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Cheng J, Peng C, Rong F, Wang Y, Tan Y, Yu Y. Mobile phone addiction and suicide behaviors among Chinese adolescents: The mediation of poor sleep quality. J Behav Addict 2024; 13:88-101. [PMID: 38224348 PMCID: PMC10988414 DOI: 10.1556/2006.2023.00078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 07/18/2023] [Accepted: 12/03/2023] [Indexed: 01/16/2024] Open
Abstract
Background and aims Mobile phone addiction (MPA) is emerging among adolescents, especially during the COVID-19 pandemic. Nevertheless, there is a dearth of knowledge regarding the correlation between MPA and suicide behaviors and its mechanism. The objective of the current study is exploring the direct effect of MPA on suicide behaviors and the indirect effect through poor sleep quality. Methods A total of 18,900 Chinese adolescents aged 12 to 18 were recruited via a multi-stage cluster sampling method. Results The prevalence of MPA and poor sleep quality was 26.2 and 23.1%, respectively. During the past year, 24.4% participants were involved in suicide behaviors. Specifically, suicide ideators, suicide planners, and suicide attempters were 10.7, 8.4, and 5.3%, respectively. Particularly, rural females had the highest prevalence of suicide behaviors, MPA, and poor sleep quality. Logistic regression analysis showed that MPA was significantly associated with suicide ideators (OR = 1.22, 95% CI: 1.09-1.37, p < 0.001) and planners (OR = 1.18, 95% CI: 1.04-1.34, p < 0.05), but not for suicide attempters (p > 0.05). Structural equation modelling demonstrated that MPA had direct effect on suicide behaviors (β = 0.145, 95% CI = 0.127-0.160), and poor sleep quality partially mediated the relationship (the mediating ratio was 46.7%). The mediating ratio of poor sleep quality was the highest in urban males. Conclusions MPA has both direct and indirect effects on suicide behaviors. For suicide prevention, limited mobile phone use and improvement sleep quality may be practical for adolescents. Additionally, more efforts of intervention could give priority to rural girls.
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Affiliation(s)
- Junhan Cheng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chang Peng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Fajuan Rong
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yan Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yafei Tan
- Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yizhen Yu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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2
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Dilixiati D, Kadier K, Laihaiti D, Lu JD, Rezhake R, Azhati B, Rexiati M. The relationship between sleep disorders, quality, and duration and sexual dysfunction: a systematic review and meta-analysis. J Sex Med 2023:7143630. [PMID: 37186140 DOI: 10.1093/jsxmed/qdad054] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/24/2023] [Accepted: 03/24/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND The associations between sexual dysfunction (SD) and sleep disorders, sleep quality, and sleep duration remain unclear. AIM To assess the relationship between sleep and SD through a literature review and meta-analysis. METHODS The PubMed, Scopus, Embase, Ovid MEDLINE, and Cochrane Library databases were systematically searched from inception to November 10, 2022. OUTCOMES Pooled relative risks and 95% CIs were used to examine the association of sleep disorders with SD in longitudinal studies. Pooled odds ratios (ORs) and 95% CIs were used to examine the associations between SD and sleep disorders, sleep quality, and sleep duration in cross-sectional studies. RESULTS Forty-three articles, including 11 longitudinal studies and 32 cross-sectional studies, were included in the quantitative analysis. The pooled relative risk of SD in patients with sleep disorders was 1.97 in longitudinal studies (95% CI, 1.46-2.67, P < .001; heterogeneity: I2 = 95.0%, P < .001), while the pooled OR of SD in patients with sleep disorders was 2.05 in cross-sectional studies (95% CI, 1.76-2.39, P < .001; heterogeneity: I2 = 91.4%, P < .001). When compared with controls, subjects with poor sleep quality had a 1.49-fold increased risk of SD (OR, 1.49; 95% CI, 1.31-1.71, P < .001; heterogeneity: I2 = 73.4%, P < .001). In addition, short sleep duration was associated with the risk of SD (OR, 1.14; 95% CI, 1.06-1.22, P < .001; heterogeneity: I2 = 0.0%, P = .849). CLINICAL IMPLICATIONS The risk of SD is significantly increased in patients with sleep disorders and poor sleep quality, indicating that clinicians should monitor sleep among patients with SD. STRENGTHS AND LIMITATIONS This study is the most comprehensive meta-analysis of the association between sleep and SD to date. However, different sleep disorders may have varying associations with sleep duration and sleep quality; thus, we could not identify the independent effects across the studies. CONCLUSION Our systematic review and meta-analysis results suggest that sleep disorders, especially obstructive sleep apnea, increase the risk of SD in men and women. Poor sleep quality is significantly associated with SD. Short sleep duration is associated with an increased risk of SD.
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Affiliation(s)
- Diliyaer Dilixiati
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
- Xinjiang Clinical Medical Research Center of Urogenital Diseases, Urumqi 830054, China
| | - Kaisaierjiang Kadier
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
| | - Duolikun Laihaiti
- Department of Joint Surgery, Changji Branch of First Affiliated Hospital of Xinjiang Medical University, Changji 831199, China
| | - Jian-De Lu
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
- Xinjiang Clinical Medical Research Center of Urogenital Diseases, Urumqi 830054, China
| | - Remila Rezhake
- Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830017, China
| | - Baihetiya Azhati
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
- Xinjiang Clinical Medical Research Center of Urogenital Diseases, Urumqi 830054, China
| | - Mulati Rexiati
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
- Xinjiang Clinical Medical Research Center of Urogenital Diseases, Urumqi 830054, China
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3
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Huang Q, Lin S, Li Y, Huang S, Liao Z, Chen X, Shao T, Li Y, Cai Y, Qi J, Shen H. Suicidal Ideation Is Associated With Excessive Smartphone Use Among Chinese College Students. Front Public Health 2022; 9:809463. [PMID: 35223763 PMCID: PMC8867720 DOI: 10.3389/fpubh.2021.809463] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 12/31/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Suicidal ideation is the first step and a strong predictor of suicide. College students are at a considerably high risk of suicidal ideation, and smartphones are commonly used in this group. However, the relationship between suicidal ideation and smartphone use among Chinese college students is unclear. The current study aimed to investigate the prevalence of suicidal ideation among Chinese college students and its association with smartphone use and addiction factors. METHODS A total of 439 college students participated the survey. We collected the demographic information, physical health, psychosocial factors (depressive symptoms, social support, sleep quality), characteristics of smartphone use, and mobile phone addiction (MPA). Suicidal ideation was measured with a single question, "did you feel that life was not worth living in the past 1 year?" RESULTS The prevalence of suicidal ideation ("Yes" response) in the past year among Chinese college students was 7.5%. In binary logistic regression analysis, suicidal ideation was significantly correlated with less subjective social support (OR: 2.49, p = 0.049), lower utilization of social support (OR: 13.28, p = 0.012), more depressive symptoms (OR:4.96, p = 0.005), and more than 5 h of daily smartphone use (OR: 2.60, p = 0.025). CONCLUSION Considering the widely use of smartphones in Chinese colleges and the correlation with suicidal ideation, excessive phone use among college students should be given more attention by administrators and health workers. It is necessary to obtain more information about the intention of smartphone use, make full use of smartphones for health education, and monitor excessive use of smartphones, while improving social support and coping mechanisms for depression, to identify suicidal ideation and prevent suicidal behavior among Chinese college students.
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Affiliation(s)
- Qiuping Huang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Chinese National Technology Institute on Mental Disorders, Institute of Mental Health of Central South University, Changsha, China
| | - Shuhong Lin
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Chinese National Technology Institute on Mental Disorders, Institute of Mental Health of Central South University, Changsha, China
| | - Ying Li
- Changsha Health Vocational College, Changsha, China
| | - Shucai Huang
- Department of Psychiatry, The Fourth People's Hospital of Wuhu, Wuhu, China
| | - Zhenjiang Liao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Chinese National Technology Institute on Mental Disorders, Institute of Mental Health of Central South University, Changsha, China
| | - Xinxin Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Chinese National Technology Institute on Mental Disorders, Institute of Mental Health of Central South University, Changsha, China
| | - Tianli Shao
- Department of Psychiatry, Comorbid Somatic Diseases, Kangning Hospital of Shenzhen, Shenzhen, China
| | - Yifan Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Chinese National Technology Institute on Mental Disorders, Institute of Mental Health of Central South University, Changsha, China
| | - Yi Cai
- Department of Psychiatry, Comorbid Somatic Diseases, Kangning Hospital of Shenzhen, Shenzhen, China
| | - Jing Qi
- Department of Clinical Psychology, Brain Hospital of Hunan Province, Changsha, China
| | - Hongxian Shen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Chinese National Technology Institute on Mental Disorders, Institute of Mental Health of Central South University, Changsha, China
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4
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Wilkerson AK, McRae-Clark AL. A review of sleep disturbance in adults prescribed medications for opioid use disorder: potential treatment targets for a highly prevalent, chronic problem. Sleep Med 2021; 84:142-153. [PMID: 34153796 PMCID: PMC8503844 DOI: 10.1016/j.sleep.2021.05.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/15/2021] [Accepted: 05/20/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Sleep disturbance in individuals prescribed medications for opioid use disorder (MOUD) is common, though the nature and progression of such concerns are difficult to discern due to differing terminology and assessment type between studies. Accurately identifying and treating sleep problems in this growing population has the potential to improve comorbidity and other MOUD outcomes. OBJECTIVE The aim of the present review is to provide an overview of sleep in individuals stabilized on MOUD. Specifically, the following aspects of sleep were reviewed: 1) prevalence of clinically significant sleep disturbance; 2) sleep disturbance compared to findings in those not prescribed MOUD; 3) correlates of sleep disturbance; 4) self-reported sleep compared to objective measures. METHOD Studies were identified using 6 large databases and included if they contained at least one measure of sleep during MOUD treatment as usual. Studies were excluded if they were case studies, not available in English, or participants were in withdrawal or detoxification. RESULTS Forty-two studies were included and categorized by type of sleep assessment: validated self-report questionnaire; provider-assessed; polysomnography; multi-method. Correlates were included if they were statistically significant (generally p < 0.05). CONCLUSIONS This review indicates there is a high prevalence of chronic self-reported sleep disturbance (eg, insomnia symptoms) in this population and suggests quantitative sleep parameters (eg, total sleep time) and respiratory problems during sleep are worse than in the general population. These sleep problems are correlated with psychiatric comorbidity and other substance use. Other correlates (eg, sociodemographic factors) require further study to draw definitive conclusions.
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Affiliation(s)
- Allison K Wilkerson
- Department of Psychiatry and Behavioral Sciences, MUSC, Charleston, SC, USA.
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Naderi S, Vousooghi N, Sadighii N, Batouli SAH, Mirzaii F, Mohammad Razaghi E. Oxytocin Blocks Opioid Withdrawal Symptoms Only When Combined with Group Therapy: A Double-Blind, Randomized Controlled Clinical Trial. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2020; 14. [DOI: 10.5812/ijpbs.104627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 05/18/2020] [Accepted: 06/04/2020] [Indexed: 09/01/2023]
Abstract
Background: Oxytocin is a well-known central nervous system mediator in social-related behaviors and stress management. Oxytocin has also been shown to prevent withdrawal symptoms of opioids in animal studies. Group interactions with emotion sharing have been shown to result in an increase in endogenous oxytocin. Although abrupt discontinuation of methadone in opioid substitution therapy is not routinely recommended, it might result in severe withdrawal symptoms and relapse in cases that there is a clinical justification for quitting methadone. Objectives: To evaluate and compare the role of oxytocin and group interactions, combined or independently, in abrupt discontinuation of methadone in methadone maintenance treatment (MMT) cases, where there had been a reasonable clinical judgment to cease medication. Methods: In a double-blind randomized clinical trial, four groups of participants who were on methadone treatment for more than six months received either oxytocin or placebo and marathon group therapy or routine group therapy upon abrupt discontinuation of methadone. The participants were monitored for opioid withdrawal symptoms, depression, and anxiety during a four-month follow-up program. The participants were also screened by urine tests for lapses. Results: Administration of oxytocin combined with marathon group activity, with highly emotional content, resulted in less craving (P < 0.000) and withdrawal symptoms (P < 0.000) compared to placebo and non-marathon group intervention in different combinations, irrespective of methadone dose and age. The same combination also resulted in continued participation in group therapy for a longer period (P < 0.000). Additionally, the same combination was effective in improving mental health, as measured by the Beck Anxiety (P < 0.002) and Beck depression (P < 0.014) inventories. Conclusions: In order to prevent methadone craving and withdrawal symptoms and sustained abstinence, group therapy with a highly emotional theme appears to be an essential factor for the manifestation of oxytocin effects in the brain.
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6
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Jia G, Yuan P. The association between sleep quality and loneliness in rural older individuals: a cross-sectional study in Shandong Province, China. BMC Geriatr 2020; 20:180. [PMID: 32448162 PMCID: PMC7245933 DOI: 10.1186/s12877-020-01554-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 04/13/2020] [Indexed: 02/25/2023] Open
Abstract
Background There is a evidence of negative association between loneliness and sleep quality in older adults. However, little is known regarding the relationship between loneliness and sleep quality among Chinese rural older adults. This study examined the associations of loneliness and sleep quality in a cross-sectional study of older adults. Methods A face-to-face questionnaire survey was conducted among 1658 rural older adults in Shandong Province, China. Loneliness was assessed using the University of California at Los Angeles Loneliness Scale. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Ordinal logistic regression was conducted to examine the association of loneliness and sleep quality after adjustment for multiple confounding variables. Results After variables such as age, marriage, education, occupation, economic income, family relationships, living arrangement, smoking behavior, alcohol consumption, chronic disease experience, and quality of life were controlled in a multivariable analysis, poor sleep quality was still associated with loneliness in the rural older population. Conclusion This finding implied an adverse effect of sleep quality on the loneliness of older adults. Poor sleep quality was associated with increased odds of loneliness in Chinese rural older adults. Sleep-based interventions should be developed to prevent loneliness in rural older adults in China.
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Affiliation(s)
- Gaizhen Jia
- Department of Epidemiology and Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 17,3 section South Renmin Road, Chengdu, 610041, Sichuan, China
| | - Ping Yuan
- Department of Epidemiology and Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 17,3 section South Renmin Road, Chengdu, 610041, Sichuan, China.
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7
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Huang Q, Li Y, Huang S, Qi J, Shao T, Chen X, Liao Z, Lin S, Zhang X, Cai Y, Chen H. Smartphone Use and Sleep Quality in Chinese College Students: A Preliminary Study. Front Psychiatry 2020; 11:352. [PMID: 32435208 PMCID: PMC7218048 DOI: 10.3389/fpsyt.2020.00352] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/07/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Chinese college students are at high risk of sleep problems, and smartphone use is common among this population. However, the relationship between smartphone use characteristics and sleep problems in Chinese college students has been inadequately studied. In this preliminary study, we examined the association of poor sleep quality with smartphone use in a sample of Chinese college students from a health vocational college in Changsha, China. METHODS A total of 439 college students completed a self-report questionnaire containing the Pittsburgh Sleep Quality Index (PSQI) and questions regarding demographic information, psychosocial factors, physical health, smartphone use characteristics, and mobile phone addiction (MPA). RESULTS The results showed that the prevalence of poor sleep quality (PSQI > 7) in Chinese college students was 9.8%. In multiple logistic regression analysis, poor sleep quality was significantly associated with male gender (OR: 2.80, P: 0.022), not having good physical health (OR: 2.61, P: 0.020), headache (OR: 2.47, P: 0.014), more severe depressive symptoms (OR: 2.17, P: 0.049), > four years of smartphone use (OR: 3.38, P: 0.001), > five hours of daily smartphone use (OR: 2.19, P: 0.049), and more severe inability to control MPA craving (OR: 2.04, P: 0.040). CONCLUSION Our findings suggest that excessive smartphone use and MPA are associated with poor sleep quality in a sample of Chinese college students from a health vocational college. Because of the limited sample representativeness and cross-sectional design of this study, large-scale prospective representative studies are warranted to confirm these associations.
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Affiliation(s)
- Qiuping Huang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Center on Mental Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China.,Center of Psychology Teaching and Research, Changsha Health Vocational College, Changsha, China
| | - Ying Li
- Center of Psychology Teaching and Research, Changsha Health Vocational College, Changsha, China
| | - Shucai Huang
- Department of Psychiatry, The Fourth People's Hospital of Wuhu, Wuhu, China
| | - Jing Qi
- Department of Psychiatry, Brain Hospital of Hunan Province, Changsha, China
| | - Tianli Shao
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Center on Mental Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Xinxin Chen
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Center on Mental Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Zhenjiang Liao
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Center on Mental Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Shuhong Lin
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Center on Mental Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Xiaojie Zhang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Center on Mental Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Yi Cai
- Department of Psychiatry, Geriatric and Somatic Diseases, Brain Hospital of Human Province, Hunan University of Chinese Medicine Clinical College, Hunan Mental Behavior Disorder Research Center, Changsha, China
| | - Hongxian Chen
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Center on Mental Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
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8
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Kalmbach DA, Kingsberg SA, Roth T, Cheng P, Fellman-Couture C, Drake CL. Sexual function and distress in postmenopausal women with chronic insomnia: exploring the role of stress dysregulation. Nat Sci Sleep 2019; 11:141-153. [PMID: 31686931 PMCID: PMC6709826 DOI: 10.2147/nss.s213941] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 06/24/2019] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Menopause triggers changes in sexual function and many women develop sexual problems. Insomnia is common in postmenopausal women, and disturbed sleep has been linked to poor sexual health. Thus, postmenopausal women with insomnia may be especially vulnerable to developing sexual difficulties. This study estimated rates of sexual distress in postmenopausal women with chronic insomnia and explored associations between various facets of sexual health, insomnia symptoms, and insomnia-related stress dysregulation. DESIGN Cross-sectional. SETTING Large multi-site health system in the US. PARTICIPANTS 150 postmenopausal women diagnosed with DSM-5 chronic insomnia disorder (56.44±5.64 years) completed measures of sexual distress, sexual function, hot flashes, insomnia symptoms, depression, and stress dysregulation in the forms of cognitive-emotional arousal (worry, rumination), sleep reactivity, and somatic hyperarousal. RESULTS Nearly half of the sample endorsed clinically significant sexual distress (46.9%). Insomnia symptoms were largely associated with poor sexual arousal, orgasmic dysfunction, sexual distress, and sexual dissatisfaction. Insomnia-related stress dysregulation was similarly associated with these facets of sexual health but was also linked to problems with low desire and greater vaginal pain during sex. Hot flashes and depression were negatively associated with sexual health. CONCLUSION Postmenopausal women with chronic insomnia endorse high rates of sexual distress. Although compromised sexual function appears directly related to poor sleep itself, our data suggest that stress dysregulation may play vital role in sexual problems endorsed by postmenopausal insomniacs, particularly regarding low desire and vaginal pain. Prospective research is needed to characterize the evolution of these co-occurring symptoms.
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Affiliation(s)
- David A Kalmbach
- Division of Sleep Medicine, Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, USA
| | - Sheryl A Kingsberg
- Departments of Reproductive Biology and Psychiatry, Case Western Reserve University, Cleveland, OH, USA
| | - Thomas Roth
- Division of Sleep Medicine, Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, USA
| | - Philip Cheng
- Division of Sleep Medicine, Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, USA
| | - Cynthia Fellman-Couture
- Division of Sleep Medicine, Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, USA
| | - Christopher L Drake
- Division of Sleep Medicine, Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, USA
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Yu X, Guo H, Liu X, Wang G, Min Y, Chen SHS, Han SS, Chang RT, Zhao X, Hsing A, Zhu S, Yao K. Dry eye and sleep quality: a large community-based study in Hangzhou. Sleep 2019; 42:5532656. [PMID: 31310315 DOI: 10.1093/sleep/zsz160] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 05/16/2019] [Indexed: 12/20/2022] Open
Abstract
Abstract
Study Objectives
To investigate the relationship between dry eye and sleep quality in a large community-based Chinese population.
Methods
A total of 3,070 participants aged 18–80 were recruited from a community-based study in Hangzhou, China during 2016–2017. Sleep quality was evaluated using the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI), and dry eye was evaluated using the Ocular Surface Disease Index (OSDI) questionnaire. Multivariable linear regression and logistic regression models were used to investigate the associations, adjusting for age, smoking, drinking, season, and other potential confounders.
Results
Overall, CPSQI score and sleep dysfunction were significantly associated with mild, moderate, and severe dry eye (ORs for CPSQI score: 1.07, 1.13, 1.14, all p < 0.001; for sleep dysfunction: 1.31, 1.73, 1.66, all p < 0.05). Furthermore, worse OSDI score was presented in participants with worse CPSQI score or sleep dysfunction (CPSQI score > 7) (β: 0.13, 0.54; all p < 0.001). In addition, six of the seven components of CPSQI showed significant associations with dry eye (all p < 0.001), except for the component of sleep medication use. Moreover, we observed significant associations of dry eye in all three subscales of OSDI with CPSQI score and sleep dysfunction.
Conclusion
Our large, community-based study showed a strong association between poor sleep quality and an increased severity of dry eye, suggesting that preventing either one of the discomforts might alleviate the other.
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Affiliation(s)
- Xiaoning Yu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Huilan Guo
- Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xin Liu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Guowei Wang
- Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yan Min
- Stanford Prevention Research Center, Department of Medicine, Stanford School of Medicine, Stanford University, Stanford, CA
| | - Shih-Hua Sarah Chen
- Stanford Prevention Research Center, Department of Medicine, Stanford School of Medicine, Stanford University, Stanford, CA
| | - Summer S Han
- Department of Neurosurgery, Stanford School of Medicine, Stanford University, Stanford, CA
| | - Robert T Chang
- Department of Ophthalmology, Stanford School of Medicine, Stanford University, Stanford, CA
| | - Xueyin Zhao
- Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ann Hsing
- Stanford Prevention Research Center, Department of Medicine, Stanford School of Medicine, Stanford University, Stanford, CA
| | - Shankuan Zhu
- Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ke Yao
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Zhong BL, Xu YM, Xie WX, Lu J. Cigarette Smoking Is Significantly Linked to Sexual Dissatisfaction in Chinese Heroin-Dependent Patients Receiving Methadone Maintenance Treatment. Front Psychiatry 2019; 10:306. [PMID: 31178762 PMCID: PMC6538806 DOI: 10.3389/fpsyt.2019.00306] [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: 10/24/2018] [Accepted: 04/17/2019] [Indexed: 12/20/2022] Open
Abstract
Background: Cigarette smoking is associated with sexual dysfunction in the general population. Both smoking and sexual dysfunction are common in heroin-dependent patients (HDPs) receiving methadone maintenance treatment (MMT), but their association in MMT HDPs is rarely studied. This study examined the association between smoking and sexual dissatisfaction in Chinese HDPs receiving MMT. Methods: In total, 480 Chinese HDPs, who had sex with their regular or irregular sex partners within one month prior to the study, were included from three MMT clinics in Wuhan, China. Sexual dissatisfaction was assessed with one single question. Socio-demographic and clinical data and smoking characteristics were collected with a standardized questionnaire. Multiple binary logistic regression was used to analyze the association between smoking and sexual dissatisfaction, as well as the associations between levels of smoking and nicotine dependence and sexual dissatisfaction. Results: The prevalence of current smoking was 95.6% in HDPs receiving MMT. Rates of sexual dissatisfaction were higher in current smokers than non-smokers (32.9% vs. 14.3%) with a borderline significant P value of 0.074. After adjusting potential socio-demographic and clinical confounders, current smoking was significantly linked to sexual dissatisfaction (OR = 1.95, P = 0.026), and heavy smoking and severe nicotine dependence were significantly linked to sexual dissatisfaction (OR = 1.80, P = 0.025; OR = 3.27, P < 0.001). Conclusion: Smoking is significantly associated with sexual dysfunction in HDPs receiving MMT. It deserves further investigation as to whether quitting smoking can improve the sexual function of methadone-maintained patients.
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Affiliation(s)
- Bao-Liang Zhong
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China.,Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Yan-Min Xu
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Wu-Xiang Xie
- Peking University Clinical Research Institute, Peking University Health Science Center, Beijing, China
| | - Jin Lu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China
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11
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Zhong BL, Xu YM, Xie WX, Lu J. Frequent nightmares in Chinese patients undergoing methadone maintenance therapy: prevalence, correlates, and their association with functional impairment. Neuropsychiatr Dis Treat 2019; 15:2063-2072. [PMID: 31410010 PMCID: PMC6646172 DOI: 10.2147/ndt.s202813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 07/02/2019] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Nightmares are associated with many negative health outcomes; however, little is known about the characteristics of nightmares in heroin-dependent patients (HDPs). This study examined the prevalence and correlates of frequent nightmares (FNs) and their association with functional impairment in Chinese patients undergoing methadone maintenance therapy (MMT). PATIENTS AND METHODS In total, 603 Chinese HDPs from three MMT clinics in Wuhan, China, completed this survey. FNs were defined as reporting nightmares at least once a week. The Sheehan Disability Scale (ShDS) was used to assess the severity of functional impairment of patients. A standardized questionnaire was used to collect data on socio-demographics, drug use characteristics, physical health, mental health, and insomnia. RESULTS The prevalence of FNs in Chinese HDPs receiving MMT was 25.9%. Factors significantly associated with nightmares among MMT HDPs included an educational attainment of senior high school and above (OR=2.73, P<0.001), unemployment (OR=3.16, P<0.001), a history of re-education through forced labor (OR=3.14, P<0.001), injecting heroin before MMT (OR=3.62, P=0.002), a high dose of methadone (>70 mg/day) (OR=2.03, P=0.006), use of hypnotics (OR=1.91, P=0.044), the presence of hepatitis B virus core antibody (OR=4.63, P<0.001), pain (OR=3.20, P<0.001), anxiety (OR=2.06, P=0.039), and insomnia (OR=5.75, P<0.001). After controlling for potential confounders, nightmares were still significantly associated with a higher ShDS score (β=2.718, P=0.006). CONCLUSION FNs are prevalent among Chinese HDPs receiving MMT and significantly associated with functional impairment. Nightmares are a clinically relevant phenomenon in Chinese MMT clinics, which deserves more clinical and research attention.
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Affiliation(s)
- Bao-Liang Zhong
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, Hubei Province, People's Republic of China.,Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei Province, People's Republic of China
| | - Yan-Min Xu
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei Province, People's Republic of China
| | - Wu-Xiang Xie
- Peking University Clinical Research Institute, Peking University Health Science Center , Beijing, People's Republic of China
| | - Jin Lu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, People's Republic of China
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12
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Lin J, Chen L, Ni S, Ru Y, Ye S, Fu X, Gan D, Li J, Zhang L, Han S, Zhu S. Association between sleep quality and bone mineral density in Chinese women vary by age and menopausal status. Sleep Med 2018; 53:75-80. [PMID: 30447403 DOI: 10.1016/j.sleep.2018.09.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/24/2018] [Accepted: 09/17/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Sleep quality is closely related to bone health. Aging and estrogen deficiency are known determinants of poor sleep quality and osteoporosis. However, the impact of aging and menopause on the associations between sleep quality and bone mineral density (BMD) remains unclear. This study aimed to examine the association between sleep quality and BMD in Chinese women vary by age groups and menopausal status. METHODS A total of 2067 women aged 18-80 years were included. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) and the score >7 was indicative of poor sleep quality. BMD was determined using the dual-energy X-ray absorptiometry. Participants were categorized into three age groups. Multiple linear regression models were conducted to evaluate the associations between sleep quality and BMD. Covariates included in the models were age, menopausal status, weight, height, percent body fat, physical activity, alcohol drinking, calcium supplement use, marital status, education and metabolic diseases. RESULTS We observed that poor sleep quality was correlated to low total BMD and legs BMD in middle-aged women after adjusting for potential confounders. Furthermore, when we reran the regression models based on menopausal status in middle-aged women, significant associations between BMD and sleep quality were observed in premenopausal and early postmenopausal groups. CONCLUSION Our findings showed a more robust association between sleep quality and BMD in premenopausal and early menopausal groups. Further studies should be conducted to explore whether sleep quality intervention would improve bone health of women in these periods and prevent osteoporosis in their late life.
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Affiliation(s)
- Jie Lin
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Chronic Disease Research Institute, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Lijin Chen
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Chronic Disease Research Institute, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Saili Ni
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Chronic Disease Research Institute, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yuan Ru
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Chronic Disease Research Institute, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Sunyue Ye
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Chronic Disease Research Institute, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiaohua Fu
- Department of Reproductive Endocrinology, Zhejiang People's Hospital, Hangzhou, Zhejiang, China
| | - Da Gan
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Chronic Disease Research Institute, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jiayu Li
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Chronic Disease Research Institute, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Liang Zhang
- Department of Health, Lanxi City, Zhejiang, China
| | - Shuang Han
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Chronic Disease Research Institute, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Shankuan Zhu
- Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Chronic Disease Research Institute, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China.
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13
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Zhong BL, Xu YM, Zhu JH, Li HJ. Sexual life satisfaction of methadone-maintained Chinese patients: individuals with pain are dissatisfied with their sex lives. J Pain Res 2018; 11:1789-1794. [PMID: 30237733 PMCID: PMC6137950 DOI: 10.2147/jpr.s177564] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Purpose Pain is potentially associated with sexual dysfunction. Both sexual dysfunction and pain are common in methadone-maintained patients, but the association of pain with sexual dysfunction in methadone-maintained patients is rarely studied. This study examined the association between pain and sexual life satisfaction (SLS) in Chinese patients receiving methadone maintenance treatment (MMT). Patients and methods A total of 477 methadone-maintained patients who recently had sex with their sex partners were recruited from three MMT clinics in Wuhan, China. SLS was assessed with a single question, and the sociodemographic, psychological, and clinical data were collected with standardized questionnaires. Pain intensity was assessed with the 5-point verbal rating scale. Multiple ordinary logistic regression was used to control for potential confounders that may bias the pain–SLS relationship. Results The prevalence of self-reported dissatisfaction with one’s sexual life was significantly higher in patients with clinically significant pain (CSP) than those without CSP (41.5% vs 19.4%, χ2 =23.567, P<0.001). After controlling for potential sociodemographic, psychological, and clinical confounders, CSP was still significantly and independently associated with an increase in sexual life dissatisfaction (OR =1.89, P=0.011). Conclusion Pain is significantly associated with low SLS in methadone-maintained patients. Appropriate pain management might improve SLS of patients receiving MMT.
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Affiliation(s)
- Bao-Liang Zhong
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, Hubei Province, China.,Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei Province, China,
| | - Yan-Min Xu
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei Province, China,
| | - Jun-Hong Zhu
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei Province, China,
| | - Hong-Jie Li
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei Province, China,
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