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Bigalke JA, Greenlund IM, Bigalke JR, Carter JR. Actigraphy-based sleep and muscle sympathetic nerve activity in humans. Am J Physiol Regul Integr Comp Physiol 2024; 327:R145-R151. [PMID: 38842513 DOI: 10.1152/ajpregu.00113.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 05/30/2024] [Accepted: 06/03/2024] [Indexed: 06/07/2024]
Abstract
Short and insufficient sleep are prevalent and associated with cardiovascular disease, with the sympathetic nervous system as a suspected mediator. The purpose of the present study was to investigate the association between objective, actigraphy-based total sleep time (TST), sleep efficiency (SE), and cardiovascular and sympathetic regulation in healthy adults. We hypothesized that short TST and low SE would be associated with elevated resting blood pressure, heart rate (HR), and muscle sympathetic nerve activity (MSNA). Participants included 94 individuals [46 males, 48 females, age: 30 ± 15 yr, body mass index (BMI): 26 ± 4 kg/m2]. All participants underwent at least 7 days of at-home, wristwatch actigraphy monitoring (avg: 10 ± 3 days). Seated blood pressures were assessed using brachial blood pressure measurements, followed by a 10-minute supine autonomic testing session consisting of continuous HR (electrocardiogram), beat-by-beat blood pressure (finger plethysmograph), and MSNA (microneurography) monitoring. Partial correlations were used to determine the relationship between sleep and cardiovascular parameters while accounting for the influence of age, sex, and BMI. TST was not associated with MAP (R = -0.105, P = 0.321), HR (R = 0.093, P = 0.383), or MSNA burst frequency (BF; R = -0.168, P = 0.112) and burst incidence (BI; R = -0.162, P = 0.124). Similarly, SE was not associated with MAP (R = -0.088, P = 0.408), HR (R = -0.118, P = 0.263), MSNA BF (R = 0.038, P = 0.723), or MSNA BI (R = 0.079, P = 0.459). In contrast to recent preliminary findings, our results do not support a significant association between actigraphy-based sleep duration or efficiency and measures of resting blood pressure, heart rate, and MSNA.NEW & NOTEWORTHY The present study investigated the independent association between actigraphy-based sleep duration, efficiency, and measures of blood pressure, heart rate, and muscle sympathetic nerve activity (MSNA) in adult males and females. Contrary to our hypothesis, the findings do not support an independent association between habitual sleep and cardiovascular or sympathetic neural activity. However, these findings do not preclude a potential association between these parameters in populations with sleep disorders and/or cardiovascular disease.
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Affiliation(s)
- Jeremy A Bigalke
- Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, United States
- Department of Psychology, Montana State University, Bozeman, Montana, United States
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan, United States
| | - Ian M Greenlund
- Department of Psychology, Montana State University, Bozeman, Montana, United States
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan, United States
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | - Jennifer R Bigalke
- Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, United States
| | - Jason R Carter
- Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, United States
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan, United States
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Even C, Magzal F, Shochat T, Haimov I, Agmon M, Tamir S. Microbiota Metabolite Profiles and Dietary Intake in Older Individuals with Insomnia of Short vs. Normal Sleep Duration. Biomolecules 2024; 14:419. [PMID: 38672436 PMCID: PMC11047947 DOI: 10.3390/biom14040419] [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: 02/19/2024] [Revised: 03/23/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
Recent evidence suggests that the gut microbiota plays a role in insomnia pathogenesis. This study compared the dietary habits and microbiota metabolites of older adults with insomnia of short vs. normal sleep duration (ISSD and INSD, respectively). Data collection included sleep assessment through actigraphy, dietary analysis using the Food Frequency Questionnaire, and metabolomic profiling of stool samples. The results show that ISSD individuals had higher body mass index and a greater prevalence of hypertension. Significant dietary differences were observed, with the normal sleep group consuming more kilocalories per day and specific aromatic amino acids (AAAs) phenylalanine and tyrosine and branch-chain amino acid (BCAA) valine per protein content than the short sleep group. Moreover, metabolomic analysis identified elevated levels of the eight microbiota metabolites, benzophenone, pyrogallol, 5-aminopental, butyl acrylate, kojic acid, deoxycholic acid (DCA), trans-anethole, and 5-carboxyvanillic acid, in the short compared to the normal sleep group. The study contributes to the understanding of the potential role of dietary and microbial factors in insomnia, particularly in the context of sleep duration, and opens avenues for targeted dietary interventions and gut microbiota modulation as potential therapeutic approaches for treating insomnia.
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Affiliation(s)
- Carmel Even
- Nutritional Science Department, Tel Hai College, Upper Galilee, Kiryat Shmona 1220800, Israel (S.T.)
| | - Faiga Magzal
- Nutritional Science Department, Tel Hai College, Upper Galilee, Kiryat Shmona 1220800, Israel (S.T.)
- Laboratory of Human Health and Nutrition Sciences, MIGAL-Galilee Research Institute, Kiryat Shmona 11016, Israel
| | - Tamar Shochat
- The Cheryl Spencer Department of Nursing, University of Haifa, Haifa 3103301, Israel; (T.S.)
| | - Iris Haimov
- Department of Psychology and the Center for Psychobiological Research, The Max Stern Yezreel Valley College, Affula 19300, Israel;
| | - Maayan Agmon
- The Cheryl Spencer Department of Nursing, University of Haifa, Haifa 3103301, Israel; (T.S.)
| | - Snait Tamir
- Nutritional Science Department, Tel Hai College, Upper Galilee, Kiryat Shmona 1220800, Israel (S.T.)
- Laboratory of Human Health and Nutrition Sciences, MIGAL-Galilee Research Institute, Kiryat Shmona 11016, Israel
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Bigalke JA, Young BE, Cleveland EL, Fadel PJ, Carter JR. Aging and sympathetic transduction to blood pressure in humans: methodological and physiological considerations. Am J Physiol Heart Circ Physiol 2024; 326:H148-H157. [PMID: 37921667 PMCID: PMC11213475 DOI: 10.1152/ajpheart.00359.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 10/25/2023] [Accepted: 11/01/2023] [Indexed: 11/04/2023]
Abstract
Recent reports suggest that quantification of signal-averaged sympathetic transduction is influenced by resting muscle sympathetic nerve activity (MSNA) and burst occurrence relative to the average mean arterial pressure (MAP). Herein, we asked how these findings may influence age-related reductions in sympathetic transduction. Beat-to-beat blood pressure and MSNA were recorded during 5 min of rest in 27 younger (13 females: age, 25 ± 5 yr; BMI, 25 ± 4 kg/m2) and 26 older (15 females: age, 59 ± 5 yr; BMI, 26 ± 4 kg/m2) healthy adults. All MSNA bursts were signal averaged together. Beat-to-beat MAP values were then split into low (T1), middle (T2), and high (T3) tertiles, and signal-averaged transduction was calculated within each tertile. Resting MSNA was higher in older adults and MAP was similar between groups. Older adults exhibited blunted overall MAP transduction (younger, Δ1.5 ± 0.6 vs. older, Δ0.9 ± 0.7 mmHg; P = 0.005), which was irrespective of relation to prevailing MAP. A greater proportion of bursts occurred above the average MAP in older adults (P < 0.001), and a larger proportion of these bursts were associated with depressor responses (P = 0.005). Nonetheless, assessment of bursts above the average MAP associated with pressor responses revealed similar age-associated reductions in transduction (younger, Δ2.6 ± 1.6 vs. older, Δ1.7 ± 0.8 mmHg; P = 0.016). These findings indicate an age-related increase in burst occurrence above the average resting MAP, which alone does not explain blunted transduction, thereby supporting the physiological underpinnings of age-related decrements in sympathetic transduction to blood pressure.NEW & NOTEWORTHY The current study demonstrated that aging is associated with a greater prevalence of sympathetic bursts occurring above the average blood pressure, which offers both methodologically and physiologically relevant information regarding aging and sympathetic control of blood pressure. These data support age-related reductions in sympathetic transduction via a reduced pressor response to sympathetic bursts irrespective of the prevailing absolute blood pressure value, along with increases in sympathetic outflow necessary to maintain blood pressure.
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Affiliation(s)
- Jeremy A Bigalke
- Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, United States
- Department of Psychology, Montana State University, Bozeman, Montana, United States
| | - Benjamin E Young
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas, United States
- Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Emily L Cleveland
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana, United States
| | - Paul J Fadel
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas, United States
| | - Jason R Carter
- Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, United States
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McCall WV, Looney SW, Zulfiqar M, Ketcham E, Jones M, Mixson C, McCloud L, Miller BJ, Rosenquist PB. Daytime autonomic nervous system functions differ among adults with and without insomnia symptoms. J Clin Sleep Med 2023; 19:1885-1893. [PMID: 37421322 PMCID: PMC10620659 DOI: 10.5664/jcsm.10704] [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: 02/09/2023] [Revised: 06/27/2023] [Accepted: 06/27/2023] [Indexed: 07/10/2023]
Abstract
STUDY OBJECTIVES We gathered data to determine whether daytime assays of the autonomic nervous system would differ between persons with no vs modest insomnia symptoms and would correlate with the severity of insomnia symptoms in patients. METHODS This report is composed of 2 studies. Study 1 conducted pupillary light reflex (PLR) measurements in community volunteers who were not seeking medical care. Study 2 contrasted PLR and heart rate variability in a different sample of community volunteers and a comparison sample of adults seeking outpatient care for insomnia and psychiatric problems. All measurements were taken between 3 and 5 pm. RESULTS In Study 1, volunteers with modest insomnia symptom severity had a more rapid PLR average constriction velocity compared with those with no symptoms. In Study 2, lower heart rate variability, indicating higher levels of physiologic arousal, generally were in agreement with faster PLR average constriction velocity, both of which indicate higher levels of arousal. Insomnia symptom severity was highly correlated with faster average constriction velocity in the patient sample. CONCLUSIONS These studies suggest that (1) daytime measurements of the autonomic nervous system differ between persons with modest vs no insomnia symptoms and (2) insomnia symptom severity is highly correlated with PLR. Daytime measurement of autonomic nervous system activity might allow for daytime point-of-care measurement to characterize the level of physiologic arousal to define a hyperarousal subtype of insomnia disorder. CITATION McCall WV, Looney SW, Zulfiqar M, et al. Daytime autonomic nervous system functions differ among adults with and without insomnia symptoms. J Clin Sleep Med. 2023;19(11):1885-1893.
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Affiliation(s)
- William V. McCall
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Stephen W. Looney
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Maria Zulfiqar
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Evan Ketcham
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Megan Jones
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Carter Mixson
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Laryssa McCloud
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Brian J. Miller
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Peter B. Rosenquist
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia
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Bock JM, Greenlund IM, Somers VK, Baker SE. Sex Differences in Neurovascular Control: Implications for Obstructive Sleep Apnea. Int J Mol Sci 2023; 24:13094. [PMID: 37685900 PMCID: PMC10487948 DOI: 10.3390/ijms241713094] [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: 07/11/2023] [Revised: 08/10/2023] [Accepted: 08/14/2023] [Indexed: 09/10/2023] Open
Abstract
Patients with obstructive sleep apnea (OSA) have a heightened risk of developing cardiovascular diseases, namely hypertension. While seminal evidence indicates a causal role for sympathetic nerve activity in the hypertensive phenotype commonly observed in patients with OSA, no studies have investigated potential sex differences in the sympathetic regulation of blood pressure in this population. Supporting this exploration are large-scale observational data, as well as controlled interventional studies in healthy adults, indicating that sleep disruption increases blood pressure to a greater extent in females relative to males. Furthermore, females with severe OSA demonstrate a more pronounced hypoxic burden (i.e., disease severity) during rapid eye movement sleep when sympathetic nerve activity is greatest. These findings would suggest that females are at greater risk for the hemodynamic consequences of OSA and related sleep disruption. Accordingly, the purpose of this review is three-fold: (1) to review the literature linking sympathetic nerve activity to hypertension in OSA, (2) to highlight recent experimental data supporting the hypothesis of sex differences in the regulation of sympathetic nerve activity in OSA, and (3) to discuss the potential sex differences in peripheral adrenergic signaling that may contribute to, or offset, cardiovascular risk in patients with OSA.
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Affiliation(s)
- Joshua M. Bock
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55901, USA; (J.M.B.)
| | - Ian M. Greenlund
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55901, USA; (J.M.B.)
| | - Virend K. Somers
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55901, USA; (J.M.B.)
| | - Sarah E. Baker
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN 55901, USA
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Wan Y, Lv M, Zhou K, Li Z, Du X, Wu W, Xue R. Mood Disorders are Correlated with Autonomic Nervous Function in Chronic Insomnia Patients with OSA. Nat Sci Sleep 2023; 15:511-522. [PMID: 37426309 PMCID: PMC10327906 DOI: 10.2147/nss.s396773] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 05/21/2023] [Indexed: 07/11/2023] Open
Abstract
Purpose To evaluate the correlation between sleep microstructure, autonomic nervous system activity, and neuropsychological characteristics in chronic insomnia (CI) patients with obstructive sleep apnea (OSA). Patients and Methods Forty-five CI-OSA patients, forty-six CI patients and twenty-two matched healthy control subjects (HCs) were enrolled. CI-OSA patients were then divided into two groups: mild OSA and moderate-to-severe OSA. All participants completed neuropsychological tests, which included the Hamilton Depression and Anxiety Scales (HAMD and HAMA), the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), the Epworth Sleepiness Scale (ESS), and the Mini-mental State Examination (MMSE). The autonomic nervous system activity and sleep microstructure were examined by the PSM-100A. Results The CI-OSA patients exhibited higher scores on the PSQI, ESS, ISI, HAMA, and HAMD than HCs and CI patients (all p < 0.01). The CI-OSA patients had a lower proportion of stable sleep, REM sleep and a higher proportion of unstable sleep ratio (all p < 0.01) than HCs and CI patients (all p < 0.01). The CI-OSA patients had higher ratios of LF and LF/HF, and lower ratios of HF and Pnn50% (all p < 0.01) than HCs and CI patients (all p < 0.01). Compared to CI-mild OSA patients, the CI-moderate-to-severe OSA patients presented with a higher ESS scores, higher ratios of LF and LF/HF, and lower ratios of HF (all p < 0.05). In CI-OSA patients, higher HAMD scores were correlated with decreased MMSE scores (r=-0.678, p < 0.01). A higher LF ratio was correlated with higher HAMD and HAMA scores (r=0.321, p=0.031, r =0.449, p =0.002), and a higher HF ratio was correlated with lower HAMD and HAMA scores (r=-0.321, P =0.031, r =-0.449, p =0.002). Conclusion OSA exacerbates the abnormalities of sleep microstructure and the autonomic nervous dysfunction in CI patients. Dysfunction of the autonomic nervous system could contribute to mood deterioration in CI with OSA patients.
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Affiliation(s)
- Yahui Wan
- Departments of Neurology, Tianjin Medical University General Hospital Airport Hospital, Tianjin, 300308, People’s Republic of China
| | - Mengdi Lv
- Departments of Neurology, Tianjin First Central Hospital, Tianjin, 300190, People’s Republic of China
| | - Kaili Zhou
- Departments of Neurology, Tianjin Medical University General Hospital Airport Hospital, Tianjin, 300308, People’s Republic of China
| | - Zheng Li
- Departments of Neurology, Binhai Hospital, Peking University, Tianjin, 300450, People’s Republic of China
| | - Xueyun Du
- Departments of Neurology, Tianjin Medical University General Hospital Airport Hospital, Tianjin, 300308, People’s Republic of China
| | - Wei Wu
- Departments of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
| | - Rong Xue
- Departments of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
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Wang Y, Fan H, Ren Z, Liu X, Niu X. Sleep disorder, Mediterranean diet, and all-cause and cause-specific mortality: a prospective cohort study. BMC Public Health 2023; 23:904. [PMID: 37202744 DOI: 10.1186/s12889-023-15870-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/10/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND There is a bidirectional effect between sleep disorders and Mediterranean diet (MED), but the joint effect of MED and sleep disorders on mortality is unclear. The aim of this study was to investigate whether there is a synergistic effect of adherence to MED and sleep disorders on all-cause and cause-specific mortality. METHODS The study included 23,212 individuals in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2014. A 9-point evaluation score, alternative Mediterranean diet (aMED) index was used to assess adherence to MED. Sleep disorder and hours of sleep were assessed by structured questionnaires. Cox regression models were used to assess the relationship between sleep disorders, aMED and all-cause mortality, cause-specific mortality (cardiovascular-related death, cancer-related death). The interaction effect of sleep disorders with aMED on mortality was further assessed. RESULTS Results showed that participants with lower aMED and presence of sleep disorders had significantly higher risk of all-cause mortality and cardiovascular-related mortality (HR, 2.16, 95% CI, 1.49-3.13, P < 0.0001; HR, 2.68, 95% CI, 1.58-4.54, P = 0.0003). A significant interaction effect was found between aMED and sleep disorders on cardiovascular mortality (p for interaction = 0.033). No significant interaction existed between aMED and sleep disorders on all-cause mortality (p for interaction = 0.184) and cancer-related mortality (p for interaction = 0.955). CONCLUSIONS Poorer adherence to MED and sleep disorders synergistically increased long-term all-cause mortality and cardiovascular mortality in NHANES population.
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Affiliation(s)
- Yongle Wang
- Department of Neurology, First Hospital of Shanxi Medical University, No. 85, Jiefangnan Street, Yingze District, Taiyuan City, 030001, Shanxi Province, China
- Clinical college, Shanxi Medical University, No. 58, Xinjiannan Street, Yingze District, Taiyuan City, Shanxi Province, China
| | - Hongxuan Fan
- Clinical college, Shanxi Medical University, No. 58, Xinjiannan Street, Yingze District, Taiyuan City, Shanxi Province, China
- Department of Cardiology, Second Hospital of Shanxi Medical University, Taiyuan City, Shanxi Province, China
| | - Zhaoyu Ren
- Clinical college, Shanxi Medical University, No. 58, Xinjiannan Street, Yingze District, Taiyuan City, Shanxi Province, China
- Department of Cardiology, Second Hospital of Shanxi Medical University, Taiyuan City, Shanxi Province, China
| | - Xuchang Liu
- Clinical college, Shanxi Medical University, No. 58, Xinjiannan Street, Yingze District, Taiyuan City, Shanxi Province, China
| | - Xiaoyuan Niu
- Department of Neurology, First Hospital of Shanxi Medical University, No. 85, Jiefangnan Street, Yingze District, Taiyuan City, 030001, Shanxi Province, China.
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Liguori C, Mombelli S, Fernandes M, Zucconi M, Plazzi G, Ferini-Strambi L, Logroscino G, Mercuri NB, Filardi M. The evolving role of quantitative actigraphy in clinical sleep medicine. Sleep Med Rev 2023; 68:101762. [PMID: 36773596 DOI: 10.1016/j.smrv.2023.101762] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 01/23/2023] [Accepted: 01/23/2023] [Indexed: 01/30/2023]
Abstract
Actigraphy has a consolidated role in Insomnia and Circadian Rhythm Sleep-Wake Disorders (CRSWD) and recent studies have highlighted the use of actigraphy for narcolepsy and REM sleep behaviour disorder (RBD). This review aims at summarising the results of studies published over the last decade regarding the use of actigraphy. Thirty-five studies proved eligible, and results were analysed separately for insomnia, narcolepsy and RBD. Actigraphy showed to consistently differentiate insomnia patients from healthy controls. Furthermore, the application of advanced analytical techniques has been shown to provide both unique insights into the physiology of insomnia and sleep misperception and to improve the specificity of actigraphy in detecting wakefulness within sleep periods. Regarding narcolepsy, several studies showed that actigraphy can detect peculiar sleep/wake disruption and the effects of pharmacological treatments. Finally, although the number of studies in RBD patients is still limited, the available evidence indicates a reduced amplitude of the activity pattern, sleep-wake rhythm dysregulation and daytime sleepiness. Therefore, the potential use of these markers as predictors of phenoconversion should be further explored. In conclusion, quantitative actigraphy presents a renewed interest when considering the possibility of using actigraphy in clinical sleep medicine to diagnose, monitor, and follow sleep disorders other than CRSWD.
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Affiliation(s)
- Claudio Liguori
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy; Sleep Medicine Centre, Neurology Unit, University Hospital of Rome Tor Vergata, Rome, Italy.
| | - Samantha Mombelli
- IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, Milan, Italy
| | - Mariana Fernandes
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Marco Zucconi
- IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, Milan, Italy
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Luigi Ferini-Strambi
- IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, Milan, Italy; "Vita-Salute" San Raffaele University, Milan, Italy
| | - Giancarlo Logroscino
- Department of Translational Biomedicine and Neurosciences (DiBraiN), University of Bari Aldo Moro, Bari, Italy; Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro at Pia Fondazione "Card. G. Panico", Italy
| | - Nicola Biagio Mercuri
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy; Sleep Medicine Centre, Neurology Unit, University Hospital of Rome Tor Vergata, Rome, Italy
| | - Marco Filardi
- Department of Translational Biomedicine and Neurosciences (DiBraiN), University of Bari Aldo Moro, Bari, Italy; Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro at Pia Fondazione "Card. G. Panico", Italy
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Bigalke JA, Shan Z, Carter JR. Orexin, Sleep, Sympathetic Neural Activity, and Cardiovascular Function. Hypertension 2022; 79:2643-2655. [PMID: 36148653 PMCID: PMC9649879 DOI: 10.1161/hypertensionaha.122.19796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Inadequate sleep duration and quality are associated with reduced cardiovascular health and increased mortality. Experimental evidence points to the sympathetic nervous system as a key mediator in the observed relationship between poor sleep and cardiovascular dysfunction. However, brain mechanisms underpinning the impaired sympathetic function associated with poor sleep remain unclear. Recent evidence suggests the central orexin system, particularly orexins A and B and their receptors, have a key regulatory role for sleep in animal and human models. While orexin system activity has been observed to significantly impact sympathetic regulation in animals, the extension of these findings to humans has been difficult due to an inability to directly assess orexin system activity in humans. However, direct measures of sympathetic activity in populations with narcolepsy and chronic insomnia, 2 sleep disorders associated with deficient and excessive orexin neural activity, have allowed indirect assessment of the relationships between orexin, sleep, and sympathetic regulation. Further, the recent pharmaceutical development of dual orexin receptor antagonists for use in clinical insomnia populations offers an unprecedented opportunity to examine the mechanistic role of orexin in sleep and cardiovascular health in humans. The current review assesses the role of orexin in both sleep and sympathetic regulation from a translational perspective, spanning animal and human studies. The review concludes with future research directions necessary to fully elucidate the mechanistic role for orexin in sleep and sympathetic regulation in humans.
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Affiliation(s)
- Jeremy A. Bigalke
- Department of Health and Human Development, Montana State University, Bozeman, Montana
- Department of Psychology, Montana State University, Bozeman, Montana
| | - Zhiying Shan
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan
| | - Jason R. Carter
- Department of Health and Human Development, Montana State University, Bozeman, Montana
- Department of Psychology, Montana State University, Bozeman, Montana
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Durocher JJ, Toorongian CA, Thivierge GS. An experiential learning course for cardiovascular and sleep technology. ADVANCES IN PHYSIOLOGY EDUCATION 2022; 46:544-548. [PMID: 36007941 DOI: 10.1152/advan.00173.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/19/2022] [Accepted: 08/19/2022] [Indexed: 06/15/2023]
Abstract
Undergraduate programs related to allied health are often pursued by students to prepare for entrance into professional programs, but many students also ask about what types of employment options they may have upon completion of the bachelor's degree. This experiential learning course in cardiovascular and sleep technology was designed to provide opportunities for students to gain hands-on clinical skills that could help them to enter professional programs or to find employment in an allied health field such as cardiopulmonary rehabilitation, cardiovascular technology, or sleep technology. The prerequisites for this course were the completion of two semesters of anatomy and physiology. This course was based on experiential learning and was structured into three modules: clinical exercise physiology, autonomic physiology, and sleep physiology. As part of the course students completed a 4-page scientific report for one designated topic within each of the modules. The two exams in the course were essay based. The design of this course required students to review key topics from anatomy and physiology, to comprehend peer-reviewed manuscripts, to gain hands-on experiences with sophisticated physiological equipment, to work as individuals and in groups, and to become better oral and written communicators. The sleep physiology module included an introduction to electroencephalography (EEG) and a student-led nap study, which may be an effective way to introduce students to sleep medicine. We are hopeful that the summary of this course will be useful to physiology educators as they work to provide the most meaningful experiences to their undergraduates in the health sciences.NEW & NOTEWORTHY Experiential learning in clinical exercise, autonomic regulation, and sleep physiology is an impactful way to train undergraduate biomedical students to enter a variety of careers in healthcare, graduate programs in the health professions, or traditional research graduate programs. A hands-on course such as Cardiovascular and Sleep Technology provides a way, in addition to or independent of original research, to provide clinically relevant training.
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Affiliation(s)
- John J Durocher
- Integrative Human Health Program, Department of Biological Sciences and Integrative Physiology and Health Sciences Center, Purdue University Northwest, Hammond, Indiana
| | - Colleen A Toorongian
- Integrative Human Health Program, Department of Biological Sciences and Integrative Physiology and Health Sciences Center, Purdue University Northwest, Hammond, Indiana
| | - Grant S Thivierge
- Integrative Human Health Program, Department of Biological Sciences and Integrative Physiology and Health Sciences Center, Purdue University Northwest, Hammond, Indiana
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Liu J, Wang W, Tian J, Lv C, Fu Y, Fass R, Song G, Yu Y. Sleep Deficiency Is Associated With Exacerbation of Symptoms and Impairment of Anorectal and Autonomic Functions in Patients With Functional Constipation. Front Neurosci 2022; 16:912442. [PMID: 35873821 PMCID: PMC9301120 DOI: 10.3389/fnins.2022.912442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveSleep deficiency (SD) is commonly seen in patients with functional constipation (FC). Our aim was to determine whether the presence of SD would influence symptoms, anorectal motility, sensation, and autonomic function in FC patients.Materials and MethodsA total of 85 FC patients with SD and 193 FC patients without SD underwent high-resolution anorectal manometry. SD was assessed by using the Pittsburgh Sleep Quality Index (PSQI) score. Participants were required to fill in the entire questionnaires, including Patients’ Constipation-symptoms, State-Trait Anxiety Inventory, and Hamilton Depression Scale. Autonomic dysfunction was studied by recording the heart rate variability. Multiple logistic regression was performed to explore the potential risk factors for anorectal function.ResultsFunctional constipation patients with SD had a higher total score of constipation symptom (P < 0.001), in comparison with those without SD. FC patients with SD demonstrated significantly lower threshold volume for first sensation (P < 0.001) and urge (P < 0.001), as compared to those without SD. The PSQI score positively correlated with constipation symptom total score (P < 0.001), and negatively correlated with threshold volume for first sensation (P < 0.001) and urge (P < 0.001). FC patients with SD had a reduced vagal activity (P = 0.016) and a higher sympathetic activity as compared to those without SD (P = 0.003). Multivariate logistic regression revealed that SD, anxiety and depression were independent risk factors for anorectal function, with SD exhibiting the highest degree of association with first sensation (OR: 4.235).ConclusionSleep deficiency is associated with worse constipation related symptoms, altered anorectal function and perception, and impaired autonomic function in FC patients.
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Affiliation(s)
- Jie Liu
- Department of Gastroenterology, Affiliated Anhui Provincial Hospital, Anhui Medical University, Hefei, China
| | - Wei Wang
- Department of Gastroenterology, Affiliated Anhui Provincial Hospital, Anhui Medical University, Hefei, China
| | - Jiashuang Tian
- Department of Gastroenterology, Affiliated Anhui Provincial Hospital, Anhui Medical University, Hefei, China
| | - Chaolan Lv
- Division of Life Sciences and Medicine, Department of Gastroenterology, The First Affiliated Hospital of University of Science and Technology of China (USTC), University of Science and Technology of China, Hefei, China
| | - Yuhan Fu
- Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, United States
| | - Ronnie Fass
- Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, United States
| | - Gengqing Song
- Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, United States
- Gengqing Song,
| | - Yue Yu
- Department of Gastroenterology, Affiliated Anhui Provincial Hospital, Anhui Medical University, Hefei, China
- Division of Life Sciences and Medicine, Department of Gastroenterology, The First Affiliated Hospital of University of Science and Technology of China (USTC), University of Science and Technology of China, Hefei, China
- *Correspondence: Yue Yu,
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12
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Medalie L, Bigalke JA, Tikkanen AL, Mokhlesi B, Carter JR. Recruiting “clean” chronic insomnia participants: the unicorn of sleep research. J Clin Sleep Med 2022; 18:2081-2083. [PMID: 35499132 PMCID: PMC9340603 DOI: 10.5664/jcsm.10088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | - Jeremy A. Bigalke
- Department of Health and Human Development, Montana State University, Bozeman, Montana
- Department of Psychology, Montana State University, Bozeman, Montana
| | - Anne L. Tikkanen
- Department of Health and Human Development, Montana State University, Bozeman, Montana
| | - Babak Mokhlesi
- Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Rush University Medical Center, Chicago, Illinois
| | - Jason R. Carter
- Department of Health and Human Development, Montana State University, Bozeman, Montana
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13
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Grosicki GJ, Bunsawat K, Jeong S, Robinson AT. Racial and ethnic disparities in cardiometabolic disease and COVID-19 outcomes in White, Black/African American, and Latinx populations: Social determinants of health. Prog Cardiovasc Dis 2022; 71:4-10. [PMID: 35490870 PMCID: PMC9047517 DOI: 10.1016/j.pcad.2022.04.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 04/24/2022] [Indexed: 02/07/2023]
Abstract
Racial and ethnic-related health disparities in the United States have been intensified by the greater burden of Coronavirus Disease 2019 (COVID-19) in racial and ethnic minority populations. Compared to non-Hispanic White individuals, non-Hispanic Black and Hispanic/Latinx individuals infected by COVID-19 are at greater risk for hospitalization, intensive care unit admission, and death. There are several factors that may contribute to disparities in COVID-19-related severity and outcomes in these minority populations, including the greater burden of cardiovascular and metabolic diseases as discussed in our companion review article. Social determinants of health are a critical, yet often overlooked, contributor to racial and ethnic-related health disparities in non-Hispanic Black and Hispanic/Latinx individuals relative to non-Hispanic White individuals. Thus, the purpose of this review is to focus on the essential role of social factors in contributing to health disparities in chronic diseases and COVID-19 outcomes in minority populations. Herein, we begin by focusing on structural racism as a social determinant of health at the societal level that contributes to health disparities through downstream social level (e.g., occupation and residential conditions) and individual level health behaviors (e.g., nutrition, physical activity, and sleep). Lastly, we conclude with a discussion of practical applications and recommendations for future research and public health efforts that seek to reduce health disparities and overall disease burden.
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Affiliation(s)
- Gregory J Grosicki
- Department of Health Sciences and Kinesiology, Biodynamics and Human Performance Center, Georgia Southern University (Armstrong Campus), Savannah, GA 31419, USA
| | - Kanokwan Bunsawat
- Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, UT 84132, USA; Geriatric Research, Education, and Clinical Center, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA
| | - Soolim Jeong
- Neurovascular Physiology Laboratory, School of Kinesiology, Auburn University, Auburn, AL 36849, USA
| | - Austin T Robinson
- Neurovascular Physiology Laboratory, School of Kinesiology, Auburn University, Auburn, AL 36849, USA.
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14
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Van Puyvelde M, Mairesse O. Do C-tactile afferents go to sleep? A potential role for somatosensory stimulation in sleep regulation. Curr Opin Behav Sci 2022. [DOI: 10.1016/j.cobeha.2021.08.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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15
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Greenlund IM, Carter JR. Sympathetic neural responses to sleep disorders and insufficiencies. Am J Physiol Heart Circ Physiol 2022; 322:H337-H349. [PMID: 34995163 PMCID: PMC8836729 DOI: 10.1152/ajpheart.00590.2021] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Short sleep duration and poor sleep quality are associated with cardiovascular risk, and sympathetic nervous system (SNS) dysfunction appears to be a key contributor. The present review will characterize sympathetic function across several sleep disorders and insufficiencies in humans, including sleep deprivation, insomnia, narcolepsy, and obstructive sleep apnea (OSA). We will focus on direct assessments of sympathetic activation, e.g., plasma norepinephrine and muscle sympathetic nerve activity, but include heart rate variability (HRV) when direct assessments are lacking. The review also highlights sex as a key biological variable. Experimental models of total sleep deprivation and sleep restriction are converging to support several epidemiological studies reporting an association between short sleep duration and hypertension, especially in women. A systemic increase of SNS activity via plasma norepinephrine is present with insomnia and has also been confirmed with direct, regionally specific evidence from microneurographic studies. Narcolepsy is characterized by autonomic dysfunction via both HRV and microneurographic studies but with opposing conclusions regarding SNS activation. Robust sympathoexcitation is well documented in OSA and is related to baroreflex and chemoreflex dysfunction. Treatment of OSA with continuous positive airway pressure results in sympathoinhibition. In summary, sleep disorders and insufficiencies are often characterized by sympathoexcitation and/or sympathetic/baroreflex dysfunction, with several studies suggesting women may be at heightened risk.
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Affiliation(s)
- Ian M. Greenlund
- 1Department of Health and Human Development, Montana State University, Bozeman, Montana,2Department of Psychology, Montana State University, Bozeman, Montana
| | - Jason R. Carter
- 1Department of Health and Human Development, Montana State University, Bozeman, Montana,2Department of Psychology, Montana State University, Bozeman, Montana
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16
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Gan J, Wang XD, Shi Z, Yuan J, Zhang M, Liu S, Wang F, You Y, Jia P, Feng L, Xu J, Zhang J, Hu W, Chen Z, Ji Y. The Impact of Rotating Night Shift Work and Daytime Recharge on Cognitive Performance Among Retired Nurses. Front Aging Neurosci 2022; 13:827772. [PMID: 35145395 PMCID: PMC8821912 DOI: 10.3389/fnagi.2021.827772] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 12/22/2021] [Indexed: 11/13/2022] Open
Abstract
IntroductionThe exact relationship between long-term shift work (SW) and cognitive impairment (CI) has been poorly understood. The effects of the long-term rotating night SW (RNSW) combining daytime recharge (DTR) on cognitive function were investigated.MethodsA total 920 retired nurses and 656 retired female teachers aged ≥50 years were analyzed. Participants who worked at least once per week for 8 hat night for more than 1 year were defined as the SW group, and those without a regular nighttime shift were defined as the control group. The associations among duration, frequency, and DTR of RNSW, and neuropsychological assessments were ascertained by regression models.ResultsParticipants with RNSW had a significantly higher proportion of mild CI (MCI), both amnestic MCI (aMCI) (14.4% in 11–20 years, p < 0.05, and 17.8% in > 20 years, p < 0.001) and non-amnestic MCI (naMCI) (8.1% in 11–20 years, p < 0.05), as well as dementia (1.5% in 1–10 years, and 11.7% in > 20 years, p < 0.05) compared to controls (8.4% with aMCI, 4.4% with naMCI, and 7.0% with dementia, respectively). There were significant negative relationships between general times of night SW and scores of Mini-Mental State Examination (MMSE) (R squared = 0.01, p = 0.0014) and Montreal Cognitive Assessment (MoCA) (R squared = 0.01, p = 0.0054). Participants with ≥1 h of DTR and ≥ 11 years of RNSW were about 2-fold more likely to experience MCI compared with the subjects in the control group, especially with 3–5 h (odds ratio [OR]: 2.35; 95% confidence interval: 1.49–3.68, p < 0.001).ConclusionThe long-term RNSW was associated with a higher risk of CI, especially aMCI and dementia, and the problem cannot be improved by DTR.
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Affiliation(s)
- Jinghuan Gan
- Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiao-Dan Wang
- Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Department of Neurology, Tianjin Huanhu Hospital, Tianjin Dementia Institute, Tianjin, China
| | - Zhihong Shi
- Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Department of Neurology, Tianjin Huanhu Hospital, Tianjin Dementia Institute, Tianjin, China
| | - Junliang Yuan
- NHC Key Laboratory of Mental Health (Peking University), Department of Neurology, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
| | - Meiyun Zhang
- Department of Neurology, Tianjin People’s Hospital, Tianjin, China
| | - Shuai Liu
- Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Department of Neurology, Tianjin Huanhu Hospital, Tianjin Dementia Institute, Tianjin, China
| | - Fei Wang
- Department of Neurology, Yuncheng Central Hospital of Shanxi Province, Yuncheng, China
| | - Yong You
- Department of Neurology, Second Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Peifei Jia
- Department of Neurology, The Second Affiliated Hospital of Baotou Medical College, Baotou, China
| | - Lisha Feng
- Department of Encephalopathy, Research Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Junying Xu
- Department of Neurology, Tianjin Baodi People’s Hospital, Tianjin, China
| | - Jinhong Zhang
- Department of Neurology, Cangzhou People’s Hospital, Cangzhou, China
| | - Wenzheng Hu
- Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhichao Chen
- Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yong Ji
- Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Department of Neurology, Tianjin Huanhu Hospital, Tianjin Dementia Institute, Tianjin, China
- *Correspondence: Yong Ji,
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17
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Bock JM, Vungarala S, Covassin N, Somers VK. Sleep Duration and Hypertension: Epidemiological Evidence and Underlying Mechanisms. Am J Hypertens 2022; 35:3-11. [PMID: 34536276 DOI: 10.1093/ajh/hpab146] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/04/2021] [Accepted: 09/16/2021] [Indexed: 12/22/2022] Open
Abstract
While the contribution of several physiological systems to arterial blood pressure regulation has been studied extensively, the role of normal and disrupted sleep as a modifiable determinant of blood pressure control, and in the pathophysiology of hypertension, has only recently emerged. Several sleep disorders, including sleep apnea and insomnia, are thought to contribute to the development of hypertension, although less attention is paid to the relationship between sleep duration and blood pressure independent of sleep disorders per se. Accordingly, this review focuses principally on the physiology of sleep and the consequences of abnormal sleep duration both experimentally and at the population level. Clinical implications for patients with insomnia who may or may not have abbreviated sleep duration are explored. As a corollary, we further review studies of the effects of sleep extension on blood pressure regulation. We also discuss epidemiological evidence suggesting that long sleep may also be associated with hypertension and describe the parabolic relationship between total sleep time and blood pressure. We conclude by highlighting gaps in the literature regarding the potential role of gut microbial health in the cross-communication of lifestyle patterns (exercise, diet, and sleep) with blood pressure regulation. Additionally, we discuss populations at increased risk of short sleep, and specifically the need to understand mechanisms and therapeutic opportunities in women, pregnancy, the elderly, and in African Americans.
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Affiliation(s)
- Joshua M Bock
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Soumya Vungarala
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Naima Covassin
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Virend K Somers
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
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18
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de Zambotti M, Yuksel D, Kiss O, Barresi G, Arra N, Volpe L, King C, Baker FC. A virtual reality-based mind–body approach to downregulate psychophysiological arousal in adolescent insomnia. Digit Health 2022; 8:20552076221107887. [PMID: 35733879 PMCID: PMC9208061 DOI: 10.1177/20552076221107887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 05/30/2022] [Indexed: 11/15/2022] Open
Abstract
Objective In this study, we describe the rationale, supported by preliminary data, for a novel, digital, immersive virtual reality (VR)-based mind–body approach, designed to reduce bedtime arousal in adolescents with insomnia. Methods Fifty-two high-school students (16–20 years; 32 female) with ( N = 18) and without ( N = 34) DSM-5 insomnia symptoms engaged with 20 min of immersive VR-guided meditation and paced breathing (0.1 Hz) ( intervention condition) and 20 min of quiet activity ( control condition), right before bedtime, on two separate evenings. Results The intervention resulted in acute autonomic and cortical modulation ( p < 0.05), leading to reduced physiological arousal (↓heart rate, ↓cortisol) compared with the control condition, with similar effects in adolescents with and without insomnia. No significant changes were detected for cognitive arousal levels. During the intervention, all participants were able to achieve the targeted 0.1 Hz breathing rate, and the majority experienced no discomfort associated with the VR exposure. However, 30–40% of the participants experienced some trouble slowing down their breathing. Conclusions The study provides supporting preliminary evidence for the mechanism behind a novel VR-based digital approach, designed to regulate psychophysiological arousal levels by acting on neurocognitive and autonomic pathways. Further studies (e.g. randomized clinical trials) are needed to evaluate the isolated and synergistic effects of its components (e.g. VR vs. VR + paced breathing), and its efficacy, acceptance, and feasibility in alleviating insomnia symptoms in adolescents.
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Affiliation(s)
| | - Dilara Yuksel
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Orsolya Kiss
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Giacinto Barresi
- Rehab Technologies, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Nicole Arra
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Laila Volpe
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Christopher King
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Pediatric Pain Research Center (PPRC), Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
- Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
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Development of Autonomic Nervous System Assays as Point-of-Care Tests to Supplement Clinical Judgment in Risk Assessment for Suicidal Behavior: A Review. Curr Psychiatry Rep 2022; 24:11-21. [PMID: 35076889 DOI: 10.1007/s11920-022-01315-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/09/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW A biomarker point-of-care (POC) test that supplements the psychiatric interview and improves detection of patients at risk for suicide would be of value, and assays of autonomic nervous system (ANS) activity would satisfy the logistical requirements for a POC test. We performed a selective review of the available literature of ANS assays related to risk for suicide. RECENT FINDINGS We searched PubMed and Web of Science with the strategy: "suicide OR suicidal" AND "electrodermal OR heart rate variability OR pupillometry OR pupillography." The search produced 119 items, 21 of which provided original data regarding ANS methods and suicide. These 21 studies included 6 for electrodermal activity, 14 for heart rate variability, and 1 for the pupillary light reflex. The 21 papers showed associations between ANS assays and suicide risk in a direction suggesting underlying hyperarousal in patients at risk for suicide. ANS assays show promise for future development as POC tests to supplement clinical decision making in estimating risk for suicide.
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20
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Nie L, Pan XL, Zhang XB, Zhang S, Rao JX, Su ZF. Research on the correlation of immunity in patients with chronic insomnia. Front Psychiatry 2022; 13:1034405. [PMID: 36329922 PMCID: PMC9623272 DOI: 10.3389/fpsyt.2022.1034405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 09/23/2022] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To investigate the changes in immunity and clinical infection events among patients with chronic insomnia. MATERIALS AND METHODS Forty-two patients with chronic insomnia (age = 64.44 ± 10.53) and 47 normal controls (age = 67.08 ± 7.822) were selected to determine differences in data, such as complete blood counts (CBCs), biochemical indices, lymphocyte subsets, immunoglobulin (Ig), complement C3 and C4 and interleukin-6 (IL-6), as well as to compare the incidence of clinical infection between the two groups. RESULTS There were significant differences in erythrocyte, hemoglobin, hematocrit, albumin, globulin, creatinine, IgG, IgG/IgM ratio, CD4+ T-lymphocytes, CD19-lymphocytes, CD4+/CD8+ ratio, platelet/lymphocyte ratio, CD19/CD3 ratio, and clinical infection events between the chronic insomnia group and the control group (p < 0.05). There was no significant difference in neutrophil, lymphocyte, monocyte, and platelet counts; lymphocyte subsets CD8+ T and CD56+; platelet-to-lymphocyte ratio (PLR); neutrophil-to-lymphocyte ratio (NLR); complement C3; complement C4; IgM; IgA; and IL-6 between the experimental group and their controls (p > 0.05). The systolic and diastolic blood pressures of the chronic insomnia group did not vary widely from those of the controls (p > 0.05). CONCLUSION Patients with chronic insomnia have immunological abnormalities, characterized by a higher incidence of clinical infection.
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Affiliation(s)
- Li Nie
- Department of General Medicine, Chaohu Hospital Affiliated with Anhui Medical University, Chaohu, China
| | - Xian-Li Pan
- Department of General Medicine, Chaohu Hospital Affiliated with Anhui Medical University, Chaohu, China
| | - Xiao-Bao Zhang
- Department of General Medicine, Chaohu Hospital Affiliated with Anhui Medical University, Chaohu, China
| | - Shan Zhang
- Department of General Medicine, Chaohu Hospital Affiliated with Anhui Medical University, Chaohu, China
| | - Ji-Xian Rao
- Department of General Medicine, Chaohu Hospital Affiliated with Anhui Medical University, Chaohu, China
| | - Zeng-Feng Su
- Department of General Medicine, Chaohu Hospital Affiliated with Anhui Medical University, Chaohu, China
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21
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Bigalke JA, Carter JR. Sympathetic Neural Control in Humans with Anxiety-Related Disorders. Compr Physiol 2021; 12:3085-3117. [PMID: 34964121 DOI: 10.1002/cphy.c210027] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Numerous conceptual models are used to describe the dynamic responsiveness of physiological systems to environmental pressures, originating with Claude Bernard's milieu intérieur and extending to more recent models such as allostasis. The impact of stress and anxiety upon these regulatory processes has both basic science and clinical relevance, extending from the pioneering work of Hans Selye who advanced the concept that stress can significantly impact physiological health and function. Of particular interest within the current article, anxiety is independently associated with cardiovascular risk, yet mechanisms underlying these associations remain equivocal. This link between anxiety and cardiovascular risk is relevant given the high prevalence of anxiety in the general population, as well as its early age of onset. Chronically anxious populations, such as those with anxiety disorders (i.e., generalized anxiety disorder, panic disorder, specific phobias, etc.) offer a human model that interrogates the deleterious effects that chronic stress and allostatic load can have on the nervous system and cardiovascular function. Further, while many of these disorders do not appear to exhibit baseline alterations in sympathetic neural activity, reactivity to mental stress offers insights into applicable, real-world scenarios in which heightened sympathetic reactivity may predispose those individuals to elevated cardiovascular risk. This article also assesses behavioral and lifestyle modifications that have been shown to concurrently improve anxiety symptoms, as well as sympathetic control. Lastly, future directions of research will be discussed, with a focus on better integration of psychological factors within physiological studies examining anxiety and neural cardiovascular health. © 2022 American Physiological Society. Compr Physiol 12:1-33, 2022.
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Affiliation(s)
- Jeremy A Bigalke
- Department of Psychology, Montana State University, Bozeman, Montana, USA
| | - Jason R Carter
- Department of Psychology, Montana State University, Bozeman, Montana, USA.,Department of Health and Human Development, Montana State University, Bozeman, Montana, USA
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22
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Yu S, Hsu CY, Chuang HY, Yang CC, Lai CL, Yu HS. Abnormalities in Cutaneous Microcirculation in Patients with Alzheimer's Disease, Mild Cognitive Impairment, and Chronic Insomnia Disorder. J Clin Med 2021; 10:jcm10245718. [PMID: 34945014 PMCID: PMC8703751 DOI: 10.3390/jcm10245718] [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] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/28/2021] [Accepted: 12/02/2021] [Indexed: 11/23/2022] Open
Abstract
Impaired sympathetic response is frequently observed in neurodegenerative diseases, such as Alzheimer’s disease (AD). On the other hand, chronic insomnia disorder (CID) is also often accompanied by activation of sympathetic nerves. Considering that cutaneous microcirculation reflects sympathetic tone, we hypothesized that baseline cutaneous microcirculation in fingers, as detected by laser Doppler flowmetry (LDF), differs among patients with mild cognitive impairment (MCI), AD, and CID. As light therapy is one of the adjunctive treatments for AD and CID, we designed a randomized controlled cross-over trial of light therapy through eyes for 12 weeks with red light as treatment and green light as control limb, and examined if light therapy has an impact on cutaneous microcirculation. Before light therapy, patients with AD had significantly lower baseline cutaneous perfusion than those with CID in left and right first to fourth fingers. After red light therapy, however, cutaneous perfusion of fingers in CID patients significantly decreased (right fingers, before vs. after = 227.25 ± 62.00 vs. 162.00 ± 49.34, p = 0.007; left fingers, before vs. after = 228.99 ± 58.80 vs. 177.41 ± 59.41, p = 0.003) while cutaneous perfusion of fingers in CID patients did not significantly change after green light therapy. Light therapy with red light also significantly increased cutaneous finger perfusion in patients with AD (right fingers, before vs. after = 130.13 ± 49.82 vs. 172.38 ± 38.32, p = 0.043). Our results suggest that cutaneous perfusion is a useful tool to detect sympathetic dysfunction in patients with CID and AD, and that light therapy with red light is a potential therapeutic intervention to reverse impaired sympathetic function in patients with CID and patients with AD.
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Affiliation(s)
- Sebastian Yu
- Department of Dermatology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan;
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung 807377, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
- Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
| | - Chung-Yao Hsu
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807378, Taiwan;
| | - Hung-Yi Chuang
- Department of Public Health and Environmental and Occupational Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan;
| | - Chen-Cheng Yang
- Department of Occupational Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 807378, Taiwan;
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
| | - Chiou-Lian Lai
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807378, Taiwan;
- Correspondence: (C.-L.L.); (H.-S.Y.)
| | - Hsin-Su Yu
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
- Correspondence: (C.-L.L.); (H.-S.Y.)
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Wang Z, Liang X, Lu Y, Jiang T, Aji T, Aimulajiang K, Sun H, Zhang L, Zhou X, Tang B, Wen H. Insomnia Promotes Hepatic Steatosis in Rats Possibly by Mediating Sympathetic Overactivation. Front Physiol 2021; 12:734009. [PMID: 34630154 PMCID: PMC8497715 DOI: 10.3389/fphys.2021.734009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/27/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Insomnia is a widespread problem that can lead to the occurrence of other diseases and correlates closely with sympathetic nerve hyperactivation. Obesity-induced hepatic steatosis is mediated by sympathetic overactivation. However, it remains unclear whether insomnia may cause hepatic steatosis. The goal of this study was to preliminarily investigate whether insomnia caused hepatic steatosis in rats via sympathetic hyperactivation. Methods: A total of 32 Sprague-Dawley male rats were divided randomly into four groups: model, sympathetic denervation (Sd), estazolam, and control (eight rats/group). Model group received sustained sleep deprivation using the modified multiple platform method. In the Sd group, rats underwent sleep deprivation after receiving Sd by 6-hydroxydopamine (6-OHDA). Estazolam group: the rats concurrently received sleep deprivation and treatment with estazolam. The other eight rats housed in cages and kept in a comfortable environment were used as control. Blood samples were obtained for analysis of plasma lipids and hepatic function. Sympathetic hyperactivation-related indexes and hepatic steatosis in liver tissues were tested. Results: Liver enzymes, plasma lipid levels, and hepatic steatosis were elevated in insomnia rats, and sympathetic hyperactivation was found. Insomnia-induced hepatic steatosis was effectively lowered with pharmacological ablation of the hepatic sympathetic nerves. Furthermore, the treatment of insomnia with estazolam inhibited sympathetic activation and reduced hepatic steatosis. Conclusion: Sustained sleep deprivation-induced insomnia promotes hepatic steatosis in rats possibly by mediating sympathetic overactivation.
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Affiliation(s)
- Zongding Wang
- State Key Laboratory of Pathogenesis, Prevention, and Treatment of High Incidence Diseases in Central Asia, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.,Hepatobiliary and Hydatid Disease Department, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Xiaoyan Liang
- Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China.,Xinjiang Key Laboratory of Cardiac Electrophysiology and Cardiac Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China
| | - Yanmei Lu
- Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China.,Xinjiang Key Laboratory of Cardiac Electrophysiology and Cardiac Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China
| | - Tiemin Jiang
- State Key Laboratory of Pathogenesis, Prevention, and Treatment of High Incidence Diseases in Central Asia, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.,Hepatobiliary and Hydatid Disease Department, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Tuerganaili Aji
- State Key Laboratory of Pathogenesis, Prevention, and Treatment of High Incidence Diseases in Central Asia, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.,Hepatobiliary and Hydatid Disease Department, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Kalibixiati Aimulajiang
- State Key Laboratory of Pathogenesis, Prevention, and Treatment of High Incidence Diseases in Central Asia, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Huaxin Sun
- Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China.,Xinjiang Key Laboratory of Cardiac Electrophysiology and Cardiac Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China
| | - Ling Zhang
- Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China.,Xinjiang Key Laboratory of Cardiac Electrophysiology and Cardiac Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China
| | - Xianhui Zhou
- Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China.,Xinjiang Key Laboratory of Cardiac Electrophysiology and Cardiac Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China
| | - Baopeng Tang
- Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China.,Xinjiang Key Laboratory of Cardiac Electrophysiology and Cardiac Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China
| | - Hao Wen
- State Key Laboratory of Pathogenesis, Prevention, and Treatment of High Incidence Diseases in Central Asia, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.,Hepatobiliary and Hydatid Disease Department, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
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Kimura S, Takaoka Y, Toyoura M, Kohira S, Ohta M. Core body temperature changes in school-age children with circadian rhythm sleep-wake disorder. Sleep Med 2021; 87:97-104. [PMID: 34547649 DOI: 10.1016/j.sleep.2021.08.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/21/2021] [Accepted: 08/26/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE/BACKGROUND Core body temperature (CBT) is considered a valuable marker for circadian rhythm. This study aimed to investigate the changes in CBT that are associated with the symptoms of circadian rhythm sleep-wake disorder (CRSWD) post-treatment in children. PATIENTS/METHODS Twenty-eight school-age children [10 boys and 18 girls; mean age (±standard deviation), 13.68 ± 0.93 years] who were admitted to our hospital with CRSWD underwent treatment for 6-8 weeks according to the following protocol: lights-out for sleep at 21:00; phototherapy for waking at 6:00 or 7:00; light exercise everyday (eg, a 20- to 30-min walk). CBT was continuously measured for 24 h on the first day of admission and on the first day after treatment. RESULTS The mean time of sleep onset/offset (±standard deviation; in hours:minutes) 1 week before admission and 1 week after treatment were 23:53 ± 2:26/9:58 ± 2:15 and 21:17 ± 0:19/6:46 ± 0:32, respectively. The mean times of sleep onset and offset measured post-treatment were significantly earlier than those measured pre-treatment (p < 0.001). The mean CBT and mean minimum CBT during sleep were significantly lower on the first day post-treatment than on the first day of admission (p = 0.011 and p < 0.001, respectively). CONCLUSIONS Symptom improvements in patients with CRSWD were associated with a decrease in CBT during sleep, suggesting that CBT may be a biomarker for improvements in CRSWD. These results help elucidate the cause of this sleep disorder.
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Affiliation(s)
- Shigemi Kimura
- Children's Rehabilitation, Sleep and Development Medical Center, Hyogo Prefectural Rehabilitation Central Hospital, 1070 Akebono-cho, Nishi-ku, Kobe, 651-2181, Japan; Division of Medical Informatics and Bioinformatics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Yutaka Takaoka
- Division of Medical Informatics and Bioinformatics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan; Data Science Center for Medicine and Hospital Management, Toyama University Hospital, 2630, Sugitani, Toyama-shi, Toyama, 930-0194, Japan; Division of Medical Law and Ethics, Department of Medical Systems, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Makiko Toyoura
- Children's Rehabilitation, Sleep and Development Medical Center, Hyogo Prefectural Rehabilitation Central Hospital, 1070 Akebono-cho, Nishi-ku, Kobe, 651-2181, Japan
| | - Shinji Kohira
- Children's Rehabilitation, Sleep and Development Medical Center, Hyogo Prefectural Rehabilitation Central Hospital, 1070 Akebono-cho, Nishi-ku, Kobe, 651-2181, Japan
| | - Mika Ohta
- Division of Medical Informatics and Bioinformatics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan; Data Science Center for Medicine and Hospital Management, Toyama University Hospital, 2630, Sugitani, Toyama-shi, Toyama, 930-0194, Japan; Division of Medical Law and Ethics, Department of Medical Systems, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
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25
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Cheng P, Casement MD, Kalmbach DA, Castelan AC, Drake CL. Digital cognitive behavioral therapy for insomnia promotes later health resilience during the coronavirus disease 19 (COVID-19) pandemic. Sleep 2021; 44:zsaa258. [PMID: 33249492 PMCID: PMC7798633 DOI: 10.1093/sleep/zsaa258] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/03/2020] [Indexed: 12/15/2022] Open
Abstract
STUDY OBJECTIVES Stressful life events contribute to insomnia, psychosocial functioning, and illness. Though individuals with a history of insomnia may be especially vulnerable during stressful life events, risk may be mitigated by prior intervention. This study evaluated the effect of prior digital cognitive-behavioral therapy for insomnia (dCBT-I) versus sleep education on health resilience during the COVID-19 pandemic. METHODS COVID impact, insomnia, general- and COVID-related stress, depression, and global health were assessed in April 2020 in adults with a history of insomnia who completed a randomized controlled trial of dCBT-I (n = 102) versus sleep education control (n = 106) in 2016-2017. Regression analyses were used to evaluate the effect of intervention conditions on subsequent stress and health during the pandemic. RESULTS Insomnia symptoms were significantly associated with COVID-19 related disruptions, and those who previously received dCBT-I reported less insomnia symptoms, less general stress and COVID-related cognitive intrusions, less depression, and better global health than those who received sleep education. Moreover, the odds for resurgent insomnia was 51% lower in the dCBT-I versus control condition. Similarly, odds of moderate to severe depression during COVID-19 was 57% lower in the dCBT-I condition. CONCLUSIONS Those who received dCBT-I had increased health resilience during the COVID-19 pandemic in adults with a history of insomnia and ongoing mild to moderate mental health symptoms. These data provide evidence that dCBT-I is a powerful tool to promote mental and physical health during stressors, including the COVID-19 pandemic. CLINICAL TRIAL REGISTRATION NCT02988375.
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Affiliation(s)
- Philip Cheng
- Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI
| | | | - David A Kalmbach
- Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI
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Reyes Del Paso GA, Contreras-Merino AM, de la Coba P, Duschek S. The cardiac, vasomotor, and myocardial branches of the baroreflex in fibromyalgia: Associations with pain, affective impairments, sleep problems, and fatigue. Psychophysiology 2021; 58:e13800. [PMID: 33645659 DOI: 10.1111/psyp.13800] [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: 11/14/2020] [Revised: 02/08/2021] [Accepted: 02/15/2021] [Indexed: 12/22/2022]
Abstract
This study investigated the cardiac, vasomotor, and myocardial branches of the baroreflex in fibromyalgia using the spontaneous sequence method. Systolic blood pressure (SBP), interbeat interval (IBI), stroke volume (SV), pre-ejection period (PEP), and total peripheral resistance (TPR) were continuously recorded in 40 fibromyalgia patients and 30 healthy individuals during a cold pressor test and a mental arithmetic task. Sequences of covariation between SBP and IBI (cardiac branch), SV and PEP (myocardial branch), and TPR (vasomotor branch) were identified. Baroreflex sensitivity (BRS) was represented by the slope of the regression line between values in the sequences; baroreflex effectiveness (BEI) was indexed by the proportion of progressive SBP changes that elicited reflex responses. Patients exhibited lower BRS in the three branches, lower BEI in the cardiac and vasomotor branches, and reduced reactivity in cardiac BRS and BEI, SBP, IBI, SV, and PEP. Moreover, BRS and BEI were inversely related to clinical pain, cold pressor pain, depression, trait anxiety, sleep problems, and fatigue. Reduced function of the three baroreflex branches implies diminished resources for autonomic inotropic, chronotropic, and vascular regulation in fibromyalgia. Blunted stress reactivity indicates a limited capacity for autonomic cardiovascular adjustment to situational requirements. The associations of BRS and BEI with pain perception may reflect the antinociceptive effects arising from baroreceptor afferents, where reduced baroreflex function may contribute to the hyperalgesia characterizing fibromyalgia. The associations with affective impairments, sleep problems, and fatigue suggest that baroreflex dysfunctions are also involved in the secondary symptoms of the disorder.
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Affiliation(s)
| | | | | | - Stefan Duschek
- Institute of Psychology, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
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27
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ADVERSE EFFECT OF INSOMNIA ON BLOOD LIPIDS IN PATIENTS WITH HYPERTENSION. EUREKA: HEALTH SCIENCES 2021. [DOI: 10.21303/2504-5679.2021.001600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Insomnia is a risk factor for the development of arterial hypertension, obesity, type 2 diabetes mellitus, cardiac rhythm disorders, and myocardial infarction. At the same time, insomnia is one of the most frequent non-cardiac complaints in patients with cardiovascular diseases.
The aim of the work was to study the presence of possible relationships between insomnia and the level of blood lipids.
Materials and methods. A cross-sectional study involving 118 patients was conducted. Criteria for inclusion in the study were age over 45 years, the presence of essential hypertension. All patients included the study underwent sampling of 7 ml of venous blood in the morning under fasting conditions. The content of total cholesterol (TCS), triglycerides (TG), high-density lipoprotein cholesterol (HDL CS) was determined by enzymatic method on a biochemical analyser Humalyzer 2000. The patient was interviewed by a pre-trained study doctor.
Results. In the article a relationship between total cholesterol, low-density lipoprotein cholesterol and the presence of insomnia has been established and proved by statistical model. The overall statistical model accuracy is 89.6 % and statistical significance p < 0.005. Accuracy of insomnia prediction is 85.7 % by level of total cholesterol (TCS) and patient interview data. Only one model with best accuracy exists and it was estimated at the article.
Conclusions. Relationship between total cholesterol, low-density lipoprotein cholesterol and the presence of insomnia has been established and proved by statistical model. Accuracy of insomnia prediction is 85.7 % by level of total cholesterol (TCS) and patient interview data.
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Li SQ, Sun XW, Zhang L, Ding YJ, Li HP, Yan YR, Lin YN, Zhou JP, Li QY. Impact of insomnia and obstructive sleep apnea on the risk of acute exacerbation of chronic obstructive pulmonary disease. Sleep Med Rev 2021; 58:101444. [PMID: 33601330 DOI: 10.1016/j.smrv.2021.101444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/20/2020] [Accepted: 10/23/2020] [Indexed: 10/22/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is a major health burden worldwide. Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is characterized by worsening of patients' respiratory symptoms that requires a modification in medication. This event could accelerate disease progression and increase the risk of hospital admissions and mortality. Both insomnia and obstructive sleep apnea (OSA) are prevalent in patients with COPD, and are linked to increased susceptibility to AECOPD. Improper treatment of insomnia may increase the risk of adverse respiratory outcomes for patients with COPD, while effective continuous positive airway pressure (CPAP) treatment may reduce the risk of AECOPD and mortality in patients with overlap syndrome. Sleep disorders should be considered in clinical management for COPD.
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Affiliation(s)
- Shi Qi Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Xian Wen Sun
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Liu Zhang
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Yong Jie Ding
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Hong Peng Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Ya Ru Yan
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Ying Ni Lin
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Jian Ping Zhou
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Qing Yun Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
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McCall WV, Sareddy S, Youssef NA, Miller BJ, Rosenquist PB. The pupillary light reflex as a point-of-care test for suicide risk: Preliminary results. Psychiatry Res 2021; 295:113582. [PMID: 33234325 DOI: 10.1016/j.psychres.2020.113582] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 11/15/2020] [Indexed: 01/20/2023]
Abstract
The pupillary light reflex (PLR) reflects physiologic arousal, and a potential point-of-care biomarker of suicide risk. We collected data from 9 healthy controls, 6 non-suicidal depressed patients, 7 with prior suicide attempts but not presently suicidal, and 8 depressed patients who were actively suicidal. The pupillary maximum constriction velocity (MCV) was similar between the non-suicidal depressed patients and healthy controls (the "Never suicidal" group). Patients with prior attempt resembled the patients expressing active suicidal ideation (the "Ever suicidal" group). MCV was a significant predictor within a logistic regression model of participants who were "Ever suicidal" versus "Never suicidal".
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Affiliation(s)
- William V McCall
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, 997 St Sebastian Way, Augusta, Georgia 30909, USA.
| | - Sneha Sareddy
- Medical College of Georgia, Augusta University, Augusta, Georgia 30909, USA.
| | - Nagy A Youssef
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, 997 St Sebastian Way, Augusta, Georgia 30909, USA.
| | - Brian J Miller
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, 997 St Sebastian Way, Augusta, Georgia 30909, USA.
| | - Peter B Rosenquist
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, 997 St Sebastian Way, Augusta, Georgia 30909, USA.
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30
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Cuspidi C, Carla S, Tadic M. Sleep, hypertension, and autonomic dysfunction. J Clin Hypertens (Greenwich) 2020; 22:1491-1493. [PMID: 32710680 DOI: 10.1111/jch.13952] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/07/2020] [Accepted: 07/07/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Cesare Cuspidi
- Department of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy.,Istituto Auxologico Italiano, Milano, Italy
| | - Sala Carla
- Department of Clinical Sciences and Community Health, University of Milano and Fondazione Ospedale Maggiore IRCCS Policlinico di Milano, Milano, Italy
| | - Marijana Tadic
- University Hospital "Dr. Dragisa Misovic-Dedinje" Department of Cardiology, Belgrade, Serbia
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Aukia L, Paavonen EJ, Jänkälä T, Tolvanen M, Korja R, Karlsson L, Karlsson H, Polo-Kantola P. Insomnia symptoms increase during pregnancy, but no increase in sleepiness - Associations with symptoms of depression and anxiety. Sleep Med 2020; 72:150-156. [PMID: 32629418 DOI: 10.1016/j.sleep.2020.03.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 02/26/2020] [Accepted: 03/26/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To evaluate alteration in insomnia and sleepiness symptoms during pregnancy and assess early pregnancy risk factors for these symptoms, especially depressive and anxiety symptoms. METHODS A cohort of 1858 women was enrolled from the FinnBrain Birth Cohort Study. Insomnia and sleepiness symptoms were measured in early, mid- and late pregnancy with the Basic Nordic Sleep Questionnaire. Depressive symptoms were measured using the Edinburgh Postnatal Depression Scale and anxiety symptoms with the Symptom Checklist-90/Anxiety Scale. General linear models for repeated measures were conducted. RESULTS General sleep quality decreased (p < 0.001) and all insomnia types (p < 0.001) and sleep latencies (p < 0.001) increased as pregnancy proceeded. Snoring increased, but witnessed apneas remained rare. Nevertheless, morning (p = 0.019) and daytime (p < 0.001) sleepiness decreased from early to both mid-pregnancy and late pregnancy (p = 0.006 and p = 0.039). Women took more naps in early and late pregnancy compared to mid-pregnancy (both p < 0.001). Women with higher baseline anxiety symptoms had greater increase in sleep latency. At each pregnancy point, higher depressive and anxiety symptoms were associated with higher insomnia (p < 0.001) and sleepiness scores (p < 0.001) and higher depressive symptoms with longer sleep latencies (p < 0.001). CONCLUSION We found a marked increase in insomnia symptoms throughout pregnancy. However, sleepiness symptoms did not increase correspondingly. Both depressive and anxiety symptoms in early pregnancy were associated with higher insomnia and sleepiness symptoms in later stages of pregnancy which emphasizes the importance of their assessment in early pregnancy.
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Affiliation(s)
- Linda Aukia
- Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland.
| | - E Juulia Paavonen
- Pediatric Research Center, Child Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland
| | - Tuire Jänkälä
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland; Department of Psychology, University of Turku, Turku, Finland
| | - Mimmi Tolvanen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Riikka Korja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland; Department of Psychology, University of Turku, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland; Department of Child Psychiatry, Turku University Hospital and University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland; Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - Päivi Polo-Kantola
- Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland; Sleep Research Unit, Department of Physiology, University of Turku, Turku, Finland
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Daugherty SL, Carter JR, Bourjeily G. Cardiovascular Disease in Women Across the Lifespan: The Importance of Sleep. J Womens Health (Larchmt) 2020; 29:452-460. [PMID: 32096682 PMCID: PMC7097694 DOI: 10.1089/jwh.2020.8331] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Cardiovascular disease (CVD) and sleep disturbances are both common and associated with significant morbidity and mortality. Compared with men, women are more likely to report insufficient sleep. During the 2018 Research Conference on Sleep and the Health of Women sponsored by the National Heart, Lung, and Blood Institute, researchers in cardiology, integrative physiology and sleep medicine reviewed the current understanding of how sleep and sleep disturbances influence CVD in women across the lifespan. Women may be particularly vulnerable to the negative effects of sleep disturbances at important stages of their life, including during pregnancy and after menopause. The proposed pathways linking sleep disturbances and adverse cardiovascular outcomes in women are numerous and the complex interaction between them is not well understood. Future research focused on understanding the scope of sleep disorders in women, defining the underlying mechanisms, and testing interventions to improve sleep are critical for improving the cardiovascular health of all women.
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Affiliation(s)
- Stacie L. Daugherty
- Division of Cardiology, University of Colorado School of Medicine, Aurora, Colorado
- Adult and Children Center for Outcomes Research and Delivery Sciences (ACCORDS), University of Colorado School of Medicine, Aurora, Colorado
- Colorado Cardiovascular Outcomes Research Group, Denver, Colorado
| | - Jason R. Carter
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan
| | - Ghada Bourjeily
- Divisions of Pulmonary, Critical Care and Sleep Medicine, and Obstetric Medicine, Department of Medicine, The Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island
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Crowley SK, Rebellon J, Huber C, Leonard AJ, Henderson D, Magal M. Cardiorespiratory fitness, sleep, and physiological responses to stress in women. Eur J Sport Sci 2020; 20:1368-1377. [PMID: 31939334 DOI: 10.1080/17461391.2020.1716855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Epidemiological studies suggest that cardiorespiratory fitness (CRfitness) is associated with reduced risk of depression and anxiety in women, however, the mechanisms by which CRfitness may be protective against the development of these disorders are less clear. Because sleep problems are associated with both a higher risk for mental illness and altered physiological responses to stress, this study investigated whether sleep quality might influence the relationship between CRfitness and physiological stress responses in women. Thirty healthy women (18-45 y) who were medication-free, with regular menstrual cycles completed: (1) enrolment visit [including the assessment of CRfitness via maximal oxygen consumption during exercise]; (2) one-week sleep monitoring period including subjective (daily sleep diaries) and objective (wrist actigraphy) sleep measures; and (3) psychosocial stressor protocol (the Trier Social Stress Test; TSST) for the collection of heart rate (HR), blood pressure (BP), and salivary cortisol stress responses. Higher CRfitness was associated with reduced wake after sleep onset (WASO) duration (r = -.38, p = 0.04), higher self-reported sleep quality (higher scores reflect poorer sleep quality; r = -.37, p = 0.05), and lower HR (r = -.43, p = 0.02) during the stressor. Higher sleep quality was associated with a lower HR during the stressor (r = .44, p = 0.01). Increased WASO duration and WASO number were associated with blunted cortisol output during the stressor (r = -.44, p = 0.02, and r = -.46, p = 0.02, respectively). Results suggest that, in women, CRfitness may be protective against the deleterious effects of stress via improved sleep quality.
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Affiliation(s)
- Shannon K Crowley
- Department of Exercise Science, North Carolina Wesleyan College, Rocky Mount, NC, USA.,Department of Health Promotion, North Carolina Wesleyan College, Rocky Mount, NC, USA
| | - Julia Rebellon
- Department of Exercise Science, North Carolina Wesleyan College, Rocky Mount, NC, USA
| | - Christina Huber
- Department of Exercise Science, North Carolina Wesleyan College, Rocky Mount, NC, USA
| | - Abigail J Leonard
- Department of Exercise Science, North Carolina Wesleyan College, Rocky Mount, NC, USA
| | - Daniel Henderson
- Department of Exercise Science, North Carolina Wesleyan College, Rocky Mount, NC, USA
| | - Meir Magal
- Department of Exercise Science, North Carolina Wesleyan College, Rocky Mount, NC, USA
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Ho CN, Fu PH, Chen JY, Hung KC, Chang JH, Peng CK, Yang AC. Heart rate variability and surgical pleth index under anesthesia in poor and normal sleepers. J Clin Monit Comput 2019; 34:1311-1319. [PMID: 31872311 DOI: 10.1007/s10877-019-00450-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 12/15/2019] [Indexed: 11/26/2022]
Abstract
Poor sleep quality is associated with autonomic dysfunctions and altered pain perception and tolerance. To investigate whether autonomic dysregulations related to insomnia would still exist under general anesthesia, we adopt heart rate variability (HRV) analysis to evaluate ANS activity and surgical pleth index (SPI) to compare nociceptive/anti-nociceptive balance. We enrolled 61 adult females scheduled for gynecological surgeries under general anesthesia. All the subjects were ASA Class I to III without using medicines affecting HRV. We used the Insomnia Severity Index to evaluate sleep qualities. ECG data were recorded and signals which denote four different surgical stages were extracted (baseline, incision, mid-surgery, and end of surgery). We analyzed the HRV changes across the whole surgical period and differences among good and poor sleepers. We also compared the SPI differences among groups. For baseline HRV analysis, we found significant differences in the RMSSD (p = 0.043), pNN50 (p = 0.029), VLF power (p = 0.035), LF power (p = 0.004), and HF power (p = 0.037) between the good and poor sleeper groups. However, all intergroup differences disappeared after anesthesia induction. Temporal HRV changes significantly among different perioperative stages (RMSSD, p < 0.001; pNN50, p = 0.004; LF, p < 0.001; and HF, p < 0.001). Patients with different sleep qualities did not exhibit different SPI levels in all four periods. Poor sleepers exhibited attenuated parasympathetic activities at the baseline but no differences after the induction. Nociceptive/anti-nociceptive balance seems not be altered by poor sleep condition under general anesthesia.
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Affiliation(s)
- Chun-Ning Ho
- Department of Anesthesiology, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan, Taiwan
| | - Pei-Han Fu
- Department of Anesthesiology, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan, Taiwan
| | - Jen-Yin Chen
- Department of Anesthesiology, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan, Taiwan
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan, Taiwan
| | - Jia-Hui Chang
- Department of Medical Research, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan, Taiwan
| | - Chung-Kang Peng
- Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center, Harvard Medical School, KS-B26, 330 Brookline Ave, Boston, MA, USA
| | - Albert C Yang
- Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center, Harvard Medical School, KS-B26, 330 Brookline Ave, Boston, MA, USA.
- Institute of Brain Science/Digital Medicine Center, National Yang-Ming University, Taipei, Taiwan.
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Affiliation(s)
| | - Naima Covassin
- Department of Cardiovascular Diseases (N.C., V.K.S.), Mayo Clinic, Rochester, MN
| | - Virend K Somers
- Department of Cardiovascular Diseases (N.C., V.K.S.), Mayo Clinic, Rochester, MN
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Rassu AL, Chenini S, Barateau L, Lopez R, Evangelista E, Guiraud L, Jaussent I, Dauvilliers Y. Increased blood pressure during the suggested immobilization test in Restless Legs Syndrome. Sleep 2019; 43:5602988. [DOI: 10.1093/sleep/zsz263] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/13/2019] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
To investigate the relationship between sensory discomfort/motor component and cardiovascular autonomic response by continuous beat-to-beat blood pressure monitoring (CBPM) during the suggested immobilization test (SIT) in patients with restless legs syndrome (RLS).
Methods
Thirty-two drug-free patients with primary RLS (10 men; mean age 60.29 ± 10.81 years) and 17 healthy controls (2 men; mean age 58.82 ± 11.86 years) underwent a 1-hour SIT starting at 8 pm with concomitant CBPM to measure the heart rate (HR) and systolic/diastolic blood pressure (SBP, DBP). In all subjects, the presence of sensory discomfort and motor component during the SIT (S-SIT+ and M-SIT+, respectively) was quantified. Mixed regression models were used to compare the SBP, DBP, and HR profiles during the SIT by taking into account the repeated measures (6 time periods of 10 minutes).
Results
In patients with S-SIT+ (n = 17), SBP (p < 0.0001), DBP (p = 0.0007), and HR (p = 0.03) increased during the SIT compared with other patients and controls. Seventeen patients had M-SIT+ (none among healthy controls). Classifying patients in 4 groups in function of the presence/absence of the SIT sensory and motor components revealed that SDB and DBP increased throughout the SIT in patients with S-SIT+, independently of the motor component (p < 0.0001 and p = 0.0008 for SBD; p < 0.0001 and p = 0.01 for DBP in the S-SIT+/M-SIT− and S-SIT+/M-SIT+ groups, respectively).
Conclusion
During the SIT, BP concomitantly increased only in patients with RLS and sensory discomfort, with or without motor component. This highlights the link between evening sensory RLS symptoms, autonomic activation, and potential long-term cardiovascular consequences.
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Affiliation(s)
- Anna Laura Rassu
- Unité du Sommeil, Centre National de Référence pour la Narcolepsie, CHU Montpellier, Hôpital Gui-de-Chauliac, Service de Neurologie, Montpellier, France
| | - Sofiène Chenini
- Unité du Sommeil, Centre National de Référence pour la Narcolepsie, CHU Montpellier, Hôpital Gui-de-Chauliac, Service de Neurologie, Montpellier, France
| | - Lucie Barateau
- Unité du Sommeil, Centre National de Référence pour la Narcolepsie, CHU Montpellier, Hôpital Gui-de-Chauliac, Service de Neurologie, Montpellier, France
- INSERM, University of Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
| | - Regis Lopez
- Unité du Sommeil, Centre National de Référence pour la Narcolepsie, CHU Montpellier, Hôpital Gui-de-Chauliac, Service de Neurologie, Montpellier, France
- INSERM, University of Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
| | - Elisa Evangelista
- Unité du Sommeil, Centre National de Référence pour la Narcolepsie, CHU Montpellier, Hôpital Gui-de-Chauliac, Service de Neurologie, Montpellier, France
- INSERM, University of Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
| | - Lily Guiraud
- Unité du Sommeil, Centre National de Référence pour la Narcolepsie, CHU Montpellier, Hôpital Gui-de-Chauliac, Service de Neurologie, Montpellier, France
| | - Isabelle Jaussent
- INSERM, University of Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
| | - Yves Dauvilliers
- Unité du Sommeil, Centre National de Référence pour la Narcolepsie, CHU Montpellier, Hôpital Gui-de-Chauliac, Service de Neurologie, Montpellier, France
- INSERM, University of Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
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Cardiovascular reactivity and psychological hyperarousal in hot flash-associated insomnia disorder. Menopause 2019; 26:728-740. [DOI: 10.1097/gme.0000000000001298] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Carter JR. Microneurography and sympathetic nerve activity: a decade-by-decade journey across 50 years. J Neurophysiol 2019; 121:1183-1194. [PMID: 30673363 DOI: 10.1152/jn.00570.2018] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The technique of microneurography has advanced the field of neuroscience for the past 50 years. While there have been a number of reviews on microneurography, this paper takes an objective approach to exploring the impact of microneurography studies. Briefly, Web of Science (Thomson Reuters) was used to identify the highest citation articles over the past 50 years, and key findings are presented in a decade-by-decade highlight. This includes the establishment of microneurography in the 1960s, the acceleration of the technique by Gunnar Wallin in the 1970s, the international collaborations of the 1980s and 1990s, and finally the highest impact studies from 2000 to present. This journey through 50 years of microneurographic research related to peripheral sympathetic nerve activity includes a historical context for several of the laboratory interventions commonly used today (e.g., cold pressor test, mental stress, lower body negative pressure, isometric handgrip, etc.) and how these interventions and experimental approaches have advanced our knowledge of cardiovascular, cardiometabolic, and other human diseases and conditions.
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Affiliation(s)
- Jason R Carter
- Department of Kinesiology and Integrative Physiology, Michigan Technological University , Houghton, Michigan
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Anttalainen U, Grote L, Fietze I, Riha RL, Ryan S, Staats R, Hedner J, Saaresranta T. Insomnia symptoms combined with nocturnal hypoxia associate with cardiovascular comorbidity in the European sleep apnea cohort (ESADA). Sleep Breath 2018; 23:805-814. [PMID: 30467691 PMCID: PMC6700053 DOI: 10.1007/s11325-018-1757-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/01/2018] [Accepted: 11/13/2018] [Indexed: 01/03/2023]
Abstract
Purpose The aim of the current study was to further investigate the concept of previously reported high occurrence of comorbidities in obstructive sleep patients (OSA) with insomnia-like symptoms. We hypothesized that this finding at least partly is mediated by nocturnal hypoxia. Moreover, we speculated that the spectrum of the clinical OSA phenotypes differs between European geographical regions. Methods Cohort of the European Sleep Apnea Database (n = 17,325; 29.9% females) was divided into five subcohorts according to geographical region (North, East, South, West, Central) and further into four clinical presentation phenotypes based on daytime symptoms (EDS) and characteristics suggestive of insomnia. Results The insomnia phenotype (alone or together with EDS) dominated in all European regions. Isolated insomnia, however, was less common in the West. Insomnia phenotype was associated with the highest proportion of cardiovascular comorbidity (51.7% in the insomnia vs. 43.9% in the EDS type). Measures of nocturnal hypoxemia were independently associated with cardiovascular comorbidity in phenotypes with insomnia-like symptoms. The burden of comorbidities was high across all geographical regions and clinical phenotypes. Regional differences were clinically relevant for age (48 vs. 54 years), BMI (29 vs. 34 kg/m2), and ODI (15 vs. 32/h). Conclusion High prevalence of particularly cardiovascular comorbidity among patients with insomnia-like symptoms was linked to nocturnal hypoxemia. Considerable differences in clinical presentation were found among OSA patients across Europe. Our data underline that physicians should ask their patients with suspected OSA also for insomnia symptoms. It remains to be explored if a reduction of nocturnal hypoxemia predicts the improvement of insomnia symptoms. Electronic supplementary material The online version of this article (10.1007/s11325-018-1757-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ulla Anttalainen
- Division of Medicine, Department of Pulmonary Diseases, Turku University Hospital, P.O. Box 52, SF-20521, Turku, Finland.
- Sleep Research Centre, Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland.
| | - L Grote
- Department of Sleep Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - I Fietze
- Center of Sleep Medicine, Charité - Universitätsmedizin Berlin, Luisenstrasse 13, 101 17, Berlin, Germany
| | - R L Riha
- Department of Sleep Medicine, Royal Infirmary Edinburgh, 51 Little France Crescent EH, Edinburgh, 164 SA, Scotland
| | - S Ryan
- Department of Respiratory Medicine, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - R Staats
- Department of Respiratory Medicine, Hospital de Santa Maria, Lisbon, Portugal
| | - J Hedner
- Department of Sleep Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - T Saaresranta
- Division of Medicine, Department of Pulmonary Diseases, Turku University Hospital, P.O. Box 52, SF-20521, Turku, Finland
- Sleep Research Centre, Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland
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Crislip GR, Masten SH, Gumz ML. RECENT ADVANCES IN UNDERSTANDING THE CIRCADIAN CLOCK IN RENAL PHYSIOLOGY. CURRENT OPINION IN PHYSIOLOGY 2018; 5:38-44. [PMID: 30714020 DOI: 10.1016/j.cophys.2018.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Accumulating evidence suggests a critical role for the molecular circadian clock in the regulation of renal function. Here, we consider the most recent advances in our understanding of the relationship between the circadian clock and renal physiology.
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Affiliation(s)
- G Ryan Crislip
- Department of Medicine, Division of Nephrology, Hypertension, and Renal Transplantation.,Department of Physiology and Functional Genomics, University of Florida, Gainesville, FL 32610
| | - Sarah H Masten
- Department of Medicine, Division of Nephrology, Hypertension, and Renal Transplantation
| | - Michelle L Gumz
- Department of Medicine, Division of Nephrology, Hypertension, and Renal Transplantation.,Department of Biochemistry and Molecular Biology, University of Florida, Gainesville, FL 32610
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