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Schrager S, Williams M, Ward E, Henningfield MF, Yuroff A, Johnson G, Sullivan-Wade L, Hawkins J, Turnquist A. African American women's experiences of menopause: A focus group study. Maturitas 2024; 187:108043. [PMID: 38905863 DOI: 10.1016/j.maturitas.2024.108043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 04/25/2024] [Accepted: 06/02/2024] [Indexed: 06/23/2024]
Abstract
OBJECTIVES This study aimed to characterize African American women's experiences of menopause and their interactions with the health care system related to menopausal symptoms. STUDY DESIGN We conducted four focus groups with community-dwelling midlife African American women. MAIN OUTCOMES MEASURES Women who consented to participate completed demographic surveys. Transcripts of the four focus groups (n = 26) were analyzed and themes were elucidated. RESULTS In total, 26 midlife African American women participated in the four focus groups. Participants revealed unmet needs regarding obtaining menopause information from their clinicians. Clinician discussions about menopause tended to be initiated by patients based on their symptoms. Some women reported feeling ignored and/or dismissed by the clinician when they initiated discussions of menopause. Women wanted their clinicians to provide information on menopause, which included receiving information prior to the menopause transition to help them know what to expect. CONCLUSION Women wanted their clinicians to initiate discussions of menopause rather than wait for women to mention symptoms. Prioritizing menopause training for clinicians taking care of midlife African American women may help to improve discussions of menopause.
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Affiliation(s)
- Sarina Schrager
- Wisconsin Research and Education Network (WREN), 610 N Whitney Way, Madison, WI 53505, United States of America; Wisconsin Department of Health and Family Services, Wisconsin Well Woman Program, Madison, WI, United States of America.
| | - Makeba Williams
- Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St Louis, MO, United States of America
| | - Earlise Ward
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, 610 N Whitney Way, Madison, WI 53505, United States of America
| | - Mary F Henningfield
- Wisconsin Research and Education Network (WREN), 610 N Whitney Way, Madison, WI 53505, United States of America; Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, 610 N Whitney Way, Madison, WI 53505, United States of America
| | - Alice Yuroff
- Wisconsin Research and Education Network (WREN), 610 N Whitney Way, Madison, WI 53505, United States of America; Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, 610 N Whitney Way, Madison, WI 53505, United States of America
| | - Gale Johnson
- Wisconsin Department of Health and Family Services, Wisconsin Well Woman Program, Madison, WI, United States of America
| | - Lucretia Sullivan-Wade
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, 610 N Whitney Way, Madison, WI 53505, United States of America
| | - Jennifer Hawkins
- Wisconsin Research and Education Network (WREN), 610 N Whitney Way, Madison, WI 53505, United States of America; Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, 610 N Whitney Way, Madison, WI 53505, United States of America
| | - Alyssa Turnquist
- Wisconsin Research and Education Network (WREN), 610 N Whitney Way, Madison, WI 53505, United States of America; Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, 610 N Whitney Way, Madison, WI 53505, United States of America
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Brightman JD, Lafontant K, Suarez JRM, Crook JM, Thiamwong L. Comparing Sleep Quality, Duration, and Efficiency Among Low-Income Community-Dwelling Older Adults With and Without Physical Disabilities. J Gerontol Nurs 2024; 50:12-18. [PMID: 38959511 DOI: 10.3928/00989134-20240618-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2024]
Abstract
PURPOSE Physical disabilities may exacerbate the natural decline in sleep quality that occurs with aging. In the current study, we assessed sleep quality and medicinal sleep aid use among 87 community-dwelling older adults with (n = 24) and without (n = 63) physical disabilities. METHOD Sleep quality, duration, and efficiency were assessed subjectively with the Pittsburgh Sleep Quality Index. Sleep duration and efficiency were objectively measured with actigraphy. Participants self-reported medicinal sleep aid use. RESULTS Significant group differences were observed in sleep duration measured objectively (p = 0.01) and subjectively (p = 0.04). No other group differences were observed for sleep factors (p > 0.05) or medicinal sleep aid use (p = 0.41). CONCLUSION Findings show that physical disability may be a factor in sleep duration; however, physical disability was not found to be associated with worsened sleep perception or greater reliance on medicinal sleep aids. Future research should consider longer objective actigraphy assessment windows and explore potential subgroup differences in sex and race/ethnicity. [Journal of Gerontological Nursing, 50(7), 12-18.].
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Singh R, Gilles AA, McGrath J, Zhou ZE, Jackson CL. Disparities in sleep duration and quality by industry of employment and occupational class among Native Hawaiian/Pacific Islanders and non-Hispanic Whites in the United States. Sleep Health 2024:S2352-7218(24)00112-8. [PMID: 38890042 DOI: 10.1016/j.sleh.2024.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 03/04/2024] [Accepted: 05/14/2024] [Indexed: 06/20/2024]
Abstract
OBJECTIVE To investigate disparities in the work-sleep relationship between Native Hawaiian/Pacific Islanders (NHPIs) and non-Hispanic (NH)-White populations. METHODS Using data from a nationally representative sample of U.S. adults (n = 20,828) in the 2014 National Health Interview Survey, we estimated prevalence of short sleep duration (<7 hours) among NHPIs (10%) and NH-Whites for each of 7 employment industry categories and 3 occupational classes. Mean age was 41 ± 0.5years for NHPIs and 49 ± 0.2years for NH-Whites. Women comprised 52% of both groups. RESULTS NHPIs were more likely than NH-Whites to report short sleep duration across all industry of employment categories (except for food and accommodation services) and occupational classes. The disparity was widest among NHPI and NH-White workers in the "professional/management" industry category, with NHPIs having higher prevalence of very short (<6 hours; 20% vs. 7%) and short sleep (30% vs. 22%) durations and lower prevalence of recommended sleep duration (45% vs. 68%) and waking up feeling rested (53% vs. 67%). Among the occupational classes, the NHPI-White disparity was widest among participants who held support service occupations. Although professionals had the lowest and laborers had the highest prevalence of short sleep among the three occupational classes in both NHPI and NH-White groups, short sleep duration prevalence was higher among NHPI professionals (35%) than NH-White laborers (33%). NH-White workers across industry and occupational classes had higher sleep medication use prevalence compared to NHPI workers. CONCLUSIONS The work environment via occupation type may contribute to racial/ethnic disparities in short sleep. Further investigations are warranted.
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Affiliation(s)
- Rupsha Singh
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Department of Health and Human Services, Baltimore, Maryland, USA
| | - Allyson A Gilles
- Social Sciences Division, University of Hawai'i West O'ahu, Kapolei, Hawaii, USA
| | - John McGrath
- Social & Scientific Systems, Inc., Research Triangle Park, North Carolina, USA
| | - Zhiqing E Zhou
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA; Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA.
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Narcisse MR, McElfish PA, Schootman M, Selig JP, Kirkland T, McFarlane SI, Felix HC, Seixas A, Jean-Louis G. Type 2 diabetes and health-related quality of life among older Medicare beneficiaries: The mediating role of sleep. Sleep Med 2024; 117:209-215. [PMID: 38593616 PMCID: PMC11081429 DOI: 10.1016/j.sleep.2024.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/21/2024] [Accepted: 03/11/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVE To examine mediating effects of sleep quality and duration on the association between T2D and QoL among Medicare beneficiaries 65+. METHODS Data from the Medicare Health Outcome Survey (2015-2020) were used. The outcome was QoL (physical and mental health component-summary scores [PCS and MCS]) measured by the Veterans-Rand-12. The main predictor was diagnosed T2D. Mediators were sleep duration and sleep quality. The effect modifier was race/ethnicity. Structural Equation Modeling was used to estimate moderated-mediating effects of sleep quality and duration across race/ethnicity. RESULTS Of the 746,400 Medicare beneficiaries, 26.7% had T2D, and mean age was 76 years (SD ± 6.9). Mean PCS score was 40 (SD ± 12.2), and mean MCS score was 54.0 (SD ± 10.2). Associations of T2D with PCS and MCS were negative and significant. For all racial/ethnic groups, those with T2D reported lower PCS. For White, Black, Asian, and Hispanic beneficiaries only, those with T2D reported lower MCS. The negative impact of T2D on PCS and MCS was mediated through sleep quality, especially very bad sleep quality. CONCLUSION Improving sleep may lead to improvement in QoL in elderly adults with T2D.
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Affiliation(s)
- Marie-Rachelle Narcisse
- Department of Psychiatry and Human Behavior, Brown University, 222 Richmond St., Providence, RI, 02903, USA.
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
| | - Mario Schootman
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
| | - James P Selig
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
| | - Tracie Kirkland
- Department of Nursing, University of Southern California, Los Angeles, CA, 90033, USA
| | - Samy I McFarlane
- Department of Medicine, State University of New York-Downstate Health Sciences University, 450 Clarkson Avenue, MSC 50, Brooklyn, NY, 11203, USA
| | - Holly C Felix
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR, 72205, USA
| | - Azizi Seixas
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1600 NW 10th Ave #1140, Miami, FL, 33136, USA
| | - Girardin Jean-Louis
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1600 NW 10th Ave #1140, Miami, FL, 33136, USA
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Gao C, Scullin MK. Objective and Subjective Intraindividual Variability in Sleep: Predisposing Factors and Health Consequences. Psychosom Med 2024; 86:298-306. [PMID: 38439637 DOI: 10.1097/psy.0000000000001301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
OBJECTIVE We investigated the factors that predispose or precipitate greater intraindividual variability (IIV) in sleep. We further examined the potential consequences of IIV on overall sleep quality and health outcomes, including whether these relationships were found in both self-reported and actigraphy-measured sleep IIV. METHODS In Study 1, 699 US adults completed a Sleep Intra-Individual Variability Questionnaire and self-reported psychosocial, sleep quality, and health outcomes. In Study 2, 100 university students wore actigraphy and completed psychosocial, sleep, and health surveys at multiple timepoints. RESULTS In cross-sectional analyses that controlled for mean sleep duration, predisposing/precipitating factors to greater IIV were being an underrepresented racial/ethnic minority (Study 1: F = 13.95, p < .001; Study 2: F = 7.03, p = .009), having greater stress (Study 2: r values ≥ 0.32, p values ≤ .002) or trait vulnerability to stress (Study 1: r values ≥ 0.15, p values < .001), and showing poorer time management (Study 1: r values ≤ -0.12, p values ≤ .004; Study 2: r values ≤ -0.23, p values ≤ .028). In addition, both studies showed that greater sleep IIV was associated with decreased overall sleep quality, independent of mean sleep duration (Study 1: r values ≥ 0.20, p values < .001; Study 2: r values ≥ 0.33, p values ≤ .001). Concordance across subjective and objective IIV measures was modest ( r values = 0.09-0.35) and similar to concordance observed for subjective-objective mean sleep duration measures. CONCLUSION Risk for irregular sleep patterns is increased in specific demographic groups and may be precipitated by, or contribute to, higher stress and time management inefficiencies. Irregular sleep may lead to poor sleep quality and adverse health outcomes, independent of mean sleep duration, underscoring the importance of addressing sleep consistency.
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Affiliation(s)
- Chenlu Gao
- From the Department of Psychology and Neuroscience (Gao, Scullin), Baylor University, Waco, Texas; Department of Anesthesia, Critical Care and Pain Medicine (Gao), Massachusetts General Hospital; Division of Sleep and Circadian Disorders (Gao), Brigham and Women's Hospital; and Division of Sleep Medicine (Gao), Harvard Medical School, Boston, Massachusetts
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Tapia AL, Yu L, Lim A, Barnes LL, Hall MH, Butters MA, Buysse DJ, Wallace ML. Race and sex differences in the longitudinal changes in multidimensional self-reported sleep health characteristics in aging older adults. Sleep Health 2023; 9:947-958. [PMID: 37802678 PMCID: PMC10841494 DOI: 10.1016/j.sleh.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 06/28/2023] [Accepted: 08/15/2023] [Indexed: 10/08/2023]
Abstract
OBJECTIVES We examined within-individual changes in self-reported sleep health as community-dwelling older adults age as well as potential differences in these changes by self-reported sex and racial identity. METHODS Participants were from the United States and enrolled in the Rush Memory and Aging Project, Minority Aging Research Study, or Religious Orders Study (N = 3539, 20% Black, 75% female, mean 78years [range 65-103]), and they received annual, in-person clinical evaluations (median 5 visits [range 1-27]). A sleep health composite score measured the number of poor sleep characteristics among satisfaction, daytime sleepiness, efficiency, and duration. Mixed effects models estimated associations of age, race, sex, and their interactions on the composite and individual sleep measures, accounting for key confounders. RESULTS As they aged, Black participants shifted from reporting two poor sleep characteristics to one poor sleep characteristic, while White participants shifted from one poor characteristic to two. Regardless of age, sex, and race, participants reported that they "often" felt satisfied with their sleep and "sometimes" had trouble staying asleep. Females over age 85 and males of all ages reported the most daytime sleepiness, and older White participants (>age 90) reported the most difficulty falling asleep. CONCLUSIONS Although self-reported sleep characteristics were typically stable across age, identifying race and sex differences in self-reported sleep health can help guide future research to understand the mechanisms that underlie these differences.
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Affiliation(s)
- Amanda L Tapia
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Lan Yu
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Andrew Lim
- Department of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Lisa L Barnes
- Department of Neurological Sciences, Rush University, Chicago, Illinois, USA
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Meryl A Butters
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Meredith L Wallace
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Statistics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
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Dong J, Yu X, Wang Y, Zhang H, Guo R. Obstructive sleep apnea and cognition: insights gleaned from bibliometric analysis. Front Psychiatry 2023; 14:1259251. [PMID: 37840801 PMCID: PMC10570730 DOI: 10.3389/fpsyt.2023.1259251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/14/2023] [Indexed: 10/17/2023] Open
Abstract
Objective Obstructive sleep apnea (OSA) is associated with cognitive impairment. However, the broad trends of the research publications on OSA and cognition are unclear. This study aimed to investigate patterns of research on the relationship between OSA and cognitive function using bibliometric analysis and to identify future research directions by analyzing research trends and emerging hotspots in the field. Methods We searched Web of Science for relevant publications from 2003 to 2022 and conducted a bibliometric analysis of OSA and cognitive research using CiteSpace, R, and VOSviewer. Results A total of 1995 articles met the eligibility criteria for the analysis of OSA and cognition research. There was a notable increase in publications over time, with significant contributions from the United States, particularly Harvard University, leading to substantial academic impact. Gozal D emerged as the most prolific author (59 articles) and influential researcher (3,612 citations) in this field. Hotspot analysis revealed that investigating the pathological physiology and mechanisms of OSA-associated cognitive dysfunction is a recent area of focus, while burst detection analysis identified sleep quality and mild cognitive impairment as top investigation topics. The study by Canessa N published in the American Journal of Respiratory and Critical Care Medicine received the highest number of 77 citations. Conclusion Researchers are increasingly focusing on OSA and cognition. Currently, the majority of studies on OSA-related cognitive dysfunction are focused on correctable aspects of the condition. Future investigations into the pathology of OSA-induced cognitive impairment will facilitate more precise therapeutic interventions.
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Affiliation(s)
- Jiajia Dong
- Department of Otorhinolaryngology Head and Neck Surgery, Air Force Medical Center, Air Force Medical University, Beijing, China
| | - Xiao Yu
- Graduate School, Hebei North University, Zhangjiakou, China
| | - Yuxin Wang
- Department of Cardiovascular Medicine, Air Force Medical Center, Air Force Medical University, Beijing, China
| | - Honglei Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Air Force Medical Center, Air Force Medical University, Beijing, China
| | - Rui Guo
- Department of Otorhinolaryngology Head and Neck Surgery, Air Force Medical Center, Air Force Medical University, Beijing, China
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Alzoubaidi M, Jamous F. Getting sleep against all odds. J Clin Sleep Med 2023; 19:1387-1388. [PMID: 37259889 PMCID: PMC10394360 DOI: 10.5664/jcsm.10676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 05/31/2023] [Indexed: 06/02/2023]
Affiliation(s)
- Mohammed Alzoubaidi
- Northwestern Medical Group, Northwestern Medicine–Lake Forest Hospital, Lake Forest, Illinois
| | - Fady Jamous
- Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
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Lewis TT, Parker R, Murden R, Spikes T, Erving C, McKinnon II, Van Dyke ME, Booker B, Quyummi A, Vaccarino V, Moore RH. Network stressors, personal stressors, and ambulatory blood pressure in African-American women-Does superwoman schema play a role? Health Psychol 2023; 42:485-495. [PMID: 37338427 PMCID: PMC10361646 DOI: 10.1037/hea0001309] [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: 06/21/2023]
Abstract
OBJECTIVE Life stressors have been linked to cardiovascular risk; however, studies typically focus on stressors that directly impact the individual, that is, personal stressors. Research suggests that women, particularly African-American women, may be more vulnerable to network stressors that involve family members and friends-potentially due to norms around needing to be a "Superwoman." Yet few studies have examined these phenomena. METHOD We examined associations between network, versus personal, stressors, and elevated blood pressure (BP) in N = 392 African-American women aged 30-46. Questionnaire-assessed negative life events were classified into upsetting network or personal stressors. BP was assessed in clinic and via 48-hr ambulatory monitoring. Linear and logistic regression models examined associations between type of stressors and 48-hr daytime and nighttime systolic BP (SBP) and diastolic BP (DBP), and sustained hypertension after adjusting for relevant covariates. Interactions with questionnaire-assessed superwoman schema (SWS) were tested in exploratory analyses. RESULTS In age and sociodemographic-adjusted models, network stressors were significantly associated with daytime SBP, β (SE) = 2.01 (0.51), p ≤ .0001, and DBP, β (SE) = 1.59 (0.37), p ≤ .0001, but personal stressors were not (p values > .10). Associations persisted after adjustment for cardiovascular and psychosocial risk factors. Patterns were similar for nighttime BP and sustained hypertension. There were no interactions with SWS. CONCLUSIONS Network, but not personal, stressors were associated with elevated rates of daytime SBP and DBP, as well as sustained hypertension in African-American women, irrespective of SWS endorsement. Future research is needed to determine whether stress-management interventions focused on network stressors might impact BP in this high-risk population. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Tené T. Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Rachel Parker
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Raphiel Murden
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA
| | | | - Christy Erving
- Department of Sociology, The University of Texas at Austin, Austin, TX
| | - Izraelle I. McKinnon
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Miriam E. Van Dyke
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Bianca Booker
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Arshed Quyummi
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - Reneé H. Moore
- Department of Epidemiology and Biostatistics, Drexel University, Dornsife School of Public Health, Philadelphia, PA
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Nyarko SH, Luo L, Schlundt DG, Xiao Q. Cross-sectional association between neighborhood socioeconomic status and sleep duration among Black and white men and women: The Southern Community Cohort Study. Sleep Health 2023; 9:277-282. [PMID: 37045662 PMCID: PMC10837766 DOI: 10.1016/j.sleh.2023.01.016] [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: 04/07/2022] [Revised: 12/19/2022] [Accepted: 01/30/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVE To examine the association of neighborhood socioeconomic status (SES) with sleep duration among a large cohort of Black and white men and women in the United States. METHODS We used data from the Southern Community Cohort Study (SCCS, N = 75,248). Neighborhood SES was based on census data and sleep duration was measured by self-report. Multinomial logistic regression analysis was performed to assess the association between neighborhood SES and short (<7 hours) and long (≥9 hours) sleep in the overall sample and according to race-sex subgroups. RESULTS In the total sample, when compared with the highest quintile of neighborhood SES, the lowest quintile was associated with higher odds of both short (adjusted ORQ5 vs. Q1 [95% CI], 1.10 [1.03, 1.17]) and long sleep (1.37 [1.24, 1.52]). In race-sex specific analysis, the association between lower neighborhood SES and short sleep was only observed among white women (1.21 [1.05, 1.40]), but not in other subgroups. On the other hand, the association between lower neighborhood SES and long sleep duration was primarily observed among Black women (1.31 [1.06, 1.60]). CONCLUSIONS The association between neighborhood SES and sleep duration varied among race-and-sex subgroups. These findings provide new evidence on the importance of considering individual sociodemographic characteristics in understanding the potential effects of neighborhood socioeconomic context on sleep health.
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Affiliation(s)
- Samuel H Nyarko
- Department of Epidemiology, Human Genetics & Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA.
| | - Liying Luo
- Department of Sociology and Criminology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - David G Schlundt
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
| | - Qian Xiao
- Department of Epidemiology, Human Genetics & Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA
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Swanson LM, Hood MM, Hall MH, Avis NE, Joffe H, Colvin A, Ruppert K, Kravitz HM, Neal-Perry G, Derby CA, Hess R, Harlow SD. Sleep timing, sleep regularity, and psychological health in early late life women: Findings from the Study of Women's Health Across the Nation (SWAN). Sleep Health 2023; 9:203-210. [PMID: 36509657 PMCID: PMC10478033 DOI: 10.1016/j.sleh.2022.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To examine the associations of actigraphy-assessed sleep timing and regularity with psychological health in early late life women, whose circadian rhythms may be impacted by aging. DESIGN Cross-sectional. PARTICIPANTS A racially/ethnically diverse sample of 1197 community-dwelling women (mean age 65 years) enrolled in the Study of Women's Health Across the Nation. MEASURES Actigraphy-assessed sleep measures included timing (mean midpoint from sleep onset to wake-up) and regularity (standard deviation of midpoint in hours). Psychological health measures included a composite well-being score, the Center for Epidemiological Studies Depression Scale, and the Generalized Anxiety Disorder-7 Scale. Linear and logistic regression models, adjusted for covariates (including sleep duration), tested associations between sleep and psychological health measures. RESULTS After covariate adjustment, a sleep midpoint outside of 2:00-4: 00 AM was significantly associated with depressive symptoms (β = 0.88, 95% CI = 0.06, 1.70) and scoring above the cut-point for clinically significant depressive symptoms (OR = 1.72, 95% CI = 1.15, 2.57). Sleep irregularity was significantly associated with lower psychological well-being (β = -0.18, 95% CI = -0.33, -0.03), depressive (β = 1.36, 95% CI = 0.29, 2.44) and anxiety (β = 0.93, 95% CI = 0.40, 1.46) symptoms, and scoring above the cut-point for clinically significant depressive (OR = 1.68, 95% CI = 1.01, 2.79) and anxiety (OR = 1.62, 95% CI = 1.07, 2.43) symptoms. CONCLUSION Above and beyond sleep duration, a sleep midpoint outside of 2:00-4:00 AM was associated with depressive symptoms while sleep irregularity was associated with multiple psychological health domains in late life women.
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Affiliation(s)
- Leslie M Swanson
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.
| | - Michelle M Hood
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Nancy E Avis
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Hadine Joffe
- Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Alicia Colvin
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kristine Ruppert
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Howard M Kravitz
- Department of Psychiatry and Behavioral Sciences and Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Genevieve Neal-Perry
- Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Carol A Derby
- The Saul R. Korey Department of Neurology, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Rachel Hess
- Department of Population Health Sciences, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Siobán D Harlow
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
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12
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Letzen JE, Hunt C, Kuwabara H, McGill LS, Reid MJ, Hamilton KR, Buenaver LF, Burton E, Sheinberg R, Wong DF, Smith MT, Campbell CM. Preliminary Evidence for the Sequentially Mediated Effect of Racism-Related Stress on Pain Sensitivity Through Sleep Disturbance and Corticolimbic Opioid Receptor Function. THE JOURNAL OF PAIN 2023; 24:1-18. [PMID: 36167231 PMCID: PMC10863672 DOI: 10.1016/j.jpain.2022.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 08/10/2022] [Accepted: 09/01/2022] [Indexed: 02/08/2023]
Abstract
Sleep disturbance predicts worse pain outcomes. Because sleep disturbance inequitably impacts Black adults - with racism as the upstream cause - understanding how racism-related stress impacts pain through sleep might help minimize racialized pain inequities. This preliminary study examined sequential mediation of the effect of racism-related stress on experimental pain through sleep disturbance and corticolimbic μOR function in pain-free non-Hispanic Black (NHB) and White (NHW) adults. Participants completed questionnaires, actigraphy, positron emission tomography, and sensory testing. We reproduced findings showing greater sleep disturbance and pain sensitivity among NHB participants; greater sleep disturbance (r = .35) and lower pain tolerance (r=-.37) were significantly associated with greater racism-related stress. In a sequential mediation model, the total effect of racism-related stress on pain tolerance (β=-.38, P = .005) weakened after adding sleep disturbance and ventromedial prefrontal cortex (vmPFC) μOR binding potential (BPND) as mediators (β = -.18, P = .16). The indirect effect was statistically significant [point estimate = -.003, (-.007, -.0003). Findings showed a potential sequentially mediated effect of racism-related stress on pain sensitivity through sleep disturbance and vmPFC μOR BPND. As policy efforts are enacted to eliminate the upstream cause of systemic racism, these results cautiously suggest that sleep interventions within racism-based trauma informed therapy might help prevent downstream effects on pain. PERSPECTIVE: This preliminary study identified the effect of racism-related stress on pain through sleep disturbance and mu-opioid receptor binding potential in the ventromedial prefrontal cortex. Findings cautiously support the application of sleep interventions within racism-based trauma-informed therapy to prevent pain inequities as policy changes function to eliminate all levels of racism.
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Affiliation(s)
- Janelle E Letzen
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland..
| | - Carly Hunt
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Hiroto Kuwabara
- Department of Radiology, Johns Hopkins University, Baltimore, Maryland
| | - Lakeya S McGill
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, Maryland
| | - Matthew J Reid
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Katrina R Hamilton
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Luis F Buenaver
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Emily Burton
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Rosanne Sheinberg
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Dean F Wong
- Departments of Radiology, Psychiatry, Neurology, Neurosciences, Washington University School of Medicine, Mallinckrodt Institute of Radiology, St, Louis Missouri
| | - Michael T Smith
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Claudia M Campbell
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland
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13
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Farmer HR, Slavish DC, Ruiz J, Dietch JR, Ruggero CJ, Messman BA, Kelly K, Kohut M, Taylor DJ. Racial/ethnic variations in inflammatory markers: exploring the role of sleep duration and sleep efficiency. J Behav Med 2022; 45:855-867. [PMID: 36029411 PMCID: PMC10062430 DOI: 10.1007/s10865-022-00357-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/05/2022] [Indexed: 11/29/2022]
Abstract
Individuals from minoritized racial/ethnic groups have higher levels of circulating inflammatory markers. However, the mechanisms underlying these differences remain understudied. The objective of this study was to examine racial/ethnic variations in multiple markers of inflammation and whether impaired sleep contributes to these racial/ethnic differences. Nurses from two regional hospitals in Texas (n = 377; 71.62% White; 6.90% Black; 11.14% Hispanic, 10.34% Asian; mean age = 39.46; 91.78% female) completed seven days of sleep diaries and actigraphy to assess mean and variability in total sleep time (TST) and sleep efficiency (SE). On day 7, blood was drawn to assess 4 inflammatory markers: C-reactive protein (CRP), Interleukin-6 (IL-6), Interleukin-1 beta (IL-1β), and tumor necrosis factor-alpha (TNF-α). Results from regression models showed differences in inflammatory markers by race/ethnicity, adjusting for age and gender. The associations between sleep parameters and inflammatory markers also varied by race/ethnicity. Among White nurses, lower mean and greater variability in actigraphy-determined TST and greater variability in diary-determined TST were associated with higher levels of IL-6. Among Black nurses, lower mean diary-determined SE was associated with higher levels of IL-6 and IL-1β. Among Hispanic nurses, greater diary-determined mean TST was associated with higher CRP. Among Asian nurses, greater intraindividual variability in actigraphy-determined SE was associated with lower CRP. Among nurses, we did not find racial/ethnic disparities in levels of inflammation. However, analyses revealed differential relationships between sleep and inflammatory markers by race/ethnicity. Results highlight the importance of using a within-group approach to understand predictors of inflammatory markers.
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Affiliation(s)
- Heather R Farmer
- Department of Human Development and Family Sciences, University of Delaware, Newark, DE, 19716, USA.
| | - Danica C Slavish
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - John Ruiz
- Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Jessica R Dietch
- School of Psychological Science, Oregon State University, Corvallis, OR, USA
| | - Camilo J Ruggero
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Brett A Messman
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Kimberly Kelly
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Marian Kohut
- Department of Kinesiology, Iowa State University, Ames, IA, USA
| | - Daniel J Taylor
- Department of Psychology, University of Arizona, Tucson, AZ, USA
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14
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Salomon RE, Dobbins S, Harris C, Haeusslein L, Lin CX, Reeves K, Richoux S, Roussett G, Shin J, Dawson-Rose C. Antiracist symptom science: A call to action and path forward. Nurs Outlook 2022; 70:794-806. [PMID: 36400578 PMCID: PMC10916506 DOI: 10.1016/j.outlook.2022.07.014] [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: 04/06/2022] [Revised: 07/29/2022] [Accepted: 07/31/2022] [Indexed: 11/17/2022]
Abstract
Nurse scientists recognize the experience of racism as a driving force behind health. However, symptom science, a pillar of nursing, has rarely considered contributions of racism. Our objective is to describe findings within symptom science research related to racial disparities and/or experiences of racism and to promote antiracist symptom science within nursing research. In this manuscript, we use an antiracist lens to review a predominant symptom science theory and literature in three areas of symptom science research-oncology, mental health, and perinatal health. Finally, we make recommendations for increasing antiracist research in symptom science by altering (a) research questions, (b) recruitment methods, (c) study design, (d) data analysis, and (e) dissemination of findings. Traditionally, symptom science focuses on individual level factors rather than broader contexts driving symptom experience and management. We urge symptom science researchers to embrace antiracism by designing research with the specific intent of dismantling racism at multiple levels.
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Affiliation(s)
- Rebecca E Salomon
- The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Sarah Dobbins
- San Francisco Department of Public Health, San Francisco, California
| | | | | | - Chen-Xi Lin
- University of California, San Francisco, San Francisco, California
| | - Katie Reeves
- University of California, San Francisco, San Francisco, California
| | - Sarah Richoux
- University of California, San Francisco, San Francisco, California
| | - Greg Roussett
- University of California, San Francisco, San Francisco, California
| | - Joosun Shin
- University of California, San Francisco, San Francisco, California
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15
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Williams M, Richard-Davis G, Williams PL, Christensen L, Ward E, Schrager S. A review of African American women's experiences in menopause. Menopause 2022; 29:1331-1337. [PMID: 36126249 DOI: 10.1097/gme.0000000000002060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
IMPORTANCE AND OBJECTIVE Little is known and reported about the experiences of African American women as they transition to and experience menopause. Accepted norms are based on the experience of a predominantly White population. The aim of this study is to review available data about the distinct experiences of African American women during the menopause transition and menopause. METHODS A literature search was developed and executed by the review team in collaboration with a health sciences librarian. The search combined controlled vocabulary and title/abstract terms related to the health status disparities of African Americans in the menopause transition and menopause. The following databases were searched from inception through April 28, 2022: PubMed, Scopus (Elsevier), and Web of Science Core Collection (Clarivate). DISCUSSION AND CONCLUSION African American women experience distinct differences in physical, psychological, social, and quality of life measures during menopause. Increasing awareness about the unique menopause experiences of African American women is critically important to improve the health of this underserved population.
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Affiliation(s)
- Makeba Williams
- From the Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Gloria Richard-Davis
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR
| | | | - Leslie Christensen
- Department of Library Science, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Earlise Ward
- Department of Nursing, University of Wisconsin-Madison, WI
| | - Sarina Schrager
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI
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16
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Coborn J, de Wit A, Crawford S, Nathan M, Rahman S, Finkelstein L, Wiley A, Joffe H. Disruption of Sleep Continuity During the Perimenopause: Associations with Female Reproductive Hormone Profiles. J Clin Endocrinol Metab 2022; 107:e4144-e4153. [PMID: 35878624 PMCID: PMC9516110 DOI: 10.1210/clinem/dgac447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Indexed: 11/19/2022]
Abstract
CONTEXT Nocturnal vasomotor symptoms (nVMS), depressive symptoms (DepSx), and female reproductive hormone changes contribute to perimenopause-associated disruption in sleep continuity. Hormonal changes underlie both nVMS and DepSx. However, their association with sleep continuity parameters resulting in perimenopause-associated sleep disruption remains unclear. OBJECTIVE We aimed to determine the association between female reproductive hormones and perimenopausal sleep discontinuity independent of nVMS and DepSx. METHODS Daily sleep and VMS diaries, and weekly serum assays of female reproductive hormones were obtained for 8 consecutive weeks in 45 perimenopausal women with mild DepSx but no primary sleep disorder. Generalized estimating equations were used to examine associations of estradiol, progesterone, and follicle stimulating hormone (FSH) with mean number of nightly awakenings, wakefulness after sleep onset (WASO) and sleep-onset latency (SOL) adjusting for nVMS and DepSx. RESULTS Sleep disruption was common (median 1.5 awakenings/night, WASO 24.3 and SOL 20.0 minutes). More awakenings were associated with estradiol levels in the postmenopausal range (β = 0.14; 95% CI, 0.04 to 0.24; P = 0.007), and higher FSH levels (β [1-unit increase] = 0.12; 95% CI, 0.02 to 0.22; P = 0.02), but not with progesterone (β [1-unit increase] = -0.02; 95% CI, -0.06 to 0.01; P = 0.20) in adjusted models. Female reproductive hormones were not associated with WASO or SOL. CONCLUSION Associations of more awakenings with lower estradiol and higher FSH levels provide support for a perimenopause-associated sleep discontinuity condition that is linked with female reproductive hormone changes, independent of nVMS and DepSx.
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Affiliation(s)
| | | | - Sybil Crawford
- Tan Chingfen Graduate School of Nursing at UMass Chan Medical School, Worcester, MA, 01605, United States
| | - Margo Nathan
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 02115, United States
- Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 02115, United States
| | - Shadab Rahman
- Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 02115, United States
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, 02115, United States
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, 02115, United States
| | - Lauren Finkelstein
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 02115, United States
| | - Aleta Wiley
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 02115, United States
- Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 02115, United States
| | - Hadine Joffe
- Correspondence: Hadine Joffe, MD MSc, Brigham and Women’s Hospital, Thorn 1117, 75 Francis St, Boston MA 02115-6106, USA.
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17
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Simonelli G, Petit D, Delage JP, Michaud X, Lavoie MD, Morin CM, Godbout R, Robillard R, Vallières A, Carrier J, Bastien C. Sleep in times of crises: A scoping review in the early days of the COVID-19 crisis. Sleep Med Rev 2021; 60:101545. [PMID: 34571477 PMCID: PMC8461524 DOI: 10.1016/j.smrv.2021.101545] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/09/2021] [Accepted: 08/30/2021] [Indexed: 01/14/2023]
Abstract
During the early days of the pandemic and in the context of a seemingly unknown global threat, several potential major sleep disruptors were identified by sleep researchers and practitioners across the globe. The COVID-19 pandemic combined several features that, individually, had been shown to negatively affect sleep health in the general population. Those features included state of crisis, restrictions on in-person social interactions, as well as financial adversity. To address the lack of a comprehensive summary of sleep research across these three distinctive domains, we undertook three parallel systematic reviews based on the following themes: 1) Sleep in times of crises; 2) Sleep and social isolation; and 3) Sleep and economic uncertainty. Using a scoping review framework, we systematically identified and summarized findings from these three separated bodies of works. Potential moderating factors such as age, sex, ethnicity, socioeconomic status, psychological predisposition, occupation and other personal circumstances are also discussed. To conclude, we propose novel lines of research necessary to alleviate the short- and long-term impacts of the COVID-19 crises and highlight the need to prepare the deployment of sleep solutions in future crises.
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Affiliation(s)
- Guido Simonelli
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux Du Nord-de-l'île-de-Montréal, Montreal (Quebec) Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal (Quebec), Canada; Department of Psychology, Université de Montréal, Montreal (Quebec), Canada
| | - Dominique Petit
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux Du Nord-de-l'île-de-Montréal, Montreal (Quebec) Canada; Department of Psychiatry and Addictology, Université de Montréal, Montreal (Quebec), Canada
| | | | - Xavier Michaud
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux Du Nord-de-l'île-de-Montréal, Montreal (Quebec) Canada; Department of Psychology, Université de Montréal, Montreal (Quebec), Canada
| | | | - Charles M Morin
- École de Psychologie, Université Laval, Québec (Québec), Canada; CERVO Brain Research Center, Université Laval, Canada
| | - Roger Godbout
- Department of Psychiatry and Addictology, Université de Montréal, Montreal (Quebec), Canada; Sleep Laboratory & Clinic, Hôpital en Santé Mentale Rivière-des-Prairies, Montreal (Quebec), Canada
| | - Rebecca Robillard
- Sleep Research Unit, Royal Ottawa Institute of Mental Health Research, Ottawa (Ontario), Canada
| | - Annie Vallières
- École de Psychologie, Université Laval, Québec (Québec), Canada; CERVO Brain Research Center, Université Laval, Canada
| | - Julie Carrier
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux Du Nord-de-l'île-de-Montréal, Montreal (Quebec) Canada; Department of Psychology, Université de Montréal, Montreal (Quebec), Canada
| | - Célyne Bastien
- École de Psychologie, Université Laval, Québec (Québec), Canada; CERVO Brain Research Center, Université Laval, Canada.
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18
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Casale CE, Goel N. Genetic Markers of Differential Vulnerability to Sleep Loss in Adults. Genes (Basel) 2021; 12:1317. [PMID: 34573301 PMCID: PMC8464868 DOI: 10.3390/genes12091317] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/18/2021] [Accepted: 08/24/2021] [Indexed: 12/15/2022] Open
Abstract
In this review, we discuss reports of genotype-dependent interindividual differences in phenotypic neurobehavioral responses to total sleep deprivation or sleep restriction. We highlight the importance of using the candidate gene approach to further elucidate differential resilience and vulnerability to sleep deprivation in humans, although we acknowledge that other omics techniques and genome-wide association studies can also offer insights into biomarkers of such vulnerability. Specifically, we discuss polymorphisms in adenosinergic genes (ADA and ADORA2A), core circadian clock genes (BHLHE41/DEC2 and PER3), genes related to cognitive development and functioning (BDNF and COMT), dopaminergic genes (DRD2 and DAT), and immune and clearance genes (AQP4, DQB1*0602, and TNFα) as potential genetic indicators of differential vulnerability to deficits induced by sleep loss. Additionally, we review the efficacy of several countermeasures for the neurobehavioral impairments induced by sleep loss, including banking sleep, recovery sleep, caffeine, and naps. The discovery of reliable, novel genetic markers of differential vulnerability to sleep loss has critical implications for future research involving predictors, countermeasures, and treatments in the field of sleep and circadian science.
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Affiliation(s)
| | - Namni Goel
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 425, Chicago, IL 60612, USA;
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19
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Letzen JE, Robinson M, Saletin J, Sheinberg R, Smith MT, Campbell CM. Racial disparities in sleep-related cardiac function in young, healthy adults: Implications for cardiovascular-related health. Sleep 2021; 44:6313209. [PMID: 34214173 DOI: 10.1093/sleep/zsab164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 05/28/2021] [Indexed: 01/08/2023] Open
Abstract
STUDY OBJECTIVES Considerable evidence shows that individuals from marginalized racial/ethnic groups in the US experience greater rates of sleep disturbance and cardiovascular complications. Because sleep is a modifiable factor that is critically involved in cardiovascular health, improved understanding of the association between sleep and cardiovascular health during early adulthood can prevent cardiovascular disparities. This study examined racial/ethnic differences in cardiovascular function during sleep using heart-rate and heart-rate-variability analyses. METHODS Participants in this laboratory-based sleep study included healthy, "good sleepers" who were in early adulthood and resided in the US at the time of participation [14 non-Hispanic Black (NHB; age=30.9(6.6), 57% female), 12 Asian (Asian, age=26.0(5.2), 42% female), and 24 non-Hispanic white (NHW; age=24.6(5.8), 79% female)]. RESULTS After adjusting for demographic factors and an apnea-hypopnea index, we found significantly higher heart rate within NREM Stage 2 (N2) (b=-22.6, p=.04) and REM sleep (b=-25.8, p=.048) and lower heart rate variability during N2 sleep (b=-22.6, p=.04) among NHB individuals compared to NHW individuals. Further, NHB and Asian participants demonstrated significantly lower percent of time in slow wave sleep (SWS) compared to NHW participants (NHB: b=-22.6, p=.04; Asian: b=-22.6, p=.04). Individuals' percent of time in SWS significantly mediated differences in heart rate during N2 [indirect=0.94, 95% CI (0.03, 2.68)] and REM sleep [indirect=1.02, 95% CI (0.04, 3.04)]. CONCLUSIONS Our results showed disparities in sleep-related cardiovascular function in early adulthood that are mediated by SWS. These data suggest targeting sleep health in early adulthood might help reduce cardiovascular disease burden on individuals from marginalized groups.
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Affiliation(s)
- Janelle E Letzen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, 21224 USA
| | - Mercedes Robinson
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, 02906 USA
| | - Jared Saletin
- Department of Neurology, School of Medicine, University of California, San Francisco, San Francisco, CA 94143 USA
| | - Rosanne Sheinberg
- Department of Anesthesiology & Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, 21287 USA
| | - Michael T Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, 21224 USA
| | - Claudia M Campbell
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, 21224 USA
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20
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Abstract
OBJECTIVES The purpose of this study was to examine the specific characteristics that were directly linked to menopausal symptoms of midlife women from four major racial/ethnic groups in the United States using a decision tree analysis. METHODS This was a secondary analysis of the data from 1,027 midlife women from 2 larger Internet-based studies. The parent studies used the Midlife Women's Symptom Index with multiple questions on background characteristics and health and menopausal status. The data were analyzed using ANOVA and decision tree analyses. RESULTS Across all the racial/ethnic groups, menopausal stage and country of birth were significantly related to the total number and total severity scores of menopausal symptoms (P < 0.001). In each racial/ethnic group, different combined characteristics of the participants were closely linked to the total number and total severity scores of menopausal symptoms (P < 0.05). For instance, in African Americans, the total severity scores of menopausal symptoms increased among those who were postmenopausal (P < 0.001), US born (P < 0.001), and with low family income (P = 0.030). CONCLUSIONS Specific risk groups by the combined characteristics need to be considered in future practice with midlife women.
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Affiliation(s)
- Eun-Ok Im
- School of Nursing, Emory University, Atlanta, GA
| | - Jee-Seon Yi
- School of Nursing, Emory University, Atlanta, GA
- College of Nursing · Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea
| | - Wonshik Chee
- School of Nursing, Emory University, Atlanta, GA
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21
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What happens after menopause? (WHAM): A prospective controlled study of sleep quality up to 12 months after premenopausal risk-reducing salpingo-oophorectomy. Gynecol Oncol 2021; 162:447-453. [PMID: 34116835 DOI: 10.1016/j.ygyno.2021.05.036] [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: 02/04/2021] [Accepted: 05/31/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Sleep difficulties impair function and increase the risk of depression at menopause and premenopausal oophorectomy may further worsen sleep. However, prospective data are limited, and it remains uncertain whether Hormone Therapy (HT) improves sleep. This prospective observational study measured sleep quality before and up to 12 months after risk-reducing salpingo-oophorectomy (RRSO) compared to a similar age comparison group who retained their ovaries. METHODS Ninety-five premenopausal women undergoing RRSO and 99 comparisons were evaluated over a 12-month period using the Pittsburgh Sleep Quality Index (PSQI). RESULTS Almost half reported poor sleep quality at baseline. Overall sleep quality was not affected by RRSO until 12 months (p = 0.007). However, sleep disturbance increased by 3 months and remained significantly elevated at 12 months (p < 0.001). Trajectory analysis demonstrated that 41% had increased sleep disturbance after RRSO which persisted in 17.9%. Risk factors for sleep disturbance included severe vasomotor symptoms, obesity and smoking. Around 60% initiated HT after RRSO. Sleep quality was significantly better in HT users vs non users (p = 0.020) but HT did not restore sleep quality to baseline levels. CONCLUSIONS Overall sleep quality is not affected by RRSO, but new onset sleep disturbance is common, particularly in those with severe vasomotor symptoms. Clinicians should be alert to new-onset sleep disturbance and the potential for HT to improve sleep quality.
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22
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Matthews KA, Lee L, Kravitz HM, Joffe H, Neal-Perry G, Swanson LM, Evans MA, Hall MH. Influence of the menopausal transition on polysomnographic sleep characteristics: a longitudinal analysis. Sleep 2021; 44:6291662. [PMID: 34081126 PMCID: PMC8598193 DOI: 10.1093/sleep/zsab139] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 04/08/2021] [Indexed: 01/28/2023] Open
Abstract
STUDY OBJECTIVES To evaluate how change in menopausal status related to spectral analysis and polysomnographic measures of sleep characteristics. METHODS The Study of Women's Health Across the Nation (SWAN) Ancillary Sleep Study evaluated sleep characteristics of 159 women who were initially pre- or early perimenopausal and repeated the assessment about 3½ years later when 38 were pre- or early perimenopausal, 31 late perimenopausal, and 90 postmenopausal. Participants underwent in-home ambulatory polysomnography for two to three nights. Average EEG power in the delta and beta frequency bands was calculated during NREM and REM sleep, and sleep duration, wake after sleep onset (WASO), and apnea hypopnea index (AHI) were based on visually-scored sleep. RESULTS The women who transitioned to postmenopause had increased beta NREM EEG power at the second assessment, compared to women who remained pre-or early premenopausal; no other sleep measures varied by change in menopausal status. In multivariate models the associations remained; statistical controls for self-reported hot flashes did not explain findings. In secondary analysis, NREM beta power at the second assessment was greater among women who transitioned into the postmenopause after adjustments for initial NREM beta power. CONCLUSIONS Sleep duration and WASO did not vary by menopause transition group across assessments. Consistent with prior cross-sectional analysis, elevated beta EEG power in NREM sleep was apparent among women who transitioned to postmenopause, suggesting that independent of self-reported hot flashes, the menopausal transition is associated with physiological hyperarousal during sleep.
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Affiliation(s)
- Karen A Matthews
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA,Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA,Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA,Corresponding author. Karen A. Matthews, 3811 O’Hara St, Pittsburgh, PA 15213.
| | - Laisze Lee
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Howard M Kravitz
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA,Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Hadine Joffe
- Connors Center for Women’s Health and Gender Biology, Harvard Medical School, Brigham and Women’s Hospital, Boston, MA, USA,Department of Psychiatry, Harvard Medical School, Brigham and Women’s Hospital, Boston, MA, USA
| | - Genevieve Neal-Perry
- Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA
| | - Leslie M Swanson
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Marissa A Evans
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA,Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA,Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
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23
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Ahn S, Lobo JM, Logan JG, Kang H, Kwon Y, Sohn MW. A scoping review of racial/ethnic disparities in sleep. Sleep Med 2021; 81:169-179. [PMID: 33713923 DOI: 10.1016/j.sleep.2021.02.027] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 02/08/2021] [Accepted: 02/11/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Despite remarkable achievements in ensuring health equity, racial/ethnic disparities in sleep still persist and are emerging as a major area of concern. Accumulating evidence has not yet been well characterized from a broad perspective. We conducted a scoping review of studies on sleep disparities by race/ethnicity to summarize characteristics of existing studies and identify evidence gaps. METHODS We searched PubMed, CINAHL, PsycINFO, and Web of Science databases for studies of racial/ethnic disparities in sleep. Studies that met inclusion criteria were retrieved and organized in a data charting form by study design, sleep measuring methods, sleep features, and racial/ethnic comparisons. RESULTS One hundred sixteen studies were included in this review. Most studies focused on disparities between Whites and Blacks. Disproportionately fewer studies examined disparities for Hispanic, Asian, and other racial/ethnic groups. Self-reported sleep was most frequently used. Sleep duration, overall sleep quality, and sleep disordered breathing were frequently studied, whereas other features including sleep efficiency, latency, continuity, and architecture were understudied, particularly in racial minority groups in the US. Current study findings on racial/ethnic disparities in most of sleep features is mixed and inconclusive. CONCLUSIONS This review identified significant evidence gaps in racial/ethnic disparities research on sleep. Our results suggest a need for more studies examining diverse sleep features using standardized and robust measuring methods for more valid comparisons of sleep health in diverse race/ethnicity groups.
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Affiliation(s)
- Soojung Ahn
- School of Nursing, University of Virginia, Charlottesville, VA, USA
| | - Jennifer M Lobo
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Jeongok G Logan
- School of Nursing, University of Virginia, Charlottesville, VA, USA
| | - Hyojung Kang
- College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Younghoon Kwon
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Min-Woong Sohn
- Department of Health Management and Policy, College of Public Health, University of Kentucky, Lexington, KY, USA.
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24
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Dieli-Conwright CM, Courneya KS, Demark-Wahnefried W, Sami N, Norris MK, Fox FS, Buchanan TA, Spicer D, Bernstein L, Tripathy D. Aerobic and resistance exercise improve patient-reported sleep quality and is associated with cardiometabolic biomarkers in Hispanic and non-Hispanic breast cancer survivors who are overweight or obese: results from a secondary analysis. Sleep 2021; 44:6261067. [PMID: 33929533 PMCID: PMC8503828 DOI: 10.1093/sleep/zsab111] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 03/24/2021] [Indexed: 01/25/2023] Open
Abstract
STUDY OBJECTIVES Poor sleep quality affects nearly one-third of breast cancer survivors and is associated with insulin resistance. The purpose of this secondary analysis was to examine the effects of a 16-week exercise intervention on patient-reported sleep quality among breast cancer survivors and assess whether changes in patient-reported sleep quality were associated with cardiometabolic biomarkers. We explored Hispanic ethnicity as a moderator of the effects of exercise on patient-reported sleep quality. METHODS Breast cancer survivors who were overweight or obese were randomized to exercise (n = 50) or usual care (n = 50). The 16-week intervention included aerobic and resistance exercise. Patient-reported sleep quality (Pittsburgh Sleep Quality Index [PSQI]) and biomarkers of cardiometabolic health were assessed at baseline and post-intervention. Within- and between-group differences were assessed using general linear models repeated-measures analyses of variance and mixed-model repeated-measure analysis, respectively. Associations between changes in PSQI and cardiometabolic biomarkers were computed using Pearson correlations. Linear mixed-models were used to evaluate effect modification by ethnicity. RESULTS Participants were 52 ± 10.4 years old, and over half were of Hispanic ethnicity. As compared to usual care, PSQI global scores improved significantly in the exercise group (mean between-group difference -2.2; 95% CI -3.2 to -0.6). Change in PSQI was inversely associated with changes in all cardiometabolic biomarkers (p < 0.01) among the exercise group. Ethnicity was found to moderate the effects of exercise training on global sleep quality (p < 0.001). CONCLUSIONS An aerobic and resistance exercise intervention effectively improved patient-reported sleep quality in breast cancer survivors. Hispanic ethnicity as a moderator showed greater improvement in patient-reported sleep indicating Hispanic versus non-Hispanic breast cancer survivors may derive larger sleep benefits. CLINICAL TRAIL INFORMATION NCT01140282.
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Affiliation(s)
- Christina M Dieli-Conwright
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
- Corresponding author. Christina M. Dieli-Conwright, Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, 375 Longwood Avenue, Boston, MA 02215, USA.
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | | | - Nathalie Sami
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Mary K Norris
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Frank S Fox
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Thomas A Buchanan
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Darcy Spicer
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Leslie Bernstein
- Division of Biomarkers of Early Detection and Prevention, Beckman Research Institute, COH, Duarte, CA, USA
| | - Debu Tripathy
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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25
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Matthews KA, Lee L, Duggan KA, Pardini DA. Pathways connecting family socioeconomic status in adolescence and sleep continuity in adult Black and White men. Sleep Health 2021; 7:436-444. [PMID: 33933378 DOI: 10.1016/j.sleh.2021.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 03/08/2021] [Accepted: 03/14/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the roles of parenting and adolescent characteristics during ages 13 to 16 in connecting family socioeconomic status (SES) during adolescence with adult sleep in Black and White men. DESIGN Longitudinal school-based community study beginning in 1987-1988 when participants were enrolled in the first or seventh grade. SETTING Pittsburgh, PA. PARTICIPANTS 291 men (54.4% Black, mean age = 33, SD = 2.5) participated in 2012-2014 in a week-long study of sleep measured by actigraphy and diary. MEASURES In adolescence (ages 13-16), measures of family SES based on occupation, education, income and public assistance; parenting based on monitoring, positive expectations for future, warm parent-child relationship, and communication; and adolescent characteristics based on anxiety, hyperactivity/impulsivity, and peer rejection. In adulthood, participant SES, minutes awake after sleep onset (WASO), duration, and diary-assessed sleep quality. RESULTS Structural equation modeling confirmed significant indirect pathways: (1) low family SES in adolescence to negative parenting to low adult SES to greater WASO; (2) low family SES in adolescence to adolescent characteristics to low adult SES to greater WASO; (3) Black race to low family SES in adolescence to negative parenting to low adult SES to greater WASO; and (4) Black race to low family SES in adolescence to adolescent characteristics to adult SES to greater WASO. Similar models for duration and quality were not confirmed. CONCLUSIONS Parenting and adolescent characteristics may have an indirect association with adult sleep continuity. Parenting and mental health interventions in adolescence may improve adult sleep.
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Affiliation(s)
- Karen A Matthews
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
| | - Laisze Lee
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Katherine A Duggan
- Department of Psychology, North Dakota State University, Fargo, North Dakota, USA
| | - Dustin A Pardini
- Department of Criminology and Criminal Justice, Arizona State University, Tempe, Arizona, USA
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26
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Swanson LM, Hood MM, Hall MH, Kravitz HM, Matthews KA, Joffe H, Thurston RC, Butters MA, Ruppert K, Harlow SD. Associations between sleep and cognitive performance in a racially/ethnically diverse cohort: the Study of Women's Health Across the Nation. Sleep 2021; 44:5904755. [PMID: 32918472 DOI: 10.1093/sleep/zsaa182] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 08/25/2020] [Indexed: 01/04/2023] Open
Abstract
STUDY OBJECTIVES To determine whether actigraphy-assessed indices of sleep are associated with cognitive performance in women, and explore whether these associations vary by race/ethnicity. METHODS Participants were 1,126 postmenopausal community-dwelling females (mean age 65 years) from the observational Study of Women's Health Across the Nation (SWAN); 25% were black, 46% white, 13% Chinese, 11% Japanese, and 5% Hispanic. Actigraphy-assessed sleep measures included total sleep time, wake after sleep onset (WASO), and fragmentation. Cognitive measures included immediate and delayed verbal memory, working memory, and information processing speed. All measures were assessed in conjunction with SWAN annual visit 15. RESULTS Across the sample, after covariate adjustment, greater WASO and fragmentation were concurrently associated with slower information processing speed. Black participants had significantly worse sleep relative to other race/ethnic groups. Significant race/sleep interactions were observed; in black, but not white, participants, greater fragmentation was concurrently associated with worse verbal memory and slower information processing speed, and greater WASO was concurrently associated with slower information processing speed. Sleep-cognitive performance associations were not different in Chinese and Japanese participants relative to white participants. CONCLUSIONS Greater wakefulness and fragmentation during sleep are concurrently associated with slower information processing. Sleep continuity impacted concurrent cognitive performance in black, but not white, women. This effect may not have been detected in white women because their sleep was largely within the normal range. Future longitudinal studies in diverse samples are critical to further understand whether race/ethnicity moderates the influence of sleep on cognitive performance.
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Affiliation(s)
| | - Michelle M Hood
- Department of Epidemiology, University of Michigan, Ann Arbor, MI
| | | | - Howard M Kravitz
- Department of Psychiatry and Behavioral Sciences and Department of Preventive Medicine, Rush University Medical Center, Chicago, IL
| | | | - Hadine Joffe
- Connors Center for Women's Health and Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | | | | | | | - Siobán D Harlow
- Department of Epidemiology, University of Michigan, Ann Arbor, MI
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27
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Matthews KA, Kravitz HM, Lee L, Harlow SD, Bromberger JT, Joffe H, Hall MH. Does midlife aging impact women's sleep duration, continuity, and timing?: A longitudinal analysis from the Study of Women's Health Across the Nation. Sleep 2021; 43:5601413. [PMID: 31633180 DOI: 10.1093/sleep/zsz259] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 09/25/2019] [Indexed: 02/06/2023] Open
Abstract
Our study objectives were to evaluate the age-related changes in actigraphy measures of sleep duration, continuity, and timing across 12 years in midlife women as they traversed the menopause, and to take into account factors affecting women's sleep that also change with age. Black, white, and Chinese women were recruited from the Study of Women's Health Across the Nation (SWAN) to participate in an ancillary sleep study on two occasions over 3 years apart and a third assessment 12 years after the first (N = 300, mean ages, 52, 55, and 64 at the three assessments). Women had at least four consecutive nights of actigraphy (95% with 7 nights) and sleep diaries, and self-reported sleep complaints measured at each time point. Partial correlations adjusted for time between assessments across the 12 years were significant and moderate in size (r's = .33-.58). PROC MIXED/GLIMMIX multivariate models showed that sleep duration increased over time; wake after sleep onset (WASO) declined, midpoint of sleep interval increased, and sleep latency and number of sleep complaints did not change between the first and third assessments. Blacks and whites had a greater increase in sleep duration than Chinese. Taken together, the results of this longitudinal study suggest that sleep may not worsen, in general, in midlife women. Perhaps, the expected negative effect of aging in midlife into early old age on sleep is overstated.
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Affiliation(s)
- Karen A Matthews
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA.,Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
| | - Howard M Kravitz
- Department of Psychiatry, Rush University Medical Center, Chicago, IL.,Department of Preventive Medicine, Rush University Medical Center, Chicago, IL
| | - Laisze Lee
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Siobán D Harlow
- Department of Epidemiology, University of Michigan, Ann Arbor, MI.,Departments of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI
| | - Joyce T Bromberger
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA.,Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
| | - Hadine Joffe
- Connors Center for Women's Health and Gender Biology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA.,Department of Psychiatry, Harvard Medical School, Brigham and Women's Hospital, Boston, MA
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
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28
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Sieverdes JC, Treiber FA, Kline CE, Mueller M, Brunner-Jackson B, Sox L, Cain M, Swem M, Diaz V, Chandler J. Ethnicity Differences in Sleep Changes Among Prehypertensive Adults Using a Smartphone Meditation App: Dose-Response Trial. JMIR Form Res 2020; 4:e20501. [PMID: 33021484 PMCID: PMC7576537 DOI: 10.2196/20501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/22/2020] [Accepted: 07/26/2020] [Indexed: 01/13/2023] Open
Abstract
Background African Americans (AAs) experience greater sleep quality problems than non-Hispanic Whites (NHWs). Meditation may aid in addressing this disparity, although the dosage levels needed to achieve such benefits have not been adequately studied. Smartphone apps present a novel modality for delivering, monitoring, and measuring adherence to meditation protocols. Objective This 6-month dose-response feasibility trial investigated the effects of a breathing awareness meditation (BAM) app, Tension Tamer, on the secondary outcomes of self-reported and actigraphy measures of sleep quality and the modulating effects of ethnicity of AAs and NHWs. Methods A total of 64 prehypertensive adults (systolic blood pressure <139 mm Hg; 31 AAs and 33 NHWs) were randomized into 3 different Tension Tamer dosage conditions (5,10, or 15 min twice daily). Sleep quality was assessed at baseline and at 1, 3, and 6 months using the Pittsburgh Sleep Quality Index (PSQI) and 1-week bouts of continuous wrist actigraphy monitoring. The study was conducted between August 2014 and October 2016 (IRB #Pro00020894). Results At baseline, PSQI and actigraphy data indicated that AAs had shorter sleep duration, greater sleep disturbance, poorer efficiency, and worse quality of sleep (range P=.03 to P<.001). Longitudinal generalized linear mixed modeling revealed a dose effect modulated by ethnicity (P=.01). Multimethod assessment showed a consistent pattern of NHWs exhibiting the most favorable responses to the 5-min dose; they reported greater improvements in sleep efficiency and quality as well as the PSQI global value than with the 10-min and 15-min doses (range P=.04 to P<.001). Actigraphy findings revealed a consistent, but not statistically significant, pattern in the 5-min group, showing lower fragmentation, longer sleep duration, and higher efficiency than the other 2 dosage conditions. Among AAs, actigraphy indicated lower sleep fragmentation with the 5-min dose compared with the 10-min and 15-min doses (P=.03 and P<.001, respectively). The 10-min dose showed longer sleep duration than the 5-min and 15-min doses (P=.02 and P<.001, respectively). The 5-min dose also exhibited significantly longer average sleep than the 15-min dose (P=.03). Conclusions These findings indicate the need for further study of the potential modulating influence of ethnicity on the impact of BAM on sleep indices and user-centered exploration to ascertain the potential merits of refining the Tension Tamer app with attention to cultural tailoring among AAs and NHWs with pre-existing sleep complaints.
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Affiliation(s)
- John C Sieverdes
- College of Charleston, Health and Human Performance, Charleston, SC, United States
| | - Frank A Treiber
- College of Nursing, Medical University of South Carolina, Charleston, SC, United States.,College of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Christopher E Kline
- Department of Health & Physical Activity, University of Pittsburgh, Pittsburgh, PA, United States
| | - Martina Mueller
- College of Nursing, Medical University of South Carolina, Charleston, SC, United States
| | - Brenda Brunner-Jackson
- College of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Luke Sox
- College of Nursing, Medical University of South Carolina, Charleston, SC, United States
| | - Mercedes Cain
- College of Nursing, Medical University of South Carolina, Charleston, SC, United States
| | - Maria Swem
- College of Nursing, Medical University of South Carolina, Charleston, SC, United States
| | - Vanessa Diaz
- College of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Jessica Chandler
- College of Nursing, Medical University of South Carolina, Charleston, SC, United States
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29
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Carroll JE, Rentscher KE, Cole SW, Luo JJ, Ramilo O, Webber S, Lamkin DM, Christian LM. Sleep disturbances and inflammatory gene expression among pregnant women: Differential responses by race. Brain Behav Immun 2020; 88:654-660. [PMID: 32360438 PMCID: PMC7526416 DOI: 10.1016/j.bbi.2020.04.065] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 04/20/2020] [Accepted: 04/25/2020] [Indexed: 12/27/2022] Open
Abstract
Excessive inflammation in pregnancy predicts adverse birth outcomes, including shortened gestational length and lower birthweight, with African American women at greater risk. As substantial racial disparities in sleep quality, and evidence that African Americans have increased vulnerability for sleep-induced inflammatory dysregulation, sleep may be a critical, modifiable health behavior that contributes to racial disparities in birth outcomes. The present study examined sleep disturbance as a predictor of genome-wide transcriptome profiles of peripheral blood samples from 103 pregnant women (33 African American, 70 white) assessed at 18.7 ± 7.2 weeks gestation. We hypothesized that pregnant women with significant sleep disturbances would have gene expression profiles indicating over-expression of inflammatory pathways, with greater effects among African American compared to white women. Promoter-based bioinformatics analyses of differentially expressed genes indicated greater activation of NF-кB, AP1, and CREB transcription factors among African American women with sleep disturbances (all p < 0.05), and enhanced activation of AP1, but not NF-кB and reduced CREB activity among white women with sleep disturbances (p < 0.05). Differences in glucocorticoid receptor (GR) activity were also observed, in which African American women with sleep disturbances had reduced GR activity (p < 0.05), but white women with sleep disturbances showed a trend for enhanced GR activity (p = 0.11). Similarly, Interferon Response Factor (IRF) activity was reduced in African American women while increased in white women with sleep disturbances (p < 0.05). The current study provides novel evidence for gene expression related to inflammation, glucocorticoids, and anti-viral immunity among pregnant women with sleep disturbances, with differential effects by race. African Americans showed greater breadth and magnitude in these proinflammatory and anti-viral pathways than whites, with divergence in anti-inflammatory glucocorticoid, proinflammatory adrenergic-mediated cAMP, and anti-viral interferon responses. These data elucidate the role of sleep disturbances in intracellular inflammatory and anti-viral immunity in pregnancy and provide a potential target for intervention.
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Affiliation(s)
- Judith E Carroll
- Cousins Center for Psychoneuroimmunology, Department of Psychiatry & Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, USA.
| | - Kelly E Rentscher
- Cousins Center for Psychoneuroimmunology, Department of Psychiatry & Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, USA
| | - Steven W Cole
- Cousins Center for Psychoneuroimmunology, Department of Psychiatry & Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, USA
| | - James J Luo
- Cousins Center for Psychoneuroimmunology, Department of Psychiatry & Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, USA
| | - Octavio Ramilo
- Department of Psychiatry & Behavioral Health and The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Shannon Webber
- College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Donald M Lamkin
- Cousins Center for Psychoneuroimmunology, Department of Psychiatry & Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, USA
| | - Lisa M Christian
- Department of Psychiatry & Behavioral Health and The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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30
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Yip T, Cheon YM. Sleep, psychopathology and cultural diversity. Curr Opin Psychol 2020; 34:123-127. [PMID: 32203913 PMCID: PMC7308190 DOI: 10.1016/j.copsyc.2020.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 02/10/2020] [Accepted: 02/11/2020] [Indexed: 11/30/2022]
Abstract
Research on ethnic/racial disparities in sleep in the United States finds minorities to have shorter self-reported and actigraphy-recorded sleep duration and poorer sleep quality. Disparities in mental health mirror disparities in sleep with ethnic/racial minorities reporting higher prevalence and more severe struggles. This review focuses on recent research in sleep and mental health disparities and considers ethnic/racial discrimination as an important third variable that may link these two domains of disparities research. For example, research has found discrimination to mediate ethnic/racial disparities in sleep; at the same time, sleep has been observed to mediate the link between discrimination and mental health. The review concludes with the importance of considering ethnicity/race and accompanying sociodemographic, environmental, and behavioral influences on sleep and mental health research.
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31
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Blanc J, Seixas A, Donley T, Bubu OM, Williams N, Jean-Louis G. Resilience factors, race/ethnicity and sleep disturbance among diverse older females with hypertension. J Affect Disord 2020; 271:255-261. [PMID: 32479324 PMCID: PMC7266829 DOI: 10.1016/j.jad.2020.03.148] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 02/15/2020] [Accepted: 03/29/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND This study examined the relationships between resilience and sleep disturbance in a diverse sample of older women with a history of hypertension and whether this relationship is moderated by individuals' race/ethnicity. METHODS Sample includes 700 females from a community-based study in Brooklyn, New York with a mean age of 60.7 years (SD=6.52). Of the participants, 28.1% were born in the U.S.; 71% were African-descent, 17.4% were European and 11.6% were Hispanics descents. Data were gathered on demographics and sleep disturbance using the Comprehensive Assessment and Referral Evaluation (CARE) and the Stress Index Scale (SIS). Resilience Factors were assessed with both the Index of Self-Regulation of Emotion (ISE) and religious health beliefs. Chi-Square, Anova, Student t-tests, and multilinear regression analysis were conducted to explore associations between resilience factors and sleep disturbance. Associations between resilience factors and sleep disturbance were examined using stratified multilinear regression analysis in three models by race/ethnicity. Regression models was conducted examining the interaction between resilience factors and stress RESULTS: Resilience factor, ISE emerged as the strongest independent predictor of sleep disturbance [B(SE) = -0.368(0.008); p < .001] for African descents. ISE was not a significant predictor of sleep disturbance among Hispanic participants [B(SE) = -0.218(0.022);p = .052], however interaction effect analysis revealed that stress level moderates significantly the relationship between ISE, and their sleep disturbance [B(SE) = 0.243(0.001);p = .036]. CONCLUSIONS Results of our study suggest that resilience factors might be a more important protective factor for sleep disturbance among diverse older females.
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Affiliation(s)
- Judite Blanc
- Department of Population Health, Center for Healthful Behavior Change, New York University Langone Health, 180 Madison Avenue, 7th Floor,7-23C, New York, NY 10016, United States.
| | - Azizi Seixas
- Department of Population Health, Center for Healthful Behavior Change, New York University Langone Health
| | - Tiffany Donley
- Department of Population Health, Center for Healthful Behavior Change, New York University Langone Health
| | - Omonigho Michael Bubu
- Department of Population Health, Center for Healthful Behavior Change, New York University Langone Health
| | - Natasha Williams
- Department of Population Health, Center for Healthful Behavior Change, New York University Langone Health
| | - Girardin Jean-Louis
- Department of Population Health, Center for Healthful Behavior Change, New York University Langone Health
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32
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Genetics of Circadian and Sleep Measures in Adults: Implications for Sleep Medicine. CURRENT SLEEP MEDICINE REPORTS 2020. [DOI: 10.1007/s40675-020-00165-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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33
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El Khoudary SR, Greendale G, Crawford SL, Avis NE, Brooks MM, Thurston RC, Karvonen-Gutierrez C, Waetjen LE, Matthews K. The menopause transition and women's health at midlife: a progress report from the Study of Women's Health Across the Nation (SWAN). Menopause 2019; 26:1213-1227. [PMID: 31568098 PMCID: PMC6784846 DOI: 10.1097/gme.0000000000001424] [Citation(s) in RCA: 124] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/24/2019] [Accepted: 07/24/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Our initial understanding of the menopause transition (MT) has been framed by clinical samples of women seeking treatment rather than by population-based studies. The Study of Women's Health Across the Nation (SWAN) initiated in 1996 with an overall goal to define the MT, to characterize its biological and psychosocial antecedents and sequelae in an ethnically and racially diverse sample of midlife women. METHODS This review summarizes the central findings of SWAN to date that can inform women and their healthcare providers about the impact of the MT and midlife aging on overall health and well-being. RESULTS SWAN characterized changes in reproductive axis and menstrual cycle patterns that informed the development of the reproductive aging staging system Staging of Reproductive Aging Workshop+10; MT-related symptoms and mental health (vasomotor symptoms, sleep complaints, psychological symptoms, cognitive performance, and urogenital and sexual health); and physiological systems and functions (cardiovascular and cardiometabolic health, bone health, physical function performance) that are influenced by the MT. SWAN demonstrated substantial interrelations among these changes and significant racial/ethnic differences in the rate and magnitude of change in multiple health indictors in midlife women. The findings point to midlife as a critical stage for adopting healthy behavior and preventive strategies. CONCLUSIONS Over the past 23 years, SWAN has advanced our understanding of the impact of the MT and midlife aging on health and well-being in women. SWAN will be instrumental to determine whether MT-related changes during midlife are related to unfavorable health and well-being in early old age.
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Affiliation(s)
- Samar R. El Khoudary
- Department of Epidemiology, Graduate School of Public Health University of Pittsburgh, Pittsburgh, PA
| | - Gail Greendale
- David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Sybil L. Crawford
- University of Massachusetts Medical School, Graduate School of Nursing, Worcester, MA
| | - Nancy E. Avis
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC
| | - Maria M. Brooks
- Department of Epidemiology, Graduate School of Public Health University of Pittsburgh, Pittsburgh, PA
| | - Rebecca C. Thurston
- Department of Epidemiology, Graduate School of Public Health University of Pittsburgh, Pittsburgh, PA
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
| | | | - L. Elaine Waetjen
- Department of Obstetrics and Gynecology, University of California Davis School of Medicine, Sacramento, CA
| | - Karen Matthews
- Department of Epidemiology, Graduate School of Public Health University of Pittsburgh, Pittsburgh, PA
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
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