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Bacha AA, Suhail M, Awwad FA, Ismail EAA, Ahmad H. Role of dietary fiber and lifestyle modification in gut health and sleep quality. Front Nutr 2024; 11:1324793. [PMID: 38633603 PMCID: PMC11022964 DOI: 10.3389/fnut.2024.1324793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 02/16/2024] [Indexed: 04/19/2024] Open
Abstract
Dietary fiber has an immense role in the gut microbiome by modulating juvenile growth, immune system maturation, glucose, and lipid metabolism. Lifestyle changes might disrupt gut microbiota symbiosis, leading to various chronic diseases with underlying inflammatory conditions, obesity, and its associated pathologies. An interventional study of 16 weeks examined the impact of psyllium husk fiber with and without lifestyle modification on gut health and sleep quality in people with central obesity (men = 60 and women = 60), those aged from 40 to 60 years, those having WC ≥ 90 cm (men) and WC ≥ 80 cm (women), and no history of any chronic disease or regular medication. The participants were subgrouped into three intervention groups, namely, the psyllium husk fiber (PSH) group, the lifestyle modification (LSM) group, and the LSM&PSH group and control group with equal gender bifurcation (men = 15 and women = 15). A 24-h dietary recall, gastrointestinal tract (GIT) symptoms, and sleep quality analysis data were collected on validated questionnaires. The analyses of variance and covariance were used for baseline and post-intervention, respectively. Student's t-test was applied for pre- and post-intervention changes on the variable of interest. The intervention effect on GIT health was highly significant (P < 0.001). The mean GIT scores of the LSM, PSH, and LSM&PSH groups were 2.99 ± 0.14, 2.49 ± 0.14, and 2.71 ± 0.14, respectively, compared to the mean GIT scores of the control group. No significant (P = 0.205) effect of either intervention was observed on sleep quality. The study concluded that psyllium husk fiber significantly improved the GIT symptoms, while no significant effect of the intervention was observed on sleep quality analysis.
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Affiliation(s)
- Amjad Ali Bacha
- Department of Human Nutrition, The University of Agriculture Peshawar, Peshawar, Pakistan
- Amir Muhammad Khan Campus Mardan, The University of Agriculture Peshawar, Peshawar, Pakistan
| | - Muhammad Suhail
- Amir Muhammad Khan Campus Mardan, The University of Agriculture Peshawar, Peshawar, Pakistan
| | - Fuad A. Awwad
- Department of Quantitative Analysis, College of Business Administration, King Saud University, Riyadh, Saudi Arabia
| | - Emad A. A. Ismail
- Department of Quantitative Analysis, College of Business Administration, King Saud University, Riyadh, Saudi Arabia
| | - Hijaz Ahmad
- Center for Applied Mathematics and Bioinformatics, Gulf University for Science and Technology, Mishref, Kuwait
- Department of Computer Science and Mathematics, Lebanese American University, Beirut, Lebanon
- Section of Mathematics, International Telematic University Uninettuno, Rome, Italy
- Near East University, Operational Research Center in Healthcare, Nicosia, Türkiye
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Palagini L, Geoffroy PA, Gehrman PR, Miniati M, Gemignani A, Riemann D. Potential genetic and epigenetic mechanisms in insomnia: A systematic review. J Sleep Res 2023; 32:e13868. [PMID: 36918298 DOI: 10.1111/jsr.13868] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 03/16/2023]
Abstract
Insomnia is a stress-related sleep disorder conceptualised within a diathesis-stress framework, which it is thought to result from predisposing factors interacting with precipitating stressful events that trigger the development of insomnia. Among predisposing factors genetics and epigenetics may play a role. A systematic review of the current evidence for the genetic and epigenetic basis of insomnia was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) system. A total of 24 studies were collected for twins and family heritability, 55 for genome-wide association studies, 26 about candidate genes for insomnia, and eight for epigenetics. Data showed that insomnia is a complex polygenic stress-related disorder, and it is likely to be caused by a synergy of genetic and environmental factors, with stress-related sleep reactivity being the important trait. Even if few studies have been conducted to date on insomnia, epigenetics may be the framework to understand long-lasting consequences of the interaction between genetic and environmental factors and effects of stress on the brain in insomnia. Interestingly, polygenic risk for insomnia has been causally linked to different mental and medical disorders. Probably, by treating insomnia it would be possible to intervene on the effect of stress on the brain and prevent some medical and mental conditions.
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Affiliation(s)
- Laura Palagini
- Department of Clinical and Experimental Medicine, Unit of Psychiatry, Azienda Ospedaliero Universitaria Pisana AUOP, Pisa, Italy
| | - Pierre A Geoffroy
- Département de Psychiatrie et D'Addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, Paris, France
- GHU Paris - Psychiatry and Neurosciences, Paris, France
- Université de Paris, NeuroDiderot, INSERM, Paris, France
| | - Philip R Gehrman
- Center for Sleep and Circadian Neurobiology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mario Miniati
- Department of Clinical and Experimental Medicine, Unit of Psychiatry, Azienda Ospedaliero Universitaria Pisana AUOP, Pisa, Italy
| | - Angelo Gemignani
- Unit of Psychology, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Azienda Ospedaliero Universitaria Pisana AUOP, Pisa, Italy
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Center for Basics in NeuroModulation (NeuroModulBasics), Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Madrid‐Valero JJ, Rijsdijk F, Selzam S, Zavos HMS, Schneider M, Ronald A, Gregory AM. Sub-types of insomnia in adolescents: Insights from a quantitative/molecular twin study. JCPP ADVANCES 2023; 3:e12167. [PMID: 37753157 PMCID: PMC10519740 DOI: 10.1002/jcv2.12167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 03/30/2023] [Indexed: 09/28/2023] Open
Abstract
Background Insomnia with short sleep duration has been postulated as more severe than that accompanied by normal/long sleep length. While the short duration subtype is considered to have greater genetic influence than the other subtype, no studies have addressed this question. This study aimed to compare these subtypes in terms of: (1) the heritability of insomnia symptoms; (2) polygenic scores (PGS) for insomnia symptoms and sleep duration; (3) the associations between insomnia symptoms and a wide variety of traits/disorders. Methods The sample comprised 4000 pairs of twins aged 16 from the Twins Early Development Study. Twin models were fitted to estimate the heritability of insomnia in both groups. PGS were calculated for self-reported insomnia and sleep duration and compared among participants with short and normal/long sleep duration. Results Heritability was not significantly different in the short sleep duration group (A = 0.13 [95%CI = 0.01, 0.32]) and the normal/long sleep duration group (A = 0.35 [95%CI = 0.29, 0.40]). Shared environmental factors accounted for a substantial proportion of the variance in the short sleep duration group (C = 0.19 [95%CI = 0.05, 0.32]) but not in the normal/long sleep duration group (C = 0.00 [95%CI = 0.00, 0.04]). PGS did not differ significantly between groups although results were in the direction expected by the theory. Our results also showed that insomnia with short (as compared to normal/long) sleep duration had a stronger association with anxiety and depression (p < .05)-although not once adjusting for multiple testing. Conclusions We found mixed results in relation to the expected differences between the insomnia subtypes in adolescents. Future research needs to further establish cut-offs for 'short' sleep at different developmental stages and employ objective measures of sleep.
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Affiliation(s)
- Juan J. Madrid‐Valero
- Department of Health PsychologyFaculty of Health SciencesUniversity of AlicanteAlicanteSpain
| | - Frühling Rijsdijk
- Social, Genetic and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Saskia Selzam
- Social, Genetic and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Helena M. S. Zavos
- Department of PsychologyInstitute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | | | - Angelica Ronald
- Department of Psychological SciencesBirkbeck, University of LondonLondonUK
| | - Alice M. Gregory
- Department of PsychologyGoldsmiths, University of LondonLondonUK
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4
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Madrid-Valero JJ, Gregory AM. Behaviour genetics and sleep: A narrative review of the last decade of quantitative and molecular genetic research in humans. Sleep Med Rev 2023; 69:101769. [PMID: 36933344 DOI: 10.1016/j.smrv.2023.101769] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/05/2023]
Abstract
During the last decade quantitative and molecular genetic research on sleep has increased considerably. New behavioural genetics techniques have marked a new era for sleep research. This paper provides a summary of the most important findings from the last ten years, on the genetic and environmental influences on sleep and sleep disorders and their associations with health-related variables (including anxiety and depression) in humans. In this review we present a brief summary of the main methods in behaviour genetic research (such as twin and genome-wide association studies). We then discuss key research findings on: genetic and environmental influences on normal sleep and sleep disorders, as well as on the association between sleep and health variables (highlighting a substantial role for genes in individual differences in sleep and their associations with other variables). We end by discussing future lines of enquiry and drawing conclusions, including those focused on problems and misconceptions associated with research of this type. In this last decade our knowledge about genetic and environmental influences on sleep and its disorders has expanded. Both, twin and genome-wide association studies show that sleep and sleep disorders are substantially influenced by genetic factors and for the very first time multiple specific genetic variants have been associated with sleep traits and disorders.
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Affiliation(s)
- Juan J Madrid-Valero
- Department of Health Psychology, Faculty of Health Sciences, University of Alicante, Spain.
| | - Alice M Gregory
- Department of Psychology, Goldsmiths, University of London, London, United Kingdom
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Heritability of Sleep and Its Disorders in Childhood and Adolescence. CURRENT SLEEP MEDICINE REPORTS 2021; 7:155-166. [PMID: 34840933 PMCID: PMC8607788 DOI: 10.1007/s40675-021-00216-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 01/23/2023]
Abstract
Purpose of Review This review summarizes recent literature on the heritability of sleep and sleep disorders in childhood and adolescence. We also identify gaps in the literature and priorities for future research. Recent Findings Findings indicate that age, measurement method, reporter, and timing of sleep measurements can influence heritability estimates. Recent genome-wide association studies (GWAS) have identified differences in the heritability of sleep problems when ancestral differences are considered, but sample sizes are small compared to adult GWAS. Most studies focus on sleep variables in the full range rather than on disorder. Studies using objective measures of sleep typically comprised small samples. Summary Current evidence demonstrates a wide range of heritability estimates across sleep phenotypes in childhood and adolescence, but research in larger samples, particularly using objective sleep measures and GWAS, is needed. Further understanding of environmental mechanisms and the interaction between genes and environment is key for future research.
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6
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Michelini G, Palumbo IM, DeYoung CG, Latzman RD, Kotov R. Linking RDoC and HiTOP: A new interface for advancing psychiatric nosology and neuroscience. Clin Psychol Rev 2021; 86:102025. [PMID: 33798996 PMCID: PMC8165014 DOI: 10.1016/j.cpr.2021.102025] [Citation(s) in RCA: 98] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 03/11/2021] [Accepted: 03/19/2021] [Indexed: 12/14/2022]
Abstract
The Research Domain Criteria (RDoC) and the Hierarchical Taxonomy of Psychopathology (HiTOP) represent major dimensional frameworks proposing two alternative approaches to accelerate progress in the way psychopathology is studied, classified, and treated. RDoC is a research framework rooted in neuroscience aiming to further the understanding of transdiagnostic biobehavioral systems underlying psychopathology and ultimately inform future classifications. HiTOP is a dimensional classification system, derived from the observed covariation among symptoms of psychopathology and maladaptive traits, which seeks to provide more informative research and treatment targets (i.e., dimensional constructs and clinical assessments) than traditional diagnostic categories. This article argues that the complementary strengths of RDoC and HiTOP can be leveraged in order to achieve their respective goals. RDoC's biobehavioral framework may help elucidate the underpinnings of the clinical dimensions included in HiTOP, whereas HiTOP may provide psychometrically robust clinical targets for RDoC-informed research. We present a comprehensive mapping between dimensions included in RDoC (constructs and subconstructs) and HiTOP (spectra and subfactors) based on narrative review of the empirical literature. The resulting RDoC-HiTOP interface sheds light on the biobehavioral correlates of clinical dimensions and provides a broad set of dimensional clinical targets for etiological and neuroscientific research. We conclude with future directions and practical recommendations for using this interface to advance clinical neuroscience and psychiatric nosology. Ultimately, we envision that this RDoC-HiTOP interface has the potential to inform the development of a unified, dimensional, and biobehaviorally-grounded psychiatric nosology.
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Affiliation(s)
- Giorgia Michelini
- Semel Institute for Neuroscience & Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90024, United States of America.
| | - Isabella M Palumbo
- Department of Psychology, Georgia State University, Atlanta, GA 30303, United States of America
| | - Colin G DeYoung
- Department of Psychology, University of Minnesota, Minneapolis, MN 55455, United States of America
| | - Robert D Latzman
- Department of Psychology, Georgia State University, Atlanta, GA 30303, United States of America
| | - Roman Kotov
- Department of Psychiatry & Behavioral Health, Stony Brook University, Stony Brook, NY 11790, United States of America
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Wright L, Steptoe A, Fancourt D. Are adversities and worries during the COVID-19 pandemic related to sleep quality? Longitudinal analyses of 46,000 UK adults. PLoS One 2021; 16:e0248919. [PMID: 33765097 PMCID: PMC7993810 DOI: 10.1371/journal.pone.0248919] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/08/2021] [Indexed: 12/19/2022] Open
Abstract
Background There are concerns that both the experience of adversities during the COVID-19 pandemic and worries about experiencing adversities will have substantial and lasting effects on mental health. One pathway through which both experience of and worries about adversity may impact health is through effects on sleep. Methods We used data from 46,284 UK adults in the COVID-19 Social Study assessed weekly from 01/04/2020-12/05/2020 to study the association between adversities and sleep quality. We studied six categories of adversity including both worries and experiences of: illness with COVID-19, financial difficulty, loss of paid work, difficulties acquiring medication, difficulties accessing food, and threats to personal safety. We used random-effect within-between models to account for all time-invariant confounders. Results Both the total number of adversity experiences and total number of adversity worries were associated with lower quality sleep. Each additional experience was associated with a 1.16 (95% CI = 1.10, 1.22) times higher odds of poor quality sleep while each additional worry was associated with a 1.20 (95% CI = 1.17, 1.22) times higher odds of poor quality sleep. When considering specific experiences and worries, all worries and experiences were significantly related to poorer quality sleep except experiences relating to employment and finances. Having a larger social network offered some buffering effects on associations but there was limited further evidence of moderation by other social or psychiatric factors. Conclusion Poor sleep may be a mechanism by which COVID-19 adversities are affecting mental health. This highlights the importance of interventions that support adaptive coping strategies during the pandemic.
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Affiliation(s)
- Liam Wright
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
- * E-mail:
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, United Kingdom
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8
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Madrid-Valero JJ, Chapman R, Bailo E, Ordoñana JR, Selita F, Kovas Y, Gregory AM. What Do People Know About the Heritability of Sleep? Behav Genet 2021; 51:144-153. [PMID: 33486622 DOI: 10.1007/s10519-021-10041-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 01/06/2021] [Indexed: 11/29/2022]
Abstract
STUDY OBJECTIVES Twin studies have provided data about the relative weight of genetic and environmental factors on sleep variables over the last few decades. However, heritability is a non-intuitive concept and it is often misunderstood even amongst the scientific community. This study aimed to analyze: (1) understanding of the meaning of heritability of insomnia; (2) the accuracy of estimations of heritability in the general population regarding three sleep traits (sleep duration, sleep quality and insomnia); (3) perceptions of the effectiveness of different treatments for insomnia depending on how the disorder is presented (i.e. having an environmental or genetic etiology) and whether the subject's estimate of genetic influence on sleep traits impacted beliefs about the effectiveness of different treatments. METHODS Participants (N = 3658) completed a survey which included: questions about general genetic knowledge; a specific question about the meaning of heritability; estimates of heritability of three different sleep traits; and the effectiveness of different treatments for insomnia depending on how the etiology of this condition was presented. RESULTS Fewer than 25% of the participants selected the correct description of the heritability of insomnia. Almost half of the sample incorrectly believed that heritability refers to the chance of passing a disorder onto their children. We also found that participants provided different estimates for the effectiveness of different treatments depending on the presumed etiology of the disorder. CONCLUSION Most people do not have accurate knowledge about the concept of heritability. People's assumptions about the etiology of a disorder may influence which treatments they consider most effective.
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Affiliation(s)
- Juan J Madrid-Valero
- Department of Health Psychology, Faculty of Health Science, University of Alicante, 03690, Alicante, Spain.
| | - Robert Chapman
- Department of Psychology, Goldsmiths, University of London, London, UK
| | - Evangelina Bailo
- Department of Psychology, Goldsmiths, University of London, London, UK
| | - Juan R Ordoñana
- Department of Human Anatomy and Psychobiology, University of Murcia, Murcia, Spain.,Murcia Institute of Biomedical Research, IMIB-Arrixaca, Murcia, Spain
| | - Fatos Selita
- Department of Psychology, Goldsmiths, University of London, London, UK.,Tomsk State University, Tomsk, Russia
| | - Yulia Kovas
- Department of Psychology, Goldsmiths, University of London, London, UK.,Tomsk State University, Tomsk, Russia
| | - Alice M Gregory
- Department of Psychology, Goldsmiths, University of London, London, UK
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9
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Madrid-Valero JJ, Rubio-Aparicio M, Gregory AM, Sánchez-Meca J, Ordoñana JR. The heritability of insomnia: Systematic review and meta-analysis of twin studies. Sleep Med Rev 2021; 58:101437. [PMID: 33556853 DOI: 10.1016/j.smrv.2021.101437] [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: 07/31/2020] [Revised: 10/07/2020] [Accepted: 11/13/2020] [Indexed: 10/22/2022]
Abstract
Twin studies have consistently found that genetic factors explain a substantial proportion of the variance for insomnia. However, studies vary widely in their heritability estimates. Therefore, this meta-analysis aimed to: 1) Estimate the mean heritability of insomnia; 2) Assess heterogeneity among twin studies of insomnia; and 3) Search and analyse characteristics of the studies (moderator variables) that may explain heterogeneity among estimates. For this purpose, separate meta-analyses were carried out for MZ and DZ correlations and for heritability estimates by assuming random-effects models. Thirteen independent samples were included in this meta-analysis. The heterogeneity index for heritability estimates was significant in both best fitting models (I2 = 98.77, P < .0001) and full models (I2 = 97.80, P < .0001). MZ correlations were higher (0.37; 95%CI: 0.31,.43) than DZ correlations (0.15; 95%CI: 0.12,.18). A mean heritability of 0.39 (95%CI: 0.32,.44) was found for insomnia. These results highlight the role of genetic factors in explaining differences among the population on insomnia and Emphasize heterogeneity among studies. Further research is needed to identify variables that could explain this heterogeneity.
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Affiliation(s)
- Juan J Madrid-Valero
- Department of Health Psychology, Faculty of Health Science, University of Alicante, Spain.
| | - María Rubio-Aparicio
- Department of Health Psychology, Faculty of Health Science, University of Alicante, Spain
| | - Alice M Gregory
- Department of Psychology, Goldsmiths, University of London, London, United Kingdom
| | - Julio Sánchez-Meca
- Department of Basic Psychology and Methodology, University of Murcia, Spain
| | - Juan R Ordoñana
- Department of Human Anatomy and Psychobiology, University of Murcia, Spain; Murcia Institute of Biomedical Research, IMIB-Arrixaca, Spain
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10
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Buttazzoni A, Brar K, Minaker L. Smartphone-Based Interventions and Internalizing Disorders in Youth: Systematic Review and Meta-analysis. J Med Internet Res 2021; 23:e16490. [PMID: 33427682 PMCID: PMC7834929 DOI: 10.2196/16490] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 11/11/2020] [Accepted: 11/18/2020] [Indexed: 12/20/2022] Open
Abstract
Background Mental health disorders in youth are a global issue that have important implications for the future quality of life and morbidity of affected individuals. In the context of public health initiatives, smartphone-based interventions have been suggested to hold the potential to be an effective strategy to reduce the symptoms of mental health disorders in youth; however, further evaluation is needed to confirm their effectiveness. This systematic review and meta-analysis documents and synthesizes existing research on smartphone-based interventions targeting internalizing disorders in youth populations. Objective This study aims to synthesize existing research on smartphone-based interventions targeting internalizing disorders in youth populations. Methods PubMed and SCOPUS were searched in 2019, and 4334 potentially relevant articles were found. A total of 12 studies were included in the final synthesis. We used the Hedges g meta-analysis approach and a random effects model for analysis. Results The results of this review note that depression and anxiety are the most commonly targeted symptoms, and unlike other similar topics, most studies reviewed were linked to a proven treatment. The overall pooled effect from the meta-analysis showed small but significant effects (κ=12; N=1370; Hedges g=0.20; 95% CI 0.02-0.38) for interventions in reducing the symptoms of internalizing disorders. In total, 4 subgroup analyses examining specific symptoms and intervention styles found varied small significant and nonsignificant effects. Conclusions Future research should focus on developing robust evaluative frameworks and examining interventions among more diverse populations and settings. More robust research is needed before smartphone-based interventions are scaled up and used at the population level to address youth internalizing disorders.
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Affiliation(s)
| | - Keshbir Brar
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Leia Minaker
- School of Planning, University of Waterloo, Waterloo, ON, Canada
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11
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Morales-Muñoz I, Durdurak BB, Bilgin A, Marwaha S, Winsper C. Understanding the Relationship Between Sleep Problems in Early Childhood and Borderline Personality Disorder: A Narrative Review. Nat Sci Sleep 2021; 13:2175-2202. [PMID: 34984039 PMCID: PMC8709557 DOI: 10.2147/nss.s311672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 12/06/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Recent research indicates that sleep problems in childhood precede the development of borderline personality disorder (BPD) symptoms, but the mechanisms by which sleep problems associate with BPD are still unknown. This narrative review aims to provide some potential explanations for how early sleep problems might associate with BPD. METHODS We used the biosocial developmental model of BPD as a framework to discuss how sleep problems may associate with BPD. Articles were identified via PubMed and Embase, and papers published between January 1991 and April 2021 were extracted. Authors made a series of literature searches using the following keywords: Sleep problems, Insomnia, Nightmares, Hypothalamic-Pituitary-Adrenal Axis (HPA), Prefrontal Cortex, Family Psychopathology, Disrupted Attachment, Child Maltreatment, Impulsivity, Emotion Regulation, Internalizing, Externalizing, Rumination, Childhood, Adolescence, Young people. The inclusion criteria were published in peer-reviewed journals; human studies or reviews; published in English. The exclusion criteria were commentaries; abstracts from conferences; studies with animal samples. A total of 96 articles were included for the purpose of this review. RESULTS The evidence from this review suggests that some biological factors and core features of BPD act as potential mechanisms mediating the associations between early sleep and subsequent BPD, while some family-related factors might constitute common risk factors for sleep problems and BPD. CONCLUSION The biosocial developmental model of BPD provides a plausible characterization of how sleep disruption might lead to subsequent BPD. Further research on new developmental and early intervention approaches to understand how sleep in early stages associates with BPD could have significant clinical impact on these patients and could inform targeted therapeutic interventions.
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Affiliation(s)
- Isabel Morales-Muñoz
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK.,Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Buse Beril Durdurak
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Ayten Bilgin
- School of Psychology, University of Kent, Canterbury, UK
| | - Steven Marwaha
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK.,The Barberry National Centre for Mental Health, Birmingham and Solihull Mental Health Trust, Birmingham, UK
| | - Catherine Winsper
- Coventry and Warwickshire Partnership NHS Trust, Research and Innovation, Coventry, UK
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12
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Wright L, Steptoe A, Fancourt D. Are adversities and worries during the COVID-19 pandemic related to sleep quality? Longitudinal analyses of 46,000 UK adults. PLoS One 2021. [PMID: 33765097 DOI: 10.1101/2020.06.02.20120311v2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND There are concerns that both the experience of adversities during the COVID-19 pandemic and worries about experiencing adversities will have substantial and lasting effects on mental health. One pathway through which both experience of and worries about adversity may impact health is through effects on sleep. METHODS We used data from 46,284 UK adults in the COVID-19 Social Study assessed weekly from 01/04/2020-12/05/2020 to study the association between adversities and sleep quality. We studied six categories of adversity including both worries and experiences of: illness with COVID-19, financial difficulty, loss of paid work, difficulties acquiring medication, difficulties accessing food, and threats to personal safety. We used random-effect within-between models to account for all time-invariant confounders. RESULTS Both the total number of adversity experiences and total number of adversity worries were associated with lower quality sleep. Each additional experience was associated with a 1.16 (95% CI = 1.10, 1.22) times higher odds of poor quality sleep while each additional worry was associated with a 1.20 (95% CI = 1.17, 1.22) times higher odds of poor quality sleep. When considering specific experiences and worries, all worries and experiences were significantly related to poorer quality sleep except experiences relating to employment and finances. Having a larger social network offered some buffering effects on associations but there was limited further evidence of moderation by other social or psychiatric factors. CONCLUSION Poor sleep may be a mechanism by which COVID-19 adversities are affecting mental health. This highlights the importance of interventions that support adaptive coping strategies during the pandemic.
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Affiliation(s)
- Liam Wright
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, United Kingdom
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