita University Graduate School of Medicine and Faculty of Medicine, School of Health Science, 1-1-1 Hondo, Akita 010-8543, Japan.
| | - Atsuko Ikeda
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5, Kita-ku, Sapporo, Hokkaido 060-0812, Japan.
| | - Hiroyuki Adachi
- Department of Pediatrics, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan.
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Liu J, Ji X, Rovit E, Pitt S, Lipman T. Childhood sleep: assessments, risk factors, and potential mechanisms. World J Pediatr 2024; 20:105-121. [PMID: 36441394 PMCID: PMC9702880 DOI: 10.1007/s12519-022-00628-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 09/23/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sleep problem is a highly prevalent health issue among pediatric populations across the world. In this review, we aimed to identify risk factors contributing to sleep deficiency and poor sleep hygiene in children. Potential biological, psychosocial, and environmental mechanisms as well as research gaps in the literature are also discussed. DATA SOURCES A comprehensive search for relevant English language full-text, peer-reviewed publications was performed focusing on pediatric sleep studies from prenatal to childhood and adolescence in a variety of indexes in PubMed, SCOPUS, and Psych Info. Both relevant data based and systematic reviews are included. RESULTS This paper summarizes many risk factors for childhood sleep problems, including biological (e.g., genetics, gender, age and puberty, prenatal factors, postnatal factors); nutritional (e.g., macronutrients, micronutrients, omega-3 fatty acids, obesity); environmental (e.g., heavy metals, noise, light, air pollution); interpersonal (e.g., family, exposure to violence, screen media use, physical injury); and community/socioeconomic variables (e.g., racial/ethnicity and cultural factors, neighborhood conditions and socioeconomic status, school factors, public health disasters/emergencies), to better understand the development of sleep problems in children. CONCLUSIONS Poor childhood sleep is a multifactorial issue affected by a wide range of prenatal and early-life biological, environmental, and psychosocial risk factors and contributors. A better understanding of these risk factors and their mechanisms is an important first step to develop future research and prevention programs focusing on pediatric sleep problems.
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Affiliation(s)
- Jianghong Liu
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Room 426, Claire M. Fagin Hall, Philadelphia, PA, 19104, USA.
| | - Xiaopeng Ji
- School of Nursing, College of Health Sciences, University of Delaware, Newark, DE, 19716, USA
| | - Elizabeth Rovit
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Room 426, Claire M. Fagin Hall, Philadelphia, PA, 19104, USA
| | - Susannah Pitt
- Geisinger Commonwealth School of Medicine, Scranton, PA, 18510, USA
| | - Terri Lipman
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Room 426, Claire M. Fagin Hall, Philadelphia, PA, 19104, USA
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Lima Santos JP, Hayes R, Franzen PL, Goldstein TR, Hasler BP, Buysse DJ, Siegle GJ, Dahl RE, Forbes EE, Ladouceur CD, McMakin DL, Ryan ND, Silk JS, Jalbrzikowski M, Soehner AM. The association between cortical gyrification and sleep in adolescents and young adults. Sleep 2024; 47:zsad282. [PMID: 37935899 PMCID: PMC10782503 DOI: 10.1093/sleep/zsad282] [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: 06/23/2023] [Revised: 10/06/2023] [Indexed: 11/09/2023] Open
Abstract
STUDY OBJECTIVES Healthy sleep is important for adolescent neurodevelopment, and relationships between brain structure and sleep can vary in strength over this maturational window. Although cortical gyrification is increasingly considered a useful index for understanding cognitive and emotional outcomes in adolescence, and sleep is also a strong predictor of such outcomes, we know relatively little about associations between cortical gyrification and sleep. We aimed to identify developmentally invariant (stable across age) or developmentally specific (observed only during discrete age intervals) gyrification-sleep relationships in young people. METHODS A total of 252 Neuroimaging and Pediatric Sleep Databank participants (9-26 years; 58.3% female) completed wrist actigraphy and a structural MRI scan. Local gyrification index (lGI) was estimated for 34 bilateral brain regions. Naturalistic sleep characteristics (duration, timing, continuity, and regularity) were estimated from wrist actigraphy. Regularized regression for feature selection was used to examine gyrification-sleep relationships. RESULTS For most brain regions, greater lGI was associated with longer sleep duration, earlier sleep timing, lower variability in sleep regularity, and shorter time awake after sleep onset. lGI in frontoparietal network regions showed associations with sleep patterns that were stable across age. However, in default mode network regions, lGI was only associated with sleep patterns from late childhood through early-to-mid adolescence, a period of vulnerability for mental health disorders. CONCLUSIONS We detected both developmentally invariant and developmentally specific ties between local gyrification and naturalistic sleep patterns. Default mode network regions may be particularly susceptible to interventions promoting more optimal sleep during childhood and adolescence.
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Affiliation(s)
| | - Rebecca Hayes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Peter L Franzen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tina R Goldstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Greg J Siegle
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ronald E Dahl
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Erika E Forbes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Dana L McMakin
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Neal D Ryan
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jennifer S Silk
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Maria Jalbrzikowski
- Department of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Adriane M Soehner
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
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12
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Restrepo C, Lobbezoo F, Castrillon E, Svensson P, Santamaria A, Manfredini D. Correlations between sleep architecture and sleep-related masseter muscle activity in children with sleep bruxism. J Oral Rehabil 2024; 51:110-116. [PMID: 36790219 DOI: 10.1111/joor.13430] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 12/29/2022] [Accepted: 01/23/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Sleep bruxism (SB) occurring during No-REM (nREM) sleep and increase in microarousals per hour have been described in adults, but not in children. OBJECTIVE To assess the correlation between sleep architecture and masseter muscle activity related to sleep bruxism (SB/MMA) in children. MATERIALS AND METHODS Forty-three children aged 7-12 years (mean age: 9.4 ± 1.3) with confirmed SB underwent a two-night polysomnographic (PSG) study in a sleep laboratory, for accommodation (first night) and data collection (second night). Data on sleep architecture (total sleep duration (TSD), sleep efficiency (SE), sleep onset latency (SOL), REM and nREM sleep duration and proportion and microarousals/hour during REM and nREM sleep) and episodes/hour of SB/MMA were recorded. Single and multiple-variable linear regression analyses were performed to assess the correlation between data on sleep architecture (predictors) and SB/MMA (dependent variable). RESULTS Shorter TSD, REM and nREM stage 1 sleep duration, longer SOL and more microarousals/hour during REM and nREM sleep were found to be positive predictors of SB/MMA in children in the multiple-variable regression analysis (R2 = 0.511). CONCLUSION Within the limitations of this study, it can be concluded that SB/MMA is correlated with altered sleep architecture in children (shorter total sleep duration (TSD), shorter nREM and REM sleep and higher microarousals during REM and nREM sleep). Nevertheless, the clinical significance of these findings need to be demonstrated in future studies.
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13
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Lawrence-Sidebottom D, Huffman LG, Beam A, Parikh A, Guerra R, Roots M, Huberty J. Improvements in sleep problems and their associations with mental health symptoms: A study of children and adolescents participating in a digital mental health intervention. Digit Health 2024; 10:20552076241249928. [PMID: 38736734 PMCID: PMC11084994 DOI: 10.1177/20552076241249928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 04/10/2024] [Indexed: 05/14/2024] Open
Abstract
Objective A growing number of youth are utilizing digital mental health interventions (DMHIs) for treatment of mental health problems such as anxiety, depression, and ADHD. Although these mental health symptoms are closely related to sleep problems, it is unknown whether nonsleep DMHIs indirectly confer improvements in sleep. Using retrospective data, the current study assesses (1) whether youth sleep problems improve over participation in a nonsleep DMHI, and (2) whether mental health symptom severity and improvement are correlated with sleep problem severity over time. Methods Sleep problems and mental health symptoms were assessed every 30 days among children (ages 5-12) and adolescents (ages 13-17) participating in a pediatric digital mental health intervention (DMHI; N = 1219). Results Children and adolescents with elevated sleep problems (39.3%; n = 479) were older (P < .001), more predominantly female (P < .001), and more likely to have elevated anxiety (P < .001), depressive (P < .001) and inattention symptoms (P = .001), as compared to those with nonelevated sleep problems (60.7%; n = 740). From the baseline to last assessment, 77.3% (n = 269) of members with elevated sleep problems exhibited improvements, with sleep problems decreasing significantly over each month in care (P < .001). Members with improvements in anxiety, depressive, and/or ADHD symptoms had larger improvements in sleep over time compared to their peers with no improvement in their mental health symptoms (Months in care*Change type: P < .001 for all). Conclusions Our results provide preliminary evidence that participation in a pediatric DMHI is associated with improvements in sleep problems, even when youth are not being treated directly for sleep problems. These findings highlight a valuable secondary benefit of participating in mental health care within pediatric DMHIs and warrant further experimental research.
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Affiliation(s)
| | | | | | | | | | | | - Jennifer Huberty
- Bend Health Inc., Madison, WI, USA
- FitMinded Inc., Phoenix, AZ, USA
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14
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Zhang Y, Wang D, Ma Z, Liu W, Su Y, Wang W, You Z, Fan F. Problematic internet use and suicide ideation among Chinese adolescents: The indirect effects of insomnia, nightmares, and social jetlag. J Affect Disord 2024; 344:347-355. [PMID: 37838270 DOI: 10.1016/j.jad.2023.10.081] [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: 04/19/2023] [Revised: 09/12/2023] [Accepted: 10/09/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND Problematic Internet use (PIU) is related to suicide ideation (SI) in adolescents, but little is known about the potential mechanisms between them. This study aimed to examine the mediation roles of insomnia, nightmares, and social jetlag in the association of PIU with SI in adolescents. METHODS A total of 39,731 adolescents (mean age = 13.49 ± 0.76 years, 54.4 % males) from Shenzhen, China, participated in a cross-sectional survey. SI was assessed using the ninth item of the Patient Health Questionnaire-9. PIU was measured by the Revised Chinese Internet Addiction Scale. A self-administered questionnaire was used to assess insomnia symptoms, nightmare frequency, social jetlag, sleep duration, psychological distress, and social-demographical characteristics. Logistic regression and path analyses were performed to examine the associations between PIU, insomnia symptoms, nightmares, social jetlag, and SI. RESULTS The prevalence of PIU and SI were 14.9 % and 18.6 %, respectively. PIU, insomnia symptoms, frequent nightmares, and social jetlag were significantly associated with SI. Path analyses showed that the indirect effects of PIU on SI through insomnia symptoms, frequent nightmares, and social jetlag were significant. Conversely, social jetlag significantly mediated the pathway from SI to PIU. The mediation effect sizes of these sleep and circadian problems were slightly larger in females than in males. LIMITATIONS Cross-sectional design limited the capacity to infer causal relationships. CONCLUSIONS The associations between PIU and SI were mediated by sleep and circadian problems. These findings underscore the importance of assessing and intervening in sleep and circadian problems among adolescents with PIU or SI.
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Affiliation(s)
- Yifan Zhang
- 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
| | - Zijuan Ma
- 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
| | - 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
| | - Yunlin Su
- 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
| | - Wei 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
| | - Zhenli You
- 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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Kim M, Saade D, Dufourg MN, Charles MA, Plancoulaine S. Longitudinal sleep multi-trajectories from age 1 to 5.5 years and their early correlates: results from the Étude Longitudinale Française depuis l'Enfance birth cohort study. Sleep 2023; 46:zsad236. [PMID: 37682110 DOI: 10.1093/sleep/zsad236] [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: 04/27/2023] [Revised: 08/28/2023] [Indexed: 09/09/2023] Open
Abstract
STUDY OBJECTIVES To identify sleep multi-trajectories in children from age 1 to 5.5 years and their early correlates. METHODS We collected early family, maternal, and child characteristics, including children's nighttime sleep duration (NSD) and daytime sleep duration (DSD), night waking (NW), and sleep-onset difficulties (SOD), by parental phone interviews at age 2 months and 1-, 2-, 3.5-, and 5.5 years. Group-based multi-trajectory modeling identified sleep multi-trajectory groups. Multinomial logistic regression assessed associations with early factors. RESULTS We identified five distinct sleep multi-trajectory groups for NSD, DSD, NW, and SOD in 9273 included children. The "Good sleepers" (31.6%) and "Long sleepers" (31.0%) groups had low NW and SOD prevalence and shorter NSD but longer DSD in "Good sleepers" than in "Long sleepers." The "Good sleepers but few SOD" group (10.3%) had long NSD and DSD but a SOD peak at age 3.5 years; the "Improving NW and SOD" group (9.6%) showed short but rapidly increasing NSD to a plateau and high but decreasing NW and SOD; the "Persistent NW and SOD" group (17.5%) had persistent high NW and SOD. Maternal depression during pregnancy and sleep habits at age 1 (e.g. parental presence or feeding to fall asleep, sleeping at least part of the night away from own bed) were common risk factors associated with the most disordered sleep multi-trajectory groups. CONCLUSIONS We identified distinct sleep multi-trajectory groups and early life-associated factors in preschoolers. Most of the factors associated with the most sleep-disordered multi-trajectory groups are likely modifiable and provide clues for early prevention interventions.
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Affiliation(s)
- Mihyeon Kim
- Centre de Recherche en Epidémiologie et StatistiqueS (CRESS), Université Paris Cité, Inserm, INRAE, Paris, France
| | - Danielle Saade
- Centre de Recherche en Epidémiologie et StatistiqueS (CRESS), Université Paris Cité, Inserm, INRAE, Paris, France
| | | | - Marie-Aline Charles
- Centre de Recherche en Epidémiologie et StatistiqueS (CRESS), Université Paris Cité, Inserm, INRAE, Paris, France
- Unité mixte Inserm-Ined-EFS Elfe, INED, Paris, France and
| | - Sabine Plancoulaine
- Centre de Recherche en Epidémiologie et StatistiqueS (CRESS), Université Paris Cité, Inserm, INRAE, Paris, France
- Lyon Neuroscience Research Center (CRNL), Waking Team, Inserm UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
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16
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Tamura N, Okamura K. Social jetlag as a predictor of depressive symptoms among Japanese adolescents: Evidence from the Adolescent Sleep Health Epidemiological Cohort. Sleep Health 2023; 9:638-644. [PMID: 37453905 DOI: 10.1016/j.sleh.2023.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 06/09/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES Social jetlag, a circadian misalignment, has been associated with depressive symptoms in the general and working populations. However, evidence for this association in adolescents is inconsistent. This cross-sectional study aimed to investigate the association between social jetlag and depressive symptoms among Japanese adolescents and to evaluate differences by sex. METHODS The participants were 1493 students (13.6 ± 0.9years, 52.4% girls) from five junior high schools. Questionnaires, including demographic information and the Munich ChronoType Questionnaire, were distributed. Social jetlag was defined as the difference between midsleep on weekdays and weekends, and was categorized as <0 hour (negative), 0 to <1 hour, 1 to <2 hours, or ≥2 hours. Depressive symptoms were assessed using the Birleson Depression Self-Rating Scale for Children. Multivariate logistic regression was used to estimate the odds ratio with adjustments for potential confounders, such as puberty- and lifestyle-related factors. RESULTS The distribution of students with <0 hour, 0 to <1 hour, 1 to <2 hours, and ≥2 hours of social jetlag was 9.4%, 37.0%, 33.3%, and 20.4%, respectively. The multivariate-adjusted model revealed that social jetlag ≥2 hours and <0 hour were associated with an elevated risk of depressive symptoms among girls and boys, respectively. These associations were nonlinear for both sexes in restricted cubic spline analyses. CONCLUSIONS Social jetlag is associated with depressive symptoms among adolescents. Specifically, the risk of depressive symptoms increased with positive social jetlag scores for girls and negative social jetlag scores for boys.
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Affiliation(s)
- Norihisa Tamura
- Department of Psychology, Graduate School of Humanities and Social Sciences, Hiroshima University, Higashi-Hiroshima, Hiroshima, Japan; Center for Brain, Mind and Kansei Sciences Research, Hiroshima University, Hiroshima, Hiroshima, Japan.
| | - Kayoko Okamura
- Department of Clinical Psychology, Graduate School of Education, Hyogo University of Teacher Education, Kato, Hyogo, Japan; Osaka Municipal Nanko Kita Junior High School, Osaka, Osaka, Japan
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17
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Eschbach E, Wang J. Sleep and critical illness: a review. Front Med (Lausanne) 2023; 10:1199685. [PMID: 37828946 PMCID: PMC10566646 DOI: 10.3389/fmed.2023.1199685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 09/07/2023] [Indexed: 10/14/2023] Open
Abstract
Critical illness and stays in the Intensive Care Unit (ICU) have significant impact on sleep. Poor sleep is common in this setting, can persist beyond acute critical illness, and is associated with increased morbidity and mortality. In the past 5 years, intensive care clinical practice guidelines have directed more focus on sleep and circadian disruption, spurring new initiatives to study and improve sleep complications in the critically ill. The global SARS-COV-2 (COVID-19) pandemic and dramatic spikes in patients requiring ICU level care also brought augmented levels of sleep disruption, the understanding of which continues to evolve. This review aims to summarize existing literature on sleep and critical illness and briefly discuss future directions in the field.
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Affiliation(s)
- Erin Eschbach
- Division of Pulmonary, Critical Care, and Sleep, Mount Sinai Hospital, New York, NY, United States
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18
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Santos JPL, Hayes R, Franzen PL, Goldstein TR, Hasler BP, Buysse DJ, Siegle GJ, Dahl RE, Forbes EE, Ladouceur CD, McMakin DL, Ryan ND, Silk JS, Jalbrzikowski M, Soehner AM. The association between cortical gyrification and sleep in adolescents and young adults. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.09.15.557966. [PMID: 37745609 PMCID: PMC10516006 DOI: 10.1101/2023.09.15.557966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Study objectives Healthy sleep is important for adolescent neurodevelopment, and relationships between brain structure and sleep can vary in strength over this maturational window. Although cortical gyrification is increasingly considered a useful index for understanding cognitive and emotional outcomes in adolescence, and sleep is also a strong predictor of such outcomes, we know relatively little about associations between cortical gyrification and sleep. Methods Using Local gyrification index (lGI) of 34 bilateral brain regions and regularized regression for feature selection, we examined gyrification-sleep relationships in the Neuroimaging and Pediatric Sleep databank (252 participants; 9-26 years; 58.3% female) and identified developmentally invariant (stable across age) or developmentally specific (observed only during discrete age intervals) brain-sleep associations. Naturalistic sleep characteristics (duration, timing, continuity, and regularity) were estimated from wrist actigraphy. Results For most brain regions, greater lGI was associated with longer sleep duration, earlier sleep timing, lower variability in sleep regularity, and shorter time awake after sleep onset. lGI in frontoparietal network regions showed associations with sleep patterns that were stable across age. However, in default mode network regions, lGI was only associated with sleep patterns from late childhood through early-to-mid adolescence, a period of vulnerability for mental health disorders. Conclusions We detected both developmentally invariant and developmentally specific ties between local gyrification and naturalistic sleep patterns. Default mode network regions may be particularly susceptible to interventions promoting more optimal sleep during childhood and adolescence.
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Affiliation(s)
| | - Rebecca Hayes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Peter L Franzen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tina R Goldstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Greg J Siegle
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ronald E Dahl
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Erika E Forbes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Dana L McMakin
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Neal D Ryan
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jennifer S Silk
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Maria Jalbrzikowski
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Adriane M Soehner
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
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Rumble ME, Okoyeh P, Benca RM. Sleep and Women's Mental Health. Psychiatr Clin North Am 2023; 46:527-537. [PMID: 37500248 DOI: 10.1016/j.psc.2023.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Women have increased risks for both sleep disturbances and disorders and for mental health issues throughout their lives, starting in adolescence. Women have a higher prevalence of insomnia disorder and restless legs syndrome (RLS) versus men, and obstructive sleep apnea (OSA) is more likely as women age. Hormonal transitions are important to consider in women's sleep. For women, insomnia, OSA, and RLS are predictive of depression, and insomnia and sleep-disordered breathing are predictive of Alzheimer disease. These findings underscore the importance of assessment, treatment, and future research examining sleep and mental health in women, given their unique and increased vulnerability.
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Affiliation(s)
- Meredith E Rumble
- Department of Psychiatry, University of Wisconsin, 6001 Research Park Boulevard, Madison, WI 53719, USA.
| | - Paul Okoyeh
- Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, 791 Jonestown Road, Winston-Salem, NC 27103, USA
| | - Ruth M Benca
- Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, 791 Jonestown Road, Winston-Salem, NC 27103, USA
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20
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Duncan MJ, Mitchell J, Riazi NA, Belita E, Vanderloo LM, Carsley S, Carson V, Chaput JP, Faulkner G, Leatherdale ST, Patte KA. Sleep duration change among adolescents in Canada: Examining the impact of COVID-19 in worsening inequity. SSM Popul Health 2023; 23:101477. [PMID: 37593229 PMCID: PMC10428109 DOI: 10.1016/j.ssmph.2023.101477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/19/2023] [Accepted: 07/25/2023] [Indexed: 08/19/2023] Open
Abstract
Purpose The purpose of this study was to assess if adolescent sub-populations in Canada (i.e., based on race/ethnicity, sex/gender, socioeconomic status, and urbanicity groups) experienced a larger change in sleep duration and guideline adherence between 2019 and 2020 (pre-pandemic) and the 2020-2021 (mid-pandemic) school years. Methods Longitudinally linked data from 2019 to 2020 (pre-pandemic) and 2020-2021 (mid-pandemic) of a prospective cohort study of secondary school students (M = 14.2, SD = 1.3 years, N = 8209) in Canada were used for analyses. Regression modelling tested the main effects of race/ethnicity, sex/gender, socioeconomic status, and urbanicity on changes in sleep duration as well as adherence to Canada's 24-h Movement Guidelines for sleep (8-10 h/night). Interactions between identity variables (race/ethnicity or sex/gender) and other main effect variables were subsequently tested. Results Females gained more sleep (4.5 [1.5, 7.5] min/day more) and increased guideline adherence (AOR = 1.16 [1.04, 1.30] than males on average. Asian race/ethnic identity was associated with less sleep gain than White identity -10.1 [-19.4, -0.8], but not guideline adherence. Individuals in large urban areas gained less sleep and adhered less to guidelines than individuals from any other level of urbanicity (-21.4 [-38.5, -4.2] to -15.5 [-30.7, -0.2] min/day). Higher individual SES scores were associated with greater sleep gain (linear trend: 11.16 [1.2-21.1]). The discrepancies in sleep gain and guideline adherence between males and females were significantly modified by race/ethnicity and urbanicity. Discussion Increases in sleep duration may be one of the few benefits to adolescents during the COVID-19 pandemic but were not equally distributed across sub-populations. Efforts to promote better sleep adherence may need to account for sex/gender differences, especially in less urbanized areas and certain racial/ethnic groups.
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Affiliation(s)
- Markus J. Duncan
- Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, Saint Catharines, ON, L2S 3A1, Canada
| | - Jessica Mitchell
- Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, Saint Catharines, ON, L2S 3A1, Canada
| | - Negin A. Riazi
- Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, Saint Catharines, ON, L2S 3A1, Canada
| | - Emily Belita
- School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Leigh M. Vanderloo
- Child Health Evaluative Sciences, The Hospital for Sick Children, 686 Bay St, Toronto, ON, M5G 0A4, Canada
- Department of Science and Evaluation, ParticiPACTION, 77 Bloor St West, Suite 1205, Toronto, ON, M5S 1M2, Canada
| | - Sarah Carsley
- Public Health Ontario, 480 University Avenue, Suite 300, Toronto, ON, M5G 1V2, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Room 500, Toronto, ON, M5T 3M7, Canada
| | - Valerie Carson
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, 8840 114 St., Edmonton, AB, T6G 2H9, Canada
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
- Department of Pediatrics, University of Ottawa, 75 Laurier Ave. East, Ottawa, ON, K1N 6N5, Canada
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, Lower Mall Research Station, 2259 Lower Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Scott T. Leatherdale
- School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada
| | - Karen A. Patte
- Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, Saint Catharines, ON, L2S 3A1, Canada
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Zhou H, Zhu Z, Feng X, Zhang R. Low mindfulness is related to poor sleep quality from middle adolescents to emerging adults: a process model involving resilience and emotional dysfunction. BMC Psychiatry 2023; 23:626. [PMID: 37641001 PMCID: PMC10463593 DOI: 10.1186/s12888-023-05092-1] [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] [Received: 02/22/2023] [Accepted: 08/08/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVES Transitions from middle adolescence into merging adulthood, a life stage between age 15-25, has a high prevalence of sleep problems. Mindfulness is a trait defined as being attentive to the present moment which positively relates to sleep quality. In this study, we aimed to investigate how resilience and emotional dysfunction may influence the relationship between trait mindfulness and sleep quality. METHODS The Five Facet Mindfulness Questionnaire, Connor-Davidson Resilience Scale, Pittsburgh Sleep Quality Index and Depression Anxiety Stress Scales were used to measure the key variables through an online survey of 497 participants between middle adolescence and emerging adults (317 females, mean age 18.27 ± 0.76 years). A process model was built to investigate the mediating roles of resilience and emotional dysfunction in the impact of trait mindfulness on sleep quality, together with the relationships between their specific components. RESULTS We found a positive association between mindfulness and sleep quality through resilience and through emotional dysfunction, and through the sequential pathway from resilience to emotional dysfunction. Of note, acting with awareness (mindfulness facet) showed significant indirect effects on sleep quality, mediated by resilience and emotional dysfunction. CONCLUSIONS Our findings may unveil the underlying mechanisms of how low mindfulness induces poor sleep quality. The findings indicate that conceiving mindfulness as a multifaceted construct facilitates comprehension of its components, relationships with other variables, and underscores its potential clinical significance given its critical implications for mental health.
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Affiliation(s)
- Huaiyuan Zhou
- Cognitive Control and Brain Healthy Laboratory, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Ziqing Zhu
- Cognitive Control and Brain Healthy Laboratory, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Xiangang Feng
- Cognitive Control and Brain Healthy Laboratory, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.
- Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
| | - Ruibin Zhang
- Cognitive Control and Brain Healthy Laboratory, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.
- Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
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22
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Rocha S, Fuligni A. The impact of the COVID-19 pandemic on adolescent sleep behavior. Curr Opin Psychol 2023; 52:101648. [PMID: 37454639 PMCID: PMC10290178 DOI: 10.1016/j.copsyc.2023.101648] [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: 06/01/2023] [Revised: 06/18/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023]
Abstract
Restorative sleep is a fundamental component of adolescent wellbeing, and the COVID-19 pandemic presented both challenges and opportunities for adolescents' sleep. In this review, we synthesize emergent themes from the growing scientific evidence for the impact of the pandemic on adolescent sleep behavior across different stages of the pandemic and in different locations around the world. We also highlight the ways in which COVID-19 shaped sleep patterns among college students-a subgroup of adolescents transitioning to emerging adulthood that were particularly impacted by the shift to remote learning. Finally, we discuss variations in the impact according to several potential moderating factors in adolescents' lives and point to areas that require additional longitudinal research.
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Affiliation(s)
- Sarah Rocha
- Department of Psychology, University of California, 2311 Psychology Building, Los Angeles, CA 90095, USA.
| | - Andrew Fuligni
- Department of Psychology, Department of Psychiatry and Biobehavioral Sciences, University of California, 760 Westwood Plaza, Box 62, Los Angeles, CA 90095, USA
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23
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Kikuchi K, Michikawa T, Morokuma S, Hamada N, Suetsugu Y, Ikeda S, Nakahara K, Kato K, Ochiai M, Shibata E, Tsuji M, Shimono M, Kawamoto T, Ohga S, Kusuhara K. Sleep quality and temperament in association with autism spectrum disorder among infants in Japan. COMMUNICATIONS MEDICINE 2023; 3:82. [PMID: 37328542 DOI: 10.1038/s43856-023-00314-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 06/05/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Sleep problems and irritable temperaments are common among infants with autism spectrum disorder (ASD). The prospective association between such sleep problems and irritable temperaments and ASDs needs to be determined for elucidating the mechanism and exploring the future intervention study. Thus, in this study, we investigated whether sleep quality and temperament in 1-month-old infants are associated with the onset of ASD in 3-year-old children. We also assessed its sex-stratified associations. METHODS We conducted a longitudinal study using data from 69,751 mothers and infants from a large-cohort study, the Japan Environment and Children's Study. We examined the prospective association between infant sleep quality and temperament at 1 month of age and ASD diagnosis by 3 years of age. RESULTS Here we show infants with longer daytime sleep have a higher risk of later ASD than those with shorter daytime sleep (risk ratio [RR]: 1.33, 95% confidence interval [CI]: 1.01-1.75). Infants who experienced intense crying have a higher risk of ASD than those who did not (RR: 1.31, 95% CI: 1.00-1.72). There is a difference in sex in the association between a bad mood and later ASD. In particular, female infants experiencing bad moods have a higher risk of ASD than others (RR: 3.59, 95% CI: 1.91-6.75). CONCLUSIONS The study findings provide important information for future intervention to reduce the risk of future ASD.
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Affiliation(s)
- Kimiyo Kikuchi
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takehiro Michikawa
- Department of Environmental and Occupational Health, School of Medicine, Toho University, Tokyo, Japan
| | - Seiichi Morokuma
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
- Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Norio Hamada
- Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshiko Suetsugu
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Subaru Ikeda
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazushige Nakahara
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kiyoko Kato
- Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masayuki Ochiai
- Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Eiji Shibata
- Regional Center for Japan Environment and Children's Study, University of Occupational and Environmental Health, Kitakyushu, Japan
- Department of Obstetrics and Gynecology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Mayumi Tsuji
- Regional Center for Japan Environment and Children's Study, University of Occupational and Environmental Health, Kitakyushu, Japan
- Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Masayuki Shimono
- Regional Center for Japan Environment and Children's Study, University of Occupational and Environmental Health, Kitakyushu, Japan
- Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Toshihiro Kawamoto
- Regional Center for Japan Environment and Children's Study, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shouichi Ohga
- Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koichi Kusuhara
- Regional Center for Japan Environment and Children's Study, University of Occupational and Environmental Health, Kitakyushu, Japan
- Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
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24
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Datar A, Shier V, Liu Y. Understanding drivers of micro-level disparities in childhood body mass index, overweight, and obesity within low-income, minority communities. Prev Med Rep 2023; 32:102143. [PMID: 36875513 PMCID: PMC9981993 DOI: 10.1016/j.pmedr.2023.102143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/19/2022] [Accepted: 02/10/2023] [Indexed: 02/22/2023] Open
Abstract
The focus of childhood obesity disparities has been mainly on macro-level disparities, such as, between lower versus higher socioeconomic groups. But, less is known about micro-level disparities, that is disparities within minority and low-income populations. The present study examines individual and family level predictors of micro-level obesity disparities. We analyze data on 497 parent-child dyads living in public housing communities in Watts, Los Angeles. Cross-sectional multivariable linear and logistic regression models were estimated to examine whether individual and family level factors predict children's BMI z-scores, overweight, and obesity in the sample overall and separately by child's gender and age group. Child characteristics of our study sample included mean age 10.9 years, 74.3% Hispanic, 25.7% Non-Hispanic Black, 53.1% female, 47.5% with household income below $10,000, 53.3% with overweight or obesity, and 34.6% with obesity. Parental BMI was the strongest and most consistent predictor of child zBMI, overweight, and obesity, even after controlling for parent's diet and activity behaviors and home environment. The parenting practice of limiting children's screentime was also protective of unhealthy BMI in younger children and females. Home environment, parental diet and activity behaviors, and parenting practices related to food and bedtime routines were not significant predictors. Overall, our findings show that there is considerable heterogeneity in child BMI, overweight, and obesity even within low-income communities with similar socioeconomic and built environments in their neighborhoods. Parental factors play an important role in explaining micro-level disparities and should be an integral part of obesity prevention strategies in low-income minority communities.
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Affiliation(s)
- Ashlesha Datar
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States
| | - Victoria Shier
- Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, United States
| | - Ying Liu
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States
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25
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Kater MJ, Werner A, Schlarb AA, Lohaus A. Sleep Reactivity and Related Factors in Adolescence: An Increased Risk for Insomnia? A Longitudinal Assessment. Nat Sci Sleep 2023; 15:207-216. [PMID: 37069845 PMCID: PMC10105585 DOI: 10.2147/nss.s401452] [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: 12/14/2022] [Accepted: 03/25/2023] [Indexed: 04/19/2023] Open
Abstract
Purpose The individual vulnerability for stress-related sleep difficulties (eg, sleep reactivity) is known as a predisposing factor of insomnia in adults, yet relatively little is known about sleep reactivity in adolescence. The study goal is to determine factors related to sleep reactivity and to investigate whether sleep reactivity and related factors predict current and new incidents of insomnia in adolescents. Patients and Methods At baseline, 11-to-17-year-olds (N = 185, Mage = 14.3 years, SD = 1.8, 54% female) answered an age-appropriate version of the Ford Insomnia Response to Stress Test, questionnaires about sleep, stress, psychological symptoms, and resources, filled out a sleep diary and used actigraphy. Insomnia diagnoses according to ISCD-3 criteria were assessed at baseline, after 9 months and after one and a half years. Results Adolescents with high compared to low sleep reactivity had increased pre-sleep arousal, negative sleep-related cognitions, pre-sleep mobile phone use, stress experience, stress vulnerability, internalizing and externalizing symptoms, less social resources, and a later midpoint of bedtime. High sleep reactivity increased the likelihood for currently having insomnia, but not for the development of insomnia at subsequent assessments. Conclusion The findings suggest that high sleep reactivity is related to poor sleep health and mental health but cast doubt on sleep reactivity as a pivotal predisposing factor for the development of insomnia in adolescence.
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Affiliation(s)
- Maren-Jo Kater
- Faculty of Psychology and Sports Science, Department of Developmental Psychology and Developmental Psychopathology, Bielefeld University, Bielefeld, North Rhine Westphalia, Germany
- Correspondence: Maren-Jo Kater, Bielefeld University, Faculty of Psychology and Sports Science, Developmental Psychology and Developmental Psychopathology, P.O. Box 10 01 31, Bielefeld, 33501, Germany, Tel +49 0521 - 106 4461, Email
| | - Anika Werner
- Faculty of Psychology and Sports Science, Department of Developmental Psychology and Developmental Psychopathology, Bielefeld University, Bielefeld, North Rhine Westphalia, Germany
| | - Angelika Anita Schlarb
- Faculty of Psychology and Sports Science Clinical, Department of Psychology and Psychotherapy of Children and Adolescents, Bielefeld University, Bielefeld, North Rhine Westphalia, Germany
| | - Arnold Lohaus
- Faculty of Psychology and Sports Science, Department of Developmental Psychology and Developmental Psychopathology, Bielefeld University, Bielefeld, North Rhine Westphalia, Germany
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26
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Estes A, Munson J, St John T, Finlayson R, Pandey J, Gottlieb B, Herrington J, Schultz RT. Sleep problems in autism: Sex differences in the school-age population. Autism Res 2023; 16:164-173. [PMID: 36341856 PMCID: PMC9839593 DOI: 10.1002/aur.2848] [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: 06/15/2022] [Accepted: 10/22/2022] [Indexed: 11/09/2022]
Abstract
Clinically significant sleep problems affect up to 86% of the autistic population in school-age. Sleep problems can have negative impacts on child cognition, behavior, and health. However, sex differences in the prevalence and types of sleep problems are not well understood in autism. To evaluate sex differences in sleep problems in the school-age autistic population, we obtained parent-report of sleep problems on the Children's Sleep Habits Questionnaire and conducted direct assessments to establish diagnosis and intellectual ability in 6-12-year-old children (autism n = 250; typical development [TD] n = 114). Almost 85% of autistic females demonstrated sleep problems compared to 65.8% of autistic males, 44.8% of TD females, and 42.4% of TD males; a statistically significant increase for autistic females. Autistic females demonstrated increased bedtime resistance, sleep anxiety, and sleepiness, and decreased sleep duration, but did not differ in sleep onset delay, night wakings, parasomnias, or disordered breathing compared with autistic males. Intellectual ability was not related to increased sleep problems. Higher anxiety scores were associated with more sleep problems for males but not females. In one of the first studies to evaluate sex differences in sleep in the school-age, autistic population, autistic females demonstrated increased sleep problems compared to autistic males, TD females, and TD males. Current autism assessment and intervention practices may benefit from increased attention to sleep problems in autistic school-age females and to anxiety in autistic males to enhance well-being and behavioral and health outcomes.
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Affiliation(s)
- Annette Estes
- Department of Speech and Hearing Science, Box 357920, UW Autism Center, University of Washington, Seattle, Washington, USA
| | - Jeffrey Munson
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Tanya St John
- Department of Speech and Hearing Science, Box 357920, UW Autism Center, University of Washington, Seattle, Washington, USA
| | - Robin Finlayson
- College of Education, University of Washington, Seattle, Washington, USA
| | - Juhi Pandey
- Department of Psychiatry, Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Bridget Gottlieb
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - John Herrington
- Department of Psychiatry, Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Robert T Schultz
- Department of Psychiatry, Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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27
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He D, Meng P, Li C, Jia Y, Wen Y, Pan C, Zhang Z, Zhang J, Zhang H, Chen Y, Zhao Y, Qin X, Cai Q, Wei W, Shi S, Chu X, Zhang N, Zhang F. Association between telomere length and insomnia: A mendelian randomization and colocalization study. Sleep Med 2022; 100:304-310. [PMID: 36182724 DOI: 10.1016/j.sleep.2022.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 08/09/2022] [Accepted: 09/06/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Previous studies have suggested a potential association between sleep and telomere length (TL), but its genetic basis remains unclear. In this study, we aimed to explore the genetic correlation and potential causal association between TL and insomnia. METHODS The genome-wide association study (GWAS) datasets of TL and insomnia-related traits were used, including insomnia, snoring, daytime dozing and napping. Based on the polygenic risk scores (PRS) of TL, linear regression and linkage disequilibrium score (LDSC) regression were used to preliminarily explore the association between TL and insomnia parameters in the UK Biobank cohort. Then, we investigated the causal association between TL and insomnia by mendelian randomization (MR) analysis and colocalization analysis. RESULTS In the UK Biobank cohort, the association between TL and insomnia was observed in the female samples (t = 2.968, P = 3.00 × 10-3). LDSC detected a genetic correlation between short TL and insomnia (Rg = -9.27 × 10-2, P = 8.00 × 10-4). We found no evidence supporting significant causal association between insomnia and TL in IVW method (b = -5.95 × 10-3, P = 0.57), with horizontal pleiotropy and heterogeneity tests indicating the validity of our MR study. Finally, rs12638862 was classified as colocalized by COLOC (PP4 = 0.99), and TERC may be involved in regulating the association between insomnia and TL. CONCLUSIONS Our study found no evidence for causal association between insomnia and TL in individuals of European ancestry. We detected a candidate gene associated with both insomnia and TL, providing novel clues for understanding the roles of this association.
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Affiliation(s)
- Dan He
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Peilin Meng
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Chun'e Li
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yumeng Jia
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yan Wen
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Chuyu Pan
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Zhen Zhang
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Jingxi Zhang
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Huijie Zhang
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yujing Chen
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yijing Zhao
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Xiaoyue Qin
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Qingqing Cai
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Wenming Wei
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Sirong Shi
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Xiaoge Chu
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Na Zhang
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China.
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28
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Perez-Diaz-del-Campo N, Castelnuovo G, Caviglia GP, Armandi A, Rosso C, Bugianesi E. Role of Circadian Clock on the Pathogenesis and Lifestyle Management in Non-Alcoholic Fatty Liver Disease. Nutrients 2022; 14:nu14235053. [PMID: 36501083 PMCID: PMC9736115 DOI: 10.3390/nu14235053] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/18/2022] [Accepted: 11/25/2022] [Indexed: 11/29/2022] Open
Abstract
Several features of the modern lifestyle, such as weekly schedules or irregular daily eating patterns, have become major drivers of global health problems, including non-alcoholic fatty liver disease (NAFLD). Sleep is an essential component of human well-being, and it has been observed that when circadian rhythms are disrupted, or when sleep quality decreases, an individual's overall health may worsen. In addition, the discrepancy between the circadian and social clock, due to weekly work/study schedules, is called social jetlag and has also been associated with adverse metabolic profiles. Current management of NAFLD is based on dietary intake and physical activity, with circadian preferences and other environmental factors also needing to be taken into account. In this regard, dietary approaches based on chrononutrition, such as intermittent fasting or time-restricted feeding, have proven to be useful in realigning lifestyle behaviors with circadian biological rhythms. However, more studies are needed to apply these dietary strategies in the treatment of these patients. In this review, we focus on the impact of circadian rhythms and the role of sleep patterns on the pathogenesis and development of NAFLD, as well as the consideration of chrononutrition for the precision nutrition management of patients with NAFLD.
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Affiliation(s)
| | | | | | - Angelo Armandi
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy
- Metabolic Liver Disease Research Program, I. Department of Medicine, University Medical Center of the Johannes Gutenberg-University, 55131 Mainz, Germany
| | - Chiara Rosso
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy
- Correspondence:
| | - Elisabetta Bugianesi
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy
- Gastroenterology Unit, Città della Salute e della Scienza—Molinette Hospital, 10126 Turin, Italy
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29
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Longitudinal Associations Between Peer Victimization and Emotional Difficulties in Schoolchildren: The Role of Sleep Quality. SCHOOL MENTAL HEALTH 2022. [DOI: 10.1007/s12310-022-09558-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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30
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Long Z, Zhao A, Chen Y, Li R, Xia Y, Guo Y, Li S. The associations of chronotype and social jetlag with prosocial behavior problems among Chinese adolescents. Chronobiol Int 2022; 39:1498-1507. [PMID: 36154358 DOI: 10.1080/07420528.2022.2127362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Potential relevance between the circadian rhythm and behavioral health has got raising attention in recent years. This study aimed to examine chronotype, social jetlag and their associations with prosocial behavior problems among Chinese adolescents. A total of 4,666 middle school students aged 12-18 years were enrolled in study. Sleep characteristics were collected by the modified Chinese version of Adolescent Sleep Hygiene Scale (M-ASHS); MSFsc and mid-sleep point were calculated to determine chronotypes and social jetlag. Prosocial behavior problems were assessed by the Strength and Difficult Questionnaire (SDQ). Multivariate logistic regression was applied to analyze the relationships between chronotype and social jetlag with prosocial behavior problems. Evening chronotype was associated with higher risk of prosocial behavior problems, whether among male (OR = 1.82, 95%CI:1.27-2.61, P = .001) or female adolescents (OR = 1.83, 95%CI:1.15-2.91, P = .011). Female adolescents with social jetlag of 1-2 hours had 1.60 times the risk of prosocial behavior problems than their peers whose social jetlag was <1 h (P = .028); social jetlag ≥ 2 h was positively associated with prosocial behavior problems in both male and female adolescents (OR = 1.79 and 2.45, respectively, both P < .05). Further, the combination of intermediate chronotype and social jetlag ≥ 2 h was correlated with prosocial behavior problems only in female adolescents (OR = 3.24, 95%CI = 1.40-9.21, P = .004). Evening chronotype and higher social jetlag were risk factors for prosocial behavior problems in adolescents, especially for the female. For the promotion of prosocial behavior in adolescents, the importance of circadian rhythm should be addressed.
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Affiliation(s)
- Zichong Long
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Anda Zhao
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiting Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rong Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuanqing Xia
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yongmei Guo
- Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shenghui Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,MOE - Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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31
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Association of sleep quality with temperament among one-month-old infants in The Japan Environment and Children’s Study. PLoS One 2022; 17:e0274610. [PMID: 36103560 PMCID: PMC9473436 DOI: 10.1371/journal.pone.0274610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/30/2022] [Indexed: 11/30/2022] Open
Abstract
This study aimed to examine the association between infant sleep quality and temperament in one-month-old infants using a large cohort study data. We used data from the Japan Environment and Children’s Study, a cohort study which follows around 100,000 women from pregnancy until their children’s development. The mothers were asked about their infants’ sleep and temperament using a structured questionnaire. Frequent crying (adjusted odds ratio [AOR]: 1.05, 95% confidence interval [CI]: 1.00–1.10) and intense crying (AOR: 1.19, 95% CI: 1.13–1.25) were positively associated with longer sleep periods during the day than at night. Female infants with longer daytime sleep periods than that at nighttime were more likely to cry frequently (AOR: 1.11, 95% CI: 1.04–1.20). Parous women with infants who had frequent night awakening believed their infants cried more intensely (AOR: 1.17, 95% CI: 1.03–1.31). The study demonstrated a specific association between sleep quality and temperament in one-month-old infants. Based on the results of this study, further sleep intervention studies are required to improve infant temperament.
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Rojo-Wissar DM, Bai J, Benjamin-Neelon SE, Wolfson AR, Spira AP. Development of circadian rest-activity rhythms during the first year of life in a racially diverse cohort. Sleep 2022; 45:zsac078. [PMID: 35380731 PMCID: PMC9189964 DOI: 10.1093/sleep/zsac078] [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: 08/02/2021] [Revised: 02/26/2022] [Indexed: 11/12/2022] Open
Abstract
STUDY OBJECTIVES To describe the development of circadian rest-activity rhythms (CRARs) during infancy in a racially diverse cohort. METHODS We studied 414 infants from the Nurture birth cohort (51.2% female, 65.2% Black) who wore actigraphs on their left ankles for 4 days and nights at 3, 6, 9, and 12 months. We quantified CRARs using cosinor and non-parametric circadian rhythm analysis, and investigated change in CRARs over time, comparing 6, 9, and 12 months to CRARs at 3 months. We adjusted for baseline and time-varying covariates and used function-on-scalar regression (FOSR) to identify the specific times of day at which activity changes occurred. RESULTS Across the first year, daily mean and peak activity levels and day-to-day activity level regularity increased, and activity level fragmentation and nighttime activity decreased. Only at 9 months, compared to at 3 months, did timing of peak activity levels and the most active periods shift later, while timing of least active periods shifted earlier. FOSR analyses showed that mean activity levels decreased during nighttime hours and increased during daytime hours, with the most pronounced changes at 9 months. CONCLUSIONS Among racially diverse infants, CRARs became more robust, stable, and less fragmented over time. Findings suggest the greatest change from 3-month CRARs occurs at 9 months, which may be a key period of CRAR development. This and future research will contribute to our understanding of normative infant CRAR development in diverse populations and enable us to identify infants who may benefit from intervention.
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Affiliation(s)
- Darlynn M Rojo-Wissar
- The Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Center for Behavioral and Preventive Medicine, The Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Bradley/Hasbro Children’s Research Center, E.P. Bradley Hospital, Providence, RI, USA
- E.P. Bradley Hospital Sleep Research Laboratory, Providence, RI, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,USA
| | - Jiawei Bai
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,USA
| | - Sara E Benjamin-Neelon
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,USA
| | - Amy R Wolfson
- Department of Psychology, Loyola College of Arts and Sciences, Loyola University Maryland
, Baltimore, MD,
USA
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,USA
- Johns Hopkins Center on Aging and Health, Baltimore, MD,USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD,USA
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The effect of mobile phone use at night on the sleep of pre-adolescent (8-11 year), early adolescent (12-14 year) and late adolescent (15-18 year) children: A study of 252,195 Australian children. Sleep Health 2022; 8:277-282. [DOI: 10.1016/j.sleh.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 02/14/2022] [Accepted: 02/22/2022] [Indexed: 11/19/2022]
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Adversarial learning for semi-supervised pediatric sleep staging with single-EEG channel. Methods 2022; 204:84-91. [DOI: 10.1016/j.ymeth.2022.03.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/12/2022] [Accepted: 03/21/2022] [Indexed: 11/18/2022] Open
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Plancoulaine S, Guyon A, Inocente CO, Germe P, Zhang M, Robert P, Lin JS, Franco P. Cerebrospinal Fluid Histamine Levels in Healthy Children and Potential Implication for SIDS: Observational Study in a French Tertiary Care Hospital. Front Pediatr 2022; 10:819496. [PMID: 35450108 PMCID: PMC9016218 DOI: 10.3389/fped.2022.819496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 03/09/2022] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE A defect of the waking systems could constitute a factor of vulnerability for sudden infant death syndrome (SIDS). A decrease in orexin levels, which promotes wakefulness and activates histaminergic neurons (another hypothalamic wake-promoting system) has already been demonstrated between 2 and 6 months. This work aims to study the levels of histamine (HA), tele-methylhistamine (t-MeHA), its direct metabolite, and t-MeHA/HA ratio in the cerebrospinal fluid (CSF) of healthy children, to evaluate the maturation of the histaminergic system and its possible involvement in SIDS. METHODS Seventy Eight French children between 0 and 20 years (48.7% boys) were included, all of whom had a clinical indication for lumbar puncture, but subsequently found to be normal. Measurements of HA and t-MeHA in CSF were performed by reverse phase liquid chromatography coupled to mass spectrometry detection. Statistical analyses were performed using Spearman correlations and Non-parametric pairwise ranking tests. RESULTS A negative correlation was found between age and CSF HA (r = -0.44, p < 10-4) and t-MeHA (r = -0.70, p < 10-4) levels. In pairwise comparisons, no difference in CSF HA and t-MeHA levels was observed between youngest age groups (i.e., 0-2 mo vs. 3-6 mo), but CSF HA and t-MeHA levels were significantly lower in older children (i.e., >6 mo vs. 0-6 mo). The CSF HA decrease with age was only observed in boys, who also presented global lower CSF HA levels than girls. CONCLUSION CSF HA and t-MeHA levels decrease with age in boys, and global levels are lower in boys than in girls. These results reveal changes in histaminergic transmission and metabolism during maturation. Whether lower CSF histamine values in boys compared to girls could contribute to their higher risk of SIDS warrants further research.
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Affiliation(s)
| | - Aurore Guyon
- Integrative Physiology of the Brain Arousal System, CRNL, INSERM-U1028, CNRS UMR5292, University Lyon 1, Lyon, France.,Bioprojet Biotech, Saint-Grégoire, France
| | - Clara-Odilia Inocente
- Integrative Physiology of the Brain Arousal System, CRNL, INSERM-U1028, CNRS UMR5292, University Lyon 1, Lyon, France
| | - Philippine Germe
- Integrative Physiology of the Brain Arousal System, CRNL, INSERM-U1028, CNRS UMR5292, University Lyon 1, Lyon, France
| | - Min Zhang
- Integrative Physiology of the Brain Arousal System, CRNL, INSERM-U1028, CNRS UMR5292, University Lyon 1, Lyon, France
| | | | - Jian-Sheng Lin
- Integrative Physiology of the Brain Arousal System, CRNL, INSERM-U1028, CNRS UMR5292, University Lyon 1, Lyon, France
| | - Patricia Franco
- Integrative Physiology of the Brain Arousal System, CRNL, INSERM-U1028, CNRS UMR5292, University Lyon 1, Lyon, France.,Pediatric Sleep Unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, University Lyon 1, Lyon, France
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Blume C, Schoch SF, Vienneau D, Röösli M, Kohler M, Moeller A, Kurth S, Usemann J. Association of transportation noise with sleep during the first year of life: A longitudinal study. ENVIRONMENTAL RESEARCH 2022; 203:111776. [PMID: 34329637 DOI: 10.1016/j.envres.2021.111776] [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: 05/20/2021] [Revised: 07/19/2021] [Accepted: 07/25/2021] [Indexed: 06/13/2023]
Abstract
STUDY OBJECTIVES During infancy, adequate sleep is crucial for physical and neurocognitive development. In adults and children, night-time noise exposure is associated with sleep disturbances. However, whether and to what extent infants' sleep is affected, is unknown. Thus, this study investigated the relationship between nocturnal transportation noise and actimetry-derived habitual sleep behavior across the first year of life. METHODS In 144 healthy infants (63 girls), nocturnal (23:00-7:00) transportation noise (i.e., road, railway, and aircraft) was modelled at the infants' individual places of residence. Using actimetry, we recorded movement patterns for 11 days in a longitudinal design at 3, 6, and 12 months of age and derived the recently proposed core sleep composites of night-time sleep duration, activity, and variability. Using linear mixed-effects models, we determined associations between noise exposure and sleep composites. Sex, gestational age, parents' highest educational level, infants' age, and the existence of siblings served as control variables. RESULTS In models without interactions, night-time transportation noise was unrelated to sleep composites across the first year of life (p > .16). Exploratory analyses of an interaction between noise and the existence of siblings yielded an association between night-time transportation noise and sleep duration in infants without siblings only (p = .004). CONCLUSION In our study, sleep in infants during the first year of life was relatively robust against external perturbation by night-time transportation noise. However, particularly in children without siblings increasing night-time transportation noise reduced sleep duration. This suggests that the habitual noise environment may modulate individual susceptibility to adverse effects of noise on sleep.
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Affiliation(s)
- Christine Blume
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerland; Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
| | - Sarah F Schoch
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland; Center of Competence Sleep & Health Zurich, University of Zurich, Switzerland
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Malcolm Kohler
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland; Center of Competence Sleep & Health Zurich, University of Zurich, Switzerland
| | - Alexander Moeller
- Division of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, University of Zurich, Zurich, Switzerland
| | - Salome Kurth
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland; Center of Competence Sleep & Health Zurich, University of Zurich, Switzerland; Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Jakob Usemann
- Division of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, University of Zurich, Zurich, Switzerland; University Children's Hospital Basel (UKBB), Basel, Switzerland.
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Liu Y, Xian JS, Wang R, Ma K, Li F, Wang FL, Yang X, Mu N, Xu K, Quan YL, Wang S, Lai Y, Yang CY, Li T, Zhang Y, Tan B, Feng H, Chen TN, Wang LH. Factoring and correlation in sleep, fatigue and mental workload of clinical first-line nurses in the post-pandemic era of COVID-19: A multi-center cross-sectional study. Front Psychiatry 2022; 13:963419. [PMID: 36090368 PMCID: PMC9452657 DOI: 10.3389/fpsyt.2022.963419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/02/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND A better understanding of the factors and their correlation with clinical first-line nurses' sleep, fatigue and mental workload is of great significance to personnel scheduling strategies and rapid responses to anti-pandemic tasks in the post-COVID-19 pandemic era. OBJECTIVE This multicenter and cross-sectional study aimed to investigate the nurses' sleep, fatigue and mental workload and contributing factors to each, and to determine the correlation among them. METHODS A total of 1,004 eligible nurses (46 males, 958 females) from three tertiary hospitals participated in this cluster sampling survey. The Questionnaire Star online tool was used to collect the sociodemographic and study target data: Sleep quality, fatigue, and mental workload. Multi-statistical methods were used for data analysis using SPSS 25.0 and Amos 21.0. RESULTS The average sleep quality score was 10.545 ± 3.399 (insomnia prevalence: 80.2%); the average fatigue score was 55.81 ± 10.405 (fatigue prevalence: 100%); and the weighted mental workload score was 56.772 ± 17.26. Poor sleep was associated with mental workload (r = 0.303, P < 0.05) and fatigue (r = 0.727, P < 0.01). Fatigue was associated with mental workload (r = 0.321, P < 0.05). COVID-19 has caused both fatigue and mental workload. As 49% of nurses claimed their mental workload has been severely affected by COVID-19, while it has done slight harm to 68.9% of nurses' sleep quality. CONCLUSION In the post-COVID-19 pandemic era, the high prevalence of sleep disorders and fatigue emphasizes the importance of paying enough attention to the mental health of nurses in first-class tertiary hospitals. Efficient nursing strategies should focus on the interaction of sleep, fatigue and mental workload in clinical nurses. In that case, further research on solutions to the phenomenon stated above proves to be of great significance and necessity. CLINICAL TRIAL REGISTRATION [https://clinicaltrials.gov/], identifier [ChiCTR2100053133].
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Affiliation(s)
- Yan Liu
- Southwest Hospital, Administrative Office, Army Medical University, Chongqing, China
| | - Ji Shu Xian
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Rui Wang
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Kang Ma
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Fei Li
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Fei Long Wang
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Xue Yang
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Ning Mu
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Kai Xu
- Southwest Hospital, Army Aviation Medicine Teaching and Research Office, Army Medical University, Chongqing, China
| | - Yu Lian Quan
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Shi Wang
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Ying Lai
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Chuan Yan Yang
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Teng Li
- Southwest Hospital, Administrative Office, Army Medical University, Chongqing, China
| | - Yanchun Zhang
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Binbin Tan
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Hua Feng
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Tu Nan Chen
- Southwest Hospital, Army Aviation Medicine Teaching and Research Office, Army Medical University, Chongqing, China
| | - Li Hua Wang
- Southwest Hospital, Administrative Office, Army Medical University, Chongqing, China
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Tang Y, Wan Y, Xu S, Zhang S, Hao J, Tao F. Nonlinear relationship between sleep duration and non-suicidal self-injurious behaviour among Chinese adolescents. BMC Psychiatry 2021; 21:521. [PMID: 34674680 PMCID: PMC8532314 DOI: 10.1186/s12888-021-03539-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 10/13/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Previous studies have shown a positive association between sleep deprivation and non-suicidal self-injury (NSSI) among adolescents, but few studies have described the effects of oversleeping and weekend catch-up sleep on NSSI. The present study aimed to explore the nonlinear relationship between sleep duration and NSSI among Chinese adolescents. METHODS Data from China's National Adolescent Health Surveillance for the years 2014 to 2015 were collected from 15,713 students located across four provinces in China. A self-report questionnaire was used to assess sleep duration and 12-month NSSI. Binomial logistic regression models were used to examine the association between NSSI and sleep duration. The locally estimated scatter plot smoothing (LOESS) method was used to explore the associations of total NSSI number with sleep duration, and binomial regression analysis was used to test this relationship. RESULTS About 68.5% of adolescents reported sleeping less than 8 h on weeknights, while 37.8% of adolescents slept more than 10 h per night during weekends. The 12-month prevalence rate of NSSI was 29.4%. Compared to adolescents who reported weekend catch-up sleep of 0-1 h, those who slept < 0 h (adjusted odds ratio [aOR] = 1.38, 95% Confidence Interval [95% CI]: 1.16-1.64) had a higher risk of NSSI. Males who reported ≥3 h of weekend catch-up sleep had significantly increased odds of NSSI (aOR = 1.20, 95%CI: 1.01-1.42). Notably, a positive U-shaped association was observed between the sleep duration and the total NSSI number. CONCLUSIONS The findings reveal a nonlinear relationship between sleep duration and NSSI among Chinese adolescents. Therefore, it is necessary to be vigilant and screen for sleep duration among adolescents in NSSI treatment or prevention.
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Affiliation(s)
- Ying Tang
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui China ,MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032 Anhui China ,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; No 81 Meishan Road, Hefei, 230032 Anhui China
| | - Yuhui Wan
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui China ,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; No 81 Meishan Road, Hefei, 230032 Anhui China
| | - Shaojun Xu
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; No 81 Meishan Road, Hefei, 230032 Anhui China
| | - Shichen Zhang
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui China ,MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032 Anhui China
| | - Jiahu Hao
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui China ,MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; No 81 Meishan Road, Hefei, 230032 Anhui China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; No 81 Meishan Road, Hefei, 230032, Anhui, China.
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Gauld C, Lopez R, Geoffroy PA, Morin CM, Guichard K, Giroux É, Dauvilliers Y, Dumas G, Philip P, Micoulaud-Franchi JA. A systematic analysis of ICSD-3 diagnostic criteria and proposal for further structured iteration. Sleep Med Rev 2021; 58:101439. [DOI: 10.1016/j.smrv.2021.101439] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/11/2020] [Accepted: 11/11/2020] [Indexed: 12/21/2022]
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Reynaud E, Forhan A, Heude B, Charles MA, Plancoulaine S. Night-sleep Duration Trajectories and Behavior in Preschoolers: Results from a Prospective Birth Cohort Study. Behav Sleep Med 2021; 19:445-457. [PMID: 32497438 DOI: 10.1080/15402002.2020.1773467] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Short sleep duration is associated with concomitant behavioral difficulties, but the longitudinal association between sleep duration and later behavior in early childhood remains unclear. The aim was to study the association between sleep duration trajectories throughout preschool and behavior at age 5-6 years.Participants: 1021 children of the French birth-cohort EDEN were included in this study.Methods: Night-sleep duration trajectories were modeled on the basis of repeated measures collected at age 2, 3 and 5-6 years by parental questionnaires. Behavior was assessed with the Strengths and Difficulties Questionnaire (SDQ), with five subscales measuring conduct problems, emotional symptoms, peer relation problems, antisocial behavior, and hyperactivity-inattention problems. The subscales were dichotomized by the 25th percentile. Multivariable logistic regression, adjusted for baseline behavior, and assessment of multiple confounding factors allowed for studying the independent association between night-sleep duration trajectories from age 2 to 5-6 and behavior at age 5-6.Results: Five distinct sleep-duration trajectories were identified. At age 5-6 years, probability of hyperactivity-inattention problems was increased for boys belonging to the "short sleep" and "medium-low sleep" duration trajectory and girls belonging to the "changing sleep" duration trajectory as compared with children with the medium-high sleep duration trajectory (boys: OR 2.69 [95% CI 1.18-6.16], p = .03 and 1.95 [1.25-3.03], p = .003, and girls: OR 2.79 [1.09- 7.17], p = .03). No associations were observed with the other SDQ subscales.Conclusion: The persistence of short night-sleep durations in preschool years as well as a sudden decrease at age 3 are risk factors of hyperactivity-inattention problems at school start.Abbreviations: SS: short-sleep duration trajectory; MLS: medium-low-sleep duration trajectory; MHS: medium-high-sleep duration trajectory; LS: long-sleep duration trajectory; CS: changing-sleep duration trajectory.
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Affiliation(s)
- Eve Reynaud
- CNRS UPR 3212, Team 9 - Institute of Cellular and Integrative Neurosciences (INCI), Strasbourg, France.,Université de Paris, CRESS, INSERM, Paris, France
| | - Anne Forhan
- Université de Paris, CRESS, INSERM, Paris, France
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Fiese BH, Cai T, Sutter C, Bost KK. Bedtimes, Bedtime Routines, and Children's Sleep across the First Two Years of Life. Sleep 2021; 44:6149134. [PMID: 33624804 DOI: 10.1093/sleep/zsab045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 02/02/2021] [Indexed: 12/19/2022] Open
Abstract
STUDY OBJECTIVES The first objective of this study was to determine whether establishing bedtime routines in the first year of life predicts better sleep outcomes (i.e., longer sleep duration, less nighttime waking, earlier bedtime, shorter sleep latency, fewer sleep problems) across the first two years of life. The second objective was to determine whether specific adaptive bedtime activities (e.g., book reading) were associated with sleep outcomes. The third objective was to describe changes in adaptive bedtime activities (hug/kiss caregiver, say goodnight to family) across the first two years of life. METHODS Parents of 468 children from the STRONG Kids 2 birth cohort were surveyed about bedtime and bedtime routines, their child's sleep duration, nighttime waking, sleep latency and sleep problems at 3, 12, 18, and 24 months of age. RESULTS Cross-lagged panel models revealed partial evidence for reciprocal associations between bedtime routine consistency and adaptive bedtime activities and better sleep outcomes over time. Specifically, more bedtime routine consistency predicted less nighttime waking and sleep problems, and more bedtime adaptive activities predicted longer sleep duration and fewer sleep problems. DISCUSSION The findings are discussed from a developmental perspective to highlight how consistency of bedtime routines established as early as three months of age may affect sleep outcomes and that the adaptive activities associated with these routines may increase in frequency over the first two years of life.
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Chen X, Qiang Y, Liu X, Yang Q, Zhu Q, Li B, Wang R. The Prevalence of Insufficient Sleep and Bedtime Delay Among Kindergarten Children Aged 3 to 6 Years in a Rural Area of Shanghai: A Cross-Sectional Study. Front Pediatr 2021; 9:759318. [PMID: 34900866 PMCID: PMC8655690 DOI: 10.3389/fped.2021.759318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/21/2021] [Indexed: 12/15/2022] Open
Abstract
Introduction: Sleep deprivation in children is a global public health problem that affects the physical and mental development of children. Bedtime delay induced by longer screen time and heavy study load is a common cause of sleep deprivation in children. However, the prevalence of insufficient sleep and bedtime delay and related influencing factors among kindergarten children is limited in Shanghai, China. Methods: In 2018, we selected 8,586 children aged 3 to 6 years and their parents in Songjiang District, Shanghai. Data was collected among parents by face-to-face questionnaire interview with signed informed consent. We defined insufficient sleep as those who slept for < 10 h in children aged 3-5 years or 9 h in children aged 6 years within 24 h, and we define bedtime delay as children with bedtime after 21:00. SAS 9.1.3 software was used to calculate the prevalence of bedtime delay and insufficient sleep, and logistic regression was used to explore potential influencing factors. Results: The prevalence of insufficient sleep and bedtime delay among children aged 3 to 6 years was 11.67 and 56.85%, respectively. The prevalence of insufficient sleep among boys was slightly higher than among girls [odds ratio (OR) = 1.18, 95% confidence interval (CI): 1.04-1.35]. With the increase of the age of children, the prevalence of insufficient sleep increased gradually (P < 0.05). The prevalence of insufficient sleep was higher among the only child in the family (OR = 1.18, 95% CI: 1.02-1.36) and those with longer hours of TV watching (OR = 109, 95% CI: 1.02-1.16). Meanwhile, the prevalence of bedtime delay was also higher among the only child in the family (OR = 1.17, 95% CI: 1.06-1.79), among those with parents accompanying for sleep (OR = 1.21, 95% CI: 1.10-1.34), and those with longer TV watching time (OR = 1.13, 95% CI: 1.07-1.18). Conclusions: Insufficient sleep and bedtime delay were prevalent in Chinese children aged 3 to 6 years, especially in boys and older children. TV watching as well as parents accompanying for sleep were associated with insufficient sleep and bedtime delay. We recommend that parents should limit the screen time of children, advocate earlier bedtime and later morning wake-up among children, as well as make their children sleep in separate beds or rooms in younger age.
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Affiliation(s)
- Xi Chen
- Shanghai Skin Disease Hospital, Shanghai, China
| | - Yan Qiang
- Shanghai Skin Disease Hospital, Shanghai, China
| | - Xia Liu
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qing Yang
- Songjiang Maternity and Child Health Hospital, Shanghai, China
| | - Qingqing Zhu
- Songjiang Maternity and Child Health Hospital, Shanghai, China
| | - Bin Li
- Shanghai Skin Disease Hospital, Shanghai, China
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