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Dworschak C, Mäder T, Rühlmann C, Maercker A, Kleim B. Examining bi-directional links between loneliness, social connectedness and sleep from a trait and state perspective. Sci Rep 2024; 14:17300. [PMID: 39068239 PMCID: PMC11283477 DOI: 10.1038/s41598-024-68045-y] [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: 01/30/2024] [Accepted: 07/18/2024] [Indexed: 07/30/2024] Open
Abstract
Greater loneliness as well as a lack of social connectedness have often been associated with poorer sleep. However, the temporal dynamics and direction of these associations remain unclear. Aim of the current study was to examine bi-directional associations between loneliness/social connectedness and sleep in 48 stress-exposed medical students during their first medical internship, considered a period of heightened stress. We obtained trait-level questionnaire data on loneliness and global sleep completed before and during the internship as well as state-level diary- and wearable-based data on daily changes in social connectedness and sleep collected twice over the period of seven consecutive days, once before and once during the internship. Bi-directional associations among greater loneliness and higher daytime dysfunction on trait-level were identified. In addition, several uni-directional associations between loneliness/social connectedness and sleep were found on trait- and state-level. In sum, findings of this study point at a bi-directional relation among loneliness/social connectedness and sleep, in which variables seem to reciprocally influence each other across longer-term periods as well as on a day-to-day basis.
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Affiliation(s)
- Christine Dworschak
- Department of Psychology, University of Zurich, Binzmühlestrasse 14/17, 8050, Zurich, Switzerland.
| | - Thomas Mäder
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Charlotta Rühlmann
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Andreas Maercker
- Department of Psychology, University of Zurich, Binzmühlestrasse 14/17, 8050, Zurich, Switzerland
| | - Birgit Kleim
- Department of Psychology, University of Zurich, Binzmühlestrasse 14/17, 8050, Zurich, Switzerland.
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.
- Department of Experimental Psychopathology and Psychotherapy, Psychiatric University Hospital, University of Zurich, Lenggstrasse 32, 8032, Zurich, Switzerland.
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Parks DF, Schneider AM, Xu Y, Brunwasser SJ, Funderburk S, Thurber D, Blanche T, Dyer EL, Haussler D, Hengen KB. A nonoscillatory, millisecond-scale embedding of brain state provides insight into behavior. Nat Neurosci 2024:10.1038/s41593-024-01715-2. [PMID: 39009836 DOI: 10.1038/s41593-024-01715-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 06/19/2024] [Indexed: 07/17/2024]
Abstract
The most robust and reliable signatures of brain states are enriched in rhythms between 0.1 and 20 Hz. Here we address the possibility that the fundamental unit of brain state could be at the scale of milliseconds and micrometers. By analyzing high-resolution neural activity recorded in ten mouse brain regions over 24 h, we reveal that brain states are reliably identifiable (embedded) in fast, nonoscillatory activity. Sleep and wake states could be classified from 100 to 101 ms of neuronal activity sampled from 100 µm of brain tissue. In contrast to canonical rhythms, this embedding persists above 1,000 Hz. This high-frequency embedding is robust to substates, sharp-wave ripples and cortical on/off states. Individual regions intermittently switched states independently of the rest of the brain, and such brief state discontinuities coincided with brief behavioral discontinuities. Our results suggest that the fundamental unit of state in the brain is consistent with the spatial and temporal scale of neuronal computation.
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Affiliation(s)
- David F Parks
- Department of Biomolecular Engineering, University of California, Santa Cruz, CA, USA
| | - Aidan M Schneider
- Department of Biology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Yifan Xu
- Department of Biology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Samuel J Brunwasser
- Department of Biology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Samuel Funderburk
- Department of Biology, Washington University in Saint Louis, St. Louis, MO, USA
| | | | | | - Eva L Dyer
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - David Haussler
- Department of Biomolecular Engineering, University of California, Santa Cruz, CA, USA
| | - Keith B Hengen
- Department of Biology, Washington University in Saint Louis, St. Louis, MO, USA.
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3
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Li C, Peng Y, Zhu X, Liu Y, Zou J, Zhu H, Li X, Yi H, Guan J, Zhang X, Xu H, Yin S. Independent relationship between sleep apnea-specific hypoxic burden and glucolipid metabolism disorder: a cross-sectional study. Respir Res 2024; 25:214. [PMID: 38762509 PMCID: PMC11102635 DOI: 10.1186/s12931-024-02846-7] [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: 12/08/2023] [Accepted: 05/12/2024] [Indexed: 05/20/2024] Open
Abstract
OBJECTIVES Obstructive sleep apnea (OSA) is associated with abnormal glucose and lipid metabolism. However, whether there is an independent association between Sleep Apnea-Specific Hypoxic Burden (SASHB) and glycolipid metabolism disorders in patients with OSA is unknown. METHODS We enrolled 2,173 participants with suspected OSA from January 2019 to July 2023 in this study. Polysomnographic variables, biochemical indicators, and physical measurements were collected from each participant. Multiple linear regression analyses were used to evaluate independent associations between SASHB, AHI, CT90 and glucose as well as lipid profile. Furthermore, logistic regressions were used to determine the odds ratios (ORs) for abnormal glucose and lipid metabolism across various SASHB, AHI, CT90 quartiles. RESULTS The SASHB was independently associated with fasting blood glucose (FBG) (β = 0.058, P = 0.016), fasting insulin (FIN) (β = 0.073, P < 0.001), homeostasis model assessment of insulin resistance (HOMA-IR) (β = 0.058, P = 0.011), total cholesterol (TC) (β = 0.100, P < 0.001), total triglycerides (TG) (β = 0.063, P = 0.011), low-density lipoprotein cholesterol (LDL-C) (β = 0.075, P = 0.003), apolipoprotein A-I (apoA-I) (β = 0.051, P = 0.049), apolipoprotein B (apoB) (β = 0.136, P < 0.001), apolipoprotein E (apoE) (β = 0.088, P < 0.001) after adjustments for confounding factors. Furthermore, the ORs for hyperinsulinemia across the higher SASHB quartiles were 1.527, 1.545, and 2.024 respectively, compared with the lowest quartile (P < 0.001 for a linear trend); the ORs for hyper-total cholesterolemia across the higher SASHB quartiles were 1.762, 1.998, and 2.708, compared with the lowest quartile (P < 0.001 for a linear trend) and the ORs for hyper-LDL cholesterolemia across the higher SASHB quartiles were 1.663, 1.695, and 2.316, compared with the lowest quartile (P < 0.001 for a linear trend). Notably, the ORs for hyper-triglyceridemia{1.471, 1.773, 2.099} and abnormal HOMA-IR{1.510, 1.492, 1.937} maintained a consistent trend across the SASHB quartiles. CONCLUSIONS We found SASHB was independently associated with hyperinsulinemia, abnormal HOMA-IR, hyper-total cholesterolemia, hyper-triglyceridemia and hyper-LDL cholesterolemia in Chinese Han population. Further prospective studies are needed to confirm that SASHB can be used as a predictor of abnormal glycolipid metabolism disorders in patients with OSA. TRIAL REGISTRATION ChiCTR1900025714 { http://www.chictr.org.cn/ }; Prospectively registered on 6 September 2019; China.
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Affiliation(s)
- Chenyang Li
- Department of Otolaryngology-Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Yu Peng
- Department of Otolaryngology-Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Xiaoyue Zhu
- Department of Otolaryngology-Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Yupu Liu
- Department of Otolaryngology-Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Jianyin Zou
- Department of Otolaryngology-Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Huaming Zhu
- Department of Otolaryngology-Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Xinyi Li
- Department of Otolaryngology-Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Hongliang Yi
- Department of Otolaryngology-Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Jian Guan
- Department of Otolaryngology-Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China.
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China.
| | - Xu Zhang
- School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen, China.
| | - Huajun Xu
- Department of Otolaryngology-Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China.
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China.
| | - Shankai Yin
- Department of Otolaryngology-Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
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Yook S, Park HR, Joo EY, Kim H. Predicting the impact of CPAP on brain health: A study using the sleep EEG-derived brain age index. Ann Clin Transl Neurol 2024; 11:1172-1183. [PMID: 38396240 DOI: 10.1002/acn3.52032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/17/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
OBJECTIVE This longitudinal study investigated potential positive impact of CPAP treatment on brain health in individuals with obstructive sleep Apnea (OSA). To allow this, we aimed to employ sleep electroencephalogram (EEG)-derived brain age index (BAI) to quantify CPAP's impact on brain health and identify individually varying CPAP effects on brain aging using machine learning approaches. METHODS We retrospectively analyzed CPAP-treated (n = 98) and untreated OSA patients (n = 88) with a minimum 12-month follow-up of polysomnography. BAI was calculated by subtracting chronological age from the predicted brain age. To investigate BAI changes before and after CPAP treatment, we compared annual ΔBAI between CPAP-treated and untreated OSA patients. To identify individually varying CPAP effectiveness and factors influencing CPAP effectiveness, machine learning approaches were employed to predict which patient displayed positive outcomes (negative annual ΔBAI) based on their baseline clinical features. RESULTS CPAP-treated group showed lower annual ΔBAI than untreated (-0.6 ± 2.7 vs. 0.3 ± 2.6 years, p < 0.05). This BAI reduction with CPAP was reproduced independently in the Apnea, Bariatric surgery, and CPAP study cohort. Patients with more severe OSA at baseline displayed more positive annual ΔBAI (=accelerated brain aging) when untreated and displayed more negative annual ΔBAI (=decelerated brain aging) when CPAP-treated. Machine learning models achieved high accuracy (up to 86%) in predicting CPAP outcomes. INTERPRETATION CPAP treatment can alleviate brain aging in OSA, especially in severe cases. Sleep EEG-derived BAI has potential to assess CPAP's impact on brain health. The study provides insights into CPAP's effects and underscores BAI-based predictive modeling's utility in OSA management.
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Affiliation(s)
- Soonhyun Yook
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, California, 90033, USA
| | - Hea Ree Park
- Department of Neurology, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, 10380, Korea
| | - Eun Yeon Joo
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Samsung Biomedical Research Institute, School of Medicine, Sungkyunkwan University, Seoul, 06351, Korea
| | - Hosung Kim
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, California, 90033, USA
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Bikov A, Bailly S, Testelmans D, Fanfulla F, Pataka A, Bouloukaki I, Hein H, Dogas Z, Basoglu OK, Staats R, Parati G, Lombardi C, Grote L, Mihaicuta S. The relationship between periodic limb movement during sleep and dyslipidaemia in patients with obstructive sleep apnea. J Sleep Res 2024; 33:e14012. [PMID: 37596874 DOI: 10.1111/jsr.14012] [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: 04/09/2023] [Revised: 07/16/2023] [Accepted: 07/18/2023] [Indexed: 08/20/2023]
Abstract
Periodic limb movements during sleep and obstructive sleep apnea are both associated with increased sympathetic tone, and have been proposed as risk factors for heart diseases and, in particular, cardiovascular disease. As sympathetic system activation may lead to dyslipidaemia, periodic limb movements during sleep could be an additional risk factor for cardiovascular disease in patients with obstructive sleep apnea. The aim of the study was to determine whether the presence of periodic limb movements during sleep affects serum lipid levels in obstructive sleep apnea. Total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, non- high-density lipoprotein cholesterol and triglyceride levels were investigated in 4138 patients with obstructive sleep apnea in the European Sleep Apnea Database (ESADA) cohort, divided into those with periodic limb movements during sleep index ≥ 15 per hr (n = 628) and controls (n = 3510). ANCOVA adjusted for age, sex, body mass index, apnea-hypopnea index, alcohol intake, smoking status, diabetes, insomnia and study site was used to assess differences in lipids between periodic limb movements during sleep and controls. Patients with periodic limb movements during sleep (24% female, 54.4 ± 12.1 years, body mass index 31.9 ± 5.8 kg m-2 , apnea-hypopnea index 36.7 ± 25.4 per hr) had higher triglyceride (1.81 ± 1.04 versus 1.69 ± 0.90 mmol L-1 , p = 0.002) and lower high-density lipoprotein cholesterol (1.19 ± 0.34 versus 1.24 ± 0.37 mmol L-1 , p = 0.002) levels, whilst there was no difference in either total cholesterol (4.98 ± 1.10 versus 4.94 ± 1.07 mmol L-1 ), low-density lipoprotein cholesterol (3.04 ± 0.96 versus 2.98 ± 0.98 mmol L-1 ) or non- high-density lipoprotein cholesterol (3.78 ± 1.10 versus 3.70 ± 1.05 mmol L-1 ) concentrations (all p > 0.05). The results remained unchanged after most sensitivity analyses. Patients with obstructive sleep apnea with periodic limb movements during sleep had more prevalent cardiovascular disease (11% versus 6%, p < 0.01). Periodic limb movements during sleep in obstructive sleep apnea is associated with dyslipidaemia independently of important confounders. Our results highlight periodic limb movements during sleep as an additional risk factor for cardiovascular disease in obstructive sleep apnea.
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Affiliation(s)
- Andras Bikov
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Division of Infection, Immunity & Respiratory Medicine, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Sebastien Bailly
- Grenoble Alpes University, Inserm, CHU Grenoble Alpes, Grenoble, France
| | - Dries Testelmans
- Department of Pneumology, University Hospitals Leuven, Leuven, Belgium
- Department of Chronic Diseases and Metabolism, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Leuven, Belgium
| | - Francesco Fanfulla
- Sleep Medicine Unit - Istituti Clinici Scientifici Maugeri - Istituto Scientifico di Pavia e Montescano IRCCS, Pavia, Italy
| | - Athanasia Pataka
- Respiratory Failure Unit, School of Medicine, G Papanikolaou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Izolde Bouloukaki
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Holger Hein
- Private practice for Sleep Medicine and Sleep Disorders Center, Reinbek, Germany
| | - Zoran Dogas
- Sleep Medicine Center, Department of Neuroscience, University of Split School of Medicine, Split, Croatia
| | - Ozen K Basoglu
- Department of Respiratory Medicine, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Richard Staats
- Thorax Department, Centro Hospitalar Universitario Lisboa Norte, Lisbon, Portugal
- Instituto de Saúde Ambiental - ISAMB; Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Gianfranco Parati
- Sleep Center-Department of Cardiology, IRCCS, Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Carolina Lombardi
- Sleep Center-Department of Cardiology, IRCCS, Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Ludger Grote
- Center for Sleep and Wake Disorders, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Pulmonary Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Stefan Mihaicuta
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, Department of Pulmonology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Timisoara, Romania
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Hariri M, Shamshirgaran SM, Aminisani N, Abasi H, Gholami A. Is poor sleep quality associated with lipid profile in elderly population? Finding from Iranian Longitudinal Study on Ageing. Ir J Med Sci 2024; 193:123-129. [PMID: 37400651 DOI: 10.1007/s11845-023-03449-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/23/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND Abnormal lipid profile as one of reversible cardiovascular disease risk factors might be affected by poor sleep quality. AIM This study aimed to assess the association between poor sleep quality and serum concentration of lipid profile in Iranian elderly population. METHODS The study was performed on a representative sample of 3452 Iranian older people (≥60 years) who contributed in the Iranian Longitudinal Study on Ageing (IRLSA). Sleep quality was measured through the validated Persian version of Pittsburgh Sleep Quality Index (PSQI). Fasting blood samples were collected from the participants to measure plasma levels lipid profile. We used multiple linear regression model to evaluate the independent association of poor sleep quality with lipid profile. RESULTS The mean age of participants was 68.0±6.7 years and 52.5% of them were male. In total, 52.4% of study population reported poor sleep quality (PSQI>5). Mean serum concentration of triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) was 143.2±74.2 mg/dl, 195.6±43.2 mg/dl, 112.9±31.0 mg/dl, and 57.3±12.4 mg/dl, respectively. Poor sleep quality was significantly associated with serum levels of TG (β=17.85; P=0.006), LDL-C (β=5.45; P=0.039) and HDL-C (β=-2.13; P=0.039) after adjusting for studied covariates. CONCLUSION Our study illustrates that poor sleep quality is a risk factor for poorer lipid profile. Therefore, early behavioral or pharmacological interventions that improve sleep quality are necessary to modify lipid profile in elderly population.
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Affiliation(s)
- Mitra Hariri
- Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
- Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Seyed Morteza Shamshirgaran
- Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Nayyereh Aminisani
- Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Hamid Abasi
- Public Health Department, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Ali Gholami
- Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran.
- Department of Epidemiology and Biostatistics, School of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran.
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Restrepo C, Lobbezoo F, Castrillon E, Svensson P, Santamaria A, Manfredini D. Correlations between sleep architecture and sleep-related masseter muscle activity in children with sleep bruxism. J Oral Rehabil 2024; 51:110-116. [PMID: 36790219 DOI: 10.1111/joor.13430] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 12/29/2022] [Accepted: 01/23/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Sleep bruxism (SB) occurring during No-REM (nREM) sleep and increase in microarousals per hour have been described in adults, but not in children. OBJECTIVE To assess the correlation between sleep architecture and masseter muscle activity related to sleep bruxism (SB/MMA) in children. MATERIALS AND METHODS Forty-three children aged 7-12 years (mean age: 9.4 ± 1.3) with confirmed SB underwent a two-night polysomnographic (PSG) study in a sleep laboratory, for accommodation (first night) and data collection (second night). Data on sleep architecture (total sleep duration (TSD), sleep efficiency (SE), sleep onset latency (SOL), REM and nREM sleep duration and proportion and microarousals/hour during REM and nREM sleep) and episodes/hour of SB/MMA were recorded. Single and multiple-variable linear regression analyses were performed to assess the correlation between data on sleep architecture (predictors) and SB/MMA (dependent variable). RESULTS Shorter TSD, REM and nREM stage 1 sleep duration, longer SOL and more microarousals/hour during REM and nREM sleep were found to be positive predictors of SB/MMA in children in the multiple-variable regression analysis (R2 = 0.511). CONCLUSION Within the limitations of this study, it can be concluded that SB/MMA is correlated with altered sleep architecture in children (shorter total sleep duration (TSD), shorter nREM and REM sleep and higher microarousals during REM and nREM sleep). Nevertheless, the clinical significance of these findings need to be demonstrated in future studies.
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Parks DF, Schneider AM, Xu Y, Brunwasser SJ, Funderburk S, Thurber D, Blanche T, Dyer EL, Haussler D, Hengen KB. A non-oscillatory, millisecond-scale embedding of brain state provides insight into behavior. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.06.09.544399. [PMID: 37333381 PMCID: PMC10274881 DOI: 10.1101/2023.06.09.544399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Sleep and wake are understood to be slow, long-lasting processes that span the entire brain. Brain states correlate with many neurophysiological changes, yet the most robust and reliable signature of state is enriched in rhythms between 0.1 and 20 Hz. The possibility that the fundamental unit of brain state could be a reliable structure at the scale of milliseconds and microns has not been addressed due to the physical limits associated with oscillation-based definitions. Here, by analyzing high resolution neural activity recorded in 10 anatomically and functionally diverse regions of the murine brain over 24 h, we reveal a mechanistically distinct embedding of state in the brain. Sleep and wake states can be accurately classified from on the order of 100 to 101 ms of neuronal activity sampled from 100 μm of brain tissue. In contrast to canonical rhythms, this embedding persists above 1,000 Hz. This high frequency embedding is robust to substates and rapid events such as sharp wave ripples and cortical ON/OFF states. To ascertain whether such fast and local structure is meaningful, we leveraged our observation that individual circuits intermittently switch states independently of the rest of the brain. Brief state discontinuities in subsets of circuits correspond with brief behavioral discontinuities during both sleep and wake. Our results suggest that the fundamental unit of state in the brain is consistent with the spatial and temporal scale of neuronal computation, and that this resolution can contribute to an understanding of cognition and behavior.
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Affiliation(s)
- David F. Parks
- Department of Biomolecular Engineering, University of California, Santa Cruz
| | | | - Yifan Xu
- Department of Biology, Washington University in Saint Louis
| | | | | | | | | | - Eva L. Dyer
- Department of Biomedical Engineering, Georgia Tech, Atlanta GA
| | - David Haussler
- Department of Biomolecular Engineering, University of California, Santa Cruz
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Ogawa K, Kaizuma-Ueyama E, Hayashi M. Effects of using a snooze alarm on sleep inertia after morning awakening. J Physiol Anthropol 2022; 41:43. [PMID: 36587230 PMCID: PMC9804954 DOI: 10.1186/s40101-022-00317-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 12/09/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Many people use the snooze function of digital alarm clocks for morning awakening, but the effects of a snooze alarm on waking are unclear. We examined the effects of a snooze alarm on sleep inertia, which is a transitional state characterized by reduced arousal and impaired cognitive and behavioral performance immediately upon awakening. METHODS In study 1, healthy Japanese university students responded to a sleep survey during a psychology class (study 1), and we collected 293 valid responses. In study 2, we compared a separate sample of university students (n = 10) for the effects of using or not using a snooze alarm on sleep inertia immediately after awakening from normal nocturnal sleep in a sleep laboratory. RESULTS Of 293 valid respondents in study 1, 251 often used a tool to wake up in the morning (85.7%). Moreover, 70.5% reported often using the snooze function of their mobile phones, mainly to reduce anxiety about oversleeping. Study 2 indicated no differences in the sleep quality or quantity before awakening with or without the snooze alarm, except in the last 20 min. However, during the last 20 min of sleep with snooze alarm, the snooze alarm prolonged waking and stage N1 sleep. Stage N1 sleep is non-rapid eye movement sleep that is primarily defined as a drowsy state. Furthermore, Global Vigor values were enhanced after awakening compared to pre-sleep in the no-snooze condition. CONCLUSIONS Using a snooze alarm prolongs sleep inertia compared to a single alarm, possibly because snooze alarms induce repeated forced awakenings.
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Affiliation(s)
- Keiko Ogawa
- grid.257022.00000 0000 8711 3200Integrated Arts and Human Sciences Program, Graduate School of Humanities and Social Sciences, Hiroshima University, Higashi-Hiroshima, Hiroshima, Japan
| | - Emi Kaizuma-Ueyama
- grid.257022.00000 0000 8711 3200School of Integrated Arts and Sciences, Hiroshima University, Higashi-Hiroshima, Hiroshima, Japan
| | - Mitsuo Hayashi
- grid.257022.00000 0000 8711 3200Integrated Arts and Human Sciences Program, Graduate School of Humanities and Social Sciences, Hiroshima University, Higashi-Hiroshima, Hiroshima, Japan
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Sivakumaran K, Ritonja JA, Palmer N, Pasumarthi T, Waseem H, Yu T, Denning A, Michaud D, Morgan RL. Effect of sleep disturbance on biomarkers related to the development of adverse health outcomes: A systematic review of the human literature. J Sleep Res 2022; 32:e13775. [PMID: 36330773 DOI: 10.1111/jsr.13775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 10/11/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Abstract
Literature suggests that unrestricted and undisturbed sleep is vital for basic human function and performance; however, it is unclear as to what amount of sleep disturbance leads to dysregulation in biomarkers, which may underscore the development of adverse health effects. This systematic review aims to identify the amount of sleep disturbance that contributes to biomarker changes as a potential precursor to the development of adverse health effects. English-language comparative studies available in PubMed, Cochrane Central, EMBASE, and CINAHL databases from 1 January 1980 to 31 July 2021 were searched. Where possible, random-effects meta-analyses were used to examine the effect of sleep disturbances on adverse health effects. The risk of bias of individual studies was assessed using the Cochrane Risk of Bias Tool and the Risk of Bias of Nonrandomised Studies - of Exposures instruments and the certainty of the body of evidence for each outcome was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. The search identified 92 primary studies reporting on blood pressure, hypertension, heart rate, cardiac arrhythmia, cardiac output, waist circumference, cortisol, adrenaline, noradrenaline, immune system markers, glucose, insulin, cholesterol, and triglyceride levels. Although some meta-analyses suggested there may be an association between sleep disturbances and certain outcomes, the certainty in the evidence was very low due to concerns with risk of bias, inconsistency across exposures, populations, and imprecision in the estimates of effects. Further research is needed to explore the point at which types, levels and duration of sleep disturbances may begin to increase the risk of developing adverse health outcomes to inform and tailor health interventions.
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Affiliation(s)
| | - Jennifer A. Ritonja
- Université de Montréal Hospital Research Centre (CRCHUM) Montreal Quebec Canada
- Department of Social and Preventive Medicine Université de Montréal Montreal Quebec Canada
| | | | - Tejanth Pasumarthi
- Evidence Foundation Cleveland Heights Ohio USA
- School of Interdisciplinary Science McMaster University Hamilton Ontario Canada
| | - Haya Waseem
- Evidence Foundation Cleveland Heights Ohio USA
| | - Tiffany Yu
- Evidence Foundation Cleveland Heights Ohio USA
- Faculty of Health Sciences McMaster University Hamilton Ontario Canada
| | - Allison Denning
- Health Canada, Environmental and Radiation Health Sciences Directorate Consumer & Clinical Radiation Protection Bureau Ottawa Ontario Canada
| | - David Michaud
- Health Canada, Environmental and Radiation Health Sciences Directorate Consumer & Clinical Radiation Protection Bureau Ottawa Ontario Canada
| | - Rebecca L. Morgan
- Evidence Foundation Cleveland Heights Ohio USA
- Department of Health Research Methods, Evidence and Impact McMaster University Hamilton Ontario Canada
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11
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Ayabe N, Nakajima S, Okajima I, Inada K, Yamadera W, Yamashita H, Tachimori H, Kamei Y, Takeshima M, Inoue Y, Mishima K. Development and validation of the Japanese version of the Hyperarousal Scale. BMC Psychiatry 2022; 22:617. [PMID: 36123639 PMCID: PMC9484233 DOI: 10.1186/s12888-022-04243-0] [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: 07/20/2021] [Accepted: 08/29/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The objectives of this study were to develop a Japanese version of the Hyperarousal Scale (HAS-J) and investigate its factor structure, reliability, and validity, as well as to calculate a cutoff score for the HAS-J and assess different levels of hyperarousal in insomnia patients and community dwellers. METHODS We recruited 224 outpatients receiving insomnia treatment (56.3% women; mean age 51.7 ± 15.6 years) and 303 community dwellers aged 20 years or older (57.8% women; mean age 43.9 ± 15.2 years). Exploratory and confirmatory factor analysis was performed to examine the factor structure of the HAS-J. Cronbach's α and McDonald's ω were then used to test internal consistency. To examine the scale's validity, we determined correlations between the HAS-J and other indexes and compared HAS-J scores between insomnia patients and community dwellers. We also compared HAS-J scores between two community-dweller groups (normal and poor sleepers) and two insomnia patient groups (with and without alleviation after treatment). RESULTS Following exploratory and confirmatory factor analysis, a 20-item measure emerged comprising three factors: "Introspectiveness and Reactivity," "Neuroticism," and "Insomnia." Confirmatory factor analysis showed a generally good fit for the model of the three-factor structure suggested by the exploratory factor analysis loadings (χ2 (163) = 327.423, (p < 0.001), CFI = 0.914, GFI = 0.872, AGFI = 0.835, RMSEA = 0.067). In insomnia patients, internal consistency indicated sufficient reliability of the HAS-J. Correlation analysis showed weak to moderate positive correlations of the HAS-J score with other indexes, indicating concurrent validity of the HAS-J. All HAS-J subscale scores were significantly higher in insomnia patients than in community dwellers. Additionally, the total score in patients with alleviation of insomnia was comparable to that in poor sleepers and significantly higher than that in normal sleepers. CONCLUSIONS This study demonstrated the reliability and validity of the HAS-J, indicating that it is useful as a clinical scale of hyperarousal. The high level of hyperarousal in insomnia patients who were assessed to be in remission by the Insomnia Severity Index suggests a risk of insomnia recurrence in these patients.
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Affiliation(s)
- Naoko Ayabe
- Department of Regional Studies and Humanities, Faculty of Education and Human Studies, Akita University, 1-1 Tegata-Gakuenmachi, Akita, 010-8502, Japan.,Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
| | - Shun Nakajima
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
| | - Isa Okajima
- Department of Psychological Counseling, Faculty of Humanities, Tokyo Kasei University, 1-18-1 Kaga, Itabashi-ku, Tokyo, 173-8602, Japan.,Japan Somnology Center, Institute of Neuropsychiatry, 1-24-10 Yoyogi, Shibuya-ku, Tokyo, 151-0053, Japan
| | - Ken Inada
- Department of Psychiatry, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan.,Department of Psychiatry, Kitasato University, School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0375, Japan
| | - Wataru Yamadera
- Department of Psychiatry, The Jikei University Katsushika Medical Center, 6-41-2 Aoto, Katsushika-ku, Tokyo, 125-8506, Japan
| | - Hidehisa Yamashita
- Minna no Sleep and Stress care Clinic, 2-1-2 Ushitahonmachi, Higashi-ku, Hiroshima-shi, Hiroshima, 732-0066, Japan
| | - Hisateru Tachimori
- Endowed Course for Health System Innovation, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.,Department of Clinical Data Science, Clinical Research & Education Promotion Division, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Yuichi Kamei
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan.,Kamisuwa Hospital, 1-17-1 Oote, Suwa, Nagano, 392-0026, Japan
| | - Masahiro Takeshima
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan
| | - Yuichi Inoue
- Japan Somnology Center, Institute of Neuropsychiatry, 1-24-10 Yoyogi, Shibuya-ku, Tokyo, 151-0053, Japan
| | - Kazuo Mishima
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan. .,Department of Neuropsychiatry, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan. .,International Institute for Integrative Sleep Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
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12
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A 1-year longitudinal study of the stress, sleep, and parenting of mothers of toddlers. Sleep Health 2022; 8:47-53. [PMID: 34620578 PMCID: PMC8821202 DOI: 10.1016/j.sleh.2021.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/20/2021] [Accepted: 08/23/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVES The present study, building on cross-sectional research showing links between mothers' sleep, stress, and parenting, used a longitudinal design to consider (1) the temporal direction of links between mothers' sleep and stress, (2) whether mother sleep deficits predict change in parenting across time, and (3) whether mother sleep deficits mediate the inverse association between stress and positive parenting. DESIGN The study used repeated measures of stress, mother sleep, and positive parenting at toddler ages 30, 36, and 42 months. SETTING Data were collected at 2 sites, one in the Midwest and one in the East. PARTICIPANTS Four hundred thirteen mother-toddler pairs were followed. Mothers were mostly married, college educated, and middle class, but there was also considerable variability between families. MEASUREMENTS Stress was measured via parenting hassles, CHAOS, and role overload scales. Mother sleep was measured via actigraphy. Positive parenting was observed during the bedtime routine and rated using the HOME scale and other items. RESULTS Mother stress and sleep were inextricably linked across toddlerhood, and worse sleep was predictive of less observed positive parenting, even when controlling for prior levels of stress and parenting. CONCLUSIONS Improving mothers' sleep may be important in efforts to improve their parenting.
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Strikwerda M, Beulens JW, Remmelzwaal S, Schoonmade LJ, van Straten A, Schram MT, Elders PJ, Rutters F. The Association of Burnout and Vital Exhaustion With Type 2 Diabetes: A Systematic Review and Meta-Analysis. Psychosom Med 2021; 83:1013-1030. [PMID: 34334726 DOI: 10.1097/psy.0000000000000995] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study aimed to investigate the association of burnout and vital exhaustion with measures of glycemic control and type 2 diabetes (T2D) in a systematic review and meta-analysis. METHODS PubMed, Embase, and PsycINFO were searched from inception to April 2, 2020. Data extraction and quality assessment were performed using the Effective Public Health Practice Project tool. When possible, results were meta-analyzed using random-effects models and rated using the Grading of Recommendations, Assessment, Development and Evaluation. RESULTS A total of 5317 titles/abstracts were screened, 140 articles were read full text, of which 29 studies were included. Eighteen studies were cross-sectional, three prospective and eight were case-control studies. Burnout and vital exhaustion were significantly associated with T2D, with a pooled odds ratio of 1.8 (95% confidence interval [CI] = 1.4 to 2.4, I2 = 79%; 9 studies). Glycated hemoglobin A1c levels were not significantly higher in people with burnout and vital exhaustion, compared to those without, with a pooled standardized mean difference of 0.35 (95% CI = -0.62 to 1.33, I2 = 98%; 7 studies). In addition, no differences in glucose levels were observed (standardized mean difference = 0.02, 95% CI = -0.26 to 0.30, I2 = 90%; 9 studies). Sensitivity analyses showed no decrease in heterogeneity when excluding studies with low quality (I2glucose = 89%) or studies with a study n < 40 population (I2T2D = 77%). The level of Grading of Recommendations, Assessment, Development and Evaluation evidence was moderate to low quality because of 18 studies having a cross-sectional design. CONCLUSIONS Burnout and vital exhaustion might be associated with a higher risk of T2D, but not with glycemic control. Methodological shortcomings and high heterogeneity of the studies included complicate the interpretation of our results.
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Affiliation(s)
- Marije Strikwerda
- From the Amsterdam UMC, location VUmc, Department of Epidemiology and Data Science (Strikwerda, Beulens, Remmelzwaal, Rutters), Amsterdam Public Health Research Institute (Strikweda, Beulens, Remmelzwaal, Elders); Julius Centre for Health Sciences and Primary Care (Beulens), University Medical Centre Utrecht, Utrecht; the University Library (Schoonmade), VU, Amsterdam; Faculty of Behavioural and Movement Sciences and Amsterdam Public Health Research Institute (van Straten), Vrije Universiteit, HV Amsterdam; Department of Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), MHeNS School for Mental Health and Neuroscience (Schram), Maastricht University Medical Center+, Maastricht; and Amsterdam UMC, location VUmc, Department of General Practice (Elders), Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
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14
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Begum N, Taylor JR, Brown C, Rajan J, Keevil B, Pye E, Rainey T, Jones A. Morning and evening salivary cortisol levels in patients with chronic widespread pain and those at high risk. Eur J Pain 2021; 26:197-206. [PMID: 34437747 DOI: 10.1002/ejp.1854] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 08/15/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Hypothalamic-Pituitary-Adrenal (HPA) axis dysregulation has been implicated in chronic widespread pain (CWP); the hallmark of fibromyalgia (FM). This is the first study to compare HPA axis changes in individuals with CWP and those at high risk of symptom development. METHODS We sought to determine differences in morning and evening salivary cortisol levels in FM (n = 19), those at-risk (n = 20) and pain-free controls (n = 17). Risk factors included non-CWP pain, somatic symptoms, illness behaviour and sleep disturbance. We conducted the study in the absence of centrally acting medication, to address limitations of previous research. RESULTS Repeated measures ANOVA revealed significant main effects of group (p = 0.003), and time of day (p = 0.002), with no significant interaction. Cortisol levels were higher in FM (p = 0.027) and at-risk (p = 0.003) groups, compared to controls, but there was no significant difference between FM and at-risk groups. The main effect of group remained significant with sleep problems (p = 0.021) and life events (p = 0.007), but was not significant with anxiety (p = 0.076) or depression (p = 0.098) scores as covariates. With sleep problems as a covariate, cortisol levels remained significantly higher only in the at-risk group (p = 0.017). CONCLUSIONS This study indicates elevated salivary cortisol in FM and those at high risk, and identifies anxiety, depression and sleep problems as potential contributing factors. The results shed light on the dynamic relationship between stress, mood and sleep disorders and the brain's resilience to pain. SIGNIFICANCE This study examines neurobiological changes in chronic widespread pain and high risk individuals. One strength of the study is the absence of centrally acting medication. We found high salivary cortisol common to Fibromyalgia and those at risk and identified contributing factors. Our results offer insight into the early mechanistic changes underlying Fibromyalgia development and open up possibilities for early diagnosis and prevention.
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Affiliation(s)
- Nayab Begum
- Division of Neuroscience and Experimental Psychology, Human Pain Research Group, University of Manchester, Manchester, UK
| | - Jason R Taylor
- Division of Neuroscience and Experimental Psychology, Human Pain Research Group, University of Manchester, Manchester, UK
| | - Christopher Brown
- Division of Neuroscience and Experimental Psychology, Human Pain Research Group, University of Manchester, Manchester, UK.,Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Jonathan Rajan
- Division of Neuroscience and Experimental Psychology, Human Pain Research Group, University of Manchester, Manchester, UK
| | - Brian Keevil
- Department of Clinical Biochemistry, University Hospital South Manchester NHS Foundation Trust, Manchester, UK
| | - Emily Pye
- Division of Neuroscience and Experimental Psychology, Human Pain Research Group, University of Manchester, Manchester, UK
| | - Timothy Rainey
- Division of Neuroscience and Experimental Psychology, Human Pain Research Group, University of Manchester, Manchester, UK
| | - Anthony Jones
- Division of Neuroscience and Experimental Psychology, Human Pain Research Group, University of Manchester, Manchester, UK
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15
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Zeng R, Jiang YT, Chen TW, Guo DD, Li R. Longitudinal associations of sleep duration and sleep quality with coronary heart disease risk among adult population: classical meta-analysis and Bayesian network meta-analysis. Sleep Biol Rhythms 2021; 19:265-276. [DOI: 10.1007/s41105-021-00312-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 01/15/2021] [Indexed: 12/18/2022]
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16
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Thumann BF, Buck C, De Henauw S, Hadjigeorgiou C, Hebestreit A, Lauria F, Lissner L, Molnár D, Moreno LA, Veidebaum T, Ahrens W, Hunsberger M. Cross-sectional associations between objectively measured sleep characteristics and body mass index in European children and adolescents. Sleep Med 2021; 84:32-39. [PMID: 34090011 DOI: 10.1016/j.sleep.2021.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 04/30/2021] [Accepted: 05/06/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Short sleep duration has been found to be associated with a higher risk for overweight and obesity. However, previous studies have mainly relied on subjective measures of sleep duration and other sleep characteristics (eg quality, timing) have often been neglected. Therefore, we aimed to investigate associations between several, mainly objectively measured sleep characteristics and body mass index (BMI). Further, we aimed to identify distinct sleep subtypes based on these sleep characteristics and to study their association with BMI. METHODS Children aged 9-16 years participating in the European I.Family study (N = 559, 51.2% girls, 32.9% overweight/obese) wore an accelerometer for one week on their wrist and recorded their daily wake-up and lights-off times in a sleep diary. Information on sleep duration, sleep efficiency and sleep latency was derived. To identify sleep subtypes, we conducted a latent class analysis using all five sleep variables. Associations between single sleep variables, sleep subtype and age- and sex-specific BMI z-score were investigated using linear mixed-effects regression models to accommodate clustering among siblings. RESULTS No statistically significant associations were observed between the single sleep variables (sleep duration, sleep efficiency, sleep latency, wake-up and lights-off times) and BMI z-score. Four sleep subtypes were identified and children were assigned to one of the groups based on their highest probability for latent group membership: "early birds" (17.5% of the sample), "short sleep duration" (14.7%), "optimal sleep" (47.6%) and "poor sleep quality" (20.2%). Sleep subtype was not associated with BMI z-score. CONCLUSIONS Using objective sleep data, we did not find convincing evidence for associations between the sleep variables under investigation and BMI.
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Affiliation(s)
- Barbara F Thumann
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359 Bremen, Germany; Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 4K3, 9000 Ghent, Belgium; Faculty of Mathematics and Computer Science, University of Bremen, Bibliothekstr. 1, 28359 Bremen, Germany; Munich Center for the Economics of Ageing, Max Planck Institute for Social Law and Social Policy, Amalienstr. 33, 80799 Munich, Germany
| | - Christoph Buck
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359 Bremen, Germany
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 4K3, 9000 Ghent, Belgium
| | | | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359 Bremen, Germany
| | - Fabio Lauria
- Institute of Food Sciences, National Research Council, Via Roma 64, 83100 Avellino, Italy
| | - Lauren Lissner
- School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Box 453, 40530 Gothenburg, Sweden
| | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, József Attila u. 7, 7623 Pécs, Hungary
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009 Zaragoza, Spain
| | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Hiiu str. 42, 11619 Tallinn, Estonia
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359 Bremen, Germany; Faculty of Mathematics and Computer Science, University of Bremen, Bibliothekstr. 1, 28359 Bremen, Germany.
| | - Monica Hunsberger
- School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Box 453, 40530 Gothenburg, Sweden
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17
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Azfar HS, Dzhusupov KO, Orru H, Nordin S, Nordin M, Orru K. Cardiovascular Disease and Mental Distress Among Ethnic Groups in Kyrgyzstan. Front Public Health 2021; 9:489092. [PMID: 34017812 PMCID: PMC8129164 DOI: 10.3389/fpubh.2021.489092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 03/17/2021] [Indexed: 11/24/2022] Open
Abstract
The purpose of this study was to characterize different ethnic groups in Kyrgyzstan regarding cardiovascular disease (CVD) and mental distress, and to investigate the association between CVD and mental distress. The mental distress was measured in terms of sleep disturbance, burnout, and stress. Materials and Methods: A cross-sectional study was carried out among six ethnic groups in Kyrgyzstan, aged 18 years and above. The sample was stratified for age, education, family status, and income. We used the Karolinska Sleep Questionnaire to assess sleep disturbance, the physical and emotional subscale of the Shirom Melamed Burnout Questionnaire to assess burnout, and the 10-item Perceived Stress Scale to assess perceived stress. Results: The distribution of CVD differed significantly between the six ethnic groups, with higher prevalence among East Europeans, and Western Asians and lower among Other minorities and Central Asians. In all ethnic groups in Kyrgyzstan, individuals with CVD had increased odds of sleep disturbance and burnout. There was a significant difference in burnout and stress between persons with and without CVD in Kyrgyz and East European ethnic groups. Conclusion: There was a significant difference in burnout and stress between persons with and without CVD in Kyrgyz and East European ethnic groups. In addition to CVD prevention, mitigating sleep disturbance and preventing burnout in the general population should be aimed at in public health measures.
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Affiliation(s)
- Hossain Syed Azfar
- Department of Family Medicine, International School of Medicine, Bishkek, Kyrgyzstan
| | - Kenesh O Dzhusupov
- Department of Public Health, International School of Medicine, Bishkek, Kyrgyzstan
| | - Hans Orru
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.,Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Steven Nordin
- Department of Psychology, Umeå University, Umeå, Sweden
| | - Maria Nordin
- Department of Psychology, Umeå University, Umeå, Sweden
| | - Kati Orru
- Institute of Social Studies, University of Tartu, Tartu, Estonia
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Cortese R, Khalyfa A, Bao R, Gozal D. Gestational sleep apnea perturbations induce metabolic disorders by divergent epigenomic regulation. Epigenomics 2021; 13:751-765. [PMID: 33929266 DOI: 10.2217/epi-2020-0435] [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] [Indexed: 11/21/2022] Open
Abstract
Aim: Late-gestational sleep fragmentation (LG-SF) and intermittent hypoxia (LG-IH), two hallmarks of obstructive sleep apnea, lead to metabolic dysfunction in the offspring. We investigated specific biological processes that are epigenetically regulated by LG-SF and LG-IH. Materials & methods: We analyzed DNA methylation profiles in offspring visceral white adipose tissues by MeDIP-chip followed by pathway analysis. Results: We detected 1187 differentially methylated loci (p < 0.01) between LG-SF and LG-IH. Epigenetically regulated genes in LG-SF offspring were associated with lipid and glucose metabolism, whereas those in LG-IH were related to inflammatory signaling and cell proliferation. Conclusion: While LG-SF and LG-IH will result in equivalent phenotypic alterations in offspring, each paradigm appears to operate through epigenetic regulation of different biological processes.
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Affiliation(s)
- Rene Cortese
- Department of Child Health, Child Health Research Institute, School of Medicine, University of Missouri, Columbia, MO 65212, USA
| | - Abdelnaby Khalyfa
- Department of Child Health, Child Health Research Institute, School of Medicine, University of Missouri, Columbia, MO 65212, USA
| | - Riyue Bao
- Hillman Cancer Center, UPMC, Pittsburgh, PA 15232, USA
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - David Gozal
- Department of Child Health, Child Health Research Institute, School of Medicine, University of Missouri, Columbia, MO 65212, USA
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Chauvineau M, Pasquier F, Guyot V, Aloulou A, Nedelec M. Effect of the Depth of Cold Water Immersion on Sleep Architecture and Recovery Among Well-Trained Male Endurance Runners. Front Sports Act Living 2021; 3:659990. [PMID: 33870188 PMCID: PMC8044518 DOI: 10.3389/fspor.2021.659990] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/01/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: The aim of the present study was to investigate the effect of the depth of cold water immersion (CWI) (whole-body with head immersed and partial-body CWI) after high-intensity, intermittent running exercise on sleep architecture and recovery kinetics among well-trained runners. Methods: In a randomized, counterbalanced order, 12 well-trained male endurance runners ( V . O2max = 66.0 ± 3.9 ml·min-1·kg-1) performed a simulated trail (≈18:00) on a motorized treadmill followed by CWI (13.3 ± 0.2°C) for 10 min: whole-body immersion including the head (WHOLE; n = 12), partial-body immersion up to the iliac crest (PARTIAL; n = 12), and, finally, an out-of-water control condition (CONT; n = 10). Markers of fatigue and muscle damage-maximal voluntary isometric contraction (MVIC), countermovement jump (CMJ), plasma creatine kinase [CK], and subjective ratings-were recorded until 48 h after the simulated trail. After each condition, nocturnal core body temperature (T core) was measured, whereas sleep and heart rate variability were assessed using polysomnography. Results: There was a lower T core induced by WHOLE than CONT from the end of immersion to 80 min after the start of immersion (p < 0.05). Slow-wave sleep (SWS) proportion was higher (p < 0.05) during the first 180 min of the night in WHOLE compared with PARTIAL. WHOLE and PARTIAL induced a significant (p < 0.05) decrease in arousal for the duration of the night compared with CONT, while only WHOLE decreased limb movements compared with CONT (p < 0.01) for the duration of the night. Heart rate variability analysis showed a significant reduction (p < 0.05) in RMSSD, low frequency (LF), and high frequency (HF) in WHOLE compared with both PARTIAL and CONT during the first sequence of SWS. No differences between conditions were observed for any markers of fatigue and muscle damage (p > 0.05) throughout the 48-h recovery period. Conclusion: WHOLE reduced arousal and limb movement and enhanced SWS proportion during the first part of the night, which may be particularly useful in the athlete's recovery process after exercise. Future studies are, however, required to assess whether such positive sleep outcomes may result in overall recovery optimization.
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Affiliation(s)
- Maxime Chauvineau
- Laboratory of Sport, Expertise and Performance (EA 7370), French National Institute of Sport (INSEP), Paris, France
| | - Florane Pasquier
- Laboratory of Sport, Expertise and Performance (EA 7370), French National Institute of Sport (INSEP), Paris, France
| | - Vincent Guyot
- Laboratory of Sport, Expertise and Performance (EA 7370), French National Institute of Sport (INSEP), Paris, France
| | - Anis Aloulou
- Laboratory of Sport, Expertise and Performance (EA 7370), French National Institute of Sport (INSEP), Paris, France
| | - Mathieu Nedelec
- Laboratory of Sport, Expertise and Performance (EA 7370), French National Institute of Sport (INSEP), Paris, France
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Azza Y, Grueschow M, Karlen W, Seifritz E, Kleim B. How stress affects sleep and mental health: nocturnal heart rate increases during prolonged stress and interacts with childhood trauma exposure to predict anxiety. Sleep 2021; 43:5682806. [PMID: 31863098 DOI: 10.1093/sleep/zsz310] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 10/17/2019] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES Stress can adversely impact sleep health by eliciting arousal increase and a cascade of endocrine reactions that may impair sleep. To date, little is known regarding continuous effects of real-world stress on physiological sleep characteristics and potential effects on stress-related psychopathology. We examined effects of stress on heart rate (HR) during sleep and total sleep time (TST) during prolonged real-world stress exposure in medical interns. Moreover, we investigated the influence of previous stress and childhood trauma exposure on HR during sleep, TST, and its interaction in predicting anxiety. METHODS We examined a sample of 50 medical students prior to and during their first internship, a well described real-world stressor. HR and TST were continuously collected over 12 weeks non-invasively by a wrist-worn activity monitor. Prior to starting the internship, at baseline, participants reported on their sleep, anxiety, and childhood trauma exposure. They also tracked stress exposure during internship and reported on their anxiety symptoms 3 months after this professional stress. RESULTS Mean HR during sleep increased over time, while TST remained unchanged. This effect was more pronounced in interns exposed to childhood trauma exposure. In multilevel models, childhood trauma exposure also moderated the relation between individual HR increase and development of anxiety. CONCLUSIONS Prolonged stress may lead to increased HR during sleep, whereas individuals with childhood trauma exposure are more vulnerable. Childhood trauma exposure also moderated the relation between individual HR increase and development of anxiety. These findings may inform prevention and intervention measures.
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Affiliation(s)
- Yasmine Azza
- Department of Psychology, University of Zurich, Zurich, Switzerland.,Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Sleep & Health Zürich, University of Zurich, Zurich, Switzerland
| | - Marcus Grueschow
- Zurich Center for Neuroeconomics, Department of Economics, University of Zurich, Zurich, Switzerland
| | - Walter Karlen
- Mobile Health Systems Lab, Institute of Robotics and Intelligent Systems, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Sleep & Health Zürich, University of Zurich, Zurich, Switzerland
| | - Birgit Kleim
- Department of Psychology, University of Zurich, Zurich, Switzerland.,Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Sleep & Health Zürich, University of Zurich, Zurich, Switzerland
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21
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Gaffey AE, Schwartz JE, Harris KM, Hall MH, Burg MM. Effects of ambulatory blood pressure monitoring on sleep in healthy, normotensive men and women. Blood Press Monit 2021; 26:93-101. [PMID: 33136653 PMCID: PMC7933045 DOI: 10.1097/mbp.0000000000000494] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To determine the effect of ambulatory blood pressure monitoring (ABPM) on sleep quality among healthy adults and to explore possible effect modification by demographics. METHODS We examined data from 192 relatively healthy young (median age: 31; 33% men, 18% with clinic BP >130/80 mmHg) participants in an observational study of sleep and arterial stiffness. Demographic/health questionnaires were completed. A wrist-based accelerometer assessed sleep for seven nights, and sleep duration, wakefulness after sleep onset (WASO), fragmentation (physical restlessness), midpoint, and efficiency were estimated. ABPM was conducted for one 36-h period, including one actigraphy night. RESULTS Within-subject comparisons indicated that WASO and fragmentation were higher, midpoint was later, and efficiency was lower on the ABPM night (Ps < 0.001-0.038). Neither age nor sex moderated these associations. Among older adults, a later midpoint and worse fragmentation were observed with ABPM (Ps = 0.002-0.010). There was also a main effect of sex: men demonstrated shorter sleep duration, greater WASO and fragmentation, and less efficiency than women (Ps = 0.002-0.046). With ABPM, women had worse fragmentation and a later midpoint (Ps = 0.002-0.049); for men, WASO and fragmentation were worse (Ps = 0.003-0.023). Importantly, this study does not address whether the effect of wearing ABPM on sleep in turn affects BP during sleep. CONCLUSIONS ABPM appears to modestly disturb actigraphy-assessed sleep among healthy adults. Researchers and clinicians should consider the downstream effects of performing ABPM and whether these effects are more pronounced in those who typically experience sleep disturbance.
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Affiliation(s)
- Allison E. Gaffey
- Department of Internal Medicine (Cardiovascular Medicine), Yale School of Medicine, New Haven, CT
- VA Connecticut Healthcare System, West Haven, CT
| | - Joseph E. Schwartz
- Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, NY
- Department of Medicine, Columbia University, New York, NY
| | - Kristie M. Harris
- Department of Internal Medicine (Cardiovascular Medicine), Yale School of Medicine, New Haven, CT
- VA Connecticut Healthcare System, West Haven, CT
| | - Martica H. Hall
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Matthew M. Burg
- Department of Internal Medicine (Cardiovascular Medicine), Yale School of Medicine, New Haven, CT
- VA Connecticut Healthcare System, West Haven, CT
- Department of Anesthesiology, Yale School of Medicine, New Haven, CT
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22
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Automatic wavelet-based assessment of behavioral sleep using multichannel electrocorticography in rats. Sleep Breath 2021; 25:2251-2258. [PMID: 33768413 DOI: 10.1007/s11325-021-02357-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/11/2021] [Accepted: 03/19/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE During the last decade, the reported prevalence of sleep-disordered breathing in adults has been rapidly increasing. Therefore, automatic methods of sleep assessment are of particular interest. In a framework of translational neuroscience, this study introduces a reliable automatic detection system of behavioral sleep in laboratory rats based on the signal recorded at the cortical surface without requiring electromyography. METHODS Experimental data were obtained in 16 adult male WAG/Rij rats at the age of 9 months. Electrocorticographic signals (ECoG) were recorded in freely moving rats during the entire day (22.5 ± 2.2 h). Automatic wavelet-based assessment of behavioral sleep (BS) was proposed. The performance of this wavelet-based method was validated in a group of rats with genetic predisposition to absence epilepsy (n=16) based on visual analysis of their behavior in simultaneously recorded video. RESULTS The accuracy of automatic sleep detection was 98% over a 24-h period. An automatic BS assessment method can be adjusted for detecting short arousals during sleep (microarousals) with various duration. CONCLUSIONS These findings suggest that automatic wavelet-based assessment of behavioral sleep can be used for assessment of sleep quality. Current analysis indicates a temporal relationship between microarousals, sleep, and epileptic discharges in genetically prone subjects.
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23
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Deater-Deckard K, Chary M, McQuillan ME, Staples AD, Bates JE. Mothers' sleep deficits and cognitive performance: Moderation by stress and age. PLoS One 2021; 16:e0241188. [PMID: 33411778 PMCID: PMC7790244 DOI: 10.1371/journal.pone.0241188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 10/10/2020] [Indexed: 11/18/2022] Open
Abstract
There are well-known associations between stress, poor sleep, and cognitive deficits, but little is known about their interactive effects, which the present study explored in a sample of mothers of toddlers. Since certain types of cognitive decline start during the 20s and continue into later ages, we also explored whether mothers’ age interacted with stress and sleep in the prediction of cognitive functioning. We hypothesized that poorer sleep [measured using one week of 24-hour wrist actigraphy data] and having more chronic stressors [e.g., life events, household chaos, work/family role conflict] would be linked with poorer cognitive performance [both executive function and standardized cognitive ability tasks], and that the interactive combination of poorer sleep and more stressors would account for the effect. We also explored whether this process operated differently for younger versus older women. In a socioeconomically and geographically diverse community sample of 227 women with toddler-age children [age, M = 32.73 yrs, SD = 5.15 yrs], poorer cognitive performance was predicted by greater activity during the sleep period, shorter sleep duration, and lower night-to-night consistency in sleep; it was not associated with higher levels of stress. The interactive effects hypothesis was supported for sleep activity [fragmented sleep] and sleep timing [when mothers went to bed]. The combination of more exposure to stressors and frequent night waking was particularly deleterious for older women’s performance. For younger women, going to bed late was associated with poorer performance if they were experiencing high levels of stress; for those experiencing low levels of stress, going to bed late was associated with better performance.
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Affiliation(s)
- Kirby Deater-Deckard
- University of Massachusetts at Amherst, Amherst, Massachusetts, United States of America
| | - Mamatha Chary
- University of Massachusetts at Amherst, Amherst, Massachusetts, United States of America
- * E-mail:
| | - Maureen E. McQuillan
- Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Angela D. Staples
- Eastern Michigan University, Ypsilanti, Michigan, United States of America
| | - John E. Bates
- Indiana University, Bloomington, Indiana, United States of America
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24
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Gu M, Huang W, Li X, Liu Y, Wang F, Fang C, Chen T. Association of Hypertriglyceridemic Waist Phenotype with Obstructive Sleep Apnea: A Cross-Sectional Study. Nat Sci Sleep 2021; 13:2165-2173. [PMID: 34955662 PMCID: PMC8694710 DOI: 10.2147/nss.s335288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 12/06/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Hypertriglyceridemic waist (HTGW) phenotype is an independent risk factor for metabolic disorders. Although obstructive sleep apnea (OSA) is associated with metabolic disorders, it is unclear whether there is an association between HTGW phenotype and OSA. METHODS We enrolled consecutive participants presenting to a sleep center in Shanghai, China. Full-night polysomnography was performed, and serum triglyceride (TG) levels and waist circumference (WC) were calculated. HTGW phenotype was defined as increased WC (men > 90 cm, women > 80 cm) and elevated TG levels (> 1.7 mmol/L). Participants were classified into four groups: normal TG with normal WC (NTNW); normal TG with increased WC (NTGW); elevated TG with normal WC (HTNW); and elevated TG with enlarged WC, namely HTGW. The relationships between HTGW phenotypes and OSA were assessed using binary (apnea hypopnea index, [AHI]≥5/hr) and multinomial logistic regression analyses (clinical AHI severity categories). RESULTS We included 3190 participants in this cross-sectional study. Compared to the NTNW phenotype, participants with NTGW and HTGW phenotypes had the significantly higher risk of OSA (AHI ≥5/hr, odds ratio [OR] = 2.51, 95% confidence interval [CI] = 1.91-3.31; OR = 3.76, 95% CI = 2.67-5.31, respectively), after adjustment for confounders. In subgroup analyses categorised by age, sex, and BMI, the aforementioned associations remained significant. The association between the NTGW, HTGW phenotype and OSA risk remained significant across the OSA severity groups. Multinomial logistic regression also revealed that the mild (OR = 1.63, 95% CI = 1.07-2.50), moderate (OR = 1.875, 95% CI = 1.22-2.88), and severe OSA (OR = 3.18, 95% CI = 2.14-4.73) were associated with HTGW phenotype. CONCLUSION Both NTGW and HTGW phenotype were positively associated with OSA risk in all subgroups. Further longitudinal follow-up studies are needed to determine the causal link and prognostic role of these metabolic factors.
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Affiliation(s)
- Meizhen Gu
- Department of Otolaryngology-Head & Neck Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China
| | - Weijun Huang
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China.,Department of Otolaryngology Head & Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Xinyi Li
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China.,Department of Otolaryngology Head & Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Yupu Liu
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China.,Department of Otolaryngology Head & Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Fan Wang
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China.,Department of Otolaryngology Head & Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Chao Fang
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China.,Department of Otolaryngology-Head & Neck Surgery, The First Hospital of Putian, Putian, Fujian Province, People's Republic of China
| | - Ting Chen
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China.,Department of Stomatology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
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25
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Sjörs Dahlman A, Jonsdottir IH, Hansson C. The hypothalamo-pituitary-adrenal axis and the autonomic nervous system in burnout. HANDBOOK OF CLINICAL NEUROLOGY 2021; 182:83-94. [PMID: 34266613 DOI: 10.1016/b978-0-12-819973-2.00006-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Burnout constitutes a serious health concern in the modern working environment. It is a stress-related condition that has developed as a result of a prolonged psychosocial stress exposure causing a persistent mismatch between demands and resources. The main symptom is emotional exhaustion, but physical fatigue, diminished professional efficacy, cynicism, and cognitive impairments are also associated with this condition. Burnout has been used both as a psychologic term in occupational settings and as a clinical diagnosis in patient populations, and there is currently no universally accepted definition and diagnostic criteria of burnout. It has been hypothesized that the two main stress response systems, the autonomic nervous system (ANS) and the hypothalamus-pituitary-adrenal axis (HPA axis), are involved in the pathogenesis of burnout. A common hypothesis is that in the early stages of chronic stress, the HPA axis and sympathetic ANS activity tend to be higher, while it will decrease with a longer duration of chronic stress to ultimately reach a state of hypoactivity in clinical burnout. The current research in this field shows many contradictory results. Thus there is no compelling evidence of either ANS or HPA dysfunction in burnout. However, there is partial support for the hypothesis of HPA and sympathetic hyperactivity in early stages, and HPA hyporeactivity and low vagal activity in more severe burnout cases, but high-quality studies investigating the causal links are still lacking.
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Affiliation(s)
- Anna Sjörs Dahlman
- Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden; Human Factors Department, Swedish National Road and Transport Research Institute, Gothenburg, Sweden.
| | - Ingibjörg H Jonsdottir
- Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden; School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Caroline Hansson
- Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
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26
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Hashimoto Y, Sakai R, Ikeda K, Fukui M. Association between sleep disorder and quality of life in patients with type 2 diabetes: a cross-sectional study. BMC Endocr Disord 2020; 20:98. [PMID: 32605640 PMCID: PMC7325681 DOI: 10.1186/s12902-020-00579-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 06/16/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND We investigated the association between sleep symptoms, which cause sleep disorder, and quality of life (QoL) among people with type 2 diabetes (T2D). METHODS In this cross-sectional study of 342 people with T2D, the Japan National Health and Wellness Survey (NHWS) database 2016 were used. We treated the respondents who reported experiencing any of the sleep symptoms as having sleep disorders. To examine health-related QoL (HRQoL), we used the physical component summary (PCS) and the mental component summary (MCS) from the 36-Item short-form and the EuroQol 5 Dimension (EQ-5D) survey instruments. Overall activity impairment was used for assessment of the effect on the individual's ability to perform regular daily activities. We used t-test and one-way ANOVA test for comparison QoL scores between the participants with and without sleep disorders. RESULTS 66.4% of the participants with T2D reported having a sleep disorder. The PCS, MCS, EQ-5D, and overall activity impairment of people with sleep disorder was significantly poorer than those of the people without. Specific sleep symptoms, such as waking up to go to the bathroom, daytime sleepiness, and waking up too early (before the alarm clock), had high prevalence (35.4, 27.8 and 20.2%). The participants who experienced waking up to go to the bathroom or daytime sleepiness demonstrated significantly poorer QoL on all scores related to QoL, but those who experienced waking up too early only demonstrated significantly poorer QoL on the EQ-5D. CONCLUSIONS Two-thirds of people with T2D in this study suffer from sleep disorders. The people who experience waking up to go to the bathroom or daytime sleepiness had significantly poorer QoL than those without these symptoms. Thus, sleep disorders, especially the symptoms of waking up to go to the bathroom or daytime sleepiness, might be the treatment targets for QOL of people with T2DM.
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Affiliation(s)
- Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Ryosuke Sakai
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Kenichiro Ikeda
- Product Branding, Product Marketing Department, Kowa Company, Ltd., Tokyo, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
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27
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Korostovtseva L, Alieva A, Rotar O, Bochkarev M, Boyarinova M, Sviryaev Y, Konradi A, Shlyakhto E. Sleep Duration, Lipid Profile and Insulin Resistance: Potential Role of Lipoprotein(a). Int J Mol Sci 2020; 21:E4680. [PMID: 32630105 PMCID: PMC7369827 DOI: 10.3390/ijms21134680] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/22/2020] [Accepted: 06/28/2020] [Indexed: 11/29/2022] Open
Abstract
Lipoprotein (a) (Lp(a)) is considered a genetic factor for cardiovascular disease playing an important role in atherogenesis and thrombosis, but the evidence about its association with sleep duration is controversial. We evaluated the relation between self-reported sleep duration and Lp(a). Among 1600 participants of the population-based sample, we selected 1427 subjects without previously known cardiovascular events, who answered the questions about their sleep duration; had valid lipid profile results (total cholesterol, low- and high-density lipoproteins, Lp(a), apolipoprotein AI (ApoAI), ApoB, and ApoB/ApoAI); and did not take lipid-lowering drugs (mean age 46 ± 12 years). We performed a structured interview, which included questions about lifestyle, medical history, complaints, and sleep duration (How long have you been sleeping per night during the last month?). Sleep duration was classified as follows: <6 h/night-short, 6-9 h/night-normal, and ≥10 h/night-long. Overall, 73 respondents (5.2%) were short-sleepers and 69 (4.8%) long-sleepers. Males were slightly more prevalent among short-sleepers. The groups matched by age, body mass index, blood pressure, diabetes mellitus, and hypertension rate. Short-sleepers had lower rates of high total cholesterol (≥5.0 mmol/L), lower Lp(a) levels and lower rates of increased Lp(a) ≥0.5 g/L, and higher insulin and insulin resistance (assessed by the homeostatic model assessment for insulin resistance (HOMA-IR)). ApoAI, ApoB, their ratio, and other lab tests were similar in the groups. The multinomial logistic regression demonstrated that only the short sleep duration was independently (odds ratio (OR) 0.29, 95% confidence interval (CI) (0.09-0.91), p = 0.033) associated with Lp(a) (χ2 = 41.58, p = 0.003). Other influencing factors were smoking and HOMA-IR. Such an association was not found for long-sleepers. In conclusion, a short-sleep duration is associated with Lp(a). The latter might mediate the higher insulin resistance and higher cardiometabolic risks in short-sleepers.
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Affiliation(s)
- Lyudmila Korostovtseva
- Almazov National Medical Research Centre, St Petersburg 197341, Russia; (A.A.); (O.R.); (M.B.); (M.B.); (Y.S.); (A.K.); (E.S.)
| | - Asiiat Alieva
- Almazov National Medical Research Centre, St Petersburg 197341, Russia; (A.A.); (O.R.); (M.B.); (M.B.); (Y.S.); (A.K.); (E.S.)
| | - Oxana Rotar
- Almazov National Medical Research Centre, St Petersburg 197341, Russia; (A.A.); (O.R.); (M.B.); (M.B.); (Y.S.); (A.K.); (E.S.)
| | - Mikhail Bochkarev
- Almazov National Medical Research Centre, St Petersburg 197341, Russia; (A.A.); (O.R.); (M.B.); (M.B.); (Y.S.); (A.K.); (E.S.)
| | - Maria Boyarinova
- Almazov National Medical Research Centre, St Petersburg 197341, Russia; (A.A.); (O.R.); (M.B.); (M.B.); (Y.S.); (A.K.); (E.S.)
| | - Yurii Sviryaev
- Almazov National Medical Research Centre, St Petersburg 197341, Russia; (A.A.); (O.R.); (M.B.); (M.B.); (Y.S.); (A.K.); (E.S.)
- Sechenov Institute of Evolutionary Physiology and Biochemistry of RAS, St Petersburg 194223, Russia
| | - Aleksandra Konradi
- Almazov National Medical Research Centre, St Petersburg 197341, Russia; (A.A.); (O.R.); (M.B.); (M.B.); (Y.S.); (A.K.); (E.S.)
- Institute of Translational Medicine, ITMO University, St Petersburg 197101, Russia
| | - Eugene Shlyakhto
- Almazov National Medical Research Centre, St Petersburg 197341, Russia; (A.A.); (O.R.); (M.B.); (M.B.); (Y.S.); (A.K.); (E.S.)
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Vallat R, Shah VD, Redline S, Attia P, Walker MP. Broken sleep predicts hardened blood vessels. PLoS Biol 2020; 18:e3000726. [PMID: 32497046 PMCID: PMC7271997 DOI: 10.1371/journal.pbio.3000726] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 04/27/2020] [Indexed: 12/18/2022] Open
Abstract
Why does poor-quality sleep lead to atherosclerosis? In a diverse sample of over 1,600 individuals, we describe a pathway wherein sleep fragmentation raises inflammatory-related white blood cell counts (neutrophils and monocytes), thereby increasing atherosclerosis severity, even when other common risk factors have been accounted for. Improving sleep quality may thus represent one preventive strategy for lowering inflammatory status and thus atherosclerosis risk, reinforcing public health policies focused on sleep health. Why does poor quality sleep correlate with cardiovascular disease? A large population-based study suggests that fragmented sleep contributes to atherosclerosis in humans by increasing inflammatory-related activity of white blood cells.
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Affiliation(s)
- Raphael Vallat
- Center for Human Sleep Science, Department of Psychology, University of California, Berkeley, California, United States of America
| | - Vyoma D. Shah
- Center for Human Sleep Science, Department of Psychology, University of California, Berkeley, California, United States of America
| | - Susan Redline
- Department of Medicine, Brigham and Women’s Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Peter Attia
- Attia Medical, PC, San Diego and New York City, United States of America
| | - Matthew P. Walker
- Center for Human Sleep Science, Department of Psychology, University of California, Berkeley, California, United States of America
- * E-mail:
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29
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Doyle CY, Ruiz JM, Taylor DJ, Smyth JW, Flores M, Dietch J, Ahn C, Allison M, Smith TW, Uchino BN. Associations Between Objective Sleep and Ambulatory Blood Pressure in a Community Sample. Psychosom Med 2020; 81:545-556. [PMID: 31083055 PMCID: PMC6607429 DOI: 10.1097/psy.0000000000000711] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Epidemiologic data increasingly support sleep as a determinant of cardiovascular disease risk. Fewer studies have investigated the mechanisms underlying this relationship using objective sleep assessment approaches. Therefore, the aim of this study was to examine associations between daily blood pressure (BP) and both objectively assessed sleep duration and efficiency. METHODS A diverse community sample of 300 men and women aged 21 to 70 years, enrolled in the North Texas Heart Study, participated in the study. Actigraphy-assessed sleep was monitored for two consecutive nights with ambulatory BP sampled randomly within 45-minute blocks on the first and second day as well as the second night. RESULTS Overall, sleep duration results paralleled those of sleep efficiency. Individuals with lower sleep efficiency had higher daytime systolic (B = -0.35, SE = 0.11, p = .0018, R = 0.26) but not diastolic BP (B = -0.043, SE = 0.068, p = .52, R = 0.17) and higher nighttime BP (systolic: B = -0.37, SE = 0.10, p < .001, R = .15; diastolic: B = -0.20, SE = 0.059, p < .001, R = .14). Moreover, lower sleep efficiency on one night was associated with higher systolic (B = -0.51, SE = 0.11, p < .001, R = 0.23) and diastolic BP (B = -0.17, SE = 0.065, p = .012, R = .16) the following day. When 'asleep' BP was taken into account instead of nighttime BP, the associations between sleep and BP disappeared. When both sleep duration and efficiency were assessed together, sleep efficiency was associated with daytime systolic BP, whereas sleep duration was associated with nighttime BP. CONCLUSIONS Lower sleep duration and efficiency are associated with higher daytime systolic BP and higher nighttime BP when assessed separately. When assessed together, sleep duration and efficiency diverge in their associations with BP at different times of day. These results warrant further investigation of these possible pathways to disease.
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Affiliation(s)
| | | | | | | | | | | | - Chul Ahn
- University of Texas Southwestern Medical Center
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30
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Nocturnal swallowing augments arousal intensity and arousal tachycardia. Proc Natl Acad Sci U S A 2020; 117:8624-8632. [PMID: 32229567 DOI: 10.1073/pnas.1907393117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Cortical arousal from sleep is associated with autonomic activation and acute increases in heart rate. Arousals vary considerably in their frequency, intensity/duration, and physiological effects. Sleep and arousability impact health acutely (daytime cognitive function) and long-term (cardiovascular outcomes). Yet factors that modify the arousal intensity and autonomic activity remain enigmatic. In this study of healthy human adults, we examined whether reflex airway defense mechanisms, specifically swallowing or glottic adduction, influenced cardiac autonomic activity and cortical arousal from sleep. We found, in all subjects, that swallows trigger rapid, robust, and patterned tachycardia conserved across wake, sleep, and arousal states. Tachycardia onset was temporally matched to glottic adduction-the first phase of swallow motor program. Multiple swallows increase the magnitude of tachycardia via temporal summation, and blood pressure increases as a function of the degree of tachycardia. During sleep, swallows were overwhelmingly associated with arousal. Critically, swallows were causally linked to the intense, prolonged cortical arousals and marked tachycardia. Arousal duration and tachycardia increased in parallel as a function of swallow incidence. Our findings suggest that cortical feedback and tachycardia are integrated responses of the swallow motor program. Our work highlights the functional influence of episodic, involuntary airway defense reflexes on sleep and vigilance and cardiovascular function in healthy individuals.
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Gutiérrez-Carrasquilla L, López-Cano C, Sánchez E, Barbé F, Dalmases M, Hernández M, Campos A, Gaeta AM, Carmona P, Hernández C, Simó R, Lecube A. Effect of Glucose Improvement on Nocturnal Sleep Breathing Parameters in Patients with Type 2 Diabetes: The Candy Dreams Study. J Clin Med 2020; 9:jcm9041022. [PMID: 32260419 PMCID: PMC7230160 DOI: 10.3390/jcm9041022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/24/2020] [Accepted: 04/01/2020] [Indexed: 12/16/2022] Open
Abstract
Type 2 diabetes exerts a negative impact on sleep breathing. It is unknown whether a long-term improvement in glycemic control ameliorates this effect. We conducted an interventional study with 35 patients with type 2 diabetes and obstructive sleep apnea (OSA) to explore this. At home, sleep breathing parameters were assessed at baseline and after a 4-month period in which antidiabetic therapy was intensified. Patients who decreased their body mass index ≥2kg/m2 were excluded. Those with an HbA1c reduction ≥0.5% were considered good responders (n = 24). After the follow-up, good responders exhibited an improvement in the apnea–hypopnea index (AHI: 26-1 (95% IC: 8.6–95.0) vs. 20.0 (4.0–62.4) events/hour, p = 0.002) and in time with oxygen saturation below 90% (CT90: 13.3 (0.4–69.0) vs. 8.1 (0.4–71.2) %, p = 0.002). No changes were observed in the group of non–responders (p = 0.722 and p = 0.138, respectively). The percentage of moderate and severe OSA decreased among good responders (p = 0.040). In the wider population, the change in HbA1c correlated positively to decreases in AHI (r = 0.358, p = 0.035) and negatively to increases in the minimum arterial oxygen saturation (r = −0.386, p = 0.039). Stepwise multivariate regression analysis showed that baseline AHI and the absolute change in HbA1c independently predicted decreased AHI (R2 = 0.496). The improvement of glycemic control exerts beneficial effects on sleep breathing parameters in type 2 diabetes, which cannot be attributed merely to weight loss.
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Affiliation(s)
- Liliana Gutiérrez-Carrasquilla
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) research group, IRBLleida, University of Lleida, 25198 Lleida, Spain; (L.G.-C.); (C.L.-C.); (E.S.); (M.H.); (A.C.)
| | - Carolina López-Cano
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) research group, IRBLleida, University of Lleida, 25198 Lleida, Spain; (L.G.-C.); (C.L.-C.); (E.S.); (M.H.); (A.C.)
| | - Enric Sánchez
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) research group, IRBLleida, University of Lleida, 25198 Lleida, Spain; (L.G.-C.); (C.L.-C.); (E.S.); (M.H.); (A.C.)
| | - Ferran Barbé
- Respiratory Department, University Hospital Arnau de Vilanova-Santa María, Translational Research in Respiratory Medicine, IRBLleida, University of Lleida, 25198 Lleida, Spain; (F.B.); (M.D.); (A.M.G.); (P.C.)
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Mireia Dalmases
- Respiratory Department, University Hospital Arnau de Vilanova-Santa María, Translational Research in Respiratory Medicine, IRBLleida, University of Lleida, 25198 Lleida, Spain; (F.B.); (M.D.); (A.M.G.); (P.C.)
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Marta Hernández
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) research group, IRBLleida, University of Lleida, 25198 Lleida, Spain; (L.G.-C.); (C.L.-C.); (E.S.); (M.H.); (A.C.)
| | - Angela Campos
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) research group, IRBLleida, University of Lleida, 25198 Lleida, Spain; (L.G.-C.); (C.L.-C.); (E.S.); (M.H.); (A.C.)
| | - Anna Michaela Gaeta
- Respiratory Department, University Hospital Arnau de Vilanova-Santa María, Translational Research in Respiratory Medicine, IRBLleida, University of Lleida, 25198 Lleida, Spain; (F.B.); (M.D.); (A.M.G.); (P.C.)
| | - Paola Carmona
- Respiratory Department, University Hospital Arnau de Vilanova-Santa María, Translational Research in Respiratory Medicine, IRBLleida, University of Lleida, 25198 Lleida, Spain; (F.B.); (M.D.); (A.M.G.); (P.C.)
| | - Cristina Hernández
- Endocrinology and Nutrition Department, University Hospital Vall d’Hebron, Diabetes and Metabolism Research Unit, Vall d’Hebron Institut de Recerca (VHIR), Autonomous University of Barcelona, 08035 Barcelona, Spain;
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Rafael Simó
- Endocrinology and Nutrition Department, University Hospital Vall d’Hebron, Diabetes and Metabolism Research Unit, Vall d’Hebron Institut de Recerca (VHIR), Autonomous University of Barcelona, 08035 Barcelona, Spain;
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Correspondence: (R.S.); (A.L.)
| | - Albert Lecube
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) research group, IRBLleida, University of Lleida, 25198 Lleida, Spain; (L.G.-C.); (C.L.-C.); (E.S.); (M.H.); (A.C.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Correspondence: (R.S.); (A.L.)
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Manousaki D, Barnett TA, Mathieu ME, Maximova K, Simoneau G, Harnois-Leblanc S, Benedetti A, McGrath JJ, Henderson M. Tune out and turn in: the influence of television viewing and sleep on lipid profiles in children. Int J Obes (Lond) 2020; 44:1173-1184. [PMID: 32203106 DOI: 10.1038/s41366-020-0527-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 12/20/2019] [Accepted: 01/07/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Physical activity is beneficial to lipid profiles; however, the association between sedentary behavior and sleep and pediatric dyslipidemia remains unclear. We aimed to investigate whether sedentary behavior or sleep predicted lipid profiles in children over a 2-year period. SUBJECTS/METHODS Six hundered and thirty children from the QUALITY cohort, with at least one obese parent, were assessed prospectively at ages 8-10 and 10-12 years. Measures of sedentary behavior included self-reported TV viewing and computer/video game use. Seven-day accelerometry was used to derive sedentary behavior and sleep duration. Adiposity was assessed using DEXA scans. Twenty-four-hour dietary recalls yielded estimates of carbohydrate and fat intake. Outcomes included fasting total cholesterol, triglycerides, HDL and LDL-cholesterol. Multivariable models were adjusted for adiposity and diet. RESULTS At both Visit 1 (median age 9.6 year) and Visit 2 (median age 11.6 year), children were of normal weight (55%), overweight (22%), or obese (22%). Every additional hour of TV viewing at Visit 1 was associated with a 7.0% triglyceride increase (95% CI: 3.5, 10.6; P < 0.01) and 2.6% HDL decrease (95% CI: -4.2, -0.9; P < 0.01) at Visit 2; findings remained significant after adjusting for adiposity and diet. Every additional hour of sleep at Visit 1 predicted a 4.8% LDL decrease (95% CI: -9.0, -0.5; P = 0.03) at Visit 2, after adjusting for fat intake; this association became nonsignificant once controlling for adiposity. CONCLUSIONS Longer screen time during childhood appears to deteriorate lipid profiles in early adolescence, even after accounting for other major lifestyle habits. There is preliminary evidence of a deleterious effect of shorter sleep duration, which should be considered in further studies.
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Affiliation(s)
- Despoina Manousaki
- CHU Sainte-Justine Research Center, University of Montreal, Montreal, QC, Canada.,Department of Human Genetics, McGill University, Montreal, QC, Canada
| | - Tracie A Barnett
- CHU Sainte-Justine Research Center, University of Montreal, Montreal, QC, Canada.,Department of Family Medicine, McGill University, Montreal, QC, Canada.,Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Laval, QC, Canada
| | - Marie-Eve Mathieu
- CHU Sainte-Justine Research Center, University of Montreal, Montreal, QC, Canada.,Department of Kinesiology, University of Montreal, Montreal, QC, Canada
| | - Katerina Maximova
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Gabrielle Simoneau
- CHU Sainte-Justine Research Center, University of Montreal, Montreal, QC, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Soren Harnois-Leblanc
- CHU Sainte-Justine Research Center, University of Montreal, Montreal, QC, Canada.,Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, QC, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.,Department of Medicine, Respiratory epidemiology and clinical research unit, McGill University Health Centre, McGill University, Montréal, QC, Canada
| | - Jennifer J McGrath
- PERFORM Centre & Department of Psychology, Concordia University, Montréal, QC, Canada
| | - Mélanie Henderson
- CHU Sainte-Justine Research Center, University of Montreal, Montreal, QC, Canada. .,Department of Pediatrics, University of Montreal, Montreal, QC, Canada.
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Minami T, Tachikawa R, Matsumoto T, Murase K, Tanizawa K, Inouchi M, Handa T, Oga T, Hirai T, Chin K. Adrenal gland size in obstructive sleep apnea: Morphological assessment of hypothalamic pituitary adrenal axis activity. PLoS One 2019; 14:e0222592. [PMID: 31539392 PMCID: PMC6754148 DOI: 10.1371/journal.pone.0222592] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 09/03/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The association of obstructive sleep apnea (OSA) with hypothalamic pituitary adrenal (HPA) axis activation has not been fully understood from results of previous studies using hormonal assessments. We aimed to investigate the relationship between adrenal size, a potential marker reflecting HPA axis activity, and sleep parameters related to OSA. METHODS We retrospectively reviewed data on 284 consecutive adult patients aged 20 to 80 y who had undergone polysomnography and abdominal computed tomography (CT). OSA was defined as none/mild (apnea-hypopnea index [AHI] <15, n = 75), moderate (AHI 15 to 30, n = 80), and severe OSA (AHI ≥30, n = 129). Widths of adrenal body and limbs were measured by abdominal CT. RESULTS Adrenal size was greater in participants with severe OSA than in those with none/mild or moderate OSA (adrenal body width: 6.03 mm, none/mild OSA; 6.09 mm, moderate OSA; 6.78 mm, severe OSA; p <0.001; adrenal limb width: 3.75 mm, none/mild OSA; 3.95 mm, moderate OSA; 4.26 mm, severe OSA, p <0.001). Multivariate regression analysis showed that not the 3% oxygen desaturation index and time of SpO2 <90% but a higher arousal index was the only determinant factor for increased adrenal limb width (β = 0.27, p <0.001) after adjusting for other variables that could affect adrenal size. Neither the arousal index nor hypoxic parameters were associated with adrenal body width. CONCLUSIONS Results indicated that adrenal glands may enlarge in response to longstanding sleep fragmentation, suggesting the involvement of OSA in HPA axis augmentation.
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Affiliation(s)
- Takuma Minami
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryo Tachikawa
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takeshi Matsumoto
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kimihiko Murase
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kiminobu Tanizawa
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Morito Inouchi
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomohiro Handa
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toru Oga
- Department of Respiratory Medicine, Kawasaki Medical School, Kurashiki, Japan
| | - Toyohiro Hirai
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kazuo Chin
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Untargeted metabolomics analysis of rat hippocampus subjected to sleep fragmentation. Brain Res Bull 2019; 153:74-83. [PMID: 31419538 DOI: 10.1016/j.brainresbull.2019.08.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 07/25/2019] [Accepted: 08/10/2019] [Indexed: 01/08/2023]
Abstract
Sleep fragmentation (SF) commonly occurs in several pathologic conditions and is especially associated with impairments of hippocampus-dependent neurocognitive functions. Although the effects of SF on hippocampus in terms of protein or gene levels were examined in several studies, the impact of SF at the metabolite level has not been investigated. Thus, in this study, the differentially expressed large-scale metabolite profiles of hippocampus in a rat model of SF were investigated using untargeted metabolomics approaches. Forty-eight rats were divided into the following 4 groups: 4-day SF group, 4-day exercise control (EC) group, 15-day SF group, and 15-day EC group (n = 12, each). SF was accomplished by forced exercise using a walking wheel system with 30-s on/90-s off cycles, and EC condition was set at 10-min on/30-min off. The metabolite profiles of rat hippocampi in the SF and EC groups were analyzed using liquid chromatography/mass spectrometry. Multivariate analysis revealed distinctive metabolic profiles and marker signals between the SF and corresponding EC groups. Metabolic changes were significant only in the 15-day SF group. In the 15-day SF group, L-tryptophan, myristoylcarnitine, and palmitoylcarnitine were significantly increased, while adenosine monophosphate, hypoxanthine, L-glutamate, L-aspartate, L-methionine, and glycerophosphocholine were decreased compared to the EC group. The alanine, aspartate, and glutamate metabolism pathway was observed as the common key pathway in the 15-day SF groups. The results from this untargeted metabolomics study provide a perspective on metabolic impact of SF on the hippocampus.
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Neck Grasp Predicts Obstructive Sleep Apnea in Type 2 Diabetes Mellitus. SLEEP DISORDERS 2019; 2019:3184382. [PMID: 31355009 PMCID: PMC6633920 DOI: 10.1155/2019/3184382] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 06/07/2019] [Indexed: 01/03/2023]
Abstract
Aims Obstructive sleep apnea (OSA) is a common disorder with high morbidity, mortality, and an increasing prevalence in the general population. It has an even higher prevalence among individuals with type 2 diabetes mellitus (DM). The snoring, tiredness, observed apnea, high blood pressure, body-mass-index, age, neck circumference and male gender (STOP-BANG) questionnaire and Berlin Questionnaire can be cumbersome in clinical practice and require subjective data on sleepiness. We proposed prospectively studying a primary care population with type 2 DM comparing neck grasp, neck circumference, and common screening questionnaires to identify OSA. Methods Persons with a diagnosis of type 2 DM were recruited from a primary care clinic. Participants were screened using Easy Sleep Apnea Predictor (ESAP), STOP-Bang questionnaire, and Berlin questionnaire. A positive ESAP was defined as a 1cm gap when a patient encircled their hands around the neck. All subjects underwent in-laboratory PSG testing. Results Forty-three participants were enrolled and the prevalence of OSA was 90.7% (AHI ≥ 5). The median BMI was 38.0. The prevalence of mild OSA by PSG (AHI 5-14) was 27.9%, moderate OSA (AHI 15-29) was 25.6%, and severe OSA (AHI >30) was 37.2%. For mild OSA both ESAP and neck circumference showed 100% specificity. Conclusions This study reinforces the need for screening diabetic persons for obstructive sleep apnea. ESAP and neck circumference are useful for identifying persons with type 2 DM who are at risk for OSA. Together these findings could improve recognition of OSA in persons at risk for cardiovascular disease. Trial Registration of “Neck grasp as a predictor of Sleep Apnea,” https://clinicaltrials.gov/ct2/show/NCT02474823, Clinical Trials.gov Identifier, is NCT02474823.
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Barikani A, Javadi M, Rafiei S. Sleep Quality and Blood Lipid Composition Among Patients with Diabetes. Int J Endocrinol Metab 2019; 17:e81062. [PMID: 31497039 PMCID: PMC6678070 DOI: 10.5812/ijem.81062] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 04/12/2019] [Accepted: 04/17/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Recent literature has mentioned that people with sleep disorder, experience insulin sensitivity reduction and accordingly higher levels of blood glucose. OBJECTIVES This study aimed to investigate the relationship between sleep quality and blood lipid composition in patients with diabetes referring to Minoodar health center in Qazvin, Iran in 2017. METHODS Sleep duration and quality were assessed in 347 patients with diabetes using the Pittsburgh sleep quality index (PSQI). The glycosylated hemoglobin A1c (HbA1c) test was used to measure the glycemic control and total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) were used to determine blood lipid composition of the patients. Multiple regression analyses were applied to examine the associations between sleep measures and HbA1c and lipid parameters using SPSS version 20. RESULTS The patients in the poor sleep quality group had higher levels of fasting blood sugar (FBS) (146.07 ± 57.06 versus 132.8 ± 53.3 mg/dL, P = 0.02), body mass index (BMI) (29.1 ± 3.9 versus 27.6 ± 4.2 kg/m2, P = 0.005) and total cholesterol (209.9 ± 53.4 versus 193.4 ± 45.8, P = 0.02). Furthermore, the patients with short sleep duration had higher total cholesterol level compared with long sleep and medium sleep duration group (202.3 ± 50.2 versus 196.6 ± 47.7 and 195.7 ± 47.4, respectively, P = 0.05). Among different PSQI measures, subjective sleep quality was associated with lower TC and TG in unadjusted models (β = -0.0.1, P = 0.05). Furthermore, greater sleep disturbance was positively linked with higher levels of TC and TG (β = 0.1, P = 0.01 and β = 0.02, P = 0.05). CONCLUSIONS In an Iranian population with diabetes living in Qazvin city, sleep disorder is common and as study findings revealed sleep quality was recognized as an influencing factor on some of the lipid profiles, including TC and TG. Thus sleep assessment of patients with type 2 diabetes to find the early recognition of their sleep disorder should be considered an important part of the patients' treatment.
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Affiliation(s)
- Ameneh Barikani
- School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Maryam Javadi
- Children Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Sima Rafiei
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
- Corresponding Author: Assistant Professor, Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
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Deneva T, Ianakiev Y, Keskinova D. Burnout Syndrome in Physicians-Psychological Assessment and Biomarker Research. ACTA ACUST UNITED AC 2019; 55:medicina55050209. [PMID: 31137738 PMCID: PMC6571619 DOI: 10.3390/medicina55050209] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 05/21/2019] [Accepted: 05/21/2019] [Indexed: 12/15/2022]
Abstract
Background and objectives: Burnout is a syndrome typically occurring in work environments with continuous and chronic stress. Physicians are at increased risk for burnout, as a result of 24-h work, delayed work–life balance gratification, and the challenges associated with patient care. The aim of the present study was to evaluate the psychological parameters of burnout symptoms in relation to biomarkers of stress among physicians with different medical specialties. Materials and methods: A total of 303 physicians were contacted as potential participants. A comparison group of 111 individuals working outside medicine was used as a control to verify the results. The physicians were specialists in internal medicine, general surgery, pathology, and primary care. Serum cortisol, salivary cortisol, adrenocorticotropic hormone (ACTH), insulin (IRI), and prolactin levels were analyzed by chemiluminescence enzyme immunoassay (Access 2, Beckman Coulter). Fasting glucose in serum and glycated hemoglobin (HbA1C) in whole blood were measured using the automatic analyzer AU 480 Beckman Coulter system. Symptoms of burnout were measured with the Maslach Burnout Inventory (MBI). Results: The group with burnout presented significantly higher levels of serum and saliva cortisol, ACTH, prolactin, fasting glucose, and HbA1C compared with the control group. The correlation analysis between biomarkers showed a positive correlation with moderate strength between serum and saliva cortisol (r = 0.516, p = 0.01),as well as serum and saliva cortisol with ACTH (r = 0.418; r = 0.412, p = 0.01) and HbA1C (r = 0.382; r = 0.395, p = 0.01). A weak positive correlation was found between serum and saliva cortisol with prolactin (r = 0.236; r = 0.267, p < 0.01) and glucose (r = 0.271; r = 0.297, p < 0.01). In the multiple logistic regression model, saliva cortisol, HbA1C, and age were significantly associated with burnout (chi-square = 16.848, p < 0.032). Conclusion: Our findings demonstrated the interest of exploring biomarkers of stress related to burnout in health professionals.
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Affiliation(s)
- Tanya Deneva
- Department of Clinical Laboratory, Medical University, University Hospital "St. George", 4002 Plovdiv, Bulgaria.
| | - Youri Ianakiev
- Department of Psychology, University of Plovdiv Paisii Hilendarski, 4000 Plovdiv, Bulgaria.
| | - Donka Keskinova
- Department of Applied and Institutional Sociology, University of Plovdiv Paisii Hilendarski, 4000 Plovdiv, Bulgaria.
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Disturbed Sleep as a Mechanism of Race Differences in Nocturnal Blood Pressure Non-Dipping. Curr Hypertens Rep 2019; 21:51. [DOI: 10.1007/s11906-019-0954-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Poor sleep quality and lipid profile in a rural cohort (The Baependi Heart Study). Sleep Med 2019; 57:30-35. [DOI: 10.1016/j.sleep.2018.12.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 08/15/2018] [Accepted: 12/20/2018] [Indexed: 12/11/2022]
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Jonsdottir IH, Sjörs Dahlman A. MECHANISMS IN ENDOCRINOLOGY: Endocrine and immunological aspects of burnout: a narrative review. Eur J Endocrinol 2019; 180:R147-R158. [PMID: 30576285 PMCID: PMC6365671 DOI: 10.1530/eje-18-0741] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 12/20/2018] [Indexed: 12/11/2022]
Abstract
Burnout has several different definitions, and attempts have been made to discriminate between burnout as a psychological construct and burnout as a clinical entity. A large body of research has focused on elucidating the biological link between stress exposure and burnout and/or finding a clinically usable biomarker for burnout. The objective of this narrative review is to summarize the main endocrine and immune findings in relation to burnout. The literature has primarily focused on dysregulation of the hypothalamus-pituitary-adrenal (HPA) axis. However, albeit the large body of studies, it cannot be concluded that clear effects are seen on HPA axis function in people with burnout. The HPA axis and anabolic acute reactivity to stress might be affected in clinical burnout. Plausible, effects of chronic stress might rather be seen when measuring responses to acute stress rather than resting state hormonal levels. Studies on other hormones, including thyroid hormones, prolactin and growth hormone in burnout subjects are inconclusive. It is important to note that this field is faced with many methodological challenges, one being the diurnal and pulsatile nature of many of the hormones of interest, including cortisol, which is not always considered. Another challenge is the heterogeneity regarding definitions and measurements of stress and burnout. Existing studies on burnout and immune function are heterogeneous regarding the results and no firm conclusion can be made if clinically relevant immune changes are present in burnout subjects. An overall conclusion is that existing research cannot confirm any homogenous reliable endocrinological or immunological changes related to burnout.
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Affiliation(s)
- Ingibjörg H Jonsdottir
- Institute of Stress Medicine, Region Västra Götaland
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
- Correspondence should be addressed to I H Jonsdottir;
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Zhao X, Li X, Xu H, Qian Y, Fang F, Yi H, Guan J, Yin SK. Relationships between cardiometabolic disorders and obstructive sleep apnea: Implications for cardiovascular disease risk. J Clin Hypertens (Greenwich) 2019; 21:280-290. [PMID: 30667162 DOI: 10.1111/jch.13473] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/12/2018] [Accepted: 11/27/2018] [Indexed: 01/13/2023]
Affiliation(s)
- Xiaolong Zhao
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine; Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai China
- Otolaryngological Institute of Shanghai Jiao Tong University; Shanghai China
- Shanghai Key Laboratory of Sleep Disordered Breathing; Shanghai China
| | - Xinyi Li
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine; Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai China
- Otolaryngological Institute of Shanghai Jiao Tong University; Shanghai China
- Shanghai Key Laboratory of Sleep Disordered Breathing; Shanghai China
| | - Huajun Xu
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine; Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai China
- Otolaryngological Institute of Shanghai Jiao Tong University; Shanghai China
- Shanghai Key Laboratory of Sleep Disordered Breathing; Shanghai China
| | - Yingjun Qian
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine; Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai China
- Otolaryngological Institute of Shanghai Jiao Tong University; Shanghai China
- Shanghai Key Laboratory of Sleep Disordered Breathing; Shanghai China
| | - Fang Fang
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine; Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai China
- Otolaryngological Institute of Shanghai Jiao Tong University; Shanghai China
- Shanghai Key Laboratory of Sleep Disordered Breathing; Shanghai China
| | - Hongliang Yi
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine; Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai China
- Otolaryngological Institute of Shanghai Jiao Tong University; Shanghai China
- Shanghai Key Laboratory of Sleep Disordered Breathing; Shanghai China
| | - Jian Guan
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine; Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai China
- Otolaryngological Institute of Shanghai Jiao Tong University; Shanghai China
- Shanghai Key Laboratory of Sleep Disordered Breathing; Shanghai China
| | - Shan kai Yin
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine; Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai China
- Otolaryngological Institute of Shanghai Jiao Tong University; Shanghai China
- Shanghai Key Laboratory of Sleep Disordered Breathing; Shanghai China
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Zhang Y, Xing Y, Yuan H, Gang X, Guo W, Li Z, Wang G. Impaired Glucose Metabolisms of Patients with Obstructive Sleep Apnea and Type 2 Diabetes. J Diabetes Res 2018; 2018:6714392. [PMID: 30671481 PMCID: PMC6323486 DOI: 10.1155/2018/6714392] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 11/04/2018] [Indexed: 01/17/2023] Open
Abstract
AIMS Obstructive sleep apnea (OSA) is a very common disorder which is associated with metabolic comorbidities. The aims of this study were to analyze clinical data of patients with OSA and evaluate influence of sleep-disordered breathing on glycometabolism and its underlying mechanisms. METHODS We designed a cross-sectional study involving 53 OSA patients in The First Hospital of Jilin University from March 2015 to March 2016. They underwent a full-night polysomnography, measurement of fasting blood glucose and blood lipid profiles. Besides, we chose 20 individuals with type 2 diabetes mellitus (T2DM) as a subgroup for an in-depth study. This group additionally underwent a steamed bread meal test and measurement of HbA1c, C-reactive protein, tumor necrosis factor-α, interleukin 6, morning plasma cortisol, and growth hormone. RESULTS The two groups which with or without T2DM showed no significant differences in baseline characteristics. As for OSA patients with T2DM, the severe OSA group had higher homeostasis model assessment of insulin resistance (HOMA-IR) (P = 0.013) than the mild-to-moderate OSA group, whereas had lower morning plasma cortisol levels (P = 0.005) than the mild-to-moderate OSA group. AHI was positive correlated with HOMA-IR (r = 0.523, P = 0.018), yet negative correlated with morning plasma cortisol (r = -0.694, P = 0.001). However, nadir SpO2 was positive correlated with morning plasma cortisol (r s = 0.646, P = 0.002), while negative correlated with HOMA-IR (r s = -0.489, P = 0.029). CONCLUSIONS Our study showed that sleep-disordered breathing exerted negative influence on glucose metabolisms. The impairment of hypothalamic-pituitary-adrenal axis activity may be one of the underlying mechanisms of the glycometabolic dysfunctions in OSA with T2DM patients.
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Affiliation(s)
- Ye Zhang
- Department of Endocrinology & Metabolism, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yanpeng Xing
- Department of Gastrointestinal Surgery, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Haibo Yuan
- Department of Respiratory, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Xiaokun Gang
- Department of Endocrinology & Metabolism, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Weiying Guo
- Department of Endocrinology & Metabolism, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Zhuo Li
- Department of Endocrinology & Metabolism, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Guixia Wang
- Department of Endocrinology & Metabolism, The First Hospital of Jilin University, Changchun, Jilin, China
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Silva MDME, Lorenzi CH, Schneider BB, Seidel CEF, Salomé I, Gianini VCM, Pessoa RR, Mercer PBS, Witt MCZ. Restless legs syndrome in Parkinson's disease and increased cardiovascular risk. ARQUIVOS DE NEURO-PSIQUIATRIA 2018; 76:731-735. [DOI: 10.1590/0004-282x20180114] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 07/29/2018] [Indexed: 11/22/2022]
Abstract
ABSTRACT Restless legs syndrome (RLS) is a disorder commonly found in patients with Parkinson's disease, with descriptions for both conditions impairing dopaminergic transmission in central nervous system. Previous studies in varied populations indicate an association between the presence of RLS and increased cardiovascular risk and, so far, there are no consistent studies of this association in Parkinson's disease. Objective: To analyze the influence of RLS on cardiovascular risk in patients with Parkinson's disease. Methods: We reviewed the medical records of 202 patients diagnosed with Parkinson's disease and verified the presence of RLS, cardiovascular comorbidities, blood pressure measurements, lipid profiles and Framingham Risk Scores. Results: Statistically significant higher values of total cholesterol were found for the RLS group (mean 216.6 mg/dL), as well as for LDL cholesterol (mean 145 mg/dL). No statistical difference was found among the other factors. Conclusion: Patients with Parkinson's disease and RLS have a higher prevalence of dyslipidemia than patients without RLS, suggesting a correlation between restless legs and hyperlipidemia. It is questioned whether the dopaminergic substrate is the main factor in the genesis of the syndrome, as even with the use of dopaminergic agonists by both groups, it was possible to observe differences between groups. The hypothesis of the real interference of the syndrome treatment as a protective factor for cardiovascular risk was generated.
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44
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de Looff PC, Cornet LJM, Embregts PJCM, Nijman HLI, Didden HCM. Associations of sympathetic and parasympathetic activity in job stress and burnout: A systematic review. PLoS One 2018; 13:e0205741. [PMID: 30335812 PMCID: PMC6193670 DOI: 10.1371/journal.pone.0205741] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 10/01/2018] [Indexed: 12/19/2022] Open
Abstract
This systematic review examines the relationship between sympathetic and parasympathetic activity on the one hand and job stress and burnout on the other, and is registered at PROSPERO under CRD42016035918. Background: Previous research has shown that prolonged job stress may lead to burnout, and that differences in heart rate variability are apparent in people who have heightened job stress. Aims: In this systematic review, the associations between job stress or burnout and heart rate (variability) or skin conductance are studied. Besides, it was investigated which–if any–guidelines are available for ambulatory assessment and reporting of the results. Methods: We extracted data from relevant databases following the PRESS checklist and contacted authors for additional resources. Participants included the employed adult population comparing validated job stress and burnout questionnaires examining heart rate and electrodermal activity. Synthesis followed the PRISMA guidelines of reporting systematic reviews. Results: The results showed a positive association between job stress and heart rate, and a negative association between job stress and heart rate variability measures. No definite conclusion could be drawn with regard to burnout and psychophysiological measures. No studies on electrodermal activity could be included based on the inclusion criteria. Conclusions: High levels of job stress are associated with an increased heart rate, and decreased heart rate variability measures. Recommendations for ambulatory assessment and reporting (STROBE) are discussed in light of the findings.
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Affiliation(s)
- P. C. de Looff
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- Wier, Specialized and Forensic Care, Fivoor, Den Dolder, The Netherlands
- Expertcentre “De Borg”, Den Dolder, The Netherlands
- * E-mail:
| | - L. J. M. Cornet
- Psychology of Conflict, Risk and Safety, University of Twente, Enschede, The Netherlands
| | - P. J. C. M. Embregts
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - H. L. I. Nijman
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- Wier, Specialized and Forensic Care, Fivoor, Den Dolder, The Netherlands
- Expertcentre “De Borg”, Den Dolder, The Netherlands
| | - H. C. M. Didden
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- Expertcentre “De Borg”, Den Dolder, The Netherlands
- Trajectum, Specialized and Forensic Care, Zwolle, The Netherlands
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Zou J, Xia Y, Xu H, Fu Y, Qian Y, Li X, Zhao X, Zou J, Meng L, Liu S, Zhu H, Yi H, Guan J, Chen B, Yin S. Independent relationships between cardinal features of obstructive sleep apnea and glycometabolism: a cross-sectional study. Metabolism 2018; 85:340-347. [PMID: 29382505 DOI: 10.1016/j.metabol.2017.11.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 11/15/2017] [Accepted: 11/21/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is associated with abnormal glycometabolism; however, the cardinal features of OSA, such as sleep fragmentation (SF) and intermittent hypoxia (IH), have yet to show clear, independent associations with glycometabolism. METHODS We enrolled 1834 participants with suspected OSA from July 2008 to July 2013 to participate in this study. Polysomnographic variables, biochemical indicators, and physical measurements were collected for each participant. Multiple linear regression analyses were used to evaluate independent associations between cardinal features of OSA and glycometabolism. Logistic regressions were used to determine the odds ratios (ORs) for abnormal glucose metabolism across microarousal index (MAI) and oxygen desaturation index (ODI) quartiles. The effect of the interaction between MAI and ODI on glycometabolism was also evaluated. RESULTS The MAI was independently associated with fasting insulin levels (β = 0.024, p = 0.001) and the homeostasis model assessment of insulin resistance (HOMA-IR; β = 0.006, p = 0.002) after multiple adjustments of confounding factors. In addition, the ORs for hyperinsulinemia across higher MAI quartiles were 1.081, 1.349, and 1.656, compared with the lowest quartile (p = 0.015 for a linear trend). Similarly, the ODI was independently associated with fasting glucose levels (β = 0.003, p < 0.001), fasting insulin levels (β = 0.037, p < 0.001), and the HOMA-IR (β = 0.010, p < 0.001) after adjusting for multiple factors. The ORs for hyperglycemia across higher ODI quartiles were 1.362, 1.231, and 2.184, compared with the lowest quartile (p < 0.05 for a linear trend). In addition, the ORs for hyperinsulinemia and abnormal HOMA-IR across ODI quartiles had the same trends. There was no interaction between MAI and ODI with respect to glycometabolism. CONCLUSION SF was independently associated with hyperinsulinemia, and IH was independently associated with hyperglycemia, hyperinsulinemia, and an abnormal HOMA-IR. We found no interaction between SF and IH with respect to OSA-related abnormal glycometabolism.
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Affiliation(s)
- Juanjuan Zou
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Yunyan Xia
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Huajun Xu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Yiqun Fu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Yingjun Qian
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Xinyi Li
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Xiaolong Zhao
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Jianyin Zou
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Lili Meng
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Suru Liu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Huaming Zhu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Hongliang Yi
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Jian Guan
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China.
| | - Bin Chen
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China.
| | - Shankai Yin
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China.
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Tirado R, Masdeu MJ, Vigil L, Rigla M, Luna A, Rebasa P, Pareja R, Hurtado M, Caixàs A. Impact of Bariatric Surgery on Heme Oxygenase-1, Inflammation, and Insulin Resistance in Morbid Obesity with Obstructive Sleep Apnea. Obes Surg 2018; 27:2338-2346. [PMID: 28283920 DOI: 10.1007/s11695-017-2635-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Morbid obesity and obstructive sleep apnea (OSA) interact at an inflammatory level. Bariatric surgery reduces inflammatory responses associated with obesity. Heme oxygenase-1 (HO-1) is an enzyme with anti-inflammatory properties, which might be increased in morbid obesity or OSA. We studied morbidly obese patients with OSA to determine: (a) HO-1 plasma concentrations according to OSA severity and their relationship with insulin resistance and inflammation and (b) the impact of bariatric surgery on HO-1 and parameters of insulin resistance and inflammation. MATERIAL AND METHODS We analyzed the homeostasis model insulin resistance index (HOMA) and plasma concentrations of HO-1, tumor necrosis factor alpha, interleukin-6, interleukin-1-beta, C reactive protein (CRP), and adiponectin according to polysomnography findings in 66 morbidly obese patients before bariatric surgery and 12 months after surgery. RESULTS Before surgery, HO-1 plasma concentrations were similar in three groups of patients with mild, moderate, and severe OSA, and correlated with HOMA (r = 0.27, p = 0.02). Twelve months after surgery, low-grade inflammation and insulin resistance had decreased in all the groups, but HO-1 plasma concentration had decreased only in the severe OSA group (p = 0.02). In this group, the reduction in HO-1 correlated with a reduction in CRP concentrations (r = 0.43, p = 0.04) and with improved HOMA score (r = 0.37, p = 0.03). CONCLUSIONS Bariatric surgery decreases HO-1 concentrations in morbid obesity with severe OSA, and this decrease is associated with decreases in insulin resistance and in inflammation.
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Affiliation(s)
- Raquel Tirado
- Endocrinology and Nutrition Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, c/ Parc Taulí no 1, 08208, Sabadell, Barcelona, Spain
| | - Maria José Masdeu
- Pneumology Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, c/ Parc Taulí no 1, 08208, Sabadell, Barcelona, Spain
| | - Laura Vigil
- Pneumology Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Ciber de Enfermedades Respiratorias-Ciberes, c/ Parc Taulí no 1, 08208, Sabadell, Barcelona, Spain
| | - Mercedes Rigla
- Endocrinology and Nutrition Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, c/ Parc Taulí no 1, 08208, Sabadell, Barcelona, Spain
| | - Alexis Luna
- Surgery Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, c/ Parc Taulí no 1, 08208, Sabadell, Barcelona, Spain
| | - Pere Rebasa
- Surgery Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, c/ Parc Taulí no 1, 08208, Sabadell, Barcelona, Spain
| | - Rocío Pareja
- Endocrinology and Nutrition Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, c/ Parc Taulí no 1, 08208, Sabadell, Barcelona, Spain
| | - Marta Hurtado
- Endocrinology and Nutrition Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, c/ Parc Taulí no 1, 08208, Sabadell, Barcelona, Spain
| | - Assumpta Caixàs
- Endocrinology and Nutrition Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, c/ Parc Taulí no 1, 08208, Sabadell, Barcelona, Spain.
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Jordan ML, Perez-Escamilla R, Desai MM, Shamah-Levy T. Household Food Insecurity and Sleep Patterns Among Mexican Adults: Results from ENSANUT-2012. J Immigr Minor Health 2018; 18:1093-1103. [PMID: 26163336 DOI: 10.1007/s10903-015-0246-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
To examine the independent association of household food insecurity with sleep duration and quality in a nationally representative survey of adults in Mexico. The Latin American and Caribbean Food Security Scale was used to categorize households as secure, mild (43.7 %), moderate (19.0 %), or severe (11.8 %). We assessed the association between household food insecurity and self-reported sleep duration and quality among 11,356 adults using weighted multinomial and binomial logistic regression. After adjusting for potential confounders, a significant association was found between severe household food insecurity and getting less than the recommended 7-8 h of sleep [adjusted odds ratio (AOR) =1.83, 95 % confidence interval (CI) =1.37-2.43]. Compared with food-secure households, odds of poor sleep quality increased with level of severity (AOR = 1.27, 95 % CI 1.04-1.56 for mild; AOR = 1.71, 95 % CI 1.36-2.14 for moderate; and AOR = 1.89, 95 % CI 1.45-2.45 for severe household food insecurity). Household food insecurity is associated with inadequate sleep duration and poor sleep quality among Mexican adults. This study underscores the adverse effects of household food insecurity on the well-being of vulnerable populations.
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Affiliation(s)
| | | | | | - Teresa Shamah-Levy
- National Institute of Public Health, Center for Population Health Research, Cuernavaca Morelos, Mexico
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48
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Lecube A, Simó R, Pallayova M, Punjabi NM, López-Cano C, Turino C, Hernández C, Barbé F. Pulmonary Function and Sleep Breathing: Two New Targets for Type 2 Diabetes Care. Endocr Rev 2017; 38:550-573. [PMID: 28938479 DOI: 10.1210/er.2017-00173] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 08/29/2017] [Indexed: 02/07/2023]
Abstract
Population-based studies showing the negative impact of type 2 diabetes (T2D) on lung function are overviewed. Among the well-recognized pathophysiological mechanisms, the metabolic pathways related to insulin resistance (IR), low-grade chronic inflammation, leptin resistance, microvascular damage, and autonomic neuropathy are emphasized. Histopathological changes are exposed, and findings reported from experimental models are clearly differentiated from those described in humans. The accelerated decline in pulmonary function that appears in patients with cystic fibrosis (CF) with related abnormalities of glucose tolerance and diabetes is considered as an example to further investigate the relationship between T2D and the lung. Furthermore, a possible causal link between antihyperglycemic therapies and pulmonary function is examined. T2D similarly affects breathing during sleep, becoming an independent risk factor for higher rates of sleep apnea, leading to nocturnal hypoxemia and daytime sleepiness. Therefore, the impact of T2D on sleep breathing and its influence on sleep architecture is analyzed. Finally, the effect of improving some pathophysiological mechanisms, primarily IR and inflammation, as well as the optimization of blood glucose control on sleep breathing is evaluated. In summary, the lung should be considered by those providing care for people with diabetes and raise the central issue of whether the normalization of glucose levels can improve pulmonary function and ameliorate sleep-disordered breathing. Therefore, patients with T2D should be considered a vulnerable group for pulmonary dysfunction. However, further research aimed at elucidating how to screen for the lung impairment in the population with diabetes in a cost-effective manner is needed.
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Affiliation(s)
- Albert Lecube
- Endocrinology and Nutrition Department, Hospital Universitari Arnau de Vilanova, Institut de Recerca Biomédica de Lleida, Universitat de Lleida, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Spain
| | - Rafael Simó
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Spain.,Endocrinology and Nutrition Department, Hospital Universitari Vall d'Hebron, Diabetes and Metabolism Research Unit, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Spain
| | - Maria Pallayova
- Department of Medicine, Weill Cornell Medicine.,Department of Human Physiology and Sleep Laboratory, Faculty of Medicine, Pavol Jozef Šafárik University, Slovak Republic
| | - Naresh M Punjabi
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University.,Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University
| | - Carolina López-Cano
- Endocrinology and Nutrition Department, Hospital Universitari Arnau de Vilanova, Institut de Recerca Biomédica de Lleida, Universitat de Lleida, Spain
| | - Cecilia Turino
- Respiratory Department, Hospital Universitari Arnau de Vilanova-Santa María, Institut de Recerca Biomédica de Lleida, Universitat de Lleida, Spain
| | - Cristina Hernández
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Spain.,Endocrinology and Nutrition Department, Hospital Universitari Vall d'Hebron, Diabetes and Metabolism Research Unit, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Spain
| | - Ferran Barbé
- Respiratory Department, Hospital Universitari Arnau de Vilanova-Santa María, Institut de Recerca Biomédica de Lleida, Universitat de Lleida, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Spain
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Ruchała M, Bromińska B, Cyrańska-Chyrek E, Kuźnar-Kamińska B, Kostrzewska M, Batura-Gabryel H. Obstructive sleep apnea and hormones - a novel insight. Arch Med Sci 2017; 13:875-884. [PMID: 28721156 PMCID: PMC5507108 DOI: 10.5114/aoms.2016.61499] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Accepted: 06/07/2016] [Indexed: 12/13/2022] Open
Abstract
Obstructive sleep apnea (OSA), a disorder characterized by repetitive collapse of the upper respiratory tract during sleep, occurs in about 4% of middle-aged men and 2% of women. The incidence of the disorder is rising due to an increase in obesity and ageing of the population. Patients with obstructive sleep apnea are at elevated risk of some endocrinal and metabolic disorders, which may lead to serious consequences including shortening of life expectancy. The recognition and understanding of interactions between local upper airway dysfunction and its endocrinal consequences is therefore vital. In this review we will focus on the influence of OSA on bone metabolism and endocrine homeostasis.
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Affiliation(s)
- Marek Ruchała
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Barbara Bromińska
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Ewa Cyrańska-Chyrek
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Barbara Kuźnar-Kamińska
- Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Magdalena Kostrzewska
- Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Halina Batura-Gabryel
- Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences, Poznan, Poland
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50
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Sasaki S, Yoshioka E, Saijo Y, Bannai A, Kita T, Tamakoshi A, Kishi R. A prospective cohort study of insomnia and chronic kidney disease in Japanese workers. Sleep Breath 2017; 22:257-265. [DOI: 10.1007/s11325-017-1508-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 04/23/2017] [Accepted: 05/03/2017] [Indexed: 01/04/2023]
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