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Hunt AP, Pagnussat AS, Lehn A, Moore D, Schweitzer D, Laakso EL, Hennig E, Morris ME, Kerr G, Stewart I. Evidence of heat sensitivity in people with Parkinson's disease. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024; 68:1169-1178. [PMID: 38602550 PMCID: PMC11108869 DOI: 10.1007/s00484-024-02658-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/28/2024] [Accepted: 03/13/2024] [Indexed: 04/12/2024]
Abstract
Examining how heat affects people with Parkinson's disease is essential for informing clinical decision-making, safety, well-being, and healthcare planning. While there is evidence that the neuropathology associated with Parkinson's disease affects thermoregulatory mechanisms, little attention has been given to the association of heat sensitivity to worsening symptoms and restricted daily activities in people with this progressive disease. Using a cross-sectional study design, we examined the experiences of people diagnosed with Parkinson's disease in the heat. Two-hundred and forty-seven people completed an online survey (age: 66.0 ± 9.2 years; sex: male = 102 (41.3%), female = 145 (58.7%)), of which 195 (78.9%) reported becoming more sensitive to heat with Parkinson's disease. Motor and nonmotor symptoms worsened with heat in 182 (73.7%) and 203 (82.2%) respondents, respectively. The most commonly reported symptoms to worsen included walking difficulties, balance impairment, stiffness, tremor, fatigue, sleep disturbances, excess sweating, difficulty concentrating, and light-headedness when standing. Concerningly, over half indicated an inability to work effectively in the heat, and nearly half reported that heat impacted their ability to perform household tasks and social activities. Overall, heat sensitivity was common in people with Parkinson's disease and had a significant impact on symptomology, day-to-day activities and quality of life.
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Affiliation(s)
- Andrew P Hunt
- School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, 4059, Australia.
| | - Aline Souza Pagnussat
- Department of Physical Therapy, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
- Department of Physical Therapy, Georgia State University, Atlanta, USA
| | - Alexander Lehn
- Princess Alexandra Hospital, Brisbane, QLD, Australia
- School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Daniel Moore
- School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Melbourne, Australia
| | - Daniel Schweitzer
- School of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Centre for Neurosciences, Mater Hospital, Brisbane, QLD, Australia
- Wesley Hospital, Brisbane, QLD, Australia
| | - E-Liisa Laakso
- Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Ewald Hennig
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, 4059, Australia
| | - Meg E Morris
- The Victorian Rehabilitation Centre and ARCH, La Trobe University, Bundoora, 3086, Australia
| | - Graham Kerr
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, 4059, Australia
| | - Ian Stewart
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, 4059, Australia
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Mun S, Yoo J, Lee S, Yim MH, Kim S, Kim D, Kim MJ, Lee Y, Park JH. Resting energy expenditure differs among individuals with different levels of perceived thermal sensitivity: A cross-sectional study. Medicine (Baltimore) 2024; 103:e38293. [PMID: 38787987 PMCID: PMC11124673 DOI: 10.1097/md.0000000000038293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024] Open
Abstract
Metabolic rate has been used in thermophysiological models for predicting the thermal response of humans. However, only a few studies have investigated the association between an individual's trait-like thermal sensitivity and resting energy expenditure (REE), which resulted in inconsistent results. This study aimed to explore the association between REE and perceived thermal sensitivity. The REE of healthy adults was measured using an indirect calorimeter, and perceived thermal intolerance and sensation in the body were evaluated using a self-administered questionnaire. In total, 1567 individuals were included in the analysis (women = 68.9%, age = 41.1 ± 13.2 years, body mass index = 23.3 ± 3.3 kg/m2, REE = 1532.1 ± 362.4 kcal/d). More women had high cold intolerance (31.8%) than men (12.7%), and more men had high heat intolerance (23.6%) than women (16.1%). In contrast, more women experienced both cold (53.8%) and heat (40.6%) sensations in the body than men (cold, 29.1%; heat, 27.9%). After adjusting for age, fat-free mass, and fat mass, lower cold intolerance, higher heat intolerance, and heat sensation were associated with increased REE only in men (cold intolerance, P for trend = .001; heat intolerance, P for trend = .037; heat sensation, P = .046), whereas cold sensation was associated with decreased REE only in women (P = .023). These findings suggest a link between the perceived thermal sensitivity and REE levels in healthy individuals.
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Affiliation(s)
- Sujeong Mun
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Junghun Yoo
- Department of Health Care Policy, Korea Institute for Health and Social Affairs, Sejong, Republic of Korea
| | - Sanghun Lee
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- Korean Convergence Medical Science, University of Science and Technology, Daejeon, Republic of Korea
| | - Mi Hong Yim
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Soyoung Kim
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- Korean Convergence Medical Science, University of Science and Technology, Daejeon, Republic of Korea
| | - Daehyeok Kim
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Min-Ji Kim
- Clinical Research Coordinating Team, R&D Strategy Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Youngseop Lee
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Jeong Hwan Park
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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Battistel L, Vilardi A, Zampini M, Parin R. An investigation on humans' sensitivity to environmental temperature. Sci Rep 2023; 13:21353. [PMID: 38049468 PMCID: PMC10695924 DOI: 10.1038/s41598-023-47880-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 11/19/2023] [Indexed: 12/06/2023] Open
Abstract
While earlier investigations into thermal perception focused on measuring the detection of temperature changes across distinct bodily regions, the complex nature of thermal perception throughout the entire body remains a subject of ongoing exploration. To address this, we performed an experiment using four climate chambers with oscillating temperatures between 24 °C ± 1 °C. Our study involved 26 participants who moved between these chambers and had the task of reporting whether the second chamber entered was warmer or colder than the previous one. We collected 3120 temperature judgments, which we analysed via generalised linear mixed-effects models. The results showed surprisingly accurate temperature discrimination abilities and limited variation between individuals. Specifically, the Point of Subjective Equality stood at - 0.13 °C (± 0.02 °C), the Just Noticeable Difference (JND) was 0.38 °C (± 0.02 °C), the JND95 (indicating 95% accuracy) 0.92 °C (± 0.05 °C), the negative ceiling performance level (CPL) was - 0.91 °C (± 0.28 °C) and the positive CPL 0.80 °C (± 0.34 °C). The implications of the JND95 and the CPLs are particularly noteworthy, as they hold potential to significantly contribute to the advancement of intelligent algorithms for temperature control systems within building environments.
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Affiliation(s)
- Laura Battistel
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Corso Bettini 31, Rovereto, TN, Italy.
- terraXcube, Eurac Research, Via Ipazia 2, 39100, Bolzano, Italy.
| | - Andrea Vilardi
- terraXcube, Eurac Research, Via Ipazia 2, 39100, Bolzano, Italy
| | - Massimiliano Zampini
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Corso Bettini 31, Rovereto, TN, Italy
| | - Riccardo Parin
- terraXcube, Eurac Research, Via Ipazia 2, 39100, Bolzano, Italy
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Li G, Chen Y, Chaudhary S, Li CS, Hao D, Yang L, Li CSR. Sleep dysfunction mediates the relationship between hypothalamic-insula connectivity and anxiety-depression symptom severity bidirectionally in young adults. Neuroimage 2023; 279:120340. [PMID: 37611815 DOI: 10.1016/j.neuroimage.2023.120340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/03/2023] [Accepted: 08/21/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND The hypothalamus plays a crucial role in regulating sleep-wake cycle and motivated behavior. Sleep disturbance is associated with impairment in cognitive and affective functions. However, how hypothalamic dysfunction may contribute to inter-related sleep, cognitive, and emotional deficits remain unclear. METHODS We curated the Human Connectome Project dataset and investigated how hypothalamic resting state functional connectivities (rsFC) were associated with sleep dysfunction, as evaluated by the Pittsburgh Sleep Quality Index (PSQI), cognitive performance, and subjective mood states in 687 young adults (342 women). Imaging data were processed with published routines and evaluated with a corrected threshold. We examined the inter-relationship amongst hypothalamic rsFC, PSQI score, and clinical measures with mediation analyses. RESULTS In whole-brain regressions with age and drinking severity as covariates, men showed higher hypothalamic rsFC with the right insula in correlation with PSQI score. No clusters were identified in women at the same threshold. Both hypothalamic-insula rsFC and PSQI score were significantly correlated with anxiety and depression scores in men. Further, mediation analyses showed that PSQI score mediated the relationship between hypothalamic-insula rsFC and anxiety/depression symptom severity bidirectionally in men. CONCLUSIONS Sleep dysfunction is associated with negative emotions and hypothalamic rsFC with the right insula, a core structure of the interoceptive circuits. Notably, anxiety-depression symptom severity and altered hypothalamic-insula rsFC are related bidirectionally by poor sleep quality. These findings are specific to men, suggesting potential sex differences in the neural circuits regulating sleep and emotional states that need to be further investigated.
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Affiliation(s)
- Guangfei Li
- Department of Biomedical engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China; Beijing International Science and Technology Cooperation Base for Intelligent Physiological Measurement and Clinical Transformation, Beijing, China.
| | - Yu Chen
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
| | - Shefali Chaudhary
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
| | - Clara S Li
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA; Smith College, Northampton MA, USA
| | - Dongmei Hao
- Department of Biomedical engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China; Beijing International Science and Technology Cooperation Base for Intelligent Physiological Measurement and Clinical Transformation, Beijing, China
| | - Lin Yang
- Department of Biomedical engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China; Beijing International Science and Technology Cooperation Base for Intelligent Physiological Measurement and Clinical Transformation, Beijing, China
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA; Department of Neuroscience, Yale University School of Medicine, New Haven CT, USA; Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven CT, USA; Wu Tsai Institute, Yale University, New Haven CT, USA
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Vabba A, Panasiti MS, Scattolin M, Spitaleri M, Porciello G, Aglioti SM. The thermoception task: a thermal imaging-based procedure for measuring awareness of changes in peripheral body temperature. J Neurophysiol 2023; 130:1053-1064. [PMID: 37529855 PMCID: PMC10635420 DOI: 10.1152/jn.00014.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 07/31/2023] [Accepted: 07/31/2023] [Indexed: 08/03/2023] Open
Abstract
Although thermal body signals provide crucial information about the state of an organism and changes in body temperature may be a sign of affective states (e.g., stress, pain, sexual arousal), research on thermal awareness is limited. Here we developed a task measuring awareness of changes in peripheral body temperature (thermal interoception) and compared it to the classical heartbeat counting task (cardiac interoception). With an infrared light bulb we delivered stimuli of different temperature intensities to the right hand of 31 healthy participants. Thermal interoceptive accuracy, i.e., the difference between participants' real and perceived change in hand temperature, showed good interindividual variability. We found that thermal interoception did not correlate with (and was generally higher than) cardiac interoception, suggesting that different interceptive channels provide separate contributions to awareness of bodily states. Moreover, the results hint at the great salience of thermal signals and the need for thermoregulation in day-to-day life. Finally, thermal interoceptive accuracy was associated with self-reported awareness of body temperature changes and with the ability to regulate distress by focusing on body sensations. Our task has the potential to significantly increase current knowledge about the role of interoception in cognition and behavior, particularly in social and emotional contexts.NEW & NOTEWORTHY We developed a novel task measuring awareness of changes in peripheral body temperature (i.e., thermal interoception). To avoid tactile confounds present in existing thermoceptive tasks, we used an infrared light bulb to deliver stimuli of different temperature intensities to the hand of participants and asked them to judge the perceived change in their hand temperature. Performance in the task showed good interindividual variability, did not correlate with cardiac interoceptive tasks, and was associated with self-reported thermosensitivity.
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Affiliation(s)
- Alisha Vabba
- Sapienza University of Rome and CLN2S@Sapienza, Istituto Italiano di Tecnologia, Rome, Italy
- IRCCS, Santa Lucia Foundation, Rome, Italy
| | - Maria Serena Panasiti
- IRCCS, Santa Lucia Foundation, Rome, Italy
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Marina Scattolin
- Sapienza University of Rome and CLN2S@Sapienza, Istituto Italiano di Tecnologia, Rome, Italy
| | - Marco Spitaleri
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Giuseppina Porciello
- IRCCS, Santa Lucia Foundation, Rome, Italy
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Salvatore Maria Aglioti
- Sapienza University of Rome and CLN2S@Sapienza, Istituto Italiano di Tecnologia, Rome, Italy
- IRCCS, Santa Lucia Foundation, Rome, Italy
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Moini Jazani A, Nasimi Doost Azgomi H, Nasimi Doost Azgomi A, Hossein Ayati M, Nasimi Doost Azgomi R. Efficacy of hydrotherapy, spa therapy, and balneotherapy on sleep quality: a systematic review. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:975-991. [PMID: 37145200 DOI: 10.1007/s00484-023-02471-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 04/01/2023] [Accepted: 04/04/2023] [Indexed: 05/06/2023]
Abstract
The purpose of this article was to review and assess the results obtained from human studies on the effects of hydrotherapy, balneotherapy, and spa therapy on sleep disorders. In this study, databases such as Pubmed, Embase, Web of Science, Google Scholar, Cochrane, Scopus, and sciences direct database were searched from the beginning to September 2022. All human studies that examined the effect of hydrotherapy, balneotherapy, and spa therapy on sleep disorders were published in the form of a full article in English. In the end, only 18 of the 189 articles met the criteria for analysis. Most studies have shown that balneotherapy, spa therapy, and hydrotherapy may by affecting some hormones such as histamine, serotonin, sympathetic nerves, and regulating body temperature led to increased quality and quantity of sleep. Also, the results obtained from Downs and Black show that 3 studies were rated as very good, 7 studies as good, 7 studies as fair, and 1 study as weak. The results of studies also showed that hydrotherapy leads to an improvement in the PSQI score index. Nevertheless, more clinical trials are needed to determine the mechanism of action of hydrotherapy on sleep disorders.
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Affiliation(s)
- Arezoo Moini Jazani
- Traditional Medicine and Hydrotherapy Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Hamidreza Nasimi Doost Azgomi
- Traditional Medicine and Hydrotherapy Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
- Students Research Committee, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Alireza Nasimi Doost Azgomi
- Traditional Medicine and Hydrotherapy Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
- Students Research Committee, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mohammad Hossein Ayati
- Traditional Medicine and Hydrotherapy Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
- Departman of Medical History, School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Nasimi Doost Azgomi
- Traditional Medicine and Hydrotherapy Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
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von Salis S, Ehlert U, Fischer S. Altered Experienced Thermoregulation in Depression-No Evidence for an Effect of Early Life Stress. Front Psychiatry 2021; 12:620656. [PMID: 34366905 PMCID: PMC8333702 DOI: 10.3389/fpsyt.2021.620656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 06/28/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives: Accumulating evidence suggests that individuals with depression are characterised by difficulties in thermoregulatory cooling. The aim of this study was to investigate, for the first time, whether depressed individuals are aware of these alterations, what their physical consequences are and whether they may be rooted in early life stress. Methods: A total of N = 672 medically healthy individuals from the general population were recruited to participate in an online survey. Participants were divided into depressed vs. non-depressed using the Patient Health Questionnaire. Experienced autonomic and behavioural thermoregulation as well as vigilance problems in response to temperature increases were assessed by the Experienced Temperature Sensitivity and Regulation Survey. The Childhood Trauma Questionnaire was administered to assess early life stress. Results: Controlling for age, sex, body mass index, and physical activity, depressed vs. non-depressed individuals did not differ in their experienced autonomic and behavioural responses to temperature increases. However, the depressed individuals reported comparably greater difficulties in concentrating and drowsiness/fatigue in warm environments (p = 0.029), during physical exertion (p = 0.029), and during stress (p < 0.001). There were no differences in the experienced thermoregulation between depressed individuals with vs. without early life stress. Conclusions: Depressed individuals experienced more severe physical impairments (i.e., greater vigilance problems) in response to intense warmth when compared to non-depressed individuals. These differences were not attributable to comorbid illnesses, the intake of medication, or physical deconditioning. Further enquiries in clinical populations are warranted to investigate to what extent the observed alterations map onto specific symptoms of depression (e.g., sleep disturbances).
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Affiliation(s)
- Sarina von Salis
- Clinical Psychology and Psychotherapy, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | - Susanne Fischer
- Clinical Psychology and Psychotherapy, Institute of Psychology, University of Zurich, Zurich, Switzerland
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9
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Richardson MB, Li P, Gohlke JM, Allison DB. Effects of Indoor Thermal Environment on Human Food Intake, Productivity, and Comfort: Pilot, Randomized, Crossover Trial. Obesity (Silver Spring) 2018; 26:1826-1833. [PMID: 30426700 PMCID: PMC6580845 DOI: 10.1002/oby.22328] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 05/02/2018] [Accepted: 05/02/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE It was hypothesized that exposure to mild temperatures above the human thermoneutral zone would decrease caloric intake in a sedentary office environment. METHODS Women (n = 25) were randomized in a crossover design to perform seated office work for 7 hours in a thermoneutral condition (control, 19°C-20°C) and a condition above the thermoneutral zone (warm, 26°C-27°C). Food intake was estimated by weight and bomb calorimetry, peripheral temperature by thermal imaging, and thermal comfort and productivity by questionnaires. Mixed effects models were used to examine the effects of thermal condition on caloric intake. RESULTS Participants ate, on average, 357 kcal less in the warm condition, adjusting for BMI and peripheral temperature (P = 0.0219). According to the survey results at midday (after 3.5 hours of exposure), 96% of the participants in the warm condition reported being comfortable (n = 24) compared with 32% in the control condition (n = 8). More participants reported being as productive or more productive than usual in the warm condition (n = 22, 88%) than in the control condition (n = 12, 48%). CONCLUSIONS This line of research is worthy of further exploration. Untightening climate control toward warmer conditions during summer to increase comfort and productivity while decreasing caloric intake may prove both effective and comfortable.
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Affiliation(s)
- Molly B. Richardson
- Department of Population Health Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA
| | - Peng Li
- Department of Biostatistics, UAB, Birmingham, AL
| | - Julia M. Gohlke
- Department of Population Health Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA
| | - David B. Allison
- Indiana University School of Public Health-Bloomington, Bloomington, IN
- Corresponding Author Indiana University School of Public Health-Bloomington, 1025 E 7th St, PH 111, Bloomington, IN 47405, (812) 855-1250,
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Te Lindert BHW, Van Someren EJW. Skin temperature, sleep, and vigilance. HANDBOOK OF CLINICAL NEUROLOGY 2018; 156:353-365. [PMID: 30454600 DOI: 10.1016/b978-0-444-63912-7.00021-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A large number of studies have shown a close association between the 24-hour rhythms in core body temperature and sleep propensity. More recently, studies have have begun to elucidate an intriguing association of sleep with skin temperature as well. The present chapter addresses the association of sleep and alertness with skin temperature. It discusses whether the association could reflect common underlying drivers of both sleep propensity and skin vasodilation; whether it could reflect efferents of sleep-regulating brain circuits to thermoregulatory circuits; and whether skin temperature could provide afferent input to sleep-regulating brain circuits. Sleep regulation and concomitant changes in skin temperature are systematically discussed and three parallel factors suggested: a circadian clock mechanism, a homeostatic hourglass mechanism, and a third set of sleep-permissive and wake-promoting factors that gate the effectiveness of signals from the clock and hourglass in the actual induction of sleep or maintenance of alert wakefulness. The chapter moreover discusses how the association between skin temperature and arousal can change with sleep deprivation and insomnia. Finally it addresses whether the promising laboratory findings on the effects of skin temperature manipulations on vigilance can be applied to improve sleep in everyday life.
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Affiliation(s)
- Bart H W Te Lindert
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
| | - Eus J W Van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands; Departments of Psychiatry and Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
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Insomnia heterogeneity: Characteristics to consider for data-driven multivariate subtyping. Sleep Med Rev 2016; 36:71-81. [PMID: 29066053 DOI: 10.1016/j.smrv.2016.10.005] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 08/24/2016] [Accepted: 10/26/2016] [Indexed: 12/20/2022]
Abstract
Meta-analyses and systematic reviews have reported surprisingly few consistent insomnia-characteristics with respect to cognitions, mood, traits, history of life events and family history. One interpretation of this limited consistency is that different subtypes of insomnia exist, each with its own specific multivariate profile of characteristics. Because previously unrecognized subtypes will be differentially represented in individual studies and dilute effect sizes of subtype-dependent characteristics of importance, they are unlikely to be reported consistently in individual studies, let alone in meta-analyses. This review therefore aims to complement meta-analyses by listing previously reported psychometric characteristics of insomnia, irrespective of the degree of consistency over studies. The review clearly indicates that characteristics of insomnia may not be limited to sleep. Reports suggest that at least some individuals with insomnia may deviate from people without sleep complaints with respect to demographics, mental and physical health, childhood trauma, life events, fatigue, sleepiness, hyperarousal, hyperactivity, other sleep disorders, lifetime sleep history, chronotype, depression, anxiety, mood, quality of life, personality, happiness, worry, rumination, self-consciousness, sensitivity, dysfunctional beliefs, self-conscious emotion regulation, coping, nocturnal mentation, wake resting-state mentation, physical activity, food intake, temperature perception and hedonic evaluation. The value of this list of characteristics is that 1) internet has now made it feasible to asses them all in a large sample of people suffering from insomnia, and 2) statistical methods like latent class analysis and community detection can utilize them for a truly bottom-up data-driven search for subtypes. The supplement to this review provides a blueprint of this multivariate approach as implemented in the Sleep registry platform (www.sleepregistry.nl), that allows for bottom-up subtyping and fosters cross-cultural comparison and worldwide collaboration on insomnia subtype finding - and beyond.
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