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Law KC, O'Connell KL, Jacobson SV, Baer MM, Baker PM, Tull MT. Influences of sleep, cortisol reactivity, and risk/reward-based decision-making on suicide. J Behav Ther Exp Psychiatry 2024; 85:101975. [PMID: 38870548 PMCID: PMC11347093 DOI: 10.1016/j.jbtep.2024.101975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 04/03/2024] [Accepted: 05/25/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND AND OBJECTIVES Poor sleep quality is a known contributor to suicidal thoughts and behaviors. This study examines whether sleep quality modulates the effect of an individual's stress response and risk/reward-based decision making on suicide risk. METHODS Participants were 160 adults at a residential substance use treatment facility with lifetime exposure to trauma who completed a clinician-administered measure of suicide risk, the Iowa Gambling Task (IGT), and a self-report measure of sleep. Cortisol reactivity (i.e., changes in cortisol before and after a personalized trauma script) was used to measure stress response. We used quantile regression to examine the effects of sleep, cortisol, and risk/reward decision-making on suicide risk. RESULTS We found poor sleep quality to be increasingly salient in individuals at greater risk for suicide than those at lower risk for suicide. Furthermore, individuals with moderate to moderate-high levels of suicide risk seem to have greater cortisol reactivity. In the low-moderate quantile, we found suicide risk to be associated with both high stress reactivity and low-risk, high-reward decision-making, as well as low stress reactivity and high-risk/low-reward decision-making. LIMITATIONS These findings should be interpreted considering several methodological constraints, such as the use of a pre-determined sample and instruments not tailored for our hypotheses, the MINI 'Suicide' Module's limited differentiation between suicidal ideation and behavior, and variably timed cortisol sampling. CONCLUSIONS Despite these limitations, the findings from this study support the use of evidence-based interventions focused on improving sleep quality and managing emotional reactivity to decrease suicide risk.
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Affiliation(s)
- Keyne C Law
- Department of Clinical Psychology, Seattle Pacific University, Seattle, WA, USA.
| | | | - Samantha V Jacobson
- Department of Clinical Psychology, Seattle Pacific University, Seattle, WA, USA
| | - Margaret M Baer
- Department of Psychology, University of Toledo, Toledo, OH, USA
| | - Phillip M Baker
- Department of Psychology, Seattle Pacific University, Seattle, WA, USA
| | - Matthew T Tull
- Department of Psychology, University of Toledo, Toledo, OH, USA; Lyra Health Inc., Burlingame, CA, USA
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Upenieks L, Hill TD, Orfanidis C. Crisis of Faith and Sleep Quality in the United States: A Literal Dark Night of the Soul? JOURNAL OF RELIGION AND HEALTH 2024; 63:3066-3087. [PMID: 38095765 DOI: 10.1007/s10943-023-01958-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/04/2023] [Indexed: 08/13/2024]
Abstract
A crisis of faith is an intrapersonal struggle with ultimate meaning that occurs when one's supramundane reality is called in question. We propose a theoretical model which suggests that a crisis of faith will contribute to poorer sleep quality by undermining a general sense of meaning and purpose in life, especially among women. We use national survey data from the Wave 5 of the Baylor Religion Survey United States (N = 1395). Ordinary least squares regression models with robust standard errors are utilized. Sobel-Goodman mediation techniques are used to test the proposed mediating pathway. Our results suggest that a crisis of faith is associated with lower sleep quality, and that this pathway is partially mediated by a lower sense of meaning and purpose in life. Finally, we found that the relationship between a crisis of faith and lower sleep quality was weaker for women. We discuss the implications of our results and suggest how future research may explore the relevance of a crisis of faith for well-being as well as other aspects of the human condition.
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Affiliation(s)
- Laura Upenieks
- Department of Sociology, Baylor University, 97326 One Bear Place, Waco, TX, 76798, USA.
| | - Terrence D Hill
- Department of Sociology, University of Texas at San Antonio, San Antonio, USA
| | - Christos Orfanidis
- Ontario Institute for Studies in Education, University of Toronto, Toronto, Canada
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de Villiers O, Elliot-Wilson C, Thomas KGF, Semple PL, Naiker T, Henry M, Ross IL. Sleep and cognition in South African patients with non-functioning pituitary adenomas. PLoS One 2024; 19:e0296387. [PMID: 38236816 PMCID: PMC10796019 DOI: 10.1371/journal.pone.0296387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 12/12/2023] [Indexed: 01/22/2024] Open
Abstract
Strong lines of evidence in the neuroscience literature indicate that (a) healthy sleep facilitates cognitive processing, and (b) sleep disruption is associated with cognitive dysfunction. Despite the fact that patients with pituitary disease often display both disrupted sleep and cognitive dysfunction, few previous studies investigate whether these clinical characteristics in these patients might be related. Hence, we explored whether sleep disruption in patients with pituitary disease mediates their cognitive dysfunction. We recruited 18 patients with non-functioning pituitary adenomas (NFPA) and 19 sociodemographically matched healthy controls. They completed the Global Sleep Assessment Questionnaire (thus providing self-report data regarding sleep disruption) and were administered the Brief Test of Adult Cognition by Telephone, which assesses cognitive functioning in the domains of processing speed, working memory, episodic memory, inhibition, and reasoning. We found no significant differences in cognition between patients and controls. Furthermore, spectra of sleep disturbance did not differ significantly between patients and controls. Our data suggest that NFPA patients' cognition and sleep quality is relatively intact, and that sleep disruption does not mediate cognitive dysfunction. Larger studies should characterize sleep and cognition in patients with NFPA (and other pituitary diseases) to confirm whether disruption of the former mediates impairment in the latter.
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Affiliation(s)
- Olivia de Villiers
- ACSENT Laboratory, Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Claudia Elliot-Wilson
- ACSENT Laboratory, Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Kevin G. F. Thomas
- ACSENT Laboratory, Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Patrick L. Semple
- Division of Neurosurgery, University of Cape Town, Cape Town, South Africa
| | - Thurandrie Naiker
- Department of Radiation Oncology, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Michelle Henry
- Numeracy Centre, University of Cape Town, Cape Town, South Africa
| | - Ian L. Ross
- Division of Endocrinology, University of Cape Town, Cape Town, South Africa
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Filetti C, Kane-Grade F, Gunnar M. The Development of Stress Reactivity and Regulation in Children and Adolescents. Curr Neuropharmacol 2024; 22:395-419. [PMID: 37559538 PMCID: PMC10845082 DOI: 10.2174/1570159x21666230808120504] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 02/03/2023] [Accepted: 02/10/2023] [Indexed: 08/11/2023] Open
Abstract
Adversity experienced in early life can have detrimental effects on physical and mental health. One pathway in which these effects occur is through the hypothalamic-pituitary-adrenal (HPA) axis, a key physiological stress-mediating system. In this review, we discuss the theoretical perspectives that guide stress reactivity and regulation research, the anatomy and physiology of the axis, developmental changes in the axis and its regulation, brain systems regulating stress, the role of genetic and epigenetics variation in axis development, sensitive periods in stress system calibration, the social regulation of stress (i.e., social buffering), and emerging research areas in the study of stress physiology and development. Understanding the development of stress reactivity and regulation is crucial for uncovering how early adverse experiences influence mental and physical health.
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Affiliation(s)
- Clarissa Filetti
- Institute of Child Development, University of Minnesota, Minneapolis, USA
| | - Finola Kane-Grade
- Institute of Child Development, University of Minnesota, Minneapolis, USA
| | - Megan Gunnar
- Institute of Child Development, University of Minnesota, Minneapolis, USA
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5
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Sulu C, Senel GB, Koca O, Alaylioglu M, Demir AN, Durcan E, Ak DG, Dursun E, Konukoglu D, Ozkaya HM, Karadeniz D, Kadioglu P. The relations of circulating agouti-related peptide and leptin with altered sleep architecture in patients with active Cushing's disease: a pilot study. J Endocrinol Invest 2024; 47:167-178. [PMID: 37306895 DOI: 10.1007/s40618-023-02133-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/05/2023] [Indexed: 06/13/2023]
Abstract
AIM To evaluate sleep architecture of patients with Cushing's disease (CD) and to explore whether agouti-related peptide (AgRP) and/or leptin play a permissive role in sleep alterations in patients with active CD. METHODS We performed polysomnography on 26 patients with active CD and age 26 age- and sex-matched control subjects. Blood samples were obtained from all participants for the analyzes of AgRP and leptin. The laboratory and sleep-related parameters were compared. RESULTS The groups were similar in age, gender, and body mass index. The CD group had reduced sleep efficiency (71.6 ± 12.1% vs. 78.8 ± 12.6%, p = 0.042) and increased wake after sleep onset (WASO%) (24.7 ± 13.1% vs. 17.4 ± 11.6%, p = 0.040) as compared to control group. Seventeen patients with CD (65.4%) and 18 control subjects (69.2%) had obstructive sleep apnea. Serum AgRP (13.2 ± 7.4 pg/ml vs. 9 ± 3.1, p = 0.029), leptin (59.5 mcg/l, [IQR] 32.6-94.6 vs. 25.3 mcg/l, [IQR] 12.9-57.5, p = 0.007) were higher in CD group. AgRP and leptin correlated negatively with total sleep time, sleep efficiency, stage N2 sleep (%), and positively with WASO%. In multiple regression analyses, serum cortisol (ß = - 0.359, p = 0.042) and AgRP (ß = - 0.481, p = 0.01) were significant predictor of sleep efficiency. AgRP was also significant predictor of WASO% (ß = 0.452 and p < 0.05). CONCLUSIONS Active CD carries an increased risk of impaired sleep efficiency and continuity which may worsen health-related quality of life. Elevated circulating AgRP and, to a lesser extent, leptin may be associated with decreased sleep efficiency and continuity in patients with CD. Patients with CD who have subjective sleep symptoms should be screened with polysomnography.
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Affiliation(s)
- C Sulu
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Kocamustafapasa Street No:53, Fatih, 34098, Istanbul, Turkey
| | - G B Senel
- Sleep and Disorders Unit, Department of Neurology, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - O Koca
- Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - M Alaylioglu
- Department of Neuroscience, Institute of Neurological Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - A N Demir
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Kocamustafapasa Street No:53, Fatih, 34098, Istanbul, Turkey
| | - E Durcan
- Department of Endocrinology, Bagcilar Training Hospital, Istanbul, Turkey
| | - D G Ak
- Department of Neuroscience, Institute of Neurological Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - E Dursun
- Department of Neuroscience, Institute of Neurological Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - D Konukoglu
- Department of Biochemistry, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - H M Ozkaya
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Kocamustafapasa Street No:53, Fatih, 34098, Istanbul, Turkey
- Pituitary Center, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - D Karadeniz
- Sleep and Disorders Unit, Department of Neurology, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - P Kadioglu
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Kocamustafapasa Street No:53, Fatih, 34098, Istanbul, Turkey.
- Pituitary Center, Istanbul University-Cerrahpasa, Istanbul, Turkey.
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Kurt Gök D, İsmailoğulları S, Aldemir R, Tokmakçı M, Firat ST, Karaca Z, Keleştemur F, Zararsiz G. The effects of hypercortisolism on the frequency and magnitude of sleep EEG waves in patients with Cushing syndrome: A spectral analysis study. Neurophysiol Clin 2023; 53:102893. [PMID: 37657229 DOI: 10.1016/j.neucli.2023.102893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 09/03/2023] Open
Abstract
OBJECTIVES Our aim was to investigate the effects of endogenous chronic hypercortisolism on sleep electroencephalogram (EEG) and differences between the adrenocorticotropic hormone (ACTH)-dependent and independent Cushing Syndrome (CS) patients through a sleep spectral analysis program. METHODS A total of 32 patients diagnosed as having endogenous CS (12 ACTH-dependent and 20 ACTH-independent) and a control group comprising 16 healthy individuals were included in the study. Polysomnographic analysis was performed. Blood samples were collected at 08:00 AM for analysis of ACTH and basal cortisol, and at 00:00 AM for midnight cortisol levels. The frequency and power of the slow wave activity (SWA), theta, alpha, and beta waves of the first and last non-rapid eye movement (NREM) cycles were measured with a spectral analysis program. RESULTS The CS patient group had higher SWA power, especially in the first NREM cycle. In the ACTH-dependent group, SWA maximum and mean power values were higher in the frontal channels in the first NREM, compared to the last NREM sleep stage (p<0.05). CONCLUSION Cortisol has been found to be associated with SWA waves, making these waves higher in power, especially in the first NREM phase. This difference was much less pronounced in the final NREM sleep stage. The difference between the first and last NREM sleep stages with respect to the power of SWA in the frontal channel in the ACTH-dependent group suggests that not only cortisol but also high levels of ACTH affect the power of slow waves during sleep.
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Affiliation(s)
- Duygu Kurt Gök
- Department of Neurology, Kayseri City Education and Research Hospital, Kayseri, Turkey.
| | - Sevda İsmailoğulları
- Department of Neurology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Ramazan Aldemir
- Department of Electronics and Automation, Biomedical Device Technology, Kayseri Vocational School of Higher Education, Kayseri University, City Kayseri, Turkey
| | - Mahmut Tokmakçı
- Department of Biomedical Engineering, Faculty of Engineering, Erciyes University, Kayseri, Turkey
| | - Sedat Tarik Firat
- Department of Medical Oncology, Kayseri City Education and Research Hospital, Kayseri, Turkey
| | - Züleyha Karaca
- Department of Endocrinology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Fahrettin Keleştemur
- Department of Endocrinology, Faculty of Medicine, Yeditepe University, Istanbul, Turkey
| | - Gökmen Zararsiz
- Department of Biostatistics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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7
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De Alcubierre D, Ferrari D, Mauro G, Isidori AM, Tomlinson JW, Pofi R. Glucocorticoids and cognitive function: a walkthrough in endogenous and exogenous alterations. J Endocrinol Invest 2023; 46:1961-1982. [PMID: 37058223 PMCID: PMC10514174 DOI: 10.1007/s40618-023-02091-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/05/2023] [Indexed: 04/15/2023]
Abstract
PURPOSE The hypothalamic-pituitary-adrenal (HPA) axis exerts many actions on the central nervous system (CNS) aside from stress regulation. Glucocorticoids (GCs) play an important role in affecting several cognitive functions through the effects on both glucocorticoid (GR) and mineralocorticoid receptors (MR). In this review, we aim to unravel the spectrum of cognitive dysfunction secondary to derangement of circulating levels of endogenous and exogenous glucocorticoids. METHODS All relevant human prospective and retrospective studies published up to 2022 in PubMed reporting information on HPA disorders, GCs, and cognition were included. RESULTS Cognitive impairment is commonly found in GC-related disorders. The main brain areas affected are the hippocampus and pre-frontal cortex, with memory being the most affected domain. Disease duration, circadian rhythm disruption, circulating GCs levels, and unbalanced MR/GR activation are all risk factors for cognitive decline in these patients, albeit with conflicting data among different conditions. Lack of normalization of cognitive dysfunction after treatment is potentially attributable to GC-dependent structural brain alterations, which can persist even after long-term remission. CONCLUSION The recognition of cognitive deficits in patients with GC-related disorders is challenging, often delayed, or mistaken. Prompt recognition and treatment of underlying disease may be important to avoid a long-lasting impact on GC-sensitive areas of the brain. However, the resolution of hormonal imbalance is not always followed by complete recovery, suggesting irreversible adverse effects on the CNS, for which there are no specific treatments. Further studies are needed to find the mechanisms involved, which may eventually be targeted for treatment strategies.
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Affiliation(s)
- D De Alcubierre
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - D Ferrari
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - G Mauro
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
| | - A M Isidori
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - J W Tomlinson
- Oxford Centre for Diabetes, Endocrinology and Metabolism, NIHR Oxford Biomedical Research Centre, University of Oxford, Churchill Hospital, Oxford, UK
| | - R Pofi
- Oxford Centre for Diabetes, Endocrinology and Metabolism, NIHR Oxford Biomedical Research Centre, University of Oxford, Churchill Hospital, Oxford, UK.
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Nobari H, Azarian S, Saedmocheshi S, Valdés-Badilla P, García Calvo T. Narrative review: The role of circadian rhythm on sports performance, hormonal regulation, immune system function, and injury prevention in athletes. Heliyon 2023; 9:e19636. [PMID: 37809566 PMCID: PMC10558889 DOI: 10.1016/j.heliyon.2023.e19636] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 08/21/2023] [Accepted: 08/29/2023] [Indexed: 10/10/2023] Open
Abstract
Objectives This study was a narrative review of the importance of circadian rhythm (CR), describes the underlying mechanisms of CR in sports performance, emphasizes the reciprocal link between CR, endocrine homeostasis and sex differences, and the unique role of the circadian clock in immune system function and coordination. Method As a narrative review study, a comprehensive search was conducted in PubMed, Scopus, and Web of Science (core collection) databases using the keywords "circadian rhythm", "sports performance", "hormonal regulation", "immune system", and "injury prevention". Inclusion criteria were studies published in English and peer-reviewed journals until July 2023. Studies that examined the role of CR in sports performance, hormonal status, immune system function, and injury prevention in athletes were selected for review. Results CR is followed by almost all physiological and biochemical activities in the human body. In humans, the superchiasmatic nucleus controls many daily biorhythms under solar time, including the sleep-wake cycle. A body of literature indicates that the peak performance of essential indicators of sports performance is primarily in the afternoon hours, and the evening of actions occurs roughly at the peak of core body temperature. Recent studies have demonstrated that the time of day that exercise is performed affects the achievement of good physical performance. This review also shows various biomarkers of cellular damage in weariness and the underlying mechanisms of diurnal fluctuations. According to the clock, CR can be synchronized with photonic and non-photonic stimuli (i.e., temperature, physical activity, and food intake), and feeding patterns and diet changes can affect CR and redox markers. It also emphasizes the reciprocal links between CR and endocrine homeostasis, the specific role of the circadian clock in coordinating immune system function, and the relationship between circadian clocks and sex differences. Conclusion The interaction between insufficient sleep and time of day on performance has been established in this study because it is crucial to balance training, recovery, and sleep duration to attain optimal sports performance.
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Affiliation(s)
- Hadi Nobari
- Faculty of Sport Sciences, University of Extremadura, 10003, Cáceres, Spain
- Department of Exercise Physiology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, 56199-11367, Iran
| | - Somayeh Azarian
- Department of Exercise Physiology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, 56199-11367, Iran
| | - Saber Saedmocheshi
- Department of Physical Education and Sport Sciences, Faculty of Humanities and Social Sciences, University of Kurdistan, Sanandaj, 66177-15175, Iran
| | - Pablo Valdés-Badilla
- Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca, 3530000, Chile
- Sports Coach Career, School of Education, Universidad Viña del Mar, Viña del Mar, 2520000, Chile
| | - Tomás García Calvo
- Faculty of Sport Sciences, University of Extremadura, 10003, Cáceres, Spain
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Feng W, Yang Z, Liu Y, Chen R, Song Z, Pan G, Zhang Y, Guo Z, Ding X, Chen L, Wang Y. Gut microbiota: A new target of traditional Chinese medicine for insomnia. Biomed Pharmacother 2023; 160:114344. [PMID: 36738504 DOI: 10.1016/j.biopha.2023.114344] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/20/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
All species have a physiological need for sleep, and sleep is crucial for the preservation and restoration of many physiological processes in the body. Recent research on the effects of gut microbiota on brain function has produced essential data on the relationship between them. It has been discovered that dysregulation of the gut-brain axis is related to insomnia. Certain metabolites of gut microbiota have been linked to insomnia, and disturbances in gut microbiota can worsen insomnia. Traditional Chinese medicine (TCM) has unique advantages for the treatment of insomnia. Taking the gut microbiota as the target and determining the scientific relevance of TCM to the prevention and treatment of insomnia may lead to new concepts for the treatment of sleep disorders and improve the therapeutic effect of sleep. Taking the gut microbiota as an entry point, this paper reviews the relationship between gut microbiota and TCM, the relationship between gut microbiota and insomnia, the mechanism by which gut microbiota regulate sleep, and the mechanism by which TCM regulates gut microbiota for insomnia prevention and treatment. This review provides new ideas for the prevention and treatment of insomnia through TCM and new ideas for drug development.
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Affiliation(s)
- Wanying Feng
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
| | - Zhihua Yang
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
| | - Yangxi Liu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China.
| | - Rui Chen
- College of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
| | - Zhihui Song
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
| | - Guiyun Pan
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
| | - Yuhang Zhang
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
| | - Zehui Guo
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
| | - Xinya Ding
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China.
| | - Lu Chen
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
| | - Yi Wang
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
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Xu W, Cui Y, Guo D, Wang W, Xu H, Qiao S, Yu H, Ji E, Liu Y, Li Q. UPLC-MS/MS simultaneous quantification of urinary circadian rhythm hormones and related metabolites: Application to air traffic controllers. J Chromatogr B Analyt Technol Biomed Life Sci 2023; 1222:123664. [PMID: 37040674 DOI: 10.1016/j.jchromb.2023.123664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/31/2022] [Accepted: 03/02/2023] [Indexed: 03/09/2023]
Abstract
Civil aviation flight crew and civil aviation air traffic controllers are prone to circadian rhythm abnormalities, which can lead to a slew of other maladies. It could endanger people's health and provide a serious threat to the safety of civil aviation flights if it is not appropriately evaluated and addressed. Early detection of rhythm irregularities and prompt treatment for particular populations that are vulnerable to rhythm disorders are crucial for enhancing civil aviation safety. In general, monitoring of the classical circadian rhythm biomarkers (melatonin or cortisol) in plasma or saliva is an effective way to evaluate the rhythm status. Due to the challenging sample procedure and the trauma of plasma, urine sample testing has received an increasing amount of attention. While, urine circadian rhythm biomarkers have seldom been examined, and the relationship between urinary steroid hormones and melatonin is still poorly understood. In most cases, hormones are determined by immunoassays respectively, mainly enzyme-linked immunosorbent assay (ELISA) or radioimmunoassay (RIA). There are also reports describing the liquid chromatography with tandem mass spectrometry (LC-MS/MS) technique as a method of melatonin or few steroid hormones quantification, however, the simultaneous detection of multiple rhythmic hormones in human urine is rarely reported. For the quantification of the rhythmic hormones in human urine, an accurate approach using ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was devised in this work. Nine endogenous hormones (melatonin, 6-hydroxymelatonin, 6-sulfatoxymelatonin, cortisol, corticosterone, cortisone, testosterone, epitestosterone and androsterone), in human overnight urine, were quantified after solid phase extraction (SPE). A reverse phase HSS C18 column was used for chromatographic separation with a 9-minute gradient elution and deuterated analogues of each analyte were applied as internal standards. This method was successfully applied to the analysis of 596 overnight urine samples (23:00-9:00) collected from 84 air traffic controllers in the Beijing area during shift work. This study's findings showed a clear correlation not only between melatonin and its metabolites; cortisol-related metabolites, but also between melatonin metabolites and endogenous metabolites upstream and downstream of cortisol, implying that these two categories of hormones can be used as potential biological rhythm indicators to provide circadian rhythm data support for future studies on circadian rhythm disorders.
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Affiliation(s)
- Weizhe Xu
- Civil Aviation Medical Center, Civil Aviation Administration of China, Beijing 100123, China
| | - Yujing Cui
- Civil Aviation Medical Center, Civil Aviation Administration of China, Beijing 100123, China
| | - Danming Guo
- Civil Aviation Medical Center, Civil Aviation Administration of China, Beijing 100123, China
| | - Wei Wang
- Civil Aviation Medical Center, Civil Aviation Administration of China, Beijing 100123, China
| | - Haishan Xu
- Civil Aviation Medical Center, Civil Aviation Administration of China, Beijing 100123, China
| | - Shi Qiao
- Civil Aviation Medical Center, Civil Aviation Administration of China, Beijing 100123, China
| | - Hongyan Yu
- Civil Aviation Medical Center, Civil Aviation Administration of China, Beijing 100123, China
| | - Enhui Ji
- Civil Aviation Medical Center, Civil Aviation Administration of China, Beijing 100123, China
| | - Yongsuo Liu
- Civil Aviation Medical Center, Civil Aviation Administration of China, Beijing 100123, China
| | - Qingyan Li
- Civil Aviation Medical Center, Civil Aviation Administration of China, Beijing 100123, China
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11
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Li Y, Wang Y, Guan X, Yue J, Wu HE, Zhen S, He SC, Zhang XY. Genotype-genotype interactions of the OXTR gene polymorphisms are associated with self-reported daytime dysfunction, sleep latency and personal distress. J Sleep Res 2023; 32:e13668. [PMID: 35706410 DOI: 10.1111/jsr.13668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 05/20/2022] [Accepted: 05/22/2022] [Indexed: 02/03/2023]
Abstract
The oxytocin receptors located in the corticotropin-releasing factor neurons of the paraventricular nucleus are stimulated by oxytocin. Oxytocin functions as the regulator of the corticotropin-releasing factor system and in turn promotes sleep quality. The objective of this study was to examine the main and genotype-genotype interactive effects of the oxytocin receptor gene (OXTR) polymorphisms on sleep quality. A total of 324 participants were randomly recruited from a university in Beijing, China. Sleep quality was measured with the Pittsburgh Sleep Quality Index. The OXTR single-nucleotide polymorphisms (rs2254298, rs2268498, rs13316193, rs2268490 and rs2268491) were genotyped. The results showed that gender and age were associated with various empathy traits (all p < 0.001). The Pittsburgh Sleep Quality Index was positively correlated with the Personal Distress subscale of empathy (p < 0.001). Both rs2254298 and rs2268491 interacted with rs13316193 to influence daytime dysfunction and Personal Distress (all p < 0.05), indicating that in individuals with rs13316193 CC/CT genotype, those with rs2254298 AA/AG or rs2268491 TT/TC genotypes displayed higher daytime dysfunction and Personal Distress scores than those with rs2254298 GG or rs2268491 CC genotypes. Conversely, among the individuals with rs2254298 GG or rs2268491 CC genotypes, the rs13316193 C allele carriers had lower daytime dysfunction and Personal Distress scores than rs13316193 TT homozygotes. There was also a significant interaction between rs2268490 and rs2268498 on the sleep latency dimension of the Pittsburgh Sleep Quality Index. Our findings reveal for the first time the genotype-genotype interactions of the OXTR gene on sleep quality, which may open new research avenues for studying psychopathology involving sleep problems.
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Affiliation(s)
- Yuling Li
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Yuan Wang
- PLA Strategic Support Force Medical Center, Beijing, China
| | - Xin Guan
- PLA Strategic Support Force Medical Center, Beijing, China
| | - Jingyan Yue
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Hanjing Emily Wu
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Shiqian Zhen
- Institute of Circulation and Consumption, Chinese Academy of International Trade and Economic Cooperation, Beijing, China
| | - Shu-Chang He
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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12
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Effect of subjective sleep quality on aggression: A two-year longitudinal and fMRI pilot study. Biol Psychol 2023; 176:108454. [PMID: 36535515 DOI: 10.1016/j.biopsycho.2022.108454] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/25/2022] [Accepted: 11/12/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND/OBJECTIVE To examine the causal relationship between sleep quality and aggression and their reliable cognitive neural mechanisms. METHOD We conducted two follow-up measures on subjective sleep quality, aggression, and resting-state functional magnetic resonance imaging (rs-fMRI) of 455 college students, with a two-year interval between the two follow-up measures. We used cross-lag model on the questionnaire and amplitude of low-frequency fluctuation (ALFF) on rs-fMRI for data analysis. RESULTS 1) The cross-lag model showed that sleep quality at the first time could predict aggression at the second time. 2) ALFF showed poor sleep quality decreased spontaneous activity in prefrontal regions, but increased activity in limbic system regions, which may be the possible neural basis linking poor sleep quality with increased aggressive behavior. CONCLUSIONS There is a causal relationship between subjective sleep quality and aggressive behavior. Our finding proposes a new view of how sleep quality affects aggressive behavior.
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13
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Buban KN, Saperstein SE, Oyola MG, Rothwell SW, John Wu T. Alterations in the activation of corticotropin-releasing factor neurons in the paraventricular nucleus following a single or multiple days of sleep restriction. Neurosci Lett 2023; 792:136940. [PMID: 36336086 DOI: 10.1016/j.neulet.2022.136940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 10/17/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
Sleep disturbances are common among disorders associated with hypothalamic pituitary-adrenal (HPA) axis dysfunction, such as depression and anxiety. This comorbidity may partly be the result of the intersection between the role of the HPA axis in mediating the stress response and its involvement in sleep-wake cyclicity. Our previous work has shown that following 20 h of sleep restriction, mice show a blunting of the HPA axis in response to an acute stressor. Furthermore, these responses differ in a sex-dependent manner. This study sought to examine the effect of sleep restriction on corticotropin-releasing factor (CRF)-containing neurons in the paraventricular nucleus (PVN) of the hypothalamus. Male and female Crf-IRES-Cre: Ai14 (Tdtomato) reporter mice were sleep restricted for 20 h daily for either a single or three consecutive days using the modified multiple platform method. These mice allowed the visualization of CRF+ neurons throughout the brain. Animals were subjected to acute restraint stress, and their brains were collected to assess PVN neuronal activation via c-Fos immunohistochemistry. Analyses of cell counts revealed an ablation of the restraint-induced increase in both CRF/c-Fos colocalization and overall c-Fos expression in female mice following both a single day and three days of sleep restriction. Males showed an overall decrease in restraint-induced c-Fos levels following a single day of sleep restriction. However, male mice examined after three days of sleep restriction showed a recovery in PVN-CRF and overall PVN neuronal activation. These data suggest the sex dependent dysregulation in CRF function following sleep restriction.
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Affiliation(s)
- Katelyn N Buban
- Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Samantha E Saperstein
- Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Mario G Oyola
- Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Stephen W Rothwell
- Department of Anatomy, Physiology and Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - T John Wu
- Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
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14
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De Nys L, Anderson K, Ofosu EF, Ryde GC, Connelly J, Whittaker AC. The effects of physical activity on cortisol and sleep: A systematic review and meta-analysis. Psychoneuroendocrinology 2022; 143:105843. [PMID: 35777076 DOI: 10.1016/j.psyneuen.2022.105843] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/16/2022] [Accepted: 06/19/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Managing stress and having good quality sleep are inter-related factors that are essential for health, and both factors seem to be affected by physical activity. Although there is an established bidirectional relationship between stress and sleep, remarkably few studies have been designed to examine the effects of physical activity on cortisol, a key biomarker for stress, and sleep. Research is particularly scarce in older people despite both sleep and cortisol changing with age. This systematic literature review addresses this gap. METHODS A systematic review was conducted following the PRISMA guidelines. Original, peer-reviewed records of intervention studies such as randomized controlled trials (RCTs) and non-RCTs with relevant control groups were eligible for inclusion. The Participant, Intervention, Comparison, Outcome (PICO) characteristics were (1) adults or older adults (2) physical activity programmes of any duration, (3) controls receiving no intervention or controls included in a different programme, (4) cortisol measurement, and subjective or objective measures of sleep. RESULTS Ten original studies with low-to-moderate risk of bias were included. Findings from this review indicated with moderate- and low-certainty evidence, respectively, that physical activity was an effective strategy for lowering cortisol levels (SMD [95% CI] = -0.37 [-0.52, -0.21] p < .001) and improving sleep quality (SMD [95% CI] = -0.30 [-0.56, -0.04], p = .02). Caution is needed to generalize these findings to the general population, as included trials were predominantly participants with breast cancer, included few males and no older adults. CONCLUSION Cortisol regulation and sleep quality are intertwined, and physical activity programmes could improve both in several ways. Further, physical activity may benefit adults with long term conditions or current poor (mental) health states the most, although more research is needed to support this claim fully. Few intervention studies have examined the inter-relationship between cortisol and sleep outcomes in males or older adults, indicating fruitful enquiry for future research.
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Affiliation(s)
- Len De Nys
- Faculty of Health Sciences and Sport, University of Stirling, Scotland, UK.
| | - Kerry Anderson
- Faculty of Health Sciences and Sport, University of Stirling, Scotland, UK
| | - Esther F Ofosu
- Faculty of Health Sciences and Sport, University of Stirling, Scotland, UK
| | - Gemma C Ryde
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland, UK
| | - Jenni Connelly
- Faculty of Health Sciences and Sport, University of Stirling, Scotland, UK
| | - Anna C Whittaker
- Faculty of Health Sciences and Sport, University of Stirling, Scotland, UK
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15
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Van Gastel A. Drug-Induced Insomnia and Excessive Sleepiness. Sleep Med Clin 2022; 17:471-484. [PMID: 36150808 DOI: 10.1016/j.jsmc.2022.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Undesirable side effects of insomnia and/or sleepiness may occur with many prescribed drugs, psychotropics as well as non-psychotropics. These central nervous system effects can be explained by the interactions of the drug with any of the numerous neurotransmitters and receptors that are involved in sleep and wakefulness. Also a close - sometimes bidirectional - relationship between disease and (disturbed) sleep/wakefulness is often present e.g. in chronic pain; drug effects may lead this vicious circle in both ways. Besides the importance for health and quality of life, effects on sleep or waking function can be a potential source of non-compliance.
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Affiliation(s)
- Ann Van Gastel
- Multidisciplinary Sleep Disorders Centre and University Department of Psychiatry, Antwerp University Hospital, Drie Eikenstraat 655, 2650 Edegem, Antwerp, Belgium; Faculty of Medicine and Health Sciences, Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp (UA), Campus Drie Eiken, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium.
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16
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Medel‐Matus JS, Orozco‐Suárez S, Escalante RG. Factors not considered in the study of drug-resistant epilepsy: Psychiatric comorbidities, age, and gender. Epilepsia Open 2022; 7 Suppl 1:S81-S93. [PMID: 34967149 PMCID: PMC9340311 DOI: 10.1002/epi4.12576] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 12/20/2021] [Accepted: 12/27/2021] [Indexed: 11/10/2022] Open
Abstract
In basic research and clinical practice, the control of seizures has been the most important goal, but it should not be the only one. There are factors that remain poorly understood in the study of refractory epilepsy such as the age and gender of patients and the presence of psychiatric comorbidities. It is known that in patients with drug-resistant epilepsy (DRE), the comorbidities contribute to the deterioration of the quality of life, increase the severity, and worsen the prognosis of epilepsy. Some studies have demonstrated that patients diagnosed with a co-occurrence of epilepsy and psychiatric disorders are more likely to present refractory seizures and the probability of seizure remission after pharmacotherapy is reduced. The evidence of this association suggests the presence of shared pathogenic mechanisms that may include endocrine disorders, neuroinflammatory processes, disturbances of neurotransmitters, and mechanisms triggered by stress. Additionally, significant demographic, clinical, and electrographic differences have been observed between women and men with epilepsy. Epilepsy affects the female gender in a greater proportion, although there are no studies that report whether refractoriness affects more females. The reasons behind these sex differences are unclear; however, it is likely that sex hormones and sex brain differences related to chromosomal genes play an important role. On the other hand, it has been shown in industrialized countries that prevalence of DRE is higher in the elderly when compared to youngsters. Conversely, this phenomenon is not observed in developing regions, where more cases are found in children and young adults. The correct identification and management of these factors is crucial in order to improve the quality of life of the patients.
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Affiliation(s)
- Jesús Servando Medel‐Matus
- Department of PediatricsNeurology DivisionDavid Geffen School of Medicine at University of California Los AngelesLos AngelesCaliforniaUSA
| | - Sandra Orozco‐Suárez
- Unit of Medical Research in Neurological DiseasesSpecialty Hospital “Dr. Bernardo Sepúlveda”National Medical Center S.XXIMexico CityMexico
| | - Ruby G. Escalante
- Department of PediatricsNeurology DivisionDavid Geffen School of Medicine at University of California Los AngelesLos AngelesCaliforniaUSA
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17
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Kater MJ, Werner A, Schlarb AA, Lohaus A. Stress reactivity in salivary cortisol and electrocardiogram in adolescents: Investigating sleep disturbances and insomnia. J Sleep Res 2022; 31:e13591. [PMID: 35843709 DOI: 10.1111/jsr.13591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/09/2022] [Accepted: 03/09/2022] [Indexed: 01/03/2023]
Abstract
This study examined the role of sleep disturbances and insomnia in the context of stress reactivity in adolescence. One-hundred and thirty-five 11-18 year olds (Mage = 14.2 years, SD = 1.9, 52% female) completed the Trier Social Stress Test for Children. Salivary cortisol and subjective stress ratings were collected at six time points, and heart rate as well as heart rate variability were measured pre-, during and post-stress induction. Additionally, sleep disturbances and insomnia diagnosis were assessed by a self-report questionnaire and a sleep interview. Robust mixed models investigated if adolescents with compared with adolescents without (a) sleep disturbances and (b) insomnia differ regarding cortisol, heart rate, heart rate variability and psychological stress reactivity considering gender effects. The results indicated that boys with high sleep disturbances showed higher cortisol activity compared with boys with low sleep disturbances, B = 0.88, p < 0.05. Moreover, in boys with insomnia, heart rate and alpha 1 significantly differ less than in boys without insomnia. These findings support the notion of sex differences regarding the association between poor sleep and increased activity of the hypothalamic-pituitary-adrenal axis, and a less adaptable autonomic nervous system in boys in response to an experimental social stress task.
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Affiliation(s)
- Maren-Jo Kater
- Faculty of Psychology and Sports Science, Developmental Psychology and Developmental Psychopathology, Bielefeld University, Bielefeld, Germany
| | - Anika Werner
- Faculty of Psychology and Sports Science, Developmental Psychology and Developmental Psychopathology, Bielefeld University, Bielefeld, Germany
| | - Angelika A Schlarb
- Faculty of Psychology and Sports Science, Clinical Psychology and Psychotherapy of Children and Adolescents, Bielefeld University, Bielefeld, Germany
| | - Arnold Lohaus
- Faculty of Psychology and Sports Science, Developmental Psychology and Developmental Psychopathology, Bielefeld University, Bielefeld, Germany
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18
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de Feijter M, Katimertzoglou A, Tiemensma J, Ikram MA, Luik AI. Polysomnography-estimated sleep and the negative feedback loop of the hypothalamic-pituitary-adrenal (HPA) axis. Psychoneuroendocrinology 2022; 141:105749. [PMID: 35427952 DOI: 10.1016/j.psyneuen.2022.105749] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 03/22/2022] [Accepted: 03/22/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Sleep and stress are highly interrelated. To improve our understanding of the role of sleep in functioning of the negative feedback loop of the stress system, we assessed the association between sleep and functioning of the hypothalamic-pituitary-adrenal (HPA) axis in a population-based sample. METHODS This study included 403 participants (mean age: 62.4 ± 5.0 years, 55% women) of the population-based Rotterdam Study. Between 2012 and 2014, sleep was assessed with polysomnography. Functioning of the negative feedback loop of the HPA axis was estimated by measuring cortisol levels before and after the intake of a very low dose of dexamethasone (0.25 mg) on average 0.9 ± 37.8 days after the polysomnography. We used linear regression analyses adjusted for multiple confounders and performed sensitivity analyses in a sample excluding those with clinically relevant depressive symptoms and using psychoactive medicine, and a sample excluding non-suppressors. RESULTS Short N2 sleep (adjusted difference = 0.005, 95%CI = 0.002;0.009), long N3 sleep (adjusted difference = -0.007, 95%CI = -0.010;-0.003), and short sleep onset latency (adjusted difference = 0.006, 95%CI = 0.001;0.011) were associated with an enhanced response to dexamethasone, but the association of sleep onset latency did not survive multiple testing correction. Associations remained similar after excluding those with clinically relevant depressive symptoms and those using psychoactive medicine or exclusion of non-suppressors. CONCLUSIONS This study suggests that more slow wave sleep is particularly associated with a stronger suppression of cortisol within the negative feedback loop of the HPA axis. These findings provide further support that slow wave sleep is important for health.
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Affiliation(s)
- Maud de Feijter
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
| | | | - Jitske Tiemensma
- Department of Anesthesiology, Center for Pain Medicine, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
| | - Annemarie I Luik
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, The Netherlands; Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
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19
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Zhu M, Yuan L, Wu Y, Chu L, Wang W, Zhang H, Liao W, Peng X, Deng H. Simultaneous LC-MS/MS quantification of glucocorticoids, melatonin and its metabolites in hair. J Chromatogr B Analyt Technol Biomed Life Sci 2022; 1196:123217. [DOI: 10.1016/j.jchromb.2022.123217] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 02/21/2022] [Accepted: 03/08/2022] [Indexed: 11/29/2022]
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20
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Wolters F, van Middendorp H, van den Bergh O, Biermasz NR, Meijer OC, Evers AWM. Conditioning of the Cortisol Awakening Response in Healthy Males: Study Protocol for a Randomized, Controlled Trial (Preprint). JMIR Res Protoc 2022. [DOI: 10.2196/38087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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21
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A Review of the Associations Between Obstructive Sleep Apnea and Gestational Diabetes Mellitus and Possible Mechanisms of Disease. Reprod Sci 2022; 30:81-92. [PMID: 35257355 PMCID: PMC9810675 DOI: 10.1007/s43032-022-00904-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 02/25/2022] [Indexed: 01/07/2023]
Abstract
Obstructive sleep apnea (OSA) usually leads to the occurrence of diabetes. Gestational diabetes mellitus (GDM) is a common gestational complication associated with adverse maternal and fetal outcomes. Increasing studies suggest that women with OSA during pregnancy may be at a significantly greater risk of developing GDM. It is crucial to explore the association between OSA and GDM and the mechanisms underlying this association. In this review, we presented a comprehensive literature review of the following: the association between OSA and GDM, the possible mechanisms of this association, and the effects of continuous positive airway pressure (CPAP) on OSA with GDM. The results showed that most authors suggested that there was an association between OSA and GDM. The intermittent hypoxemia (IH) and reduction of slow-wave sleep (SWS) may be the key to this association. IH induces the products of oxidative stress and inflammation as well as dysregulation of the hypothalamic-pituitary-adrenal, which lead to diabetes. In addition, SWS reduction in OSA enhances the inflammation by increasing the inflammatory cytokines, increases the sympathetic activation, and causes changes in leptin level, which result in the development of GDM. Additionally, whether CPAP is beneficial to GDM remains still unclear.
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22
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Xu YM, Li C, Zhu R, Zhong BL. Prevalence and Correlates of Insomnia Symptoms in Older Chinese Adults During the COVID-19 Outbreak: A Classification Tree Analysis. J Geriatr Psychiatry Neurol 2022; 35:223-228. [PMID: 35245996 PMCID: PMC8899830 DOI: 10.1177/08919887221078561] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/13/2021] [Accepted: 05/24/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To examine prevalence and correlates of insomnia symptoms in older Chinese adults (OCAs) during the COVID-19 outbreak. BACKGROUND During the COVID-19 pandemic, insomnia is a major health concern of elderly individuals, but its subtypes have not been investigated. METHODS Altogether, 590 OCAs (50+ years) were recruited via snowball sampling during the COVID-19 outbreak. Standardized self-report questions were used to assess the presence of difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and early morning awakening (EMA). Classification tree analysis (CTA) was used to identify correlates of insomnia. RESULTS The one-month prevalence (95% confidence interval) of any subtype of insomnia symptoms was 23.4% (20.0-26.8%), with DIS, DMS, and EMA being 15.4% (12.5-18.3%), 17.1% (14.1-20.2%), and 11.2% (8.64-13.7%), respectively. Worry about being infected with COVID-19 emerged as the most salient correlate of insomnia (P < .001); compared to participants who were not worried about being infected, those who were worried and very worried were 3.2-fold (24.3% vs 7.5%) and 5.5-fold (24.3% vs 7.5%) more likely to have insomnia, respectively. Among participants in the "very worried" branch, those residing in Wuhan were 1.8-fold more likely to have insomnia than those residing in other places (50.0% vs 27.5%, P = .011). Among participants in the "worried" branch, unemployed persons were 2.0-fold more likely to have insomnia than employed persons (37.0% vs 18.1%, P < .001). CONCLUSIONS Insomnia symptoms were prevalent among OCAs during the COVID-19 outbreak. Selective intervention programs targeting elderly individuals who are worried about being infected, living in the epicenter of COVID-19, and unemployed might be effective.
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Affiliation(s)
- Yan-Min Xu
- Department of Psychiatry,
Wuhan
Mental Health Center, Wuhan,
China
- Department of Psychiatry,
Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University
of Science & Technology, Wuhan,
China
| | - Chao Li
- Department of Psychiatry,
Yunnan Mental
Health Center, Kunming, China
| | - Ruizi Zhu
- Department of Sociology,
Queen’s
University, Kingston, ON, Canada
| | - Bao-Liang Zhong
- Department of Psychiatry,
Wuhan
Mental Health Center, Wuhan,
China
- Department of Psychiatry,
Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University
of Science & Technology, Wuhan,
China
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23
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Kelly RJ, Zeringue MM, El-Sheikh M. Adolescents' sleep and adjustment: Reciprocal effects. Child Dev 2022; 93:540-555. [PMID: 34757645 PMCID: PMC8930734 DOI: 10.1111/cdev.13703] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Reciprocal relations between sleep and adjustment were investigated. Participants included 246 adolescents (M = 15.80 years; 67.5% White, 32.5% Black/African American; 53% female, 47% male) at Time 1 (data collected 2012-2013), 227 at Time 2 (M = 16.78 years) and 215 at Time 3 (M = 17.70 years). Sleep-wake variables were measured with self-reports (sleepiness) and actigraphy (average sleep minutes and efficiency, variability in sleep minutes and efficiency). Adolescents reported on depression and anxiety symptoms, and parents reported on externalizing problems. Greater variability in sleep duration and efficiency as well as sleepiness predicted adjustment problems (range of R2 : 36%-60%). Reciprocal relations were supported mostly for sleepiness (range of R2 : 16%-32%). Results help understand bidirectional relations between sleep and adjustment.
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Affiliation(s)
- Ryan J. Kelly
- Department of Individual, Family and Community Education, University of New Mexico
| | - Megan M. Zeringue
- Department of Human Development and Family Studies, Auburn University
| | - Mona El-Sheikh
- Department of Human Development and Family Studies, Auburn University
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24
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Tohidinik HR, Rodríguez A, Regueira-Méndez C, Takkouche B. Sleep quality and risk of recurrent aphthous ulcers: A Spanish cohort study. Oral Dis 2021; 28:1882-1890. [PMID: 34242451 DOI: 10.1111/odi.13955] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/18/2021] [Accepted: 06/20/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Recurrent aphthous stomatitis (RAS) is a condition that affects 20% of the world population and is characterized by painful ulcers in the oral mucosa. So far, the epidemiology and risk factors of RAS have been infrequently studied. Our objective was to determine whether sleep-related factors are related to the occurrence of RAS in the first prospective study carried out on this topic. METHODS A cohort of 11210 Spanish students, 13-17 years old, was followed up for one year. Sleep disorders were assessed at baseline using a standard validated questionnaire. RESULTS We detected 2655 new cases of RAS with a total of 287,262 person-week of follow-up. Subjects with high (4th quartile) Insomnia Index showed an incidence rate ratio (IRR) of RAS of 1.29 (95% confidence interval (CI) 1.15-1.45), while subjects with high Hypersomnia Index presented an IRR of 1.42 (95% CI 1.26-1.61). A high score of sleep-related phenomena was also associated with an increased IRR: 1.53 (95% CI 1.37-1.69). Adolescents with high level of sleep satisfaction were at lower risk of RAS: 0.88 (95% CI 0.77-1.01). CONCLUSION These findings suggest that sleep disorders are moderately associated with RAS in adolescents.
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Affiliation(s)
- Hamid Reza Tohidinik
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.,Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Almudena Rodríguez
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Carlos Regueira-Méndez
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP, Madrid, Spain
| | - Bahi Takkouche
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP, Madrid, Spain
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El Mlili N, Ahabrach H, Cauli O. Hair Cortisol Concentration as a Biomarker of Sleep Quality and Related Disorders. Life (Basel) 2021; 11:life11020081. [PMID: 33499247 PMCID: PMC7911396 DOI: 10.3390/life11020081] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 01/20/2021] [Accepted: 01/21/2021] [Indexed: 12/11/2022] Open
Abstract
Cortisol is the end product of the hypothalamic-pituitary-adrenal (HPA) axis, and its production is increased mainly in stressful situations or in chronic disorders accompanied by stress enhancement. Altered cortisol concentrations have been reported in a number of neuropsychiatric diseases and sleep disorders. Cortisol concentrations have been measured using several methods, and in several matrixes, such as blood, saliva, and urine. However, lately, hair cortisol, for several reasons, has emerged as a promising biomarker of long-term retrospective HPA activation. Several experimental approaches for cortisol measurement with the corresponding concentration reference ranges and a summary of findings from scientific literature on this field are presented. There is evidence of a close relationship between HPA functional alteration and the development of neuropsychiatric disorders. Sleep disorders are the most common manifestation in several neuropsychiatric conditions, and have also been associated to cortisol alterations in both adults and children. Many studies indicate that hair cortisol constitutes a valuable tool for further contributing to existing data on salivary, plasma, or urinary cortisol concentrations in patients with sleep disorders.
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Affiliation(s)
- Nisrin El Mlili
- Higher Institute of Nursing Professions and Health Techniques (ISPITS), 93000 Tetouan, Morocco; (N.E.M.); (H.A.)
- Department of Biology and Health, Faculty of Sciences, University Abdelmalek Essâadi, 93000 Tetouan, Morocco
| | - Hanan Ahabrach
- Higher Institute of Nursing Professions and Health Techniques (ISPITS), 93000 Tetouan, Morocco; (N.E.M.); (H.A.)
- Department of Biology and Health, Faculty of Sciences, University Abdelmalek Essâadi, 93000 Tetouan, Morocco
| | - Omar Cauli
- Department of Nursing, University of Valencia, 46010 Valencia, Spain
- Frailty and Cognitive Impairment Group (FROG), University of Valencia, 46010 Valencia, Spain
- Chair of Healthy, Active and Participatory Aging, Valencia City Council, University of Valencia, 46010 Valencia, Spain
- Correspondence:
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Henry M, Thomas KGF, Ross IL. Sleep, Cognition and Cortisol in Addison's Disease: A Mechanistic Relationship. Front Endocrinol (Lausanne) 2021; 12:694046. [PMID: 34512546 PMCID: PMC8429905 DOI: 10.3389/fendo.2021.694046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 08/02/2021] [Indexed: 11/19/2022] Open
Abstract
Sleep is a critical biological process, essential for cognitive well-being. Neuroscientific literature suggests there are mechanistic relations between sleep disruption and memory deficits, and that varying concentrations of cortisol may play an important role in mediating those relations. Patients with Addison's disease (AD) experience consistent and predictable periods of sub- and supra-physiological cortisol concentrations due to lifelong glucocorticoid replacement therapy, and they frequently report disrupted sleep and impaired memory. These disruptions and impairments may be related to the failure of replacement regimens to restore a normal circadian rhythm of cortisol secretion. Available data provides support for existing theoretical frameworks which postulate that in AD and other neuroendocrine, neurological, or psychiatric disorders, disrupted sleep is an important biological mechanism that underlies, at least partially, the memory impairments that patients frequently report experiencing. Given the literature linking sleep disruption and cognitive impairment in AD, future initiatives should aim to improve patients' cognitive performance (and, indeed, their overall quality of life) by prioritizing and optimizing sleep. This review summarizes the literature on sleep and cognition in AD, and the role that cortisol concentrations play in the relationship between the two.
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Affiliation(s)
- Michelle Henry
- Centre for Higher Education Development, University of Cape Town, Cape Town, South Africa
- *Correspondence: Michelle Henry,
| | | | - Ian Louis Ross
- Division of Endocrinology, Department of Medicine, University of Cape Town, Cape Town, South Africa
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Sprajcer M, Jay SM, Vincent GE, Zhou X, Vakulin A, Lack L, Ferguson SA. Are Individuals with Low Trait Anxiety Better Suited to On-Call Work? Clocks Sleep 2020; 2:473-486. [PMID: 33198226 PMCID: PMC7712885 DOI: 10.3390/clockssleep2040035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/22/2020] [Accepted: 11/03/2020] [Indexed: 11/21/2022] Open
Abstract
Research has indicated that individuals with certain traits may be better suited to shiftwork and non-standard working arrangements. However, no research has investigated how individual differences impact on-call outcomes. As such, this study investigated the impact of trait anxiety on sleep and performance outcomes on-call. Seventy male participants (20–35 years) completed an adaptation night, a control night, and two on-call nights in a laboratory. Trait anxiety was determined using the State Trait Anxiety Inventory (STAI) X-2, and participants completed the STAI X-1 prior to bed each night to assess state anxiety. Sleep was measured using polysomnography and quantitative electroencephalographic analysis. Performance was assessed using a 10-min psychomotor vigilance task (PVT) performed each day at 0930, 1200, 1430 and 1700 h. Data pooled from three separate but inter-related studies was used for these analyses. Results indicated that the effects of trait anxiety on state anxiety, sleep and performance outcomes on-call were generally limited. These findings suggest that on-call outcomes are not negatively affected by higher levels of trait anxiety.
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Affiliation(s)
- Madeline Sprajcer
- Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Wayville 5034, SA, Australia; (S.M.J.); (G.E.V.); (S.A.F.)
- Correspondence:
| | - Sarah M Jay
- Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Wayville 5034, SA, Australia; (S.M.J.); (G.E.V.); (S.A.F.)
| | - Grace E Vincent
- Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Wayville 5034, SA, Australia; (S.M.J.); (G.E.V.); (S.A.F.)
| | - Xuan Zhou
- Australian Centre for Precision Health, University of South Australia, Adelaide 5000, SA, Australia;
| | - Andrew Vakulin
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide 5042, SA, Australia;
- Woolcock Institute of Medical Research, Centre for Sleep and Chronobiology, Sydney 2037, NSW, Australia
| | - Leon Lack
- Adelaide Institute for Sleep Health, College of Education, Psychology, and Social Work, Flinders University, Adelaide 5042, SA, Australia;
| | - Sally A Ferguson
- Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Wayville 5034, SA, Australia; (S.M.J.); (G.E.V.); (S.A.F.)
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Li Y, Cao Z, Wu S, Wang C, He S, Dong Y, Zhang X. Association of job stress, CLOCK gene polymorphism and their interaction with poor sleep quality. J Sleep Res 2020; 30:e13133. [PMID: 32633440 DOI: 10.1111/jsr.13133] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/12/2020] [Accepted: 06/03/2020] [Indexed: 12/13/2022]
Abstract
Job stress and the Circadian Locomotor Output Cycles Kaput (CLOCK) gene could affect circadian rhythm and sleep quality. The main aim of our present study was to investigate the association of job stress, CLOCK gene polymorphism and their interaction with sleep quality in a non-clinical Chinese Han population, which has not been reported to date. Using a cross-sectional design, 450 subjects were recruited in Beijing. Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI) and job stress was measured with the Work Stress Scale. CLOCK gene rs11932595 polymorphism was genotyped in 297 blood samples. Correlation analysis showed a close but different association of high job stress with the PSQI and its components. Analysis of variance showed significant main effects of the CLOCK gene rs11932595 polymorphism. G-allele carriers had a higher score in the PSQI, sleep duration, sleep latency and sleep disturbances. Further interaction analyses showed an ordinal interaction on sleep duration, and a disordinal interaction on daytime dysfunction. Specifically, G-allele carriers had poorer sleep duration than AA homozygotes when in high job stress, while the two subgroups displayed similar sleep duration when in low job stress, conforming to the diathesis-stress model. In comparison to G-allele carriers, AA homozygotes experienced less daytime dysfunction when in low job stress whereas more daytime dysfunction when in high job stress, fitting with the differential susceptibility model. As genetic links have been revealed, our investigation might be conducive for elucidating aetiological factors for sleep quality and targets for implementing interventions to attain good sleep quality.
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Affiliation(s)
- Yuling Li
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Zeyuan Cao
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China.,Bioinformatics program, Boston University, Boston, MA, USA
| | - Shuang Wu
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Chao Wang
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Shuchang He
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Yan Dong
- Department of Psychology, Renmin University of China, Beijing, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Healthy, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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Nollet M, Wisden W, Franks NP. Sleep deprivation and stress: a reciprocal relationship. Interface Focus 2020; 10:20190092. [PMID: 32382403 PMCID: PMC7202382 DOI: 10.1098/rsfs.2019.0092] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2020] [Indexed: 12/19/2022] Open
Abstract
Sleep is highly conserved across evolution, suggesting vital biological functions that are yet to be fully understood. Animals and humans experiencing partial sleep restriction usually exhibit detrimental physiological responses, while total and prolonged sleep loss could lead to death. The perturbation of sleep homeostasis is usually accompanied by an increase in hypothalamic–pituitary–adrenal (HPA) axis activity, leading to a rise in circulating levels of stress hormones (e.g. cortisol in humans, corticosterone in rodents). Such hormones follow a circadian release pattern under undisturbed conditions and participate in the regulation of sleep. The investigation of the consequences of sleep deprivation, from molecular changes to behavioural alterations, has been used to study the fundamental functions of sleep. However, the reciprocal relationship between sleep and the activity of the HPA axis is problematic when investigating sleep using traditional sleep-deprivation protocols that can induce stress per se. This is especially true in studies using rodents in which sleep deprivation is achieved by exogenous, and potentially stressful, sensory–motor stimulations that can undoubtedly confuse their conclusions. While more research is needed to explore the mechanisms underlying sleep loss and health, avoiding stress as a confounding factor in sleep-deprivation studies is therefore crucial. This review examines the evidence of the intricate links between sleep and stress in the context of experimental sleep deprivation, and proposes a more sophisticated research framework for sleep-deprivation procedures that could benefit from recent progress in biotechnological tools for precise neuromodulation, such as chemogenetics and optogenetics, as well as improved automated real-time sleep-scoring algorithms.
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Affiliation(s)
- Mathieu Nollet
- Department of Life Sciences, Imperial College London, London, UK.,UK Dementia Research Institute at Imperial College London, London, UK
| | - William Wisden
- Department of Life Sciences, Imperial College London, London, UK.,UK Dementia Research Institute at Imperial College London, London, UK.,Centre for Neurotechnology, Imperial College London, London, UK
| | - Nicholas P Franks
- Department of Life Sciences, Imperial College London, London, UK.,UK Dementia Research Institute at Imperial College London, London, UK.,Centre for Neurotechnology, Imperial College London, London, UK
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Steur LMH, Kaspers GJL, van Someren EJW, van Eijkelenburg NKA, van der Sluis IM, Dors N, van den Bos C, Tissing WJE, Grootenhuis MA, van Litsenburg RRL. The impact of maintenance therapy on sleep-wake rhythms and cancer-related fatigue in pediatric acute lymphoblastic leukemia. Support Care Cancer 2020; 28:5983-5993. [PMID: 32285260 PMCID: PMC7686190 DOI: 10.1007/s00520-020-05444-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 03/27/2020] [Indexed: 02/06/2023]
Abstract
Purpose To assess the impact of maintenance therapy and the additional impact of dexamethasone treatment on cancer-related fatigue and sleep-wake rhythms in pediatric acute lymphoblastic leukemia (ALL) patients and to determine the association between these outcomes. Methods A national cohort of pediatric ALL patients (≥ 2 years) was included (± 1 year post-diagnosis). Patients receiving dexamethasone were assessed twice (assessment with and without dexamethasone). Actigraphy assessments were used to calculate sleep-wake outcomes with nonparametric methods. Cancer-related fatigue was assessed with the PedsQL Multidimensional Fatigue Scale. Sleep-wake rhythms and cancer-related fatigue were compared between patients participating in the assessment without dexamethasone and healthy children (linear regression) and between assessments with and without dexamethasone (mixed models). Using linear regression, associations between sleep-wake outcomes and cancer-related fatigue were determined during assessments with and without dexamethasone. Results Responses were collected for 125 patients (113 assessments with and 81 without dexamethasone). The sleep-wake rhythm was less stable (p = 0.03) and less robust (p = 0.01), with lower physical activity levels (p < 0.001) and higher cancer-related fatigue levels (p < 0.001) in ALL patients compared to healthy children. Physical activity was lower (p = 0.001) and cancer-related fatigue more severe (p ≤ 0.001) during assessments with dexamethasone compared to without dexamethasone. Sleep-wake outcomes were significantly associated with cancer-related fatigue during periods without dexamethasone, but not during periods with dexamethasone. Conclusion Sleep-wake rhythms are disturbed, physical activity levels lower, and cancer-related fatigue levels higher during maintenance therapy. Interventions aimed to enhance sleep-wake rhythms during maintenance therapy could improve cancer-related fatigue. Families should be supported in coping with the additional burden of dexamethasone treatment to improve well-being of ALL patients. Electronic supplementary material The online version of this article (10.1007/s00520-020-05444-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- L M H Steur
- Emma Children's Hospital, Amsterdam UMC, Pediatric Oncology, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, ZH 8D12, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
| | - G J L Kaspers
- Emma Children's Hospital, Amsterdam UMC, Pediatric Oncology, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, ZH 8D12, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Dutch Childhood Oncology Group, Utrecht, The Netherlands
| | - E J W van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (an institute of the Royal Netherlands Academy of Arts and Sciences), Amsterdam, The Netherlands
- Department of Integrative Neurophysiology, Amsterdam Neuroscience, Center for Neurogenomics and Cognitive Research (CNCR), VU University Amsterdam, Amsterdam, The Netherlands
- Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - N K A van Eijkelenburg
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - I M van der Sluis
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Department of Pediatric Oncology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, the Netherlands
| | - N Dors
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Department of Pediatric Oncology, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands
| | - C van den Bos
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Department of Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Academic Medical Center, Amsterdam, the Netherlands
| | - W J E Tissing
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Department of pediatric oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M A Grootenhuis
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - R R L van Litsenburg
- Emma Children's Hospital, Amsterdam UMC, Pediatric Oncology, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, ZH 8D12, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands.
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Liu CY, Tsai CJ, Yasugaki S, Nagata N, Morita M, Isotani A, Yanagisawa M, Hayashi Y. Copine-7 is required for REM sleep regulation following cage change or water immersion and restraint stress in mice. Neurosci Res 2020; 165:14-25. [PMID: 32283105 DOI: 10.1016/j.neures.2020.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/01/2020] [Accepted: 04/02/2020] [Indexed: 10/24/2022]
Abstract
Sleep is affected by the environment. In rodents, changes in the amount of rapid eye movement sleep (REMS) can precede those of other sleep/wake stages. The molecular mechanism underlying the dynamic regulation of REMS remains poorly understood. Here, we focused on the sublaterodorsal nucleus (SLD), located in the pontine tegmental area, which plays a crucial role in the regulation of REMS. We searched for genes selectively expressed in the SLD and identified copine-7 (Cpne7), whose involvement in sleep was totally unknown. We generated Cpne7-Cre knock-in mice, which enabled both the knockout (KO) of Cpne7 and the genetic labeling of Cpne7-expressing cells. While Cpne7-KO mice exhibited normal sleep under basal conditions, the amount of REMS in Cpne7-KO mice was larger compared to wildtype mice following cage change or water immersion and restraint stress, both of which are conditions that acutely reduce REMS. Thus, it was suggested that copine-7 is involved in negatively regulating REMS under certain conditions. In addition, chemogenetically activating Cpne7-expressing neurons in the SLD reduced the amount of REMS, suggesting that these neurons negatively regulate REMS. These results identify copine-7 and Cpne7-expressing neurons in the SLD as candidate molecular or neuronal components of the regulatory system that controls REMS.
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Affiliation(s)
- Chih-Yao Liu
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan; Ph.D. Program in Human Biology, School of Integrative and Global Majors, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Chia-Jung Tsai
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan; Ph.D. Program in Human Biology, School of Integrative and Global Majors, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Shinnosuke Yasugaki
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan; Doctoral Program in Biomedical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Nanae Nagata
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Miho Morita
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Ayako Isotani
- NPO for Biotechnology Research and Development, 3-1 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Masashi Yanagisawa
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan; Ph.D. Program in Human Biology, School of Integrative and Global Majors, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan; Doctoral Program in Biomedical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan; Department of Molecular Genetics, University of Texas Southwestern Medical Center, 75390, Dallas, TX, USA; Life Science Center for Survival Dynamics, Tsukuba Advanced Research Alliance (TARA), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan; R&D Center for Frontiers of MIRAI in Policy and Technology (F-MIRAI), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Yu Hayashi
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan; Ph.D. Program in Human Biology, School of Integrative and Global Majors, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan; Doctoral Program in Biomedical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
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Gender differences in the associations between types of childhood maltreatment and sleep disturbance among Chinese adolescents. J Affect Disord 2020; 265:595-602. [PMID: 32090782 DOI: 10.1016/j.jad.2019.11.099] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 10/15/2019] [Accepted: 11/21/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND To explore the association between different types of childhood maltreatment and sleep disturbance among Chinese adolescents, with a particular focus on gender differences. METHODS A cross-sectional study was conducted in 7 randomly selected provinces of China via the 2015 School-Based Chinese Adolescents Health Survey. Questionnaires from 153,547 students were completed and were eligible for this study. The Chinese Version of the Pittsburgh Sleep Quality Index (CPSQI) and Childhood Trauma Questionnaire-Short Form (CTQ-SF) were used to assess sleep disturbance and childhood maltreatment, respectively. RESULTS The prevalence of sleep disturbance among adolescents in China was 21.6%. A significantly increased risk of sleep disturbance was associated with physical abuse (aOR=1.22, 95% CI=1.21-1.24), emotional abuse (aOR=1.15, 95% CI=1.14-1.15), sexual abuse (aOR=1.16, 95% CI=1.15-1.18), physical neglect (aOR=1.04, 95% CI=1.03-1.05), and emotional neglect (aOR=1.03, 95% CI=1.02-1.03). A significant dose-response relationship was found between cumulative childhood maltreatment experiences and sleep disturbance. The interaction terms (between physical abuse/emotional abuse/sexual abuse/physical neglect/emotional neglect/number of childhood traumas and gender) were significantly associated with sleep disturbance. Further stratification analyses by gender showed that girls who reported experiencing one or more of these five types of childhood maltreatment had a higher risk of sleep disturbance than boys. LIMITATIONS The study only included school students, and the cross-sectional design limited our ability to make causal inferences. CONCLUSIONS The study findings suggest that childhood maltreatment increases the risk of sleep disturbance in adolescents. Furthermore, exposure to single and multiple types of childhood maltreatment predicts lower sleep quality in girls.
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Park I, Oh SM, Lee KH, Kim S, Jeon JE, Lee HY, Jeon S, Kim SJ, Lee YJ. The Moderating Effect of Sleep Disturbance on the Association of Stress with Impulsivity and Depressed Mood. Psychiatry Investig 2020; 17:243-248. [PMID: 32126742 PMCID: PMC7113181 DOI: 10.30773/pi.2019.0181] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 11/18/2019] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This study was performed to investigate the associations of life event stress with impulsivity, anxiety, and depressed mood as a function of the presence of a sleep disturbance. METHODS In total, 214 participants (age 38.96±10.53 years; 111 females) completed self-report questionnaires, including the Life Experience Survey (LES), Pittsburgh Sleep Quality Index (PSQI), Barratt's Impulsivity Scale (BIS), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI). The presence of a sleep disturbance was defined as a PSQI score >5. RESULTS In total, 127 participants presented with a sleep disturbance (age 39.33±10.92 years; 64 females), whereas the remaining 87 did not (age 38.43±9.97 years; 47 females). Negative LES scores were significantly correlated with BIS (r=0.22, p=0.001), BAI (r=0.46, p< 0.001), and BDI (r=0.51, p<0.001) scores, and PSQI scores were significantly correlated with BAI (r=0.49, p<0.001) and BDI (r=0.60, p< 0.001) scores. Moderation analysis revealed statistically significant interactions between negative LES scores and the presence of a sleep disturbance on BIS (p=0.044) and BDI (p=0.014) but not on BAI (p=0.194) scores. CONCLUSION The findings of the present study suggest that life event stress has varying degrees of influence on mental health, especially impulsivity and depressed mood, depending on the presence or absence of a sleep disturbance.
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Affiliation(s)
- Inkyung Park
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa, USA
| | - Seong Min Oh
- Department of Psychiatry, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Kyung Hwa Lee
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Soohyun Kim
- Department of Neurology, Gangneung Asan Hospital, Gangneung, Republic of Korea
| | - Jeong Eun Jeon
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ha Young Lee
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sehyun Jeon
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Seog Ju Kim
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Yu Jin Lee
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul, Republic of Korea
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Gerhardt C, Kottwitz MU, Lüdin TJ, Gabriel D, Elfering A. Work and sleep quality in railway employees: an actigraphy study. ERGONOMICS 2020; 63:13-30. [PMID: 31594485 DOI: 10.1080/00140139.2019.1677945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 09/25/2019] [Indexed: 06/10/2023]
Abstract
This actigraphy study tests whether daily work stressors (time pressure, social stressors), work resources (control, social support) and mental detachment from work predict sleep quality, when controlling for demands and control after work. Fifty-two railway employees participated during five consecutive workdays by completing diary questionnaires and wearing an actigraphy device. The results confirmed that social stressors from supervisors predicted more frequent sleep fragmentation and lower sleep efficiency the following night. Higher levels of daily time control at work predicted shorter sleep-onset latency and better self-reported sleep quality. Leisure time control as a covariate turned out to be a private resource, followed by fewer awakenings the following night. Detachment after work related negatively to social stressors and time pressure at work but was unrelated to indicators of sleep quality; detachment after work neither mediated nor moderated the relationship between social stressors from supervisors and sleep quality. Work redesign to increase time control and reduce social stressors is recommended to preserve daily recovery in railway employees. Practitioner summary: Sleep is important to renew health- and safety-related resources in railway employees. This diary and actigraphy study shows that higher daily work stressors were antecedents of lower sleep quality the following night, while more time control was followed by better sleep quality. Work redesign could promote health and safety by improving sleep quality.
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Affiliation(s)
| | - Maria Undine Kottwitz
- Department of Psychology, University of Mannheim, Mannheim, Germany
- National Centre of Competence in Research, Affective Sciences, University of Geneva, CISA, Geneva, Switzerland
| | | | | | - Achim Elfering
- Department of Psychology, University of Bern, Bern, Switzerland
- National Centre of Competence in Research, Affective Sciences, University of Geneva, CISA, Geneva, Switzerland
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McManus B, Galbraith JW, Heaton K, Mrug S, Ponce BA, Porterfield JR, Schall MC, Stavrinos D. Sleep and stress before and after duty across residency years under 2017 ACGME hours. Am J Surg 2019; 220:83-89. [PMID: 31757438 DOI: 10.1016/j.amjsurg.2019.10.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 10/15/2019] [Accepted: 10/31/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Residents may differentially experience high stress and poor sleep across multiple post-graduate years (PGYs), negatively affecting safety. This study characterized sleep and stress among medical and surgical residents across multiple PGYs and at specific times surrounding duty. METHOD Thirty-two medical and surgical residents (Mage = 28.6 years; 56% male) across PGYs 1-5 participated in 3 appointments (immediately before duty, after duty, and on an off day) providing 96 data points. Sleep, stress, and occupational fatigue were measured by both self-report and objectively (actigraphy, salivary coritsol). RESULTS Residents averaged 7 h of actigraphy-estimated sleep per night but varied ±3 h day-to-day. Residents reported clinically poor sleep quality. Life stress decreased by PGY-2. All residents averaged elevated life stress values. Poor sleep quality did not differ among PGY cohorts. DISCUSSION Poor sleep quality is similar between early residency cohorts (PGY-1) and later residency cohorts (PGY-3+). Persistent fatigue is highest in later residency cohorts. Even the most experienced residents may struggle with persisting fatigue. Current hour policies may have shortcomings in addressing this risk.
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Affiliation(s)
- Benjamin McManus
- University of Alabama at Birmingham, Department of Psychology, United States.
| | - James W Galbraith
- University of Mississippi Medical Center, Department of Emergency Medicine, United States.
| | - Karen Heaton
- University of Alabama at Birmingham, School of Nursing, United States.
| | - Sylvie Mrug
- University of Alabama at Birmingham, Department of Psychology, United States.
| | - Brent A Ponce
- University of Alabama at Birmingham, Department of Orthopaedic Surgery, United States.
| | - John R Porterfield
- University of Alabama at Birmingham, Department of Surgery, United States.
| | - Mark C Schall
- Auburn University, Industrial and Systems Engineering, United States.
| | - Despina Stavrinos
- University of Alabama at Birmingham, Department of Psychology, United States.
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Coto J, Garcia A, Hart KC, Graziano PA. Associations Between Disruptive Behavior Problems, Parenting Factors, and Sleep Problems Among Young Children. J Dev Behav Pediatr 2019; 39:610-620. [PMID: 29923894 PMCID: PMC6826338 DOI: 10.1097/dbp.0000000000000595] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To examine within an at-risk/clinical sample of preschool-aged children with externalizing problems: (1) which disruptive behavior and attention disorder symptoms (i.e., inattention, hyperactivity/impulsivity, and oppositionality/aggression) and (2) what aspects of parenting (e.g., discipline practices or stress) are related to children's sleep problems (e.g., sleep habit and night waking problems). METHOD The sample consisted of 148 children (meanage = 5.06 years, 82% male) with at-risk/clinically elevated levels of externalizing behavior problems and their primary caregiver. As part of a larger study, parents reported on their stress and parenting practices and their children's behavioral and sleep functioning. Positive and negative parenting behaviors ("do" and "don't" skills, respectively) were also observed during a 15-minute parent-child interaction during play. RESULTS Oppositionality/aggression was the only disruptive behavior and attention disorder symptom associated with more sleep habit problems. Higher levels of inconsistent discipline and "don't" skills were also associated with more sleep habit problems. Within a combined model, an interaction emerged such that the association between "don't" skills and elevated sleep habit problems was only evident at low levels of inconsistent discipline. In terms of night waking problems, there was only an association with parenting stress, whereas the other parenting factors and disruptive behavior and attention disorder symptoms were unrelated. CONCLUSION Although the directionality of our associations cannot be ascertained because of the cross-sectional nature of our study, these findings, nevertheless, highlight the importance of parenting factors (e.g., inconsistent discipline and parenting stress) when considering sleep difficulties in young children with disruptive behavior and attention disorders.
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Affiliation(s)
- Jennifer Coto
- Department of Psychology and Center for Children and Families, Florida International University, Miami, FL
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Vincent GE, Jay SM, Preece H, Hall SJ, Aisbett B, Baumert M, Sprajcer M, Lack L, Ferguson SA. Overnight heart rate variability and next day cortisol response during simulated on-call conditions. Psychoneuroendocrinology 2019; 109:104406. [PMID: 31472434 DOI: 10.1016/j.psyneuen.2019.104406] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 08/09/2019] [Accepted: 08/12/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study had two specific objectives, 1) to investigate the impact of being on-call on overnight heart rate variability during sleep and; 2) to examine whether being on-call overnight impacted next-day salivary cortisol concentrations. METHODS Data are reported from three within-subject laboratory studies (n = 24 in each study) that assessed varying on-call conditions. Healthy male participants (n = 72 total) completed a four-night laboratory protocol, comprising an adaptation night, a control night, and two counterbalanced on-call nights with varying on-call conditions. These on-call conditions were designed to determine the impact of, Study 1: the likelihood of receiving a call (definitely, maybe), Study 2: task stress (high-stress, low-stress), and Study 3: chance of missing the alarm (high-chance, low-chance), on measures of physiological stress. Overnight heart rate variability (HRV) (during sleep) was measured using two-lead electrocardiography, and time- and frequency-domain variables were analysed. Saliva samples were collected at 15-min time intervals from 0700-0800 h to determine cortisol awakening response outcomes and at four daily time points (0930 h, 1230 h, 1430 h, and 1730 h) to assess diurnal cortisol profiles. RESULTS There were few differences in HRV measures during sleep across all three studies. The only exception was in Study 1 where the standard deviation of the time interval between consecutive heartbeats and the root mean square of consecutive differences between heartbeats were lower across all sleep stages in the definitely condition, when compared to control. Across all three studies, being on-call overnight also had little impact on next-day cortisol awakening response (CAR), with the exception of Study 2 where the 1) CAR area under the curve with respect to increase was blunted in the high-stress condition, compared to the control and low-stress conditions and, 2) CAR reactivity was higher in low-stress condition, compared with the high-stress condition. In Study 1, diurnal cortisol area under the curve with respect to ground was lower in the on-call conditions (definitely and maybe) when compared to control. There were no differences in diurnal cortisol measures in Study 3. CONCLUSION This is the first study to investigate how different aspects of being on-call affect physiological stress responses. Overall, relatively little differences in measures of overnight heart rate variability and next-day cortisol response were recorded in all three studies. Further research utilising real on-call work tasks, not just on-call expectations (as in the current study) will help determine the impact of on-call work on the physiological stress response.
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Affiliation(s)
- Grace E Vincent
- Central Queensland University, Health, Medical and Applied Sciences, Adelaide, SA, Australia.
| | - Sarah M Jay
- Central Queensland University, Health, Medical and Applied Sciences, Adelaide, SA, Australia
| | - Helen Preece
- Central Queensland University, Health, Medical and Applied Sciences, Adelaide, SA, Australia
| | - Sarah J Hall
- Deakin University, Institute of Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia
| | - Brad Aisbett
- Deakin University, Institute of Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia
| | - Mathias Baumert
- School of Electrical and Electronic Engineering, The University of Adelaide, Australia
| | - Madeline Sprajcer
- Central Queensland University, Health, Medical and Applied Sciences, Adelaide, SA, Australia
| | - Leon Lack
- School of Psychology, Flinders University of South Australia, Adelaide, SA, Australia
| | - Sally A Ferguson
- Central Queensland University, Health, Medical and Applied Sciences, Adelaide, SA, Australia
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Ramamoorthy S, Kamaldeen D, Ravichandran L, Sundaramahalingam M. Effect of stress on sleep hygiene among school going adolescents in Chennai. J Family Med Prim Care 2019; 8:2917-2920. [PMID: 31681667 PMCID: PMC6820412 DOI: 10.4103/jfmpc.jfmpc_564_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 08/22/2019] [Accepted: 09/03/2019] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Stress is a psychophysiological phenomenon. Due to recent lifestyle modifications prevalence of stress is increasing among adults and adolescents. Adolescence is a period of storm and stress and any excess stress would have negative impact on their sleep and would ultimately affect their academic performance and health. Hence the current study proposes to evaluate the effect of stress on sleep hygiene among school going adolescents in Chennai. MATERIALS AND METHODS A cross-sectional study and participants were healthy male (84) and female (48) school going adolescents between the age group of 15-19 years (n = 132). Stress was assessed using Perceived Stress Scale (PSS) and sleep hygiene was assessed using Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD). RESULTS In all, 84.8% of the adolescents reported that they are academically overloaded. Both the genders were found to be moderately stressed (Males: 63.6%; females: 66.7%). Prevalence of sleep disturbances was found to be 23.5% and increase in stress was found to be associated with decrease in sleep quality. DISCUSSION The study shows that prevalence of stress is high among adolescents and it is negatively influencing their sleep hygiene. Hence, early identification and management of stress is required for school going late adolescents for better academic performance and wellbeing.
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Affiliation(s)
- Srihari Ramamoorthy
- Department of Physiology, Sri Ramachandra Medical College and RI, Chennai, Tamil Nadu, India
| | - Dilara Kamaldeen
- Department of Physiology, Sri Ramachandra Medical College and RI, Chennai, Tamil Nadu, India
| | - Latha Ravichandran
- Department of Paediatrics, Sri Ramachandra Medical College and RI, Chennai, Tamil Nadu, India
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Tsai JC, Chou KR, Tsai HT, Yen YC, Niu SF. Effects of Nocturnal Sleep Quality on Diurnal Cortisol Profiles and Attention in Nurses: A Cross-Sectional Study. Biol Res Nurs 2019; 21:510-518. [DOI: 10.1177/1099800419861695] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Objective: Low sleep quality (LSQ) activates the hypothalamic–pituitary–adrenal (HPA) axis and is related to arousal. Nursing staff, who work in shifts, tend to exhibit LSQ, which affects the level of vigor after awakening. This study investigated the effects of nocturnal sleep quality on diurnal cortisol profiles and sustained attention in day-shift nurses. Method: This study adopted a prospective cross-sectional design. Participants were recruited from a university-affiliated hospital in northern Taiwan. In the initial stage of this study, the Chinese Pittsburgh Sleep Quality Index (PSQI) Questionnaire was administered to 199 participants to categorize them as either LSQ (PSQI > 5) or high sleep quality (HSQ; PSQI ≤ 5). Participants were then randomly sampled from the two groups. Nocturnal sleep data and four diurnal saliva samples were collected for each participant. Sustained attention was measured before they started work. A total of 32 and 29 participants in the HSQ and LSQ groups, respectively, completed the data collection process. Results: Compared with the HSQ group, the LSQ group exhibited earlier wake-up times ( p = .02), a flatter cortisol awakening response (CAR) slope ( p < .01), a flatter morning-to-evening slope ( p < .01), and prolonged reaction speed and mean reaction time before starting work ( p < .01). Conclusion: Compared with the HSQ group, the LSQ group exhibited impaired HPA-axis regulation, with a flatter CAR and diurnal cortisol slope and poor sustained attention in the morning. Nursing staff are advised to achieve HSQ to improve attention and performance levels and maintain optimum work safety.
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Affiliation(s)
- Jui-Chen Tsai
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Taipei Medical University, Shuang Ho Hospital, Taipei, Taiwan
| | - Kuei-Ru Chou
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Taipei Medical University, Shuang Ho Hospital, Taipei, Taiwan
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Hsiu-Ting Tsai
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yu-Chun Yen
- Research Center of Biostatistics, College of Management, Taipei Medical University, Taipei, Taiwan
| | - Shu-Fen Niu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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Dai C, Qiu H, Huang Q, Hu P, Hong X, Tu J, Xie Q, Li H, Ren W, Ni S, Chen F. The effect of night shift on sleep quality and depressive symptoms among Chinese nurses. Neuropsychiatr Dis Treat 2019; 15:435-440. [PMID: 30799922 PMCID: PMC6369837 DOI: 10.2147/ndt.s190689] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
PURPOSE Night shift is associated with adverse physical and psychological health outcomes such as poor sleep quality and depressive symptoms. We aimed to compare sleep quality as well as depressive symptoms in nurses working night shifts to those working day shifts only and explore the association between sleep quality and depressive symptoms among nurses. PATIENTS AND METHODS Eight hundred sixty-five nurses were enrolled in the current study. Sleep quality and depressive symptoms among nurses were evaluated by the Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depressive Disorders Rating Scale (HADS), respectively. RESULTS PSQI and HADS scores were both significantly higher in the nurses working night shifts (P<0.05) than in those working day shifts only. Besides, there was a positive correlation between PSQI and HADS scores. Binary logistic regression showed that night shift and poor sleep quality were independent risk factors of depressive symptoms among nurses. CONCLUSION Higher rates of depression among Chinese nurses working night shifts may be associated with poor sleep quality induced by night shift.
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Affiliation(s)
- Caijun Dai
- Jinhua Municipal Central Hospital, Jinhua 321000, China,
| | - Huihua Qiu
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Qiqi Huang
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Pinglang Hu
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Xianchai Hong
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Junwei Tu
- Jinhua Municipal Central Hospital, Jinhua 321000, China,
| | - Qiangli Xie
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Haiyan Li
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Wenwei Ren
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Shuhong Ni
- Jinhua Municipal Central Hospital, Jinhua 321000, China,
| | - Fujian Chen
- Anji County People's Hospital, Huzhou 313300, China,
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Abstract
Sleep is a phenomenon in animal behavior as enigmatic as it is ubiquitous, and one deeply tied to endocrine function. Though there are still many unanswered questions about the neurochemical basis of sleep and its functions, extensive interactions have been identified between sleep and the endocrine system, in both the endocrine system's effect on sleep and sleep's effect on the endocrine system. Unfortunately, until recent years, much research on sleep behavior largely disregarded its connections with the endocrine system. Use of both clinical studies and rodent models to investigate interactions between neuroendocrine function, including biological sex, and sleep therefore presents a promising area of further exploration. Further investigation of the neurobiological and neuroendocrine basis of sleep could have wide impact on a number of clinical and basic science fields. In this review, we summarize the state of basic sleep biology and its connections to the field of neuroendocrine biology, as well as suggest key future directions for the neuroendocrine regulation of sleep that may significantly impact new therapies for sleep disorders in women and men.
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Affiliation(s)
- Philip C Smith
- Department of Pharmacology, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Jessica A Mong
- Department of Pharmacology, University of Maryland School of Medicine, Baltimore, MD, USA
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Kalmbach DA, Anderson JR, Drake CL. The impact of stress on sleep: Pathogenic sleep reactivity as a vulnerability to insomnia and circadian disorders. J Sleep Res 2018; 27:e12710. [PMID: 29797753 PMCID: PMC7045300 DOI: 10.1111/jsr.12710] [Citation(s) in RCA: 245] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 04/12/2018] [Accepted: 04/13/2018] [Indexed: 12/19/2022]
Abstract
Sleep reactivity is the trait-like degree to which stress exposure disrupts sleep, resulting in difficulty falling and staying asleep. Individuals with highly reactive sleep systems experience drastic deterioration of sleep when stressed, whereas those with low sleep reactivity proceed largely unperturbed during stress. Research shows that genetics, familial history of insomnia, female gender and environmental stress influence how the sleep system responds to stress. Further work has identified neurobiological underpinnings for sleep reactivity involving disrupted cortical networks and dysregulation in the autonomic nervous system and hypothalamic-pituitary-adrenal axis. Sleep reactivity is most pathologically and clinically pertinent when in excess, such that high sleep reactivity predicts risk for future insomnia disorder, with early evidence suggesting high sleep reactivity corresponds to severe insomnia phenotypes (sleep onset insomnia and short sleep insomnia). High sleep reactivity is also linked to risk of shift-work disorder, depression and anxiety. Importantly, stress-related worry and rumination may exploit sensitive sleep systems, thereby augmenting the pathogenicity of sleep reactivity. With the development of cost-effective assessment of sleep reactivity, we can now identify individuals at risk of future insomnia, shift-work disorder and mental illness, thus identifying a target population for preventive intervention. Given that insomniacs with high sleep reactivity tend to present with severe insomnia phenotypes, patient sleep reactivity may inform triaging to different levels of treatment. Future research on sleep reactivity is needed to clarify its neurobiology, characterize its long-term prospective associations with insomnia and shift-work disorder phenotypes, and establish its prognostic value for mental illness and other non-sleep disorders.
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Affiliation(s)
- David A. Kalmbach
- Sleep Disorders and Research Center, Henry Ford Hospital, Detroit, Michigan
| | - Jason R. Anderson
- Department of Psychological Sciences, Kent State University, Kent, Ohio
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Chatterjee A, Thompson JW, Svensson K, Tamayo Y Ortiz M, Wright R, Wright R, Tellez-Rojo M, Baccarelli A, Cantoral A, Schnaas L, Oken E. Maternal antenatal stress has little impact on child sleep: results from a prebirth cohort in Mexico City. Sleep Health 2018; 4:397-404. [PMID: 30241653 PMCID: PMC6152833 DOI: 10.1016/j.sleh.2018.07.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 07/27/2018] [Accepted: 07/31/2018] [Indexed: 01/28/2023]
Abstract
STUDY OBJECTIVES Maternal antenatal stress may influence offspring development and behavior, but any association with child sleep is unknown. METHODS From 2007 to 2011, we recruited pregnant women in Mexico City to the Programming Research in Obesity, Growth, Environment, and Social Stressors prebirth cohort. Mothers completed the Perceived Stress Scale (PSS, a 4-item questionnaire assessing past-month stress) and the Crisis in Family Systems measure assessing negative life events (NLEs; how many domains among the 11 assessed in which the mother experienced a stressful event in the prior 6 months)-with higher scores reflecting higher stress-and provided 5 timed salivary samples per day on 2 consecutive days, from which we derived cortisol area under the curve, slope, and awakening response. At age 4-6 years, children's sleep was estimated using accelerometry over a 7-day period. We performed secondary analysis of associations of antenatal maternal stress with child sleep duration and efficiency (time asleep/time in bed) using linear regression adjusted for maternal and child characteristics. RESULTS Among 594 mother-child dyads, mean antenatal PSS score was 5.2 (SD = 3.2) out of 16, and mean NLE was 3.2 (SD = 2) out of 11; child sleep duration was 7.7 hours (SD = 0.7), and sleep efficiency was 79% (SD = 6). There was no association between any of the stress measures-PSS, NLE, or salivary cortisol-and sleep duration or sleep efficiency in adjusted or unadjusted models. CONCLUSIONS Among mother-child dyads in a Mexico City cohort, antenatal stress was not associated with important changes in child sleep at 4-6 years.
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Affiliation(s)
- Avik Chatterjee
- Division of Global Health Equity, Department of Internal Medicine, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115.
| | - Jennifer W Thompson
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Dr, Suite 401E, Boston, MA 02215
| | - Katherine Svensson
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029
| | - Marcela Tamayo Y Ortiz
- Center for Nutrition and Health Research, National Institute of Public Health, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera CP, 62100, Cuernavaca, Morelos. México; Mexican Council for Science and Technology, National Institute of Public Health Mexico, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera CP, 62100, Cuernavaca, Morelos. México
| | - Robert Wright
- Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029; Mailman School of Public Health, Columbia University, 722 W 168th St, NY, NY 10032
| | - Rosalind Wright
- Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029; Mailman School of Public Health, Columbia University, 722 W 168th St, NY, NY 10032
| | - Martha Tellez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera CP, 62100, Cuernavaca, Morelos. México
| | - Andrea Baccarelli
- Mailman School of Public Health, Columbia University, 722 W 168th St, NY, NY 10032
| | - Alejandra Cantoral
- Center for Nutrition and Health Research, National Institute of Public Health, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera CP, 62100, Cuernavaca, Morelos. México
| | - Lourdes Schnaas
- National Institute of Perinatology, Calle Montes Urales 800, Miguel Hidalgo, Lomas Virreyes, 11000 Ciudad de México, CDMX, Mexico
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Dr, Suite 401E, Boston, MA 02215
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Andorko ND, Millman ZB, Klingaman E, Medoff D, Kline E, DeVylder J, Reeves G, Schiffman J. Association between sleep, childhood trauma and psychosis-like experiences. Schizophr Res 2018; 199. [PMID: 29526453 PMCID: PMC6129231 DOI: 10.1016/j.schres.2018.02.052] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Psychosis-like experiences (PLEs), or attenuated positive symptoms of psychosis, present along a severity continuum and have been associated with distressing thoughts and impairments in functioning. Although knowledge of the clinical importance of PLEs is expanding, risk factors for their expression are still poorly understood. Sleep disturbances are one known factor that exacerbate PLEs expression and distress, and trauma exposure is associated with occurrence of PLEs, as well as increased risk of later sleep difficulties. This study examined the joint influences of sleep and trauma on PLEs in an undergraduate sample. Self-report questionnaires on presence and distress of PLEs, sleep problems, and occurrence of previous traumatic experiences were completed by participants (N=409). In order to determine the unique impact of sleep on PLEs, three sets of predictors: sociodemographic, psychosocial (including trauma), and sleep were entered in steps into a hierarchical multiple regression model. In the final model, specific sleep domains uniquely predicted PLEs, while previous trauma exposure, which was a significant predictor when entered in step two with other psychosocial variables, was no longer a significant predictor. Results suggest the possibility that disruptions in sleep following or occurring alongside a traumatic experience may somehow contribute to, or exacerbate the presence of PLEs.
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Affiliation(s)
- Nicole D. Andorko
- Department of Psychology, University of Maryland Baltimore County, Baltimore, Maryland
| | - Zachary B. Millman
- Department of Psychology, University of Maryland Baltimore County, Baltimore, Maryland
| | - Elizabeth Klingaman
- VA Capitol Health Care Network, Mental Illness Research, Education, and Clinical Center (MIRECC), Baltimore, MD, United States; Department of Psychiatry, University of Maryland, School of Medicine, Baltimore, MD, United States.
| | - Deborah Medoff
- Department of Psychiatry, University of Maryland, School of Medicine, Baltimore, MD, United States.
| | - Emily Kline
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, United States.
| | - Jordan DeVylder
- Graduate School of Social Service, Fordham University, New York, NY, United States.
| | - Gloria Reeves
- Department of Psychiatry, University of Maryland, School of Medicine, Baltimore, MD, United States.
| | - Jason Schiffman
- Department of Psychology, University of Maryland Baltimore County, Baltimore, MD, United States.
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Hadlow N, Brown S, Wardrop R, Conradie J, Henley D. Where in the world? Latitude, longitude and season contribute to the complex co-ordinates determining cortisol levels. Clin Endocrinol (Oxf) 2018; 89:299-307. [PMID: 29846966 DOI: 10.1111/cen.13754] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 05/27/2018] [Accepted: 05/28/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Cortisol is a critical stress hormone with circadian rhythms synchronized by light. There are seasonal differences in expression of pro-inflammatory genes and in some diseases moderated by glucocorticoids. As light changes with season and with latitude and longitude, we assessed changes in population cortisol associated with these parameters. DESIGN Retrospective data audit. PATIENTS Populations across 4 states of Australia over 3 years. MEASUREMENTS Serum cortisol levels, age, gender, time of collection, sunrise time, season and location were determined. RESULTS In 4 geographically separate populations (n = 84 937), sunrise time and time of sample collection were the most important factors influencing median cortisol. Over 2 hours in the morning cortisol could decrease by up to 76 nmol/L, and for each hour that sunrise time advanced there was up to 6.9% increase in cortisol. A cyclic seasonal pattern of cortisol was confirmed each year in all populations with autumn/winter cortisol highest compared to spring/summer with differences of up to 44 nmol/L. There was less change in cortisol in latitudes closer to the equator but cortisol progressively increased from 25 to 30°S of the equator. In more southerly latitudes, seasonal cortisol variation also increased, and over the entire latitude range, there was up to 50 nmol/L change in cortisol. Longitude variation within a time zone had a minimal effect on median cortisol. CONCLUSIONS Location, time of year and time of day are important influences on population cortisol levels. Elevated autumn/winter morning cortisol levels are likely due to sampling closer to the circadian peak due to later sunrise time. Understanding how the environment can influence cortisol levels may further our knowledge of physiology and disease.
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Affiliation(s)
- Narelle Hadlow
- Department of Clinical Biochemistry, PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- School of Pathology and Laboratory Medicine, University of Western Australia, Crawley, Western Australia, Australia
| | - Suzanne Brown
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Robert Wardrop
- Department of Clinical Biochemistry, PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Johan Conradie
- Department of Biochemistry, Western Diagnostic Pathology, Myaree, Western Australia, Australia
| | - David Henley
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia
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Bartlett DM, Domínguez D JF, Reyes A, Zaenker P, Feindel KW, Newton RU, Hannan AJ, Slater JA, Eastwood PR, Lazar AS, Ziman M, Cruickshank T. Investigating the relationships between hypothalamic volume and measures of circadian rhythm and habitual sleep in premanifest Huntington's disease. Neurobiol Sleep Circadian Rhythms 2018; 6:1-8. [PMID: 31236517 PMCID: PMC6586591 DOI: 10.1016/j.nbscr.2018.07.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 06/28/2018] [Accepted: 07/02/2018] [Indexed: 01/01/2023] Open
Abstract
Objective Pathological changes within the hypothalamus have been proposed to mediate circadian rhythm and habitual sleep disturbances in individuals with Huntington's disease (HD). However, investigations examining the relationships between hypothalamic volume and circadian rhythm and habitual sleep in individuals with HD are sparse. This study aimed to comprehensively evaluate the relationships between hypothalamic pathology and circadian rhythm and habitual sleep disturbances in individuals with premanifest HD. Methods Thirty-two individuals with premanifest HD and twenty-nine healthy age- and gender-matched controls participated in this dual-site, cross-sectional study. Magnetic resonance imaging scans were performed to evaluate hypothalamic volume. Circadian rhythm and habitual sleep were assessed via measurement of morning and evening cortisol and melatonin levels, wrist-worn actigraphy, the Consensus Sleep Diary and sleep questionnaires. Information on mood, physical activity levels and body composition were also collected. Results Compared to healthy controls, individuals with premanifest HD displayed significantly reduced grey matter volume in the hypothalamus, decreased habitual sleep efficiency and increased awakenings; however, no alterations in morning cortisol or evening melatonin release were noted in individuals with premanifest HD. While differences in the associations between hypothalamic volume and cortisol and melatonin output existed in individuals with premanifest HD compared to healthy controls, no consistent associations were observed between hypothalamic volume and circadian rhythm or habitual sleep outcomes. Conclusion While significant differences in associations between hypothalamic volume and cortisol and melatonin existed between individuals with premanifest HD and healthy controls, no differences in circadian markers were observed between the groups. This suggests that circadian regulation is maintained despite hypothalamic pathology, perhaps via neural compensation. Longitudinal studies are required to further understand the relationships between the hypothalamus and circadian rhythm and habitual sleep disturbances in HD as the disease course lengthens.
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Affiliation(s)
- Danielle M Bartlett
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia
| | - Juan F Domínguez D
- School of Psychology, Australian Catholic University, Melbourne, Victoria, Australia
| | - Alvaro Reyes
- Facultad de Ciencias de la Rehabilitacion, Universidad Andres Bello, Santiago, Chile
| | - Pauline Zaenker
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia
| | - Kirk W Feindel
- Centre for Microscopy, Characterisation and Analysis, University of Western Australia, Crawley, Western Australia, Australia
| | - Robert U Newton
- Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,University of Queensland Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
| | - Anthony J Hannan
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - James A Slater
- Centre for Sleep Science, School of Human Sciences, Faculty of Science, University of Western Australia, Crawley, Western Australia, Australia
| | - Peter R Eastwood
- Centre for Sleep Science, School of Human Sciences, Faculty of Science, University of Western Australia, Crawley, Western Australia, Australia
| | - Alpar S Lazar
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk, United Kingdom
| | - Mel Ziman
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia.,School of Biomedical Science, University of Western Australia, Crawley, Western Australia, Australia
| | - Travis Cruickshank
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia.,Peron Institute for Neurological and Translational Science, Perth, Western Australia, Australia
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van Dalfsen JH, Markus CR. The influence of sleep on human hypothalamic–pituitary–adrenal (HPA) axis reactivity: A systematic review. Sleep Med Rev 2018; 39:187-194. [DOI: 10.1016/j.smrv.2017.10.002] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 09/01/2017] [Accepted: 10/12/2017] [Indexed: 01/01/2023]
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Relationship between Job Stress and 5-HT2A Receptor Polymorphisms on Self-Reported Sleep Quality in Physicians in Urumqi (Xinjiang, China): A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15051034. [PMID: 29883419 PMCID: PMC5982073 DOI: 10.3390/ijerph15051034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 05/15/2018] [Accepted: 05/18/2018] [Indexed: 01/07/2023]
Abstract
The serotonin receptor (5-HTR) plays a key role in sleep quality regulation. Job-related stress is an important factor that influences sleep quality. However, few reports on the interaction between 5-HTR2A polymorphisms and job stress, and how they may impact upon sleep quality are available. Therefore this study investigated the effects of job stress, 5-HTR2A polymorphisms, and their interaction on sleep quality, in physicians. Using a two-stage stratified sampling method, 918 participants were initially invited to participate in the study. After screening for study inclusion and exclusion criteria, 504 subjects were eventually included in the study. Job stress and sleep quality were assessed using the Job Stress Survey (JSS) and Pittsburgh Sleep Quality Index (PSQI), respectively. The 5-HTR2A receptor gene polymorphisms T102C and -1438G/A of were determined using polymerase chain reaction-restriction fragment length polymorphism. Job stress was significantly associated with sleep quality. High levels of job stress were linked to a higher risk of poor sleep quality compared to low or moderate levels [odds ratio (OR) = 2.909, 95% confidence interval (CI): 1.697–4.986]. High levels of stress may reduce subjects’ sleep quality, leading to an increase the likelihood of sleep disturbances and subsequent daytime dysfunction. The 5-HTR2A receptor gene polymorphism T102C was not significantly associated with sleep quality in this study, however, the -1438G/A polymorphism was significantly associated with sleep quality. The GG genotype of the -1438G/A polymorphism was linked to poorer sleep quality. When compared with subjects with low job-related stress levels×AG/AA genotype (OR = 2.106, 95% CI: 1.278–3.471), physicians with high job-related stress levels×GG genotype had a higher risk of experiencing poor sleep quality (OR = 13.400, 95% CI: 3.143–57.137). The findings of our study indicate that job stress and 5-HTR2A receptor gene polymorphisms are associated with sleep quality in physicians. Subjects with high job stress level or/and the -1438G/A GG genotype were more likely to report poor sleep quality, and furthermore, their combination effect on sleep quality was higher than their independent effects, so it may be suggested that job-related stress and genes have a cumulative effect on sleep quality; that is, stress can increase the risk of poor sleep quality, but this effect is worse in a group of people with specific gene polymorphisms.
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