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Irwin MR, Hoang D, Olmstead R, Sadeghi N, Breen EC, Bower JE, Cole S. Tai Chi compared with cognitive behavioral therapy and the reversal of systemic, cellular and genomic markers of inflammation in breast cancer survivors with insomnia: A randomized clinical trial. Brain Behav Immun 2024; 120:159-166. [PMID: 38777285 DOI: 10.1016/j.bbi.2024.05.022] [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: 12/01/2023] [Revised: 05/06/2024] [Accepted: 05/19/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Insomnia contributes to inflammation in breast cancer survivors. This study evaluates whether insomnia treatment reverses inflammation in breast cancer survivors with insomnia. METHODS Participants (n = 90) were randomized to 3 months of Tai Chi (n = 45) or cognitive behavioral therapy for insomnia (CBT-I)(n = 45), and followed for one year post-intervention to 15 month endpoint. Our previous report found that Tai Chi as compared to CBT-I resulted in similar rates of insomnia response and remission over 15 months. Here, we analyze changes in plasma C-reactive protein and pro- and anti-inflammatory cytokines, Toll-like receptor (TLR)-4 stimulated monocyte production of interleukin (IL)-6 and tumor necrosis factor-α (TNF), and cellular pro-inflammatory and anti-viral gene expression (Conserved Transcriptional Response to Adversity RNA profile; CTRA) over 15 months. RESULTS Insomnia treatment resulted in decreases in the TLR-4 stimulated monocyte production of IL-6, TNF, and their co-expression, as well as decreases in the CTRA profile, decreases inflammatory gene transcripts, and increases in anti-viral gene transcripts over 15 months (all P's < 0.01). In addition, as compared to CBT-I, Tai Chi resulted in greater decreases in plasma IL-6 (P < 0.05), and greater decreases in TLR-4 activated monocyte production of IL-6 and co-expression of IL-6 and TNF at 15 month endpoint. CBT-I resulted in greater increases in anti-viral gene transcripts. CONCLUSIONS Administration of either CBT-I or Tai Chi effectively treats insomnia, and shows additional benefits of reducing cellular and genomic markers of inflammation, and increasing anti-viral genomic markers in breast cancer survivors with insomnia. Tai Chi, as compared to CBT-I, yields greater and more durable decreases in systemic- and cellular inflammation. Targeting insomnia might mitigate the risk of inflammation-related co-morbidities in breast cancer survivors.
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Affiliation(s)
- Michael R Irwin
- Cousins Center for Psychoneuroimmunology (MRI, DH, RO, CC, NS, ECB, JEB, SC), UCLA Semel Institute for Neuroscience, Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, SC), UCLA David Geffen School of Medicine (DH), Department of Psychology (JEB), University of California, Los Angeles, United States.
| | - Danny Hoang
- Cousins Center for Psychoneuroimmunology (MRI, DH, RO, CC, NS, ECB, JEB, SC), UCLA Semel Institute for Neuroscience, Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, SC), UCLA David Geffen School of Medicine (DH), Department of Psychology (JEB), University of California, Los Angeles, United States.
| | - Richard Olmstead
- Cousins Center for Psychoneuroimmunology (MRI, DH, RO, CC, NS, ECB, JEB, SC), UCLA Semel Institute for Neuroscience, Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, SC), UCLA David Geffen School of Medicine (DH), Department of Psychology (JEB), University of California, Los Angeles, United States.
| | - Nina Sadeghi
- Cousins Center for Psychoneuroimmunology (MRI, DH, RO, CC, NS, ECB, JEB, SC), UCLA Semel Institute for Neuroscience, Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, SC), UCLA David Geffen School of Medicine (DH), Department of Psychology (JEB), University of California, Los Angeles, United States.
| | - Elizabeth C Breen
- Cousins Center for Psychoneuroimmunology (MRI, DH, RO, CC, NS, ECB, JEB, SC), UCLA Semel Institute for Neuroscience, Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, SC), UCLA David Geffen School of Medicine (DH), Department of Psychology (JEB), University of California, Los Angeles, United States.
| | - Julienne E Bower
- Cousins Center for Psychoneuroimmunology (MRI, DH, RO, CC, NS, ECB, JEB, SC), UCLA Semel Institute for Neuroscience, Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, SC), UCLA David Geffen School of Medicine (DH), Department of Psychology (JEB), University of California, Los Angeles, United States.
| | - Steve Cole
- Cousins Center for Psychoneuroimmunology (MRI, DH, RO, CC, NS, ECB, JEB, SC), UCLA Semel Institute for Neuroscience, Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, SC), UCLA David Geffen School of Medicine (DH), Department of Psychology (JEB), University of California, Los Angeles, United States.
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Jaspan VN, Greenberg GS, Parihar S, Park CM, Somers VK, Shapiro MD, Lavie CJ, Virani SS, Slipczuk L. The Role of Sleep in Cardiovascular Disease. Curr Atheroscler Rep 2024; 26:249-262. [PMID: 38795275 PMCID: PMC11192677 DOI: 10.1007/s11883-024-01207-5] [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: 05/01/2024] [Indexed: 05/27/2024]
Abstract
PURPOSE OF REVIEW Sleep is an important component of cardiovascular (CV) health. This review summarizes the complex relationship between sleep and CV disease (CVD). Additionally, we describe the data supporting the treatment of sleep disturbances in preventing and treating CVD. RECENT FINDINGS Recent guidelines recommend screening for obstructive sleep apnea in patients with atrial fibrillation. New data continues to demonstrate the importance of sleep quality and duration for CV health. There is a complex bidirectional relationship between sleep health and CVD. Sleep disturbances have systemic effects that contribute to the development of CVD, including hypertension, coronary artery disease, heart failure, and arrhythmias. Additionally, CVD contributes to the development of sleep disturbances. However, more data are needed to support the role of screening for and treatment of sleep disorders for the prevention of CVD.
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Affiliation(s)
- Vita N Jaspan
- Division of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Garred S Greenberg
- Division of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Siddhant Parihar
- Division of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Christine M Park
- Division of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Virend K Somers
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Michael D Shapiro
- Center for Preventive Cardiology, Section On Cardiovascular Medicine, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA
| | - Carl J Lavie
- Ochsner Clinical School, John Ochsner Heart and Vascular Institute, The University of Queensland School of Medicine, New Orleans, LA, USA
| | - Salim S Virani
- Office of the Vice Provost (Research), The Aga Khan University, Karachi, Pakistan
- Division of Cardiology, The Texas Heart Institute/Baylor College of Medicine, Houston, TX, USA
- Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX, USA
| | - Leandro Slipczuk
- Division of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Bronx, NY, USA.
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Lašaitė L, Radzevičienė L. Sleep quality in relation to perceived psychological stress in patients with type 2 diabetes and in age- and sex-matched control individuals. Acta Diabetol 2024; 61:781-790. [PMID: 38480555 DOI: 10.1007/s00592-024-02261-w] [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: 12/12/2023] [Accepted: 02/17/2024] [Indexed: 05/18/2024]
Abstract
AIM To assess sleep quality in relation to perceived stress in patients with type 2 diabetes (T2DM) and age- and sex-matched controls. METHODS Perceived stress level and sleep quality assessed in 154 patients with T2DM (58 men, 96 women, age 58.3 ± 11.9 years), 154 matched controls (58 men, 96 women, age 56.8 ± 12.2 years) using Perceived Stress Scale and Pittsburgh Sleep Quality Index. RESULTS Patients with T2DM had worse subjective sleep quality (p < 0.001), sleep latency (p = 0.047) than controls. Patients with high stress level had worse subjective sleep quality (p = 0.027), higher use of sleeping medication (p = 0.023), daytime dysfunction (p < 0.001) than those with low stress level. No significant differences in sleep quality between controls with high and low perceived stress level. Perceived stress level in patients with T2DM correlated with subjective sleep quality (r = 0.260, p = 0.002), sleep duration (r = 0.228, p = 0.005), use of sleep medication (r = 0.245, p = 0.004), daytime dysfunction (r = 0.326, p < 0.001), in age- and sex-matched controls-to daytime dysfunction (r = 0.191, p = 0.037). CONCLUSION Sleep quality (subjective sleep quality, sleep latency) is worse in patients with type 2 diabetes than in age- and sex-matched controls. Patients with high perceived stress level have worse subjective sleep quality, higher use of sleeping medication, daytime dysfunction than patients with low perceived stress level; no significant differences in sleep quality between controls with high and low stress level. Perceived stress level in patients with type 2 diabetes is related to subjective sleep quality, sleep duration, use of sleep medication, daytime dysfunction, in age- and sex-matched controls-to daytime dysfunction.
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Affiliation(s)
- Lina Lašaitė
- Institute of Endocrinology, Lithuanian University of Health Sciences, Eivenių 2, 50161, Kaunas, Lithuania.
| | - Lina Radzevičienė
- Institute of Endocrinology, Lithuanian University of Health Sciences, Eivenių 2, 50161, Kaunas, Lithuania
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Irwin MR, Straub RH, Smith MT. Heat of the night: sleep disturbance activates inflammatory mechanisms and induces pain in rheumatoid arthritis. Nat Rev Rheumatol 2023; 19:545-559. [PMID: 37488298 DOI: 10.1038/s41584-023-00997-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2023] [Indexed: 07/26/2023]
Abstract
Sleep has a homeostatic role in the regulation of the immune system and serves to constrain activation of inflammatory signalling and expression of cellular inflammation. In patients with rheumatoid arthritis (RA), a misaligned inflammatory profile induces a dysregulation of sleep-wake activity, which leads to excessive inflammation and the induction of increased sensitivity to pain. Given that multiple biological mechanisms contribute to sleep disturbances (such as insomnia), and that the central nervous system communicates with the innate immune system via neuroendocrine and neural effector pathways, potential exists to develop prevention opportunities to mitigate the risk of insomnia in RA. Furthermore, understanding these risk mechanisms might inform additional insomnia treatment strategies directed towards steering and reducing the magnitude of the inflammatory response, which together could influence outcomes of pain and disease activity in RA.
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Affiliation(s)
- Michael R Irwin
- Department of Psychiatry and Behavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience and Human Behaviour, Los Angeles, CA, USA.
| | - Rainer H Straub
- Laboratory of Experimental Rheumatology and Neuroendocrine Immunology, Department of Internal Medicine I, University Hospital, Regensburg, Germany
| | - Michael T Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
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Carroll JE, Olmstead R, Cole SW, Breen EC, Arevalo JM, Irwin MR. Remission of insomnia in older adults treated with cognitive behavioral therapy for insomnia (CBT-I) reduces p16 INK4a gene expression in peripheral blood: secondary outcome analysis from a randomized clinical trial. GeroScience 2023; 45:2325-2335. [PMID: 36849678 PMCID: PMC10651570 DOI: 10.1007/s11357-023-00741-5] [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: 12/06/2022] [Accepted: 01/23/2023] [Indexed: 03/01/2023] Open
Abstract
Late life insomnia may increase risk for accelerated biological aging. Intervening to treat insomnia may provide protection from biological aging by reducing the prevalence of senescent cells in the immune system, as indicated by gene expression of a marker of cellular senescence, p16INK4a. In the present study, we determine whether treatment of insomnia in older adults with cognitive behavioral therapy for insomnia (CBT-I) would reduce p16INK4a gene expression in peripheral blood mononuclear cells (PBMC), compared to a sleep education therapy (SET), an active comparator condition. Secondly, we investigate the relationship between sustained insomnia remission and reduced expression of p16INK4a. Participants 60 + years old with insomnia were enrolled in a randomized controlled trial and assigned to CBT-I or SET. Analyses of 231 older adults (CBT-I = 119; SET = 112) examine baseline, post (2 months), and 24 months gene expression of p16INK4a. Compared to baseline, expression of p16INK4a increased in the SET group over 24 months (P = 0.03), but showed no change in the CBT-I group. Those who received CBT-I and experienced sustained remission of insomnia had a significant decline in p16INK4a expression by 24 months compared to baseline (P = 0.02). Individuals not sustaining remission of insomnia exhibited overall increase expression of p16INK4a by 24 months (P = 0.03). In older adults with insomnia, p16INK4a increases over 24 months, while CBT-I treatment of insomnia mitigates the increase in p16INK4a. Further, sustained remission of insomnia using CBT-I leads to a decrease in p16INK4a. These results suggest that behavioral interventions that are effective at treating insomnia might reduce the population of senescent cells in circulating blood.
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Affiliation(s)
- Judith E Carroll
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA.
- Jane & Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, UCLA David Geffen School of Medicine, University of California, 300 UCLA Medical Plaza, Suite 3330, Los Angeles, CA, 90095, USA.
| | - Richard Olmstead
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA
- Jane & Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, UCLA David Geffen School of Medicine, University of California, 300 UCLA Medical Plaza, Suite 3330, Los Angeles, CA, 90095, USA
| | - Steve W Cole
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA
- Jane & Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, UCLA David Geffen School of Medicine, University of California, 300 UCLA Medical Plaza, Suite 3330, Los Angeles, CA, 90095, USA
| | - Elizabeth C Breen
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA
- Jane & Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, UCLA David Geffen School of Medicine, University of California, 300 UCLA Medical Plaza, Suite 3330, Los Angeles, CA, 90095, USA
| | - Jesusa M Arevalo
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA
- Jane & Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, UCLA David Geffen School of Medicine, University of California, 300 UCLA Medical Plaza, Suite 3330, Los Angeles, CA, 90095, USA
| | - Michael R Irwin
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA
- Jane & Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, UCLA David Geffen School of Medicine, University of California, 300 UCLA Medical Plaza, Suite 3330, Los Angeles, CA, 90095, USA
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Duan D, Kim LJ, Jun JC, Polotsky VY. Connecting insufficient sleep and insomnia with metabolic dysfunction. Ann N Y Acad Sci 2023; 1519:94-117. [PMID: 36373239 PMCID: PMC9839511 DOI: 10.1111/nyas.14926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The global epidemic of obesity and type 2 diabetes parallels the rampant state of sleep deprivation in our society. Epidemiological studies consistently show an association between insufficient sleep and metabolic dysfunction. Mechanistically, sleep and circadian rhythm exert considerable influences on hormones involved in appetite regulation and energy metabolism. As such, data from experimental sleep deprivation in humans demonstrate that insufficient sleep induces a positive energy balance with resultant weight gain, due to increased energy intake that far exceeds the additional energy expenditure of nocturnal wakefulness, and adversely impacts glucose metabolism. Conversely, animal models have found that sleep loss-induced energy expenditure exceeds caloric intake resulting in net weight loss. However, animal models have significant limitations, which may diminish the clinical relevance of their metabolic findings. Clinically, insomnia disorder and insomnia symptoms are associated with adverse glucose outcomes, though it remains challenging to isolate the effects of insomnia on metabolic outcomes independent of comorbidities and insufficient sleep durations. Furthermore, both pharmacological and behavioral interventions for insomnia may have direct metabolic effects. The goal of this review is to establish an updated framework for the causal links between insufficient sleep and insomnia and risks for type 2 diabetes and obesity.
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Affiliation(s)
- Daisy Duan
- Division of Endocrinology, Diabetes, and Metabolism; Department of Medicine; Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Lenise J. Kim
- Division of Pulmonary and Critical Care; Department of Medicine; Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jonathan C. Jun
- Division of Pulmonary and Critical Care; Department of Medicine; Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Vsevolod Y. Polotsky
- Division of Pulmonary and Critical Care; Department of Medicine; Johns Hopkins University School of Medicine, Baltimore, Maryland
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7
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Lo YJ, Mishra VK, Lo HY, Dubey NK, Lo WC. Clinical Spectrum and Trajectory of Innovative Therapeutic Interventions for Insomnia: A Perspective. Aging Dis 2022:AD.2022.1203. [PMID: 37163444 PMCID: PMC10389812 DOI: 10.14336/ad.2022.1203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 12/03/2022] [Indexed: 05/12/2023] Open
Abstract
Increasing incidences of insomnia in adults, as well as the aging population, have been reported for their negative impact on the quality of life. Insomnia episodes may be associated with neurocognitive, musculoskeletal, cardiovascular, gastrointestinal, renal, hepatic, and metabolic disorders. Epidemiological evidence also revealed the association of insomnia with oncologic and asthmatic complications, which has been indicated as bidirectional. Two therapeutic approaches including cognitive behavioral therapy (CBT) and drugs-based therapies are being practiced for a long time. However, the adverse events associated with drugs limit their wide and long-term application. Further, Traditional Chinese medicine, acupressure, and pulsed magnetic field therapy may also provide therapeutic relief. Notably, the recently introduced cryotherapy has been demonstrated as a potential candidate for insomnia which could reduce pain, by suppressing oxidative stress and inflammation. It seems that the synergistic therapeutic approach of cryotherapy and the above-mentioned approaches might offer promising prospects to further improve efficacy and safety. Considering these facts, this perspective presents a comprehensive summary of recent advances in pathological aetiologies of insomnia including COVID-19, and its therapeutic management with a greater emphasis on cryotherapy.
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Affiliation(s)
| | | | | | - Navneet Kumar Dubey
- Victory Biotechnology Co., Ltd., Taipei 114757, Taiwan
- ShiNeo Technology Co., Ltd., New Taipei City 24262, Taiwan
| | - Wen-Cheng Lo
- Department of Surgery, Division of Neurosurgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Department of Neurosurgery, Taipei Medical University Hospital, Taipei 11031, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, Taipei 11031, Taiwan
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8
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Bigalke JA, Shan Z, Carter JR. Orexin, Sleep, Sympathetic Neural Activity, and Cardiovascular Function. Hypertension 2022; 79:2643-2655. [PMID: 36148653 PMCID: PMC9649879 DOI: 10.1161/hypertensionaha.122.19796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Inadequate sleep duration and quality are associated with reduced cardiovascular health and increased mortality. Experimental evidence points to the sympathetic nervous system as a key mediator in the observed relationship between poor sleep and cardiovascular dysfunction. However, brain mechanisms underpinning the impaired sympathetic function associated with poor sleep remain unclear. Recent evidence suggests the central orexin system, particularly orexins A and B and their receptors, have a key regulatory role for sleep in animal and human models. While orexin system activity has been observed to significantly impact sympathetic regulation in animals, the extension of these findings to humans has been difficult due to an inability to directly assess orexin system activity in humans. However, direct measures of sympathetic activity in populations with narcolepsy and chronic insomnia, 2 sleep disorders associated with deficient and excessive orexin neural activity, have allowed indirect assessment of the relationships between orexin, sleep, and sympathetic regulation. Further, the recent pharmaceutical development of dual orexin receptor antagonists for use in clinical insomnia populations offers an unprecedented opportunity to examine the mechanistic role of orexin in sleep and cardiovascular health in humans. The current review assesses the role of orexin in both sleep and sympathetic regulation from a translational perspective, spanning animal and human studies. The review concludes with future research directions necessary to fully elucidate the mechanistic role for orexin in sleep and sympathetic regulation in humans.
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Affiliation(s)
- Jeremy A. Bigalke
- Department of Health and Human Development, Montana State University, Bozeman, Montana
- Department of Psychology, Montana State University, Bozeman, Montana
| | - Zhiying Shan
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan
| | - Jason R. Carter
- Department of Health and Human Development, Montana State University, Bozeman, Montana
- Department of Psychology, Montana State University, Bozeman, Montana
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Sivakumaran K, Ritonja JA, Palmer N, Pasumarthi T, Waseem H, Yu T, Denning A, Michaud D, Morgan RL. Effect of sleep disturbance on biomarkers related to the development of adverse health outcomes: A systematic review of the human literature. J Sleep Res 2022; 32:e13775. [PMID: 36330773 DOI: 10.1111/jsr.13775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 10/11/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Abstract
Literature suggests that unrestricted and undisturbed sleep is vital for basic human function and performance; however, it is unclear as to what amount of sleep disturbance leads to dysregulation in biomarkers, which may underscore the development of adverse health effects. This systematic review aims to identify the amount of sleep disturbance that contributes to biomarker changes as a potential precursor to the development of adverse health effects. English-language comparative studies available in PubMed, Cochrane Central, EMBASE, and CINAHL databases from 1 January 1980 to 31 July 2021 were searched. Where possible, random-effects meta-analyses were used to examine the effect of sleep disturbances on adverse health effects. The risk of bias of individual studies was assessed using the Cochrane Risk of Bias Tool and the Risk of Bias of Nonrandomised Studies - of Exposures instruments and the certainty of the body of evidence for each outcome was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. The search identified 92 primary studies reporting on blood pressure, hypertension, heart rate, cardiac arrhythmia, cardiac output, waist circumference, cortisol, adrenaline, noradrenaline, immune system markers, glucose, insulin, cholesterol, and triglyceride levels. Although some meta-analyses suggested there may be an association between sleep disturbances and certain outcomes, the certainty in the evidence was very low due to concerns with risk of bias, inconsistency across exposures, populations, and imprecision in the estimates of effects. Further research is needed to explore the point at which types, levels and duration of sleep disturbances may begin to increase the risk of developing adverse health outcomes to inform and tailor health interventions.
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Affiliation(s)
| | - Jennifer A. Ritonja
- Université de Montréal Hospital Research Centre (CRCHUM) Montreal Quebec Canada
- Department of Social and Preventive Medicine Université de Montréal Montreal Quebec Canada
| | | | - Tejanth Pasumarthi
- Evidence Foundation Cleveland Heights Ohio USA
- School of Interdisciplinary Science McMaster University Hamilton Ontario Canada
| | - Haya Waseem
- Evidence Foundation Cleveland Heights Ohio USA
| | - Tiffany Yu
- Evidence Foundation Cleveland Heights Ohio USA
- Faculty of Health Sciences McMaster University Hamilton Ontario Canada
| | - Allison Denning
- Health Canada, Environmental and Radiation Health Sciences Directorate Consumer & Clinical Radiation Protection Bureau Ottawa Ontario Canada
| | - David Michaud
- Health Canada, Environmental and Radiation Health Sciences Directorate Consumer & Clinical Radiation Protection Bureau Ottawa Ontario Canada
| | - Rebecca L. Morgan
- Evidence Foundation Cleveland Heights Ohio USA
- Department of Health Research Methods, Evidence and Impact McMaster University Hamilton Ontario Canada
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Ahmet’yanov MA, Reikhert LI, Kicherova OA, Veeva DM, Makarova DV. Sleep Disorders in Patients after COVID-19. NEUROSCIENCE AND BEHAVIORAL PHYSIOLOGY 2022; 52:645-648. [PMID: 36119651 PMCID: PMC9468523 DOI: 10.1007/s11055-022-01290-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/11/2021] [Indexed: 11/21/2022]
Abstract
Healthy sleep is required to ensure the body’s homeostatic stability, the consistency of immunological reactions, and optimum functioning of the internal organs, the nervous system, and cognitive functions. Patterns of changes to the circadian rhythms have been studied in many diseases, though infection with SARS-CoV-2 is a new reality and the basic mechanisms of functioning of the body in this pathology require deeper investigation. Despite the difficulty of analytical investigations in pandemic conditions, experience of the diagnosis of COVID-19 has now been acquired and treatment algorithms have been developed for different clinical situations; vaccines have been developed. Least studied are questions of the long-term sequelae of COVID-19. At the same time, there are good grounds for suggesting that patients need long-term rehabilitation in the post-covid period of SARS-CoV-2, for reasons including damage to the nervous system. Analysis of publications – from descriptions of clinical cases to literature reviews – allows empirical experience to be accumulated, providing the opportunity for future identification of prognostic markers for the disease for effective prevention of long-term sequelae. The results of current prospective studies draw attention to the occurrence of dyssomnia and obstructive sleep apnea not only as a common consequence of coronavirus infection, but also as a factor significantly worsening the prognosis in the acute period of illness. It has repeatedly been shown that sleep deprivation has adverse influences on the body’s resistance, including to SARS-CoV-2, and requires correction to improve prognoses in the acute and long-term periods of illness in COVID-19 patients.
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Irwin MR. Sleep disruption induces activation of inflammation and heightens risk for infectious disease: Role of impairments in thermoregulation and elevated ambient temperature. Temperature (Austin) 2022; 10:198-234. [PMID: 37332305 PMCID: PMC10274531 DOI: 10.1080/23328940.2022.2109932] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/25/2022] [Accepted: 07/30/2022] [Indexed: 10/15/2022] Open
Abstract
Thermoregulation and sleep are tightly coordinated, with evidence that impairments in thermoregulation as well as increases in ambient temperature increase the risk of sleep disturbance. As a period of rest and low demand for metabolic resources, sleep functions to support host responses to prior immunological challenges. In addition by priming the innate immune response, sleep prepares the body for injury or infection which might occur the following day. However when sleep is disrupted, this phasic organization between nocturnal sleep and the immune system becomes misaligned, cellular and genomic markers of inflammation are activated, and increases of proinflammatory cytokines shift from the nighttime to the day. Moreover, when sleep disturbance is perpetuated due to thermal factors such as elevated ambient temperature, the beneficial crosstalk between sleep and immune system becomes further imbalanced. Elevations in proinflammatory cytokines have reciprocal effects and induce sleep fragmentation with decreases in sleep efficiency, decreases in deep sleep, and increases in rapid eye movement sleep, further fomenting inflammation and inflammatory disease risk. Under these conditions, sleep disturbance has additional potent effects to decrease adaptive immune response, impair vaccine responses, and increase vulnerability to infectious disease. Behavioral interventions effectively treat insomnia and reverse systemic and cellular inflammation. Further, insomnia treatment redirects the misaligned inflammatory- and adaptive immune transcriptional profiles with the potential to mitigate risk of inflammation-related cardiovascular, neurodegenerative, and mental health diseases, as well as susceptibility to infectious disease.
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Affiliation(s)
- Michael R. Irwin
- University of California, Los Angeles – Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Los Angeles, California, USA
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12
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Sun J, Wang W, Zhang R, Duan H, Tian X, Xu C, Li X, Zhang D. Multivariate genome-wide association study of depression, cognition, and memory phenotypes and validation analysis identify 12 cross-ethnic variants. Transl Psychiatry 2022; 12:304. [PMID: 35907915 PMCID: PMC9338946 DOI: 10.1038/s41398-022-02074-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 07/15/2022] [Accepted: 07/19/2022] [Indexed: 11/10/2022] Open
Abstract
To date, little is known about the pleiotropic genetic variants among depression, cognition, and memory. The current research aimed to identify the potential pleiotropic single nucleotide polymorphisms (SNPs), genes, and pathways of the three phenotypes by conducting a multivariate genome-wide association study and an additional pleiotropy analysis among Chinese individuals and further validate the top variants in the UK Biobank (UKB). In the discovery phase, the participants were 139 pairs of dizygotic twins from the Qingdao Twins Registry. The genome-wide efficient mixed-model analysis identified 164 SNPs reaching suggestive significance (P < 1 × 10-5). Among them, rs3967317 (P = 1.21 × 10-8) exceeded the genome-wide significance level (P < 5 × 10-8) and was also demonstrated to be associated with depression and memory in pleiotropy analysis, followed by rs9863698, rs3967316, and rs9261381 (P = 7.80 × 10-8-5.68 × 10-7), which were associated with all three phenotypes. After imputation, a total of 457 SNPs reached suggestive significance. The top SNP chr6:24597173 was located in the KIAA0319 gene, which had biased expression in brain tissues. Genes and pathways related to metabolism, immunity, and neuronal systems demonstrated nominal significance (P < 0.05) in gene-based and pathway enrichment analyses. In the validation phase, 12 of the abovementioned SNPs reached the nominal significance level (P < 0.05) in the UKB. Among them, three SNPs were located in the KIAA0319 gene, and four SNPs were identified as significant expression quantitative trait loci in brain tissues. These findings may provide evidence for pleiotropic variants among depression, cognition, and memory and clues for further exploring the shared genetic pathogenesis of depression with Alzheimer's disease.
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Affiliation(s)
- Jing Sun
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, Qingdao, Shandong Province, China
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Weijing Wang
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, Qingdao, Shandong Province, China
| | - Ronghui Zhang
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, Qingdao, Shandong Province, China
| | - Haiping Duan
- Qingdao Municipal Center for Disease Control and Prevention, No. 175 Shandong Road, Shibei District, Qingdao, Shandong Province, China
| | - Xiaocao Tian
- Qingdao Municipal Center for Disease Control and Prevention, No. 175 Shandong Road, Shibei District, Qingdao, Shandong Province, China
| | - Chunsheng Xu
- Qingdao Municipal Center for Disease Control and Prevention, No. 175 Shandong Road, Shibei District, Qingdao, Shandong Province, China
| | - Xue Li
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, Qingdao, Shandong Province, China.
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13
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Ribeiro A, Gabriel R, Garcia B, Cuccio C, Aqeel W, Moreno A, Landeen C, Hurley A, Kavey N, Pfaff D. Temporal relations between peripheral and central arousals in good and poor sleepers. Proc Natl Acad Sci U S A 2022; 119:e2201143119. [PMID: 35696573 PMCID: PMC9231500 DOI: 10.1073/pnas.2201143119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/12/2022] [Indexed: 12/15/2022] Open
Abstract
Good sleepers and patients with insomnia symptoms (poor sleepers) were tracked with two measures of arousal; conventional polysomnography (PSG) for electroencephalogram (EEG) assessed cortical arousals, and a peripheral arterial tonometry device was used for the detection of peripheral nervous system (PNS) arousals associated with vasoconstrictions. The relationship between central (cortical) and peripheral (autonomic) arousals was examined by evaluating their close temporal dynamics. Cortical arousals almost invariably were preceded and followed by peripheral activations, while large peripheral autonomic arousals were followed by cortical arousals only half of the time. The temporal contiguity of these two types of arousals was altered in poor sleepers, and poor sleepers displayed a higher number of cortical and peripheral arousals compared with good sleepers. Given the difference in the number of peripheral autonomic arousals between good and poor sleepers, an evaluation of such arousals could become a means of physiologically distinguishing poor sleepers.
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Affiliation(s)
- Ana Ribeiro
- Laboratory of Neurobiology and Behavior, The Rockefeller University, New York, NY 10065
- Division of Natural Sciences, College of Mount Saint Vincent, New York, NY 10471
| | - Rachel Gabriel
- Division of Natural Sciences, College of Mount Saint Vincent, New York, NY 10471
| | - Bernardo Garcia
- Division of Natural Sciences, College of Mount Saint Vincent, New York, NY 10471
| | - Casey Cuccio
- Division of Natural Sciences, College of Mount Saint Vincent, New York, NY 10471
| | - William Aqeel
- Division of Natural Sciences, College of Mount Saint Vincent, New York, NY 10471
| | - Alejandro Moreno
- Division of Natural Sciences, College of Mount Saint Vincent, New York, NY 10471
| | - Colby Landeen
- Division of Natural Sciences, College of Mount Saint Vincent, New York, NY 10471
| | - Arlene Hurley
- Laboratory of Neurobiology and Behavior, The Rockefeller University, New York, NY 10065
| | - Neil Kavey
- Laboratory of Neurobiology and Behavior, The Rockefeller University, New York, NY 10065
- Department of Psychiatry, Columbia University, New York, NY 10032
| | - Donald Pfaff
- Laboratory of Neurobiology and Behavior, The Rockefeller University, New York, NY 10065
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Spaggiari G, Romeo M, Casarini L, Granata ARM, Simoni M, Santi D. Human fertility and sleep disturbances: A narrative review. Sleep Med 2022; 98:13-25. [PMID: 35772248 DOI: 10.1016/j.sleep.2022.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 06/06/2022] [Accepted: 06/10/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Many factors may be hidden behind the global fertility decline observed in Western countries. Alongside the progressively increased age of infertile couples, environmental and behavioural factors, including non-optimal lifestyle habits, should be considered. Among these, sleep disorders have been suggested to be linked to human fertility. METHODS This is a narrative review, describing first sleep physiology, its disturbances, and the tools able to quantify sleep dysfunction. Then, we consider all available studies aimed at investigating the connection between sleep disorders and human fertility, providing a comprehensive view on this topic. RESULTS Forty-two studies investigating the relationship between sleep habits and human reproduction were included. All the published evidence was grouped according to the aspect of human fertility considered, i.e. i) female reproductive functions, ii) male reproductive functions, iii) natural conception and iv) assisted reproduction. For each of the sub-groups considered, the connection between sleep dysregulation and human fertility was classified according to specific sleep characteristics, such as sleep duration, quality, and habits. In addition, possible physio-pathological mechanisms proposed to support the link between sleep and fertility were summarized. CONCLUSION This review summarizes the most relevant findings about the intricate and still largely unknown network of molecular pathways involved in the regulation of circadian homeostasis, to which sleep contributes, essential for reproductive physiology. Thus, many mechanisms seem correlate sleep disorders to reproductive health, such as adrenal activation, circadian dysregulation, and genetic influences. This review highlights the need to properly designed trials on the topic.
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Affiliation(s)
- Giorgia Spaggiari
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy
| | - Marilina Romeo
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Livio Casarini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Antonio R M Granata
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy
| | - Manuela Simoni
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Daniele Santi
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
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15
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Matsumoto K, Izawa S, Fukaya K, Matsuda E, Fujiyama M, Matsuzawa K, Okura T, Kato M, Taniguchi SI, Yamamoto K. Hyperthyroidism in Graves Disease Causes Sleep Disorders Related to Sympathetic Hypertonia. J Clin Endocrinol Metab 2022; 107:e1938-e1945. [PMID: 35022743 DOI: 10.1210/clinem/dgac013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT It is well known that Graves disease (GD) causes sleep disorders (SDs). However, the characteristics and associated factors of SD and its clinical course post hyperthyroidism normalization remain unclear. OBJECTIVE To clarify the characteristics and associated factors of subjective SD and its clinical course after GD treatment. METHODS From November 2017 to October 2020, we enrolled 72 participants (22 newly diagnosed with GD with untreated hyperthyroidism, 20 previously diagnosed with GD with normal thyroid function, and 30 normal controls) with no other underlying SD-related diseases. We compared the groups at enrollment and conducted prospective observations after 12 months of treatment on participants with newly diagnosed GD. Main outcome measures were differences and changes in the Pittsburgh Sleep Quality Index (PSQI) global and component sleep quality scores. RESULTS PSQI global sleep quality scores (P = .036) and sleep disturbance scores (P = .011) were significantly different among the 3 groups, and were highest in the untreated hyperthyroidism group. Multiple regression analysis demonstrated that free thyroxine level, which was positively correlated with sympathetic tone (ST) as evaluated by pulse rate, and urinary total metanephrines was associated with poorer PSQI global sleep quality scores independently of other factors (P = .006). Prospective observation showed that PSQI global sleep quality scores (P = .018) and sleep disturbance scores (P = .011) significantly improved with thyroid function normalization and ST attenuation. CONCLUSION Hyperthyroidism caused by GD augmented ST and exacerbated subjective SD. Normalization of hyperthyroidism caused by GD improved subjective SD.
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Affiliation(s)
- Kazuhisa Matsumoto
- Division of Endocrinology and Metabolism, Tottori University Faculty of Medicine, Yonago, Japan
| | - Shoichiro Izawa
- Division of Endocrinology and Metabolism, Tottori University Faculty of Medicine, Yonago, Japan
| | - Kenji Fukaya
- Division of Endocrinology and Metabolism, Tottori University Faculty of Medicine, Yonago, Japan
| | - Eriko Matsuda
- Division of Otolaryngology, Head and Neck Surgery, Tottori University Faculty of Medicine, Yonago, Japan
| | - Misato Fujiyama
- Division of Otolaryngology, Head and Neck Surgery, Tottori University Faculty of Medicine, Yonago, Japan
| | - Kazuhiko Matsuzawa
- Division of Endocrinology and Metabolism, Tottori University Faculty of Medicine, Yonago, Japan
| | - Tsuyoshi Okura
- Division of Endocrinology and Metabolism, Tottori University Faculty of Medicine, Yonago, Japan
| | - Masahiko Kato
- Division of Pathobiological Science and Technology, Tottori University Faculty of Medicine, Yonago, Japan
| | - Shin-Ichi Taniguchi
- Department of Regional Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Kazuhiro Yamamoto
- Division of Endocrinology and Metabolism, Tottori University Faculty of Medicine, Yonago, Japan
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Chen J, Li Y, Xia N, Wen C, Xia T, Zhuang Y, Jiang M, Xiang Y, Zhang M, Zhan C, Yang Y, Yuan Z, Huang Q. White matter alterations in heart-kidney imbalance insomnia and Jiao-Tai-Wan treatment: A diffusion-tensor imaging study. Brain Imaging Behav 2022; 16:1803-1812. [PMID: 35338430 PMCID: PMC9279240 DOI: 10.1007/s11682-022-00653-6] [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] [Accepted: 02/21/2022] [Indexed: 11/27/2022]
Abstract
Previous studies have reported changes in white matter microstructures in patients with insomnia. However, few neuroimaging studies have focused specifically on white matter tracts in insomnia patients after having received treatment. In this prospective study, diffusion-tensor imaging was used in two samples of heart-kidney imbalance insomnia patients who were treated with placebo or Jiao-Tai-Wan, a traditional Chinese medicine commonly used to treat heart-kidney imbalance insomnia, to assess the changes in white matter tracts. Tract-based spatial statistical analyses were first applied to compare the changes in mean diffusivity and fractional anisotropy of white matter between 75 heart-kidney imbalance insomnia patients and 41 healthy control participants. In subsequent randomized, double-blind, placebo-controlled trials, comparisons of mean diffusivity and fractional anisotropy were also performed in 24 heart-kidney imbalance insomnia patients (8 males; 16 females; 42.5 ± 10.4 years) with Jiao-Tai-Wan and 26 heart-kidney imbalance insomnia patients (11 males; 15 females; 39.7 ± 9.4 years) with a placebo, with age and sex as covariates. Fractional anisotropy values in left corticospinal tract were increased in heart-kidney imbalance insomnia patients. Heart-kidney imbalance insomnia patients showed lower mean diffusivity and fractional anisotropy values of several white matter tracts than healthy control participants, such as the bilateral anterior limb of internal capsule, bilateral superior longitudinal fasciculus and bilateral posterior corona radiata. After being treated with Jiao-Tai-Wan, heart-kidney imbalance insomnia patients showed a trend towards reduced fractional anisotropy values in the left corticospinal tract. Jiao-Tai-Wan may improve the sleep quality by reversing the structural changes of the left corticospinal tract caused by heart-kidney imbalance insomnia.
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Affiliation(s)
- Jie Chen
- Department of Radiology, Wenzhou Central Hospital, Wenzhou, 325000, China.,Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Yanxuan Li
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Nengzhi Xia
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Caiyun Wen
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Tianyi Xia
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Yuandi Zhuang
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Mengmeng Jiang
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Yilan Xiang
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Mingyue Zhang
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Chenyi Zhan
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Yunjun Yang
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Zhengzhong Yuan
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
| | - Qun Huang
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
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17
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Wang Y, Han Z, Wang Y, Yan Y, Pan Z, Zhu H, Li H, Tao C, Liu P, Wang Y, Tang C, Jin H, Du J. Risk factors of sitting-induced tachycardia syndrome in children and adolescents. PLoS One 2022; 17:e0265364. [PMID: 35303039 PMCID: PMC8932569 DOI: 10.1371/journal.pone.0265364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 03/01/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The study was designed to explore the risk factors for sitting-induced tachycardia syndrome (STS) in children and adolescents. METHODS AND RESULTS In this case-control study, 46 children with STS and 184 healthy children and adolescents were recruited. Demographic characteristics, lifestyle habits, allergy history, and family history were investigated using a questionnaire. The changes in heart rate and blood pressure from supine to sitting were monitored using a sitting test. The possible differences between STS patients and healthy children were analyzed using univariate analysis. Logistic regression analysis was used to explore the independent risk factors for STS. Univariate analysis showed that the daily sleeping time of the STS children were significantly shorter than that of the control group [(8.8 ± 1.2) hours/day vs. (9.3 ± 1.0) hours/day, P = 0.009], and the proportion of positive family history of syncope in the STS patients was higher than the controls (4/42 vs. 3/181, P = 0.044). Multivariate logistic regression studies showed that reduced daily sleeping time was an independent risk factor of STS in children (P = 0.006). Furthermore, when daily sleeping time was prolonged by 1 h, the risk of STS was decreased by 37.3%. CONCLUSION Reduced daily sleeping was an independent risk factor for STS in children and adolescents.
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Affiliation(s)
- Yuanyuan Wang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Zhenhui Han
- Department of Cardiology, Children’s Hospital of Kaifeng, Henan, China
| | - Yaru Wang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Yongqiang Yan
- Department of Cardiology, Children’s Hospital of Kaifeng, Henan, China
| | - Zhitao Pan
- Department of Cardiology, Children’s Hospital of Kaifeng, Henan, China
| | - Hanwen Zhu
- Department of Pediatric Surgery, Children’s Hospital of Kaifeng, Henan, China
| | - Hongxia Li
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Chunyan Tao
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Ping Liu
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Yuli Wang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Chaoshu Tang
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China
- Department of Physiology and Pathophysiology, Health Science Centre, Peking University, Beijing, China
| | - Hongfang Jin
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Junbao Du
- Department of Pediatrics, Peking University First Hospital, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China
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Abstract
The COVID-19 pandemic affected sleep in several people. Though most of the studies argued that age, gender, employment, finances, responsibilities, and exposure to sunlight governed sleep-wake schedule and sleep disturbances, there is also scientific evidence to suggest that these issues could have aroused because of the infiltration of the central nervous system (CNS) by SARS-CoV-2. Sleep disturbances must be addressed during the pandemic as sleep disturbances and systemic inflammation run in a vicious cycle; quality of sleep and timing of vaccination can influence the immune response to vaccination and subjects having obstructive sleep apnea (OSA) are at higher risk for having SARS-CoV-2 infection-related complications.
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Affiliation(s)
- Niraj Kumar
- Department of Neurology, Division of Sleep Medicine, All India Institute of Medical Sciences, Rishikesh 249203, India
| | - Ravi Gupta
- Department of Psychiatry, Division of Sleep Medicine, All India Institute of Medical Sciences, Rishikesh 249203, India.
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19
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Chen JT, Zhang P, Kong XY, Ge YJ, Li XY, Yang S, He S, Chen GH. Changed Serum Levels of CD62E+, Angiotensin II and Copeptin in Patients with Chronic Insomnia Disorder: A Link Between Insomnia and Stroke? Sleep Med 2022; 91:96-104. [DOI: 10.1016/j.sleep.2022.02.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/15/2022] [Accepted: 02/19/2022] [Indexed: 12/16/2022]
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20
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Mignot E, Mayleben D, Fietze I, Leger D, Zammit G, Bassetti CLA, Pain S, Kinter DS, Roth T. Safety and efficacy of daridorexant in patients with insomnia disorder: results from two multicentre, randomised, double-blind, placebo-controlled, phase 3 trials. Lancet Neurol 2022; 21:125-139. [DOI: 10.1016/s1474-4422(21)00436-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/11/2021] [Accepted: 11/25/2021] [Indexed: 12/12/2022]
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21
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Greenlund IM, Carter JR. Sympathetic neural responses to sleep disorders and insufficiencies. Am J Physiol Heart Circ Physiol 2022; 322:H337-H349. [PMID: 34995163 PMCID: PMC8836729 DOI: 10.1152/ajpheart.00590.2021] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Short sleep duration and poor sleep quality are associated with cardiovascular risk, and sympathetic nervous system (SNS) dysfunction appears to be a key contributor. The present review will characterize sympathetic function across several sleep disorders and insufficiencies in humans, including sleep deprivation, insomnia, narcolepsy, and obstructive sleep apnea (OSA). We will focus on direct assessments of sympathetic activation, e.g., plasma norepinephrine and muscle sympathetic nerve activity, but include heart rate variability (HRV) when direct assessments are lacking. The review also highlights sex as a key biological variable. Experimental models of total sleep deprivation and sleep restriction are converging to support several epidemiological studies reporting an association between short sleep duration and hypertension, especially in women. A systemic increase of SNS activity via plasma norepinephrine is present with insomnia and has also been confirmed with direct, regionally specific evidence from microneurographic studies. Narcolepsy is characterized by autonomic dysfunction via both HRV and microneurographic studies but with opposing conclusions regarding SNS activation. Robust sympathoexcitation is well documented in OSA and is related to baroreflex and chemoreflex dysfunction. Treatment of OSA with continuous positive airway pressure results in sympathoinhibition. In summary, sleep disorders and insufficiencies are often characterized by sympathoexcitation and/or sympathetic/baroreflex dysfunction, with several studies suggesting women may be at heightened risk.
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Affiliation(s)
- Ian M. Greenlund
- 1Department of Health and Human Development, Montana State University, Bozeman, Montana,2Department of Psychology, Montana State University, Bozeman, Montana
| | - Jason R. Carter
- 1Department of Health and Human Development, Montana State University, Bozeman, Montana,2Department of Psychology, Montana State University, Bozeman, Montana
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22
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Um YH, Wang SM, Kang DW, Kim NY, Lim HK. Alterations of Resting-State Locus Coeruleus Functional Connectivity After Transdermal Trigeminal Electrical Neuromodulation in Insomnia. Front Psychiatry 2022; 13:875227. [PMID: 35619611 PMCID: PMC9127056 DOI: 10.3389/fpsyt.2022.875227] [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: 02/14/2022] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Transdermal trigeminal electrical neuromodulation (TTEN) is a novel treatment modality that is known for noradrenergic modulation through the trigeminal nerve and locus coeruleus (LC). This study aimed to demonstrate the alterations of LC functional connectivity (FC) in patients with insomnia after a 4-week TTEN. METHODS The Cefaly device targeting the ophthalmic division of the trigeminal nerve was applied to a total of 12 patients with insomnia to monitor for the effects of TTEN. All the patients went through a 4-week daily 20 min TTEN sessions before bedtime. Baseline and post-TTEN demographic data, polysomnography (PSG) parameters, and insomnia severity index (ISI) were attained. Data from pre- and post-intervention resting-state functional magnetic resonance imaging (MRI) were collected. LC FC differences were measured between the pre-and post-TTEN groups through seed-to-voxel analysis. Correlation analyses were conducted between LC FC changes after TTEN, ISI score changes, and PSG parameter changes. RESULTS There was a significantly decreased LC FC with occipital and temporal cortices after a 4-week TTEN. However, there was no significant correlation between LC FC, ISI score changes, and PSG parameter changes. CONCLUSION By targeting hyperarousal symptoms of insomnia, TTEN can be a promising intervention that can modulate LC FC in patients with insomnia patients. The data presented in the study are from a study exploring the effect of TTEN on insomnia (www.clinicaltrials.gov, NCT04838067).
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Affiliation(s)
- Yoo Hyun Um
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Nak-Young Kim
- Department of Psychiatry, Keyo Hospital, Keyo Medical Foundation, Uiwang, South Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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23
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Peng L, Jing J, Ma J, He S, Gao X, Wang T. Insomnia and sleep duration on COVID-19 susceptibility and hospitalization: A Mendelian randomization study. Front Public Health 2022; 10:995664. [PMID: 36249224 PMCID: PMC9561394 DOI: 10.3389/fpubh.2022.995664] [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: 07/16/2022] [Accepted: 09/07/2022] [Indexed: 01/26/2023] Open
Abstract
Background Sleep disturbance including insomnia and sleep duration is associated with an increased risk of infectious. With the ongoing coronavirus disease 2019 (COVID-19) pandemic, it is important to explore potential causal associations of sleep disturbance on COVID-19 susceptibility and hospitalization. Method Insomnia and sleep duration were selected as exposure. Outcomes included susceptibility and hospitalization for COVID-19. Two sample mendelian randomization design was used to assess causality between sleep and COVID-19. Inverse variance weighted method was used as main analysis method to combine the ratio estimates for each instrumental variable to obtain the causal effect. Cochran's Q statistic was used to test for global heterogeneity. MR-Egger and weighting median estimator (WME) were used as sensitivity analysis to ensure the stability and reliability of the results. MR-Egger intercept term was used to test the mean pleiotropy. In addition, the direct effects of insomnia and sleep duration on COVID-19 susceptibility and hospitalization were estimated using multivariable mendelian randomization (MVMR). Results Univariate MR provided no evidence of a causal associations of insomnia on COVID-19 susceptibility (OR = 1.10, 95% CI:0.95, 1.27; p = 0.21) and hospitalization (OR = 0.61, 95% CI:0.40, 0.92; p = 0.02); as does sleep duration (ORCOIVD - 19susceptibility = 0.93, 95% CI:0.86, 1.01; p = 0.07; ORCOIVD - 19 hospitalization = 1.21, 95% CI: 0.99, 1.47; p = 0.08). MVMR results showed that insomnia may be a risk factor for increased susceptibility to COVID-19 (OR = 1.65, 95% CI: 1.34, 2.05; p <0.001); and sleep duration was also associated with increased COVID-19 susceptibility (OR = 1.31, 95% CI: 1.18, 1.46; p < 0.001). Conclusion Insomnia and extreme sleep duration may risk factors for increased COVID-19 susceptibility. Relieving insomnia and maintaining normal sleep duration may be powerful measures to reduce COVID-19 infections.
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Affiliation(s)
- Liuqing Peng
- Department of Health Statistics and Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Jiarui Jing
- Department of Health Statistics and Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Jun Ma
- Department of Health Statistics and Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Simin He
- Department of Health Statistics and Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Xue Gao
- Department of Health Statistics and Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Tong Wang
- Department of Health Statistics and Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
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24
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Sigurdardottir FD, Lyngbakken MN, Hveem K, Strøm HH, Røsjø H, Redline S, Omland T. Insomnia symptoms and subclinical myocardial injury: Data from the Nord-Trøndelag Health (HUNT) study. J Sleep Res 2021; 30:e13299. [PMID: 33629480 PMCID: PMC8382789 DOI: 10.1111/jsr.13299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/10/2021] [Accepted: 01/15/2021] [Indexed: 11/29/2022]
Abstract
Insomnia symptoms are associated with increased risk of heart failure (HF) and cardiovascular (CV) mortality. We hypothesised that insomnia symptoms are cross-sectionally associated with increased cardiac troponin I (cTnI), a biomarker of subclinical myocardial injury, and that phenotyping by insomnia symptoms and cTnI enhances longitudinal risk stratification in the general population. In a population-based study, cTnI was measured in 8,398 participants (median age 49 years, 55% women), who had answered questionnaires regarding insomnia symptoms. Association between cTnI and insomnia symptoms was assessed by linear regression analysis for each response category of a sleep questionnaire. Insomnia symptoms were defined as having difficulty falling asleep almost every night, difficulty maintaining sleep almost every night, and/or non-restorative sleep once a week or more. The primary outcome measure was a composite endpoint of CV mortality or first admission for HF. In all, 844 participants reported insomnia symptoms, 585 (69%) were women. Those with insomnia symptoms had marginally, but significantly higher median cTnI than those without insomnia symptoms, (median [interquartile range] 3.4 [2.4-5.2] ng/L versus 3.2 [2.2-4.9] ng/L; p = .014), but there was no association between any insomnia symptom and cTnI in unadjusted linear regression models (β 0.06, 95% confidence interval [CI] -0.01 to 0.12). In adjusted analyses, participants with insomnia symptoms and increased cTnI were at increased risk of the composite endpoint (hazard ratio 1.71, 95% CI 1.04-2.79) compared to participants with insomnia symptoms and low cTnI. In the general population, insomnia symptoms are not associated with biochemical evidence of subclinical myocardial injury.
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Affiliation(s)
- Fjola D. Sigurdardottir
- Department of Cardiology, Akershus University Hospital, Lørenskog, Norway
- Cardiovascular Research Group, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Magnus N. Lyngbakken
- Department of Cardiology, Akershus University Hospital, Lørenskog, Norway
- Cardiovascular Research Group, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kristian Hveem
- HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Levanger, Norway
| | - Harald Hrubos Strøm
- Division of Surgery, department of Ear, Nose and Throat, Akershus University Hospital, Lørenskog, Norway
- University of Oslo, Medical faculty, Institute of basic medical sciences, department of behavioural sciences
| | - Helge Røsjø
- Cardiovascular Research Group, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Research and Innovation, Akershus University Hospital, Lørenskog, Norway
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Torbjørn Omland
- Department of Cardiology, Akershus University Hospital, Lørenskog, Norway
- Cardiovascular Research Group, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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25
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Grimaldi D, Reid KJ, Papalambros NA, Braun RI, Malkani RG, Abbott SM, Ong JC, Zee PC. Autonomic dysregulation and sleep homeostasis in insomnia. Sleep 2021; 44:6029088. [PMID: 33295989 DOI: 10.1093/sleep/zsaa274] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 11/24/2020] [Indexed: 11/12/2022] Open
Abstract
STUDY OBJECTIVES Insomnia is common in older adults, and is associated with poor health, including cognitive impairment and cardio-metabolic disease. Although the mechanisms linking insomnia with these comorbidities remain unclear, age-related changes in sleep and autonomic nervous system (ANS) regulation might represent a shared mechanistic pathway. In this study, we assessed the relationship between ANS activity with indices of objective and subjective sleep quality in older adults with insomnia. METHODS Forty-three adults with chronic insomnia and 16 age-matched healthy sleeper controls were studied. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), objective sleep quality by electroencephalogram spectral components derived from polysomnography, and ANS activity by measuring 24-h plasma cortisol and norepinephrine (NE). RESULTS Sleep cycle analysis displayed lower slow oscillatory (SO: 0.5-1.25 Hz) activity in the first cycle in insomnia compared to controls. In insomnia, 24-h cortisol levels were higher and 24-h NE levels were lower than controls. In controls, but not in insomnia, there was a significant interaction between NE level during wake and SO activity levels across the sleep cycles, such that in controls but not in insomnia, NE level during wake was positively associated with the amount of SO activity in the first cycle. In insomnia, lower 24-h NE level and SO activity in the first sleep cycle were associated with poorer subjective sleep quality. CONCLUSION Dysregulation of autonomic activity may be an underlying mechanism that links objective and subjective measures of sleep quality in older adults with insomnia, and potentially contribute to adverse health outcomes.
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Affiliation(s)
- Daniela Grimaldi
- Center for Circadian and Sleep Medicine, Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Kathryn J Reid
- Center for Circadian and Sleep Medicine, Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Nelly A Papalambros
- Center for Circadian and Sleep Medicine, Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Rosemary I Braun
- Biostatistics Division, Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.,Department of Engineering Sciences and Applied Mathematics, Northwestern University, Evanston, IL, USA.,Department of Physics and Astronomy, Northwestern University, Evanston, IL, USA
| | - Roneil G Malkani
- Center for Circadian and Sleep Medicine, Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Sabra M Abbott
- Center for Circadian and Sleep Medicine, Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Jason C Ong
- Center for Circadian and Sleep Medicine, Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Phyllis C Zee
- Center for Circadian and Sleep Medicine, Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
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26
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Wang Y, Jiang P, Tang S, Lu L, Bu X, Zhang L, Gao Y, Li H, Hu X, Wang S, Jia Z, Roberts N, Huang X, Gong Q. Left superior temporal sulcus morphometry mediates the impact of anxiety and depressive symptoms on sleep quality in healthy adults. Soc Cogn Affect Neurosci 2021; 16:492-501. [PMID: 33512508 PMCID: PMC8095089 DOI: 10.1093/scan/nsab012] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 12/21/2020] [Accepted: 01/29/2021] [Indexed: 02/05/2023] Open
Abstract
Anxiety and depressive symptoms may predispose individuals to sleep disturbance. Understanding how these emotional symptoms affect sleep quality, especially the underlying neural basis, could support the development of effective treatment. The aims of the present study were therefore to investigate potential changes in brain morphometry associated with poor sleep quality and whether this structure played a mediating role between the emotional symptoms and sleep quality. One hundred and forty-one healthy adults (69 women, mean age = 26.06 years, SD = 6.36 years) were recruited. A structural magnetic resonance imaging investigation was performed, and self-reported measures of anxiety, depressive symptoms and sleep quality were obtained for each participant. Whole-brain regression analysis revealed that worse sleep quality was associated with thinner cortex in left superior temporal sulcus (STS). Furthermore, the thickness of left STS mediated the association between the emotional symptoms and sleep quality. A subsequent commonality analysis showed that physiological component of the depressive symptoms had the greatest influence on sleep quality. In conclusion, thinner cortex in left STS may represent a neural substrate for the association between anxiety and depressive symptoms and poor sleep quality and may thus serve as a potential target for neuromodulatory treatment of sleep problems.
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Affiliation(s)
- Yanlin Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Ping Jiang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Shi Tang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Lu Lu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Xuan Bu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Lianqing Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Yingxue Gao
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Hailong Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Xinyu Hu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Song Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Zhiyun Jia
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Neil Roberts
- School of Clinical Sciences, The Queen’s Medical Research Institute (QMRI), University of Edinburgh, Edinburgh EH164TJ, UK
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan 610041, China
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Chengdu, Sichuan 610041, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan 610041, China
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Chengdu, Sichuan 610041, China
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27
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Associations between fecal short-chain fatty acids and sleep continuity in older adults with insomnia symptoms. Sci Rep 2021; 11:4052. [PMID: 33603001 PMCID: PMC7893161 DOI: 10.1038/s41598-021-83389-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 02/02/2021] [Indexed: 12/18/2022] Open
Abstract
Insomnia is a disorder characterized by difficulty falling asleep and poor sleep continuity and is associated with increased risks for physical and cognitive decline. Insomnia with short sleep duration is considered the most biologically severe phenotype of the disorder. Evidence suggests that short-chain fatty acids (SCFAs), the main byproducts of fiber fermentation in the gut, may affect sleep via gut–brain communications. This study explores associations between SCFAs and sleep continuity and compares SCFA concentrations in short vs. normal sleep insomnia phenotypes in older adults. Fifty-nine participants with insomnia symptoms (≥ 65 years), completed 2 weeks of objective sleep monitoring (actigraphy), and were divided into short and normal sleep duration phenotypes via cluster analysis. Sleep measures included total sleep time (TST), sleep onset latency (SOL), sleep efficiency (SE), and wake after sleep onset (WASO). Stool samples were collected and fecal SCFA concentrations were determined by gas-chromatography-mass-spectrometry (GCMS). Higher concentrations of acetate, butyrate, and propionate, and total SCFAs, were associated with lower SE and longer SOL after controlling for Body Mass Index (BMI). Concentrations were higher in the short sleep duration phenotype. Age, BMI, TST, and SOL explained 40.7% of the variance in total SCFAs. Findings contribute to understanding pathways along the gut–brain axis and may lead to the use of SCFAs as biomarkers of insomnia phenotypes.
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28
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Motomura Y, Katsunuma R, Ayabe N, Oba K, Terasawa Y, Kitamura S, Moriguchi Y, Hida A, Kamei Y, Mishima K. Decreased activity in the reward network of chronic insomnia patients. Sci Rep 2021; 11:3600. [PMID: 33574355 PMCID: PMC7878866 DOI: 10.1038/s41598-020-79989-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 12/04/2020] [Indexed: 12/03/2022] Open
Abstract
In modern society, many people have insomnia. Chronic insomnia has been noted as a risk factor for depression. However, there are few functional imaging studies of the brain on affective functions in chronic insomnia. This study aimed to investigate brain activities induced by emotional stimuli in chronic insomnia patients. Fifteen patients with primary insomnia and 30 age and gender matched healthy controls participated in this study. Both groups were presented images of fearful, happy, and neutral expressions consciously and non-consciously while undergoing MRI to compare the activity in regions of the brain responsible for emotions. Conscious presentation of the Happy-Neutral contrast showed significantly lower activation in the right orbitofrontal cortex of patients compared to healthy controls. The Happy-Neutral contrast presented in a non-conscious manner resulted in significantly lower activation of the ventral striatum, right insula, putamen, orbitofrontal cortex and ventral tegmental area in patients compared to healthy controls. Our findings revealed that responsiveness to positive emotional stimuli were decreased in insomniac patients. Specifically, brain networks associated with rewards and processing positive emotions showed decreased responsiveness to happy emotions especially for non-conscious image. The magnitude of activity in these areas also correlated with severity of insomnia, even after controlling for depression scale scores. These findings suggest that insomnia induces an affective functional disorder through an underlying mechanism of decreased sensitivity in the regions of the brain responsible for emotions and rewards to positive emotional stimuli.
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Affiliation(s)
- Yuki Motomura
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan. .,Faculty of Design, Kyushu University, 4-9-1 Shiobaru, Minami-ku, Fukuoka, 815-8540, Japan. .,Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan.
| | - Ruri Katsunuma
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
| | - Naoko Ayabe
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan.,Department of Regional Studies and Humanities, Faculty of Education and Human Studies, Akita University, 1-1, Tegata-Gakuenmachi, Akita, 010-8502, Japan
| | - Kentaro Oba
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan.,Department of Human Brain Science, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan
| | - Yuri Terasawa
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan.,Department of Psychology, Keio University, 4-1-1 Hiyoshi, Kohoku-ku, Yokohama, Kanagawa, 223-8521, Japan
| | - Shingo Kitamura
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
| | - Yoshiya Moriguchi
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan.,Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
| | - Akiko Hida
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
| | - Yuichi Kamei
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan.,Kamisuwa Hospital, 1-17-7 Ote, Suwa, Nagano, Japan
| | - Kazuo Mishima
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan. .,Faculty of Medicine, Akita University, 1-1-1 Hondo, Akita, 010-8543, Japan. .,International Institute for Integrative Sleep Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan.
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29
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Akıncı T, Melek Başar H. Relationship between sleep quality and the psychological status of patients hospitalised with COVID-19. Sleep Med 2021; 80:167-170. [PMID: 33601228 PMCID: PMC7842153 DOI: 10.1016/j.sleep.2021.01.034] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 01/14/2021] [Accepted: 01/24/2021] [Indexed: 01/07/2023]
Abstract
Aim We explored the sleep quality of patients who required mental health and clinical interventions in our hospital after being diagnosed with COVID-19. Method We enrolled 189 patients hospitalised with COVID-19 in April and May of 2020, of whom 78 were female and 111 male. We evaluated sleep quality and related factors in terms of demographic characteristics, the duration of hospitalisation, and Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety-Depression Scale scores. Results All participants were divided into two groups according to PSQI score: n = 102 (54%) patients with PSQI scores ≥5 and n = 87 (46%) patients with PSQI scores <5. No significant between-group difference was evident in terms of age, gender, marital status, educational level, or chronic disease history. The duration of hospitalisation (p = 0.002) and the depression rate (p = 0.010) were higher in the group exhibiting poor sleep quality (PSQI score ≥5). Conclusion The duration of hospitalisation was longer in patients experiencing poor sleep quality. Therefore, improvement in sleep quality will reduce the length of hospital and intensive care unit stays.
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Affiliation(s)
- Tuba Akıncı
- Department of Neurology, Beylikduzu State Hospital, Istanbul, Turkey.
| | - H Melek Başar
- Department of Psychiatry, Beylikduzu State Hospital, Istanbul, Turkey.
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30
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Ahmet’yanov M, Reikhert L, Kicherova O, Deeva M, Makarova D. Sleep Disorders in Patients After COVID-19. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:119-122. [DOI: 10.17116/jnevro2021121121119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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31
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Gao X, Sun H, Zhang Y, Liu L, Wang J, Wang T. Investigating Causal Relations Between Sleep-Related Traits and Risk of Type 2 Diabetes Mellitus: A Mendelian Randomization Study. Front Genet 2020; 11:607865. [PMID: 33384720 PMCID: PMC7770175 DOI: 10.3389/fgene.2020.607865] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 11/24/2020] [Indexed: 12/13/2022] Open
Abstract
Objective Extensive literature put forward the link between sleep and type 2 diabetes mellitus (T2DM), however, little is known about the underlying causality of the associations. Here we aim to assess the causal relationships between five major sleep-related traits and T2DM. Design, Setting, and Participants Two-sample Mendelian randomization (MR) was utilized to investigate the potential causal relations. Independent genetic variants associated with five sleep-related phenotypes—insomnia, sleep duration, short sleep duration, long sleep duration, and morningness—were chosen as instrumental variables to estimate the causal associations with T2DM. Summary statistics were acquired from the genome-wide association studies of UK Biobank and 23andMe (for sleep-related measures), the DIAbetes Genetics Replication And Meta-analysis and the FinnGen (for T2DM). Main Methods Individual Cochran’s Q statistic was applied to remove the pleiotropic instruments, global Q statistics and MR-Egger regression were adopted to test for the global heterogeneity and horizontal pleiotropy of the screened instruments, respectively. Two T2DM cohorts were selected to analyze their associations with sleep traits. A modified inverse variance weighted (IVW) estimate was performed to combine the ratio estimators from each instrument and acquire the causal estimate, alternative methods including IVW with first-order weights, simple and weighted median estimations, and MR-Egger regression were conducted as sensitivity analyses, to ensure the robustness and solidity of the findings. Results Two-sample MR supported findings for an adverse effect of genetically predicted insomnia on T2DM risk (odds ratio [OR] = 1.14, 95% confidence interval [CI]: 1.09–1.19, p = 1.29E–08) at the Bonferroni-adjusted level of significance (p < 0.005). We further investigated the causal role of T2DM on insomnia but obtained a non-significant estimation. There was also little evidence for the causal effect of other sleep-related measures on T2DM. Results were largely consistent when leveraging two different T2DM cohorts, and were robust among various sensitivity analyses. Conclusion Findings provide significant evidence for an adverse effect of insomnia on T2DM risk. The study extends fundamental knowledge to further understanding of the pathophysiological mechanisms of T2DM, and points out the non-negligible role of insomnia on epidemiologic intervention and clinical therapeutics of T2DM.
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Affiliation(s)
- Xue Gao
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Heli Sun
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Yu Zhang
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Long Liu
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Juping Wang
- Department of Mathematics, School of Basic Medical Sciences, Shanxi Medical University, Taiyuan, China
| | - Tong Wang
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
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32
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Hu Y, He B, Han Z, Wang Y, Tao C, Wang Y, Jin H, Du J. Risk Factors for Orthostatic Hypertension in Children. J Pediatr 2020; 227:212-217.e1. [PMID: 32668285 DOI: 10.1016/j.jpeds.2020.07.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 07/05/2020] [Accepted: 07/08/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To investigate the risk factors for orthostatic hypertension in children. STUDY DESIGN Eighty children with orthostatic hypertension were enrolled in the group with orthostatic hypertension, and 51 healthy children served as the control group. Demographic characteristics, clinical history, daily water intake, nightly sleep duration, the results of the standing test, and complete blood count were recorded and compared between the 2 groups. The risk factors for pediatric orthostatic hypertension were determined by logistic regression analysis. RESULTS Body mass index and red blood cell distribution width were higher in the group with orthostatic hypertension than in healthy children, whereas daily water intake and sleep duration were lower. Logistic regression analyses showed that, if a child suffered from overweight, suffered from obesity, had a daily water intake of less than 800 mL, or had a red blood cell distribution width that was increased by 1%, the risk of orthostatic hypertension would be increased by 6.069 times (95% CI, 1.375-26.783; P < .05), 7.482 times (95% CI, 1.835-30.515; P < .01), 4.027 times (95% CI, 1.443-11.241; P < .01), or 4.008 times (95% CI, 1.698-9.461; P < .01), respectively. However, if the sleep duration was increased by 1 hour, the risk of developing orthostatic hypertension would be decreased by 74.3% (95% CI, 54.6%-85.4%, P < .01). CONCLUSIONS Increased body mass index, inadequate water intake and sleep duration, and elevated red blood cell distribution width were identified as risk factors for pediatric orthostatic hypertension.
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Affiliation(s)
- Yang Hu
- Department of Pediatrics, Peking University First Hospital, Beijing, China; Research Unit of Clinical Diagnosis and Treatment of Pediatric Syncope and Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Bing He
- Department of Pediatrics, People's Hospital of Wuhan University, Hubei, China
| | - Zhenhui Han
- Department of Pediatrics, Children's Hospital of Kaifeng, Henan, China
| | - Yuanyuan Wang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Chunyan Tao
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Yaru Wang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Hongfang Jin
- Department of Pediatrics, Peking University First Hospital, Beijing, China.
| | - Junbao Du
- Department of Pediatrics, Peking University First Hospital, Beijing, China; Key Laboratory of Cardiovascular Sciences, Ministry of Education, Beijing, China.
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Sadeghmousavi S, Eskian M, Rahmani F, Rezaei N. The effect of insomnia on development of Alzheimer's disease. J Neuroinflammation 2020; 17:289. [PMID: 33023629 PMCID: PMC7542374 DOI: 10.1186/s12974-020-01960-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 09/23/2020] [Indexed: 02/07/2023] Open
Abstract
Alzheimer's disease (AD) is the most common type of dementia and a neurodegenerative disorder characterized by memory deficits especially forgetting recent information, recall ability impairment, and loss of time tracking, problem-solving, language, and recognition difficulties. AD is also a globally important health issue but despite all scientific efforts, the treatment of AD is still a challenge. Sleep has important roles in learning and memory consolidation. Studies have shown that sleep deprivation (SD) and insomnia are associated with the pathogenesis of Alzheimer's disease and may have an impact on the symptoms and development. Thus, sleep disorders have decisive effects on AD; this association deserves more attention in research, diagnostics, and treatment, and knowing this relation also can help to prevent AD through screening and proper management of sleep disorders. This study aimed to show the potential role of SD and insomnia in the pathogenesis and progression of AD.
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Affiliation(s)
- Shaghayegh Sadeghmousavi
- Neuroimaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa Eskian
- Neuroimaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Farzaneh Rahmani
- Neuroimaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Nima Rezaei
- Neuroimaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Slavish DC, Taylor DJ, Dietch JR, Wardle-Pinkston S, Messman B, Ruggero CJ, Kohut M, Kelly K. Intraindividual Variability in Sleep and Levels of Systemic Inflammation in Nurses. Psychosom Med 2020; 82:678-688. [PMID: 32697443 PMCID: PMC7484081 DOI: 10.1097/psy.0000000000000843] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Disturbed sleep is common among nurses and is associated with morbidity and mortality. Inflammation may be one mechanism linking sleep and disease. However, most studies rely on retrospective questionnaires to assess sleep, which fail to account for night-to-night fluctuations in sleep across time (i.e., intraindividual variability [IIV]). We examined prospective associations between mean and IIV in sleep with inflammation markers in nurses. METHODS Participants were 392 nurses (mean age = 39.54 years, 92% female, 23% night-shift working) who completed 7 days of sleep diaries and actigraphy to assess mean and IIV in total sleep time and sleep efficiency. Blood was drawn on day 7 to assess inflammation markers C-reactive protein, interleukin (IL)-6, tumor necrosis factor α, and IL-1β. RESULTS Greater IIV in total sleep time-measured via both actigraphy and sleep diary-was associated with higher IL-6 (actigraphy: b = 0.05, p = .046, sr = 0.01; diary: b = 0.04, p = .030, sr = 0.01) and IL-1β (actigraphy: b = 0.12, p = .008, sr = 0.02; diary: b = 0.09, p = .025, sr = 0.01), but not C-reactive protein or tumor necrosis factor α. IIV in actigraphy- and sleep diary-determined sleep efficiency was not associated with inflammation biomarkers, nor were any mean sleep variables. Shift work did not moderate any associations. CONCLUSIONS Nurses with more variable sleep durations had elevated levels of inflammation, which may increase risk for development of inflammatory-related diseases. Research should investigate how sleep regularization may change levels of inflammation and improve health.
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Affiliation(s)
- Danica C Slavish
- From the Department of Psychology (Slavish, Messman, Ruggero, Kelly), University of North Texas, Denton, Texas; Department of Psychology (Taylor, Wardle-Pinkston), University of Arizona, Tucson, Arizona; War Related Illness and Injury Study Center (Dietch), Palo Alto Veterans Affairs Health Care System; Department of Psychiatry and Behavioral Sciences (Dietch), Stanford University School of Medicine, Palo Alto, California; and Department of Kinesiology (Kohut), Iowa State University, Ames, Iowa
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Jung HJ, Yu ES, Kim JH. Combined Program of Cognitive-Behavioral Therapy for Insomnia and Medication Tapering in Cancer Patients: A Clinic-Based Pilot Study. Behav Sleep Med 2020; 18:386-395. [PMID: 30966825 DOI: 10.1080/15402002.2019.1597718] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: This preliminary study aimed to evaluate the efficacy of a combined program of group-based cognitive-behavioral therapy for insomnia (CBT-I) and medication tapering for reducing hypnotic use in cancer patients and to identify predictors of medication continuation. Participants: This study has a retrospective design and uses archival data from patient's medical records. Forty cancer patients with chronic insomnia received clinic- and group-based CBT-I alongside a medication tapering program. Methods: Clinical outcomes were collected from 32 patients who completed a six-week program, via their medical records. Medication dosages, Insomnia Severity Index scores, scores on the Korean version of the 16-item Dysfunctional Beliefs and Attitudes About Sleep scale, Symptom Checklist-90-Revised inventory scores, and sleep efficiency were measured pre- and posttreatment and at a follow-up after one month. Results: At posttreatment, 68.8% of patients were drug-free and 25.0% were taking hypnotic medication at a reduced dosage or frequency. Patients who were undergoing anticancer treatment were more likely to discontinue hypnotic use than patients who were off the anticancer treatment. Overall relapse rate for sleep medication at the one-month follow-up was 4.5%. Having more somatic symptoms at baseline was a significant predictor for continuing medication after CBT-I. Conclusions: The preliminary results imply that the combined program of group-based CBT-I and medication tapering may be helpful to reduce hypnotics in cancer patients with insomnia in a clinical setting. Along with combined treatment methods, future studies could explore the effects of added treatments for the reduction of physical pain on the prevention of chronic hypnotic use.
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Affiliation(s)
- Ho-Jun Jung
- Center for Tobacco Control, National Cancer Center, Gyeonggi-do, Republic of Korea
| | - Eun-Seung Yu
- Mental Health Clinic, National Cancer Center, Gyeonggi-do, Republic of Korea
| | - Jong-Heun Kim
- Mental Health Clinic, National Cancer Center, Gyeonggi-do, Republic of Korea
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36
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Slavish DC, Taylor DJ, Lichstein KL. Intraindividual variability in sleep and comorbid medical and mental health conditions. Sleep 2020; 42:5370458. [PMID: 30843059 DOI: 10.1093/sleep/zsz052] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 01/28/2019] [Indexed: 12/17/2022] Open
Abstract
STUDY OBJECTIVES Intraindividual variability (IIV) in sleep may be a risk factor for disease above the influence of mean sleep. Associations between IIV in sleep and risk for a comprehensive set of common medical and mental health conditions have not been assessed in a representative sample. METHODS This study examined mean and IIV in total sleep time (TST), sleep quality (SQ), sleep efficiency (SE), and circadian midpoint (CM) in 771 adults recruited for an epidemiological study. Participants completed 14 days of sleep diaries to assess TST, SQ, SE, and CM, after which they reported on medical conditions and mental health symptoms. Data were analyzed using logistic regression, and models controlled for gender, body mass index, age, and race. RESULTS Lower mean TST, SQ, and SE were related to increased odds of having gastrointestinal problems, depression, and anxiety. IIV in TST was related to increased odds of having neurological, breathing, and gastrointestinal problems, as well as pain and depression; all results held controlling for mean sleep and adjusting for false discovery rate. IIV in SQ and SE was not associated with odds of having any medical or mental health conditions after adjusting for false discovery rate, nor was IIV in CM or mean CM. CONCLUSIONS Confirming previous research, mean TST, SQ, and SE are related to risk for gastrointestinal problems, depression, and anxiety. IIV in TST may be a unique facet of disturbed sleep that is associated with increased risk for a diverse cluster of medical and mental health conditions.
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Affiliation(s)
| | - Daniel J Taylor
- Department of Psychology, University of North Texas, Denton, TX
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Vargas I, Nguyen AM, Muench A, Bastien CH, Ellis JG, Perlis ML. Acute and Chronic Insomnia: What Has Time and/or Hyperarousal Got to Do with It? Brain Sci 2020; 10:E71. [PMID: 32013124 PMCID: PMC7071368 DOI: 10.3390/brainsci10020071] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 01/22/2020] [Accepted: 01/25/2020] [Indexed: 11/16/2022] Open
Abstract
Nearly one-third of the population reports new onset or acute insomnia in a given year. Similarly, it is estimated that approximately 10% of the population endorses sleep initiation and maintenance problems consistent with diagnostic criteria for chronic insomnia. For decades, acute and chronic insomnia have been considered variations of the same condition or disorder, only really differentiated in terms of chronicity of symptoms (days/weeks versus months). Whether or not acute and chronic insomnia are part of the same phenomena is an important question, one that has yet to be empirically evaluated. The goal of the present theoretical review was to summarize the definitions of acute and chronic insomnia and discuss the role that hyperarousal may have in explaining how the pathophysiology of acute and chronic insomnia is likely different (i.e., what biopsychological factors precipitate and/or perpetuate acute insomnia, chronic insomnia, or both?).
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Affiliation(s)
- Ivan Vargas
- Department of Psychological Science, University of Arkansas, Fayetteville, AR 72701, USA;
| | - Anna M. Nguyen
- Department of Psychological Science, University of Arkansas, Fayetteville, AR 72701, USA;
| | - Alexandria Muench
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA (M.L.P.)
| | | | - Jason G. Ellis
- Northumbria Center for Sleep Research, Northumbria University, Newcastle NE7 7XA, UK;
| | - Michael L. Perlis
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA (M.L.P.)
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Goldstein SJ, Gaston SA, McGrath JA, Jackson CL. Sleep Health and Serious Psychological Distress: A Nationally Representative Study of the United States among White, Black, and Hispanic/Latinx Adults. Nat Sci Sleep 2020; 12:1091-1104. [PMID: 33299371 PMCID: PMC7721291 DOI: 10.2147/nss.s268087] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 09/14/2020] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Prior studies investigating the relationship between sleep and serious psychological distress (SPD) have lacked racial/ethnic diversity and generalizability. We investigated associations between sleep and SPD among a large, nationally representative, and racially/ethnically diverse sample of US adults. METHODS We pooled cross-sectional data from the 2004 to 2017 National Health Interview Survey. Participants self-reported sleep duration and sleep disturbances (eg, trouble falling and staying asleep). SPD was defined as a Kessler Psychological Distress Scale (K6) score ≥13. Adjusting for sociodemographic, health behavior, and clinical characteristics, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) of SPD for each sleep characteristic, overall and by race/ethnicity. RESULTS Among 316,840 participants, the mean age ± standard error was 46.9 ± 0.1 years, 52% were women, 75% were non-Hispanic (NH)-White, 16% NH-Black, and 9% Hispanic/Latinx. The prevalence of SPD was 3.4% for NH-Whites, 4.1% for NH-Blacks, and 4.5% for Hispanics/Latinxs. Participants with <7 hours versus 7-9 hours of sleep duration were more likely to have SPD, and the magnitude of the association was strongest among NH-Black participants (PRNH-Blacks=3.50 [95% CI: 2.97-4.13], PR Hispanics/Latinx=2.95 [2.42-3.61], and PRNH-Whites=2.66 [2.44-2.89]). Positive associations between sleep disturbances and SPD were generally stronger among NH-Black and Hispanic/Latinx compared to NH-White adults. CONCLUSION Poor sleep health was positively associated with SPD, and the magnitude of the association was generally stronger among racial/ethnic minorities. Future investigations should prospectively focus on the determinants and health consequences of SPD attributable to objectively measured sleep across racial/ethnic groups.
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Affiliation(s)
- Samuel J Goldstein
- The University of North Carolina at Chapel Hill, Department of Environmental Sciences and Engineering, Chapel Hill, NC, USA
| | - Symielle A Gaston
- Department of Health and Human Services, Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | | | - Chandra L Jackson
- Department of Health and Human Services, Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA.,Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
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Affiliation(s)
| | - Naima Covassin
- Department of Cardiovascular Diseases (N.C., V.K.S.), Mayo Clinic, Rochester, MN
| | - Virend K Somers
- Department of Cardiovascular Diseases (N.C., V.K.S.), Mayo Clinic, Rochester, MN
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40
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Grimaldi D, Goldstein MR, Carter JR. Insomnia and cardiovascular autonomic control. Auton Neurosci 2019; 220:102551. [DOI: 10.1016/j.autneu.2019.05.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 05/10/2019] [Accepted: 05/15/2019] [Indexed: 01/13/2023]
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Carter JR, Grimaldi D, Fonkoue IT, Medalie L, Mokhlesi B, Cauter EV. Assessment of sympathetic neural activity in chronic insomnia: evidence for elevated cardiovascular risk. Sleep 2019. [PMID: 29522186 DOI: 10.1093/sleep/zsy048] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Study Objectives Chronic insomnia affects up to 15 per cent of adults. Recent cross-sectional and prospective epidemiological studies report an association between insomnia and hypertension, including incident hypertension, yet mechanisms underlying the association remain unknown. We hypothesized that participants with chronic insomnia would have elevated sympathetic neural outflow, blunted baroreflex sensitivity, and augmented sympathetic neural and cardiovascular reactivity to stress when compared with good-sleeper controls. Methods Twelve participants with chronic insomnia (11 women, 1 man) and 12 controls (8 women, 4 men) underwent one night of laboratory polysomnography, two weeks of at-home wrist actigraphy, and one night of controlled laboratory sleep prior to a comprehensive morning autonomic function test. The autonomic function test consisted of simultaneous recordings of muscle sympathetic nerve activity (MSNA; microneurography), beat-to-beat blood pressure (finger plethysmography), and heart rate (electrocardiogram) during a 10 min supine baseline and a 2 min cold pressor test. Results Baseline blood pressure, heart rate, and MSNA were not different between groups, but sympathetic baroreflex sensitivity was significantly blunted in participants with insomnia (-2.1 ± 1.0 vs. -4.3 ± 1.3 bursts/100 heartbeats/mm Hg; p < 0.001). During the cold pressor test, systolic arterial pressure reactivity (Δ21 ± 11 vs. Δ14 ± 8 mm Hg; time × group = 0.04) and total MSNA reactivity (Δ127%, 54%-208% vs. Δ52%, 30%-81%; time × group = 0.02) were augmented in chronic insomnia. Conclusions Participants with chronic insomnia demonstrated impaired sympathetic baroreflex function and augmented neural cardiovascular responsiveness to stress, when compared with controls. These findings support growing evidence of cardiovascular risk and physiological hyperarousal in chronic insomnia. Clinical Trial Registration NCT02048878. https://clinicaltrials.gov/ct2/show/NCT02048878.
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Affiliation(s)
- Jason R Carter
- Sleep, Metabolism and Health Center, The University of Chicago, Chicago, IL.,Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI
| | - Daniela Grimaldi
- Sleep, Metabolism and Health Center, The University of Chicago, Chicago, IL.,Department of Neurology, Center for Circadian and Sleep Medicine, Northwestern University, Chicago, IL
| | - Ida T Fonkoue
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI
| | - Lisa Medalie
- Sleep, Metabolism and Health Center, The University of Chicago, Chicago, IL.,Section of Pulmonary and Critical Care, Sleep Disorders Center, The University of Chicago, Chicago, IL
| | - Babak Mokhlesi
- Sleep, Metabolism and Health Center, The University of Chicago, Chicago, IL.,Section of Pulmonary and Critical Care, Sleep Disorders Center, The University of Chicago, Chicago, IL
| | - Eve Van Cauter
- Sleep, Metabolism and Health Center, The University of Chicago, Chicago, IL.,Section of Endocrinology, Diabetes and Metabolism, The University of Chicago, Chicago, IL
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Parajuli S, Tiwari R, Clark DF, Mandelbrot DA, Djamali A, Casey K. Sleep disorders: Serious threats among kidney transplant recipients. Transplant Rev (Orlando) 2019; 33:9-16. [PMID: 30287137 DOI: 10.1016/j.trre.2018.09.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 09/17/2018] [Accepted: 09/21/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Sandesh Parajuli
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States.
| | - Rachna Tiwari
- Division of Sleep Medicine, William S. Middleton Memorial Veterans Hospital, Madison, WI, United States
| | - Dana F Clark
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Didier A Mandelbrot
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Arjang Djamali
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States; Division of Transplant Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Kenneth Casey
- Division of Sleep Medicine, William S. Middleton Memorial Veterans Hospital, Madison, WI, United States
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Rozing MP, Veerhuis R, Westendorp RGJ, Eikelenboom P, Stek M, Marijnissen RM, Oude Voshaar RC, Comijs HC, van Exel E. Inflammation in older subjects with early- and late-onset depression in the NESDO study: a cross-sectional and longitudinal case-only design. Psychoneuroendocrinology 2019; 99:20-27. [PMID: 30172071 DOI: 10.1016/j.psyneuen.2018.08.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 08/18/2018] [Accepted: 08/22/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Different biological mechanisms may underlie depression beginning in early life (early-onset) and depression beginning later in life (late-onset). Although the relation between inflammation and depression has been studied extensively, the distinct role of inflammation in early and late-onset depression in older patients has not been addressed before. In the cross-sectional part of this study, we explored differences in levels of circulating inflammatory markers and cytokine levels in lipopolysaccharide (LPS) stimulated whole blood between older subjects with a late-life onset depression (≥60 years) and older subjects with an early-onset depression (<60 years). Secondly, in a 2-year follow-up study, we examined if circulating and stimulated inflammatory markers influenced the change in Inventory of Depressive Symptomatology (IDS) scores, and if this relation was different for early- and late-onset depression. METHODS The study was part of the Netherlands Study of Depression in Older Persons (NESDO). We included 350 patients, all aged 60 and older, with a depressive episode in the previous 6 months: 119 with a late-onset depression and 231 with an early-onset depression. Blood samples were collected and CRP, IL-6, NGAL, GDF15, and, LPS plasma levels were determined and whole blood was LPS stimulated and cytokine levels IL-1β, IL-6, TNFα, IFNγ, IL-10, and IL-1 receptor antagonist (IL-1ra) were determined. RESULTS After adjustment for demographics, health indicators, and medication use, increased plasma CRP levels were more strongly associated with late-onset depression than early-onset depression (OR [95% CI]: 1.43 [1.05-1.94]). In the longitudinal analyses, higher circulating IL-6 levels were associated with a significantly slower decline in IDS scores in the crude and the adjusted models (p ≤ 0.027). This relation was not different between late- and early-onset depression. Other circulating and stimulated inflammatory markers were not associated with late- and/or early-onset depression. CONCLUSIONS This study provides preliminary evidence that low-grade inflammation is more strongly associated with late-onset than early-onset depression in older adults, suggesting a distinct inflammatory etiology for late-onset depression. Cytokine production capacity did not distinguish between early- and late-onset depression.
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Affiliation(s)
- M P Rozing
- Department of Public Health, section Epidemiology, University of Copenhagen, Copenhagen, Denmark; Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark; The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - R Veerhuis
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam, The Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, GGZ inGeest / Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - R G J Westendorp
- Department of Public Health, section Epidemiology, University of Copenhagen, Copenhagen, Denmark; Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - P Eikelenboom
- Amsterdam UMC, Vrije Universiteit Amsterdam, GGZ inGeest / Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - M Stek
- Amsterdam UMC, Vrije Universiteit Amsterdam, GGZ inGeest / Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - R M Marijnissen
- University Center of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Old Age Psychiatry, ProPersona, Arnhem/Wolfheze, The Netherlands
| | - R C Oude Voshaar
- University Center of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - H C Comijs
- Amsterdam UMC, Vrije Universiteit Amsterdam, GGZ inGeest / Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - E van Exel
- Amsterdam UMC, Vrije Universiteit Amsterdam, GGZ inGeest / Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Prenatal stress and the development of psychopathology: Lifestyle behaviors as a fundamental part of the puzzle. Dev Psychopathol 2018; 30:1129-1144. [PMID: 30068418 DOI: 10.1017/s0954579418000494] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Maternal psychological stress, depression, and anxiety during pregnancy (prenatal stress; PNS) are thought to impact fetal development with long-term effects on offspring outcome. These effects would include physical and mental health, including psychopathology. Maternal sleep, diet, and exercise during pregnancy are lifestyle behaviors that are understudied and often solely included in PNS studies as confounders. However, there are indications that these lifestyle behaviors may actually constitute essential mediators between PNS and fetal programming processes. The goal of this theoretical review was to investigate this idea by looking at the evidence for associations between PNS and sleep, diet, and exercise, and by piecing together the information on potential underlying mechanisms and causal pathways through which these factors may affect the offspring. The analysis of the literature led to the conclusion that sleep, diet, and exercise during pregnancy, may have fundamental roles as mediators between PNS and maternal pregnancy physiology. By integrating these lifestyle behaviors into models of prenatal programming of development, a qualitatively higher and more comprehensive understanding of the prenatal origins of psychopathology can be obtained. The review finalizes by discussing some of the present challenges facing the field of PNS and offspring programming, and offering solutions for future research.
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Jarrin DC, Alvaro PK, Bouchard MA, Jarrin SD, Drake CL, Morin CM. Insomnia and hypertension: A systematic review. Sleep Med Rev 2018; 41:3-38. [PMID: 29576408 DOI: 10.1016/j.smrv.2018.02.003] [Citation(s) in RCA: 111] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 12/16/2017] [Accepted: 02/09/2018] [Indexed: 11/26/2022]
Abstract
Insomnia is a prevalent sleep disorder that is associated with a multitude of health consequences. Particularly, insomnia has been associated with cardiovascular disease and its precursors, such as hypertension and blood pressure (BP) non-dipping. The present systematic review aimed to summarize the evidence on the concurrent and prospective associations between insomnia and hypertension and/or BP. Using electronic search engines (PubMed, SCOPUS, PsycINFO), 5,618 articles published from January 1970 to December 2017 were identified, and 64 met the inclusion criteria (26 to 162,121 participants; age range: 18-100; 46.4% male). Insomnia was based on diagnostic or non-diagnostic criteria. Hypertension was based on self-or physician-reports, antihypertensive medication use, and/or measured BP. Findings indicate that when insomnia is frequent, chronic, and/or accompanied with short sleep duration or objective markers of arousal, there is a strong association with hypertension/BP. Based on limited studies, hypertension did not significantly predict future insomnia in middle-aged adults, but did in older adults. Based on a majority of case-control studies, no differences in BP were found between participants with and without insomnia. Further research is needed to identify putative pathophysiological mechanisms underlying the link between insomnia and hypertension. The impact of insomnia therapy on BP should also be further examined in the future.
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Affiliation(s)
- Denise C Jarrin
- École de psychologie, Université Laval, Québec City, Québec, Canada; Centre d'étude des troubles du sommeil, Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec City, Canada.
| | - Pasquale K Alvaro
- The Institute for Breathing and Sleep, Austin Health, Heidelberg 3084, Victoria, Australia; School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Marc-André Bouchard
- École de psychologie, Université Laval, Québec City, Québec, Canada; Centre d'étude des troubles du sommeil, Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec City, Canada
| | - Stephanie D Jarrin
- Clinical Science Department, American University of Antigua College of Medicine, Antigua and Barbuda
| | | | - Charles M Morin
- École de psychologie, Université Laval, Québec City, Québec, Canada; Centre d'étude des troubles du sommeil, Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec City, Canada
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Yu S, Guo B, Shen Z, Wang Z, Kui Y, Hu Y, Feng F. The imbalanced anterior and posterior default mode network in the primary insomnia. J Psychiatr Res 2018; 103:97-103. [PMID: 29804003 DOI: 10.1016/j.jpsychires.2018.05.013] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 05/16/2018] [Accepted: 05/16/2018] [Indexed: 12/17/2022]
Abstract
Neuroimaging studies have demonstrated that the brain is altered both structurally and functionally in patients with primary insomnia (PI). However, most previous hypothesis-driven studies of PI might bias observations. Here, we use global functional connectivity density (gFCD), a hypothesis-free approach, to investigate the brain functional alteration in patients with PI. Forty-eight patients with PI and 51 matched healthy control (HC) subjects were recruited and underwent a resting state functional magnetic resonance imaging (fMRI) scan. Analyses of group differences of gFCD in the whole brain and the clinical significances of abnormal brain function were conducted. Compared with the HC group, patients with PI showed increased gFCD in the executive control network, salience network, dorsal attention network, and visual network. Interestingly, the gFCD in the anterior default mode network (DMN) is increased in the PI group, whereas the gFCD in the posterior DMN is decreased. In addition, the increased gFCD in the insula is associated with higher Pittsburgh Sleep Quality Index scores in the PI group. The gender and duration of disease have no significant effects on abnormal gFCD network. This study is the first attempt to explore the gFCD feature in patients with PI. Our findings support the hyperarousal model of insomnia and suggest an imbalanced neural spontaneous fluctuation between anterior and posterior DMN in the resting state in patients with PI. These findings expand our understanding of the neuropathological mechanism of primary insomnia.
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Affiliation(s)
- Siyi Yu
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Baojun Guo
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Zhifu Shen
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Zhengyan Wang
- Sichuan Integrative Medicine Hospital, Chengdu, Sichuan 610041, China
| | - Yu Kui
- Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
| | - Youping Hu
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Fen Feng
- Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China.
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47
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Abstract
PURPOSE OF REVIEW Sleep plays many roles in maintenance of cardiovascular health. This review summarizes the literature across several areas of sleep and sleep disorders in relation to cardiometabolic disease risk factors. RECENT FINDINGS Insufficient sleep duration is prevalent in the population and is associated with weight gain and obesity, inflammation, cardiovascular disease, diabetes, and mortality. Insomnia is also highly present and represents an important risk factor for cardiovascular disease, especially when accompanied by short sleep duration. Sleep apnea is a well-characterized risk factor for cardiometabolic disease and cardiovascular mortality. Other issues are relevant as well. For example, sleep disorders in pediatric populations may convey cardiovascular risks. Also, sleep may play an important role in cardiovascular health disparities. SUMMARY Sleep and sleep disorders are implicated in cardiometabolic disease risk. This review addresses these and other issues, concluding with recommendations for research and clinical practice.
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48
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Zhu Y, Kim MH, Banerjee S, Deferio J, Alexopoulos GS, Pathak J. Understanding the research landscape of major depressive disorder via literature mining: an entity-level analysis of PubMed data from 1948 to 2017. JAMIA Open 2018; 1:115-121. [PMID: 31984323 PMCID: PMC6951824 DOI: 10.1093/jamiaopen/ooy001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 01/22/2018] [Accepted: 01/24/2018] [Indexed: 11/27/2022] Open
Abstract
Objective To analyze literature-based data from PubMed to identify diseases and medications that have frequently been studied with major depressive disorder (MDD). Materials and methods Abstracts of 23 799 research articles about MDD that have been published since 1948 till 2017 were analyzed using data and text mining approaches. Methods such as information extraction, frequent pattern mining, regression, and burst detection were used to explore diseases and medications that have been associated with MDD. Results In addition to many mental disorders and antidepressants, we identified several nonmental health diseases and nonpsychotropic medications that have frequently been studied with MDD. Our results suggest that: (1) MDD has been studied with disorders such as Pain, Diabetes Mellitus, Wounds and Injuries, Hypertension, and Cardiovascular Diseases; (2) medications such as Hydrocortisone, Dexamethasone, Ketamine, and Lithium have been studied in terms of their side effects and off-label uses; (3) the relationships between nonmental disorders and MDD have gained increased attention from the scientific community; and (4) the bursts of Diabetes Mellitus and Cardiovascular Diseases explain the psychiatric and/or depression screening recommended by authoritative associations during the periods of the bursts. Discussion and conclusion This study summarized and presented an overview of the previous MDD research in terms of diseases and medications that are highly relevant to MDD. The reported results can potentially facilitate hypothesis generation for future studies. The approaches proposed in the study can be used to better understand the progress and advance of the field.
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Affiliation(s)
- Yongjun Zhu
- Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, New York, USA.,Department of Library and Information Science, Sungkyunkwan University, Seoul, South Korea
| | - Min-Hyung Kim
- Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, New York, USA
| | - Samprit Banerjee
- Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, New York, USA
| | - Joseph Deferio
- Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, New York, USA
| | - George S Alexopoulos
- Department of Psychiatry, Weill Cornell Medicine, Cornell University, New York, New York, USA
| | - Jyotishman Pathak
- Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, New York, USA
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49
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Poole L, Jackowska M. The Epidemiology of Depressive Symptoms and Poor Sleep: Findings from the English Longitudinal Study of Ageing (ELSA). Int J Behav Med 2018; 25:151-161. [PMID: 29204805 PMCID: PMC5852187 DOI: 10.1007/s12529-017-9703-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE The reasons for the comorbidity between depressed mood and poor sleep are not well understood. METHOD Participants were 5172 adults aged 50 years and older from the English Longitudinal Study of Ageing. Sleep was measured via self-report and depressive symptoms using the Centre for Epidemiological Studies Depression scale. RESULTS Greater depressive symptoms and sleep complaints were associated with female sex, non-cohabitation, relative poverty, smoking, infrequent physical activity, infrequent alcohol consumption, higher body mass index (BMI), diagnosis of hypertension, coronary heart disease, diabetes/high blood glucose, pulmonary disease, arthritis, and higher levels of fibrinogen and C-reactive protein (all p < 0.05). At a 4-year follow-up, depressive symptoms and sleep complaints were both predicted by baseline depressive symptoms and sleep complaints, relative poverty, smoking, physical inactivity, BMI, and arthritis (all p < 0.05). CONCLUSION Depressive symptoms and sleep complaints share a range of correlates cross-sectionally and prospectively. These findings highlight the common comorbidity between depressive symptoms and sleep complaints underscoring the need for further research to understand their combined detrimental effect on long-term health and wellbeing.
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Affiliation(s)
- Lydia Poole
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 6BT UK
| | - Marta Jackowska
- Department of Psychology, Whitelands College, University of Roehampton, Holybourne Avenue, London, SW15 4JD UK
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50
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Abstract
BACKGROUND Psychological distress is highly prevalent in patients with pancreatic cancer (PC), yet little is known about the pathophysiology underlying the relationship between these 2 diseases. Our aim was to systematically review the evidence examining the pathophysiological mechanisms of the association between PC and psychological distress. METHODS A systematic review of the literature was conducted using MEDLINE, Embase, PsychINFO, and CINAHL databases and reported according to the preferred reporting items for systematic reviews and meta-analyses guidelines. Studies examining the pathophysiological mechanisms between PC and psychological distress were included for analysis. RESULTS Eight studies were identified that fulfilled inclusion criteria. Four mechanisms were identified accounting for the possible relationship between psychological distress and PC, including (1) stress-induced β-adrenergic signaling, (2) interleukin-6-mediated effects, (3) kynurenine pathway upregulation, and (4) altered cerebral glucose metabolism. CONCLUSIONS The relationship between psychological distress and PC is complex, and our understanding of these mechanisms may have implications for holistic clinical management and oncological outcome. The evidence exploring the pathophysiology of this interaction is sparse, but most well established with regard to the stress-induced β-adrenergic signaling mechanism. Further studies in larger cohorts are required to elucidate the relationship between PC and psychological distress to be able to identify therapeutic targets for both conditions.
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