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Xie Z, Dai Z, Wei Y, Liu J, Zhang X, Zhong G, Zhao Y, Du J. The relationship between sleep profiles and anxiety and depression in addicted patients: A latent profile analysis. Sleep Med 2024; 122:192-197. [PMID: 39186912 DOI: 10.1016/j.sleep.2024.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2024] [Revised: 07/22/2024] [Accepted: 08/06/2024] [Indexed: 08/28/2024]
Affiliation(s)
- Zhaoyang Xie
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zheng Dai
- Department of Psychiatry, The Fifth People's Hospital of Xiangtan City, Xiangtan, Hunan, China
| | - Yicheng Wei
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingyang Liu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiyuan Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Gangliang Zhong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Jiang Du
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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2
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Bjorness TE, Greene RW. Orexin-mediated motivated arousal and reward seeking. Peptides 2024; 180:171280. [PMID: 39159833 DOI: 10.1016/j.peptides.2024.171280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 08/03/2024] [Accepted: 08/05/2024] [Indexed: 08/21/2024]
Abstract
The neuromodulator orexin has been identified as a key factor for motivated arousal including recent evidence that sleep deprivation-induced enhancement of reward behavior is modulated by orexin. While orexin is not necessary for either reward or arousal behavior, orexin neurons' broad projections, ability to sense the internal state of the animal, and high plasticity of signaling in response to natural rewards and drugs of abuse may underlie heightened drug seeking, particularly in a subset of highly motivated reward seekers. As such, orexin receptor antagonists have gained deserved attention for putative use in addiction treatments. Ongoing and future clinical trials are expected to identify individuals most likely to benefit from orexin receptor antagonist treatment to promote abstinence, such as those with concurrent sleep disorders or high craving, while attention to methodological considerations will aid interpretation of the numerous preclinical studies investigating disparate aspects of the role of orexin in reward and arousal.
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Affiliation(s)
- Theresa E Bjorness
- Research Service, VA North Texas Health Care System, Dallas, TX 75126, USA; Departments of Psychiatry University of Texas Southwestern Medical Center, Dallas, TX 75390-9111, USA.
| | - Robert W Greene
- Departments of Psychiatry University of Texas Southwestern Medical Center, Dallas, TX 75390-9111, USA; Department of Neuroscience, Peter O'Donnell Jr. Brain Institute, University of Texas Southwestern Medical Center, Dallas, TX 75390-9111, USA; International Institute for Integrative Sleep Medicine, University of Tsukuba, Tsukuba 305-8577, Japan
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Thompson LM, Slavish DC, Messman BA, Dietch JR, Kelly K, Ruggero C, Taylor DJ, Ramarushton B, Blumenthal H. Alcohol Use Predicts Longer But More Fragmented Sleep: A Daily Diary Study of Alcohol, Sleep, and PTSD in Nurses. Int J Behav Med 2024:10.1007/s12529-024-10308-z. [PMID: 38977540 DOI: 10.1007/s12529-024-10308-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND Due to the demanding nature of their profession, nurses are at risk of experiencing irregular sleep patterns, substance use, and fatigue. Evidence supports a reciprocal relationship between alcohol use and sleep disturbances; however, no research has examined such a link in a sample of nurses. One factor that may further impact the dynamic between alcohol and sleep patterns is posttraumatic stress disorder (PTSD) symptoms. We investigated the daily bidirectional associations between alcohol use and several sleep domains (i.e., self-report and actigraphy-determined sleep), and moderation by baseline PTSD symptom severity. METHOD Over a 14-day period, 392 nurses (92% female; 78% White) completed sleep diaries and actigraphy to assess alcohol use and sleep patterns. Within-person bidirectional associations between alcohol and sleep were examined using multilevel models, with symptoms of PTSD as a cross-level moderator. RESULTS Daily alcohol use (i.e., ≥ 1 alcoholic beverage; 25.76%) was associated with shorter self-reported sleep onset latency (b = -4.21, p = .003) but longer self-reported wake after sleep onset (b = 2.36, p = .009). Additionally, days with any alcohol use were associated with longer self-reported sleep duration (b = 15.60, p = .006) and actigraphy-determined sleep duration (b = 10.06, p = .037). No sleep variables were associated with next-day alcohol use. Bidirectional associations between alcohol consumption and sleep were similar regardless of baseline PTSD symptoms. CONCLUSION Our results suggested that on days when nurses drank alcohol, they experienced longer but also more fragmented sleep.
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Affiliation(s)
- Linda M Thompson
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203, USA.
| | - Danica C Slavish
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203, USA.
| | - Brett A Messman
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203, USA
| | - Jessica R Dietch
- School of Psychological Science, Oregon State University, 2950 SW Jefferson Way, Corvallis, OR, 97331, USA
| | - Kimberly Kelly
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203, USA
| | - Camilo Ruggero
- School of Behavioral and Brain Sciences, University of Texas at Dallas, 800 West Campbell Road, Richardson, TX, 75080, USA
| | - Daniel J Taylor
- Department of Psychology, University of Arizona, 1503 E University Blvd, Tucson, AZ, 85721, USA
| | - Banan Ramarushton
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203, USA
| | - Heidemarie Blumenthal
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203, USA
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4
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Brown T, Ackerman RA, Kroon E, Kuhns L, Cousijn J, Filbey FM. The role of sleep in the link between cannabis use and memory function: evidence from a cross-sectional study. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024; 50:547-556. [PMID: 38917114 DOI: 10.1080/00952990.2024.2362832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 04/29/2024] [Accepted: 05/29/2024] [Indexed: 06/27/2024]
Abstract
Background: It is known that cannabis use affects memory and sleep problems independently. However, to date, how memory and sleep problems may interact as a result of cannabis use remains unknown.Objectives: We performed a secondary analysis of existing data to determine whether sleep quality mediates the association between cannabis use and memory and whether sex moderated these effects.Methods: A total of 141 adults with cannabis use disorder (CUD) (83 men) and 87 without CUD (39 men) participated in this study. Outcome measures included self-reported sleep problems from the past 7 days (Marijuana Withdrawal Checklist), learning and memory performance via the short visual object learning task (sVOLT), short visual object learning task delayed (sVOLTd), and verbal memory via the N-back. Bootstrapped mediation and moderated mediation analyses were run to test if sleep quality mediated the association between cannabis use and memory outcomes and whether sex moderated these effects, respectively.Results: Sleep quality mediated the effect of group (i.e. adults with and without CUD) on sVOLT efficiency scores (indirect effect ß = -.08, 95% CI [-0.14, -0.04]) and sVOLTd efficiency scores (indirect effect ß = -.09, 95% CI [-0.14, -0.04]), where greater sleep difficulties was associated with poorer memory performance (decreased efficiency scores). Sex did not moderate these relationships.Conclusion: These initial findings of a mediating role of sleep in the association between CUD and visual learning memory highlight potential critical downstream effects of disrupted sleep in those with CUD and suggest the importance of investigating sleep in CUD.
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Affiliation(s)
- T Brown
- Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
| | - R A Ackerman
- Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
| | - E Kroon
- Neuroscience of Addiction (NofA) Lab, Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - L Kuhns
- Neuroscience of Addiction (NofA) Lab, Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - J Cousijn
- Neuroscience of Addiction (NofA) Lab, Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - F M Filbey
- Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
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5
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Winegar R. Enhancing sleep quality for adult patients: Interventions and insights. Nurse Pract 2024; 49:22-30. [PMID: 39149863 DOI: 10.1097/01.npr.0000000000000199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
ABSTRACT Sleep is critical to a person's physiological and psychological functioning. Approximately 30% to 40% of the general population experiences insomnia, and among patients with mental health conditions, the prevalence of insomnia and other sleep disturbances rises to about 70%. Insomnia is associated with many adverse health issues, including lower immunity, weight gain, elevated BP, and increased mortality, and it is often undiagnosed and either untreated or self-treated. Providers can work together with patients to enact measures-such as implementation of enhanced sleep hygiene, engagement in cognitive behavioral therapy, and treatment of any underlying causes-that can markedly improve patient sleep quality. This article provides an overview of evidence-based best practices and whole-person strategies that NPs can adopt to address poor sleep quality in adult patients, and it serves as a primer for primary care NPs on common presentations of several sleep disorders.
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Affiliation(s)
- Rhonda Winegar
- Rhonda Winegar is an assistant professor at the University of Texas at Arlington College of Nursing and Health Innovation in Arlington, Tex
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Heffner JS. Enhancing sleep quality for adult patients: Interventions and insights. Nurse Pract 2024; 49:41-47. [PMID: 38915146 DOI: 10.1097/01.npr.0000000000000203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
ABSTRACT Sleep is critical to a person's physiological and psychological functioning. Approximately 30% to 40% of the general population experiences insomnia, and among patients with mental health conditions, the prevalence of insomnia and other sleep disturbances rises to about 70%. Insomnia is associated with many adverse health issues, including lower immunity, weight gain, elevated BP, and increased mortality, and it is often undiagnosed and either untreated or self-treated. Providers can work together with patients to enact measures-such as implementation of enhanced sleep hygiene, engagement in cognitive behavioral therapy, and treatment of any underlying causes-that can markedly improve patient sleep quality. This article provides an overview of evidence-based best practices and whole-person strategies that NPs can adopt to address poor sleep quality in adult patients, and it serves as a primer for primary care NPs on common presentations of several sleep disorders.
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Affiliation(s)
- Jacqueline S Heffner
- Jacqueline S. Heffner is a double board-certified family NP at St. Luke's Primary Care and Dental, a Federally Qualified Health Center in Tamaqua, Pa. She is a member of the St. Luke's University Health Network institutional review board, a clinical nursing instructor for Lehigh Carbon Community College, and a member of the Schuylkill County Human Trafficking Response Team. Dr. Heffner has delivered conference presentations on preoperative physical examinations in primary care and recently presented her COPD action planning project at the 2024 AANP National Conference
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Du K, Shi Q, Zhou X, Zhang L, Su H, Zhang C, Wei Z, Liu T, Wang L, Wang X, Cong B, Yun K. Melatonin attenuates fentanyl - induced behavioral sensitization and circadian rhythm disorders in mice. Physiol Behav 2024; 279:114523. [PMID: 38492912 DOI: 10.1016/j.physbeh.2024.114523] [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: 01/08/2024] [Revised: 03/01/2024] [Accepted: 03/13/2024] [Indexed: 03/18/2024]
Abstract
Melatonin is a neurohormone synthesized by the pineal gland to regulate the circadian rhythms and has proven to be effective in treating drug addiction and dependence. However, the effects of melatonin to modulate the drug-seeking behavior of fentanyl and its underlying molecular mechanism is elusive. This study was designed to investigate the effects of melatonin on fentanyl - induced behavioral sensitization and circadian rhythm disorders in mice. The accompanying changes in the expression of Brain and Muscle Arnt-Like (BMAL1), tyrosine hydroxylase (TH), and monoamine oxidase A (MAO-A) in relevant brain regions including the suprachiasmatic nucleus (SCN), nucleus accumbens (NAc), prefrontal cortex (PFC), and hippocampus (Hip) were investigated by western blot assays to dissect the mechanism by which melatonin modulates fentanyl - induced behavioral sensitization and circadian rhythm disorders. The present study suggest that fentanyl (0.05, 0.1 and 0.2 mg/kg) could induce behavioral sensitization and melatonin (30.0 mg/kg) could attenuate the behavioral sensitization and circadian rhythm disorders in mice. Fentanyl treatment reduced the expression of BMAL1 and MAO-A and increased that of TH in relevant brain regions. Furthermore, melatonin treatment could reverse the expression levels of BMAL1, MAO-A, and TH. In conclusion, our study demonstrate for the first time that melatonin has therapeutic potential for fentanyl addiction.
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Affiliation(s)
- Kaili Du
- Department of Pathology, Shanxi Medical University, Taiyuan, 030001, China; School of Forensic Medicine, Shanxi Medical University, Taiyuan, 030001, China; School of Basic Medicine, Shanxi Medical University, Taiyuan, 030001, China
| | - Qianwen Shi
- School of Forensic Medicine, Shanxi Medical University, Taiyuan, 030001, China; Shanxi Key Laboratory of Forensic Medicine, Shanxi, 030600, China
| | - Xiuya Zhou
- Department of Pathology, Shanxi Medical University, Taiyuan, 030001, China; School of Basic Medicine, Shanxi Medical University, Taiyuan, 030001, China
| | - Lifei Zhang
- Department of Pathology, Shanxi Medical University, Taiyuan, 030001, China; School of Basic Medicine, Shanxi Medical University, Taiyuan, 030001, China
| | - Hongliang Su
- School of Forensic Medicine, Shanxi Medical University, Taiyuan, 030001, China; Shanxi Key Laboratory of Forensic Medicine, Shanxi, 030600, China
| | - Chao Zhang
- School of Forensic Medicine, Shanxi Medical University, Taiyuan, 030001, China; Shanxi Key Laboratory of Forensic Medicine, Shanxi, 030600, China
| | - Zhiwen Wei
- School of Forensic Medicine, Shanxi Medical University, Taiyuan, 030001, China; Shanxi Key Laboratory of Forensic Medicine, Shanxi, 030600, China
| | - Ting Liu
- Department of Pathology, Shanxi Medical University, Taiyuan, 030001, China; School of Basic Medicine, Shanxi Medical University, Taiyuan, 030001, China
| | - Li Wang
- Department of Pathology, Shanxi Medical University, Taiyuan, 030001, China; School of Basic Medicine, Shanxi Medical University, Taiyuan, 030001, China
| | - Xiaohui Wang
- Department of Pathology, Shanxi Medical University, Taiyuan, 030001, China; School of Basic Medicine, Shanxi Medical University, Taiyuan, 030001, China
| | - Bin Cong
- School of Forensic Medicine, Shanxi Medical University, Taiyuan, 030001, China; Shanxi Key Laboratory of Forensic Medicine, Shanxi, 030600, China; School of Forensic Medicine, Hebei Medical University, Shijiazhuang, 050017, China
| | - Keming Yun
- School of Forensic Medicine, Shanxi Medical University, Taiyuan, 030001, China; Shanxi Key Laboratory of Forensic Medicine, Shanxi, 030600, China.
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Ouellet J, Assaf R, Afzali MH, Nourbakhsh S, Potvin S, Conrod P. Neurocognitive consequences of adolescent sleep disruptions and their relationship to psychosis vulnerability: a longitudinal cohort study. NPJ MENTAL HEALTH RESEARCH 2024; 3:18. [PMID: 38714732 PMCID: PMC11076494 DOI: 10.1038/s44184-024-00058-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 02/15/2024] [Indexed: 05/10/2024]
Abstract
Adolescence is a key period for neurocognitive maturation where deviation from normal developmental trajectories may be tied to adverse mental health outcomes. Cognitive disruptions have been noted in populations at risk for psychosis and are known to accompany periods of sleep deprivation. This study aims to assess the role of cognition as a mediator between sleep disruptions and psychosis risk. A cohort of 3801 high school students (51% female, mean age = 12.8, SD = 0.45 years) was recruited from 31 Montreal high schools. Measures of sleep, psychotic-like experiences, inhibition, working memory, perceptual reasoning, and delayed recall were collected from participants on a yearly basis over the five years of their high school education. A multi-level model mediation analysis was performed controlling for sex and time squared. Response inhibition was shown to be associated with, and to mediate (B = -0.005, SD = 0.003, p = 0.005*) the relationship between sleep disruptions (B = -0.011, SD = 0.004, p < 0.001*) and psychotic-like experiences (B = 0.411, SD = 0.170, p = 0.005*). Spatial working memory deficits on a given year were associated with a higher frequency of psychotic-like experiences that same year (B = -0.046, SD = 0.018, p = 0.005*) and the following year (B = -0.051, SD = 0.023, p = 0.010*), but were not associated with sleep disturbances. No significant associations were found between our variables of interest and either delayed recall or perceptual reasoning at the within person level. Findings from this large longitudinal study provide evidence that the association between sleep disruptions and psychosis risk is specifically mediated by inhibitory rather than general cognitive impairments. The association of spatial working memory, response inhibition, and sleep disruptions with psychotic-like experiences suggests that these factors may represent potential targets for preventative interventions.
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Affiliation(s)
- Julien Ouellet
- CHU Sainte-Justine Research Center, Montreal, QC, Canada.
- Department of Neuroscience, Université de Montréal, Montreal, QC, Canada.
| | - Roxane Assaf
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
| | | | - Sima Nourbakhsh
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
| | - Stéphane Potvin
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
- Institut Universitaire en Santé Mentale de Montréal Research Center, Montreal, QC, Canada
| | - Patricia Conrod
- CHU Sainte-Justine Research Center, Montreal, QC, Canada.
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada.
- Department of Pediatrics, Université de Montréal, Montreal, QC, Canada.
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9
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Davis JP, Prindle J, Saba SK, Castro CA, Hummer J, Canning L, Pedersen ER. Longitudinal associations between insomnia, cannabis use and stress among US veterans. J Sleep Res 2024; 33:e13945. [PMID: 37243415 PMCID: PMC10676445 DOI: 10.1111/jsr.13945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 05/02/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023]
Abstract
Insomnia is highly prevalent among military veterans, with rates nearly double that of civilian populations. Insomnia typically co-occurs with other psychological problems, including substance use (e.g. cannabis) and perceived stress. Much of the research focused on insomnia, stress and cannabis use explores cannabis as a sleep aid and a mechanism for stress relief. However, recent theoretical and empirical evidence suggests a dynamic interplay between insomnia, cannabis use and perceived stress, yet few longitudinal studies exist. Using a sample of 1105 post-9/11 veterans assessed over four time points across 12 months, we used latent difference score modelling to examine proportional change between insomnia, perceived stress and cannabis use. Results revealed a complex interplay between all three constructs. In particular, we show that higher prior levels of insomnia are associated with greater increases in perceived stress, and greater prior levels of stress are associated with greater increases in cannabis use. Perhaps more importantly, our results also point to cannabis use as a catalyst for greater increases in both stress and insomnia severity. Our results suggest there may be both benefits and costs of cannabis use among veterans. Specifically, for veterans who experience chronic sleep problems, perceived stress may become overwhelming, and the benefit of stress reduction from increased cannabis use may come at the cost of increasing insomnia symptomology.
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Affiliation(s)
- Jordan P. Davis
- University of Southern California, Suzanne Dworak-Peck School of Social Work
| | - John Prindle
- University of Southern California, Suzanne Dworak-Peck School of Social Work
| | - Shaddy K. Saba
- University of Southern California, Suzanne Dworak-Peck School of Social Work
| | - Carl A. Castro
- University of Southern California, Suzanne Dworak-Peck School of Social Work
| | | | - Liv Canning
- University of Southern California, Suzanne Dworak-Peck School of Social Work
| | - Eric R. Pedersen
- University of Southern California, Keck School of Medicine, Department of Psychiatry and Behavioral Sciences
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10
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Mauries S, Bertrand L, Frija-Masson J, Benzaquen H, Kalamarides S, Sauvage K, Lejoyeux M, d’Ortho MP, Geoffroy PA. Effects of smoking on sleep architecture and ventilatory parameters including apneas: Results of the Tab-OSA study. Sleep Med X 2023; 6:100085. [PMID: 37736106 PMCID: PMC10509708 DOI: 10.1016/j.sleepx.2023.100085] [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: 06/13/2023] [Revised: 09/06/2023] [Accepted: 09/06/2023] [Indexed: 09/23/2023] Open
Abstract
Background The interaction between smoking and sleep seems appears to be bidirectional, but few studies evaluated the impact of smoking and its cessation on objective sleep parameters. In this context, this new study aimed to assess the impact of smoking and its cessation on sleep architecture and on ventilatory sleep parameters, particularly the presence of sleep apnea syndrome (apnea-hypopnea index (AHI)≥15). Methods: Patients hospitalized for polysomnographic sleep exploration were compared according to their smoking status: active smokers (AS), former smokers (FS), non-smokers (NoNi). Psychiatric and non-psychiatric co-morbidities and treatment or substance use were taken into account in the analyses. Results A total of 170 participants were included (N = 37 FS, 39 AS, 86 NoNi). A significant decrease in the mean nocturnal O2 saturation was observed for FS and AS compared to NoNi. No differences were found regarding AHI. Regarding sleep architecture, we observed a significant decrease in the slow wave sleep duration for AS compared to NoNi, and interestingly not between FS and NoNi. Conclusion This study suggests that current smokers suffer from alterations in both sleep architecture and ventilatory parameters, the later appears to persist even after smoking cessation.
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Affiliation(s)
- Sibylle Mauries
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France
| | - Léa Bertrand
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France
| | - Justine Frija-Masson
- Université de Paris, NeuroDiderot, Inserm, U1141, 48 boulevard Sérurier, 75019, Paris, France
- Explorations Fonctionnelles et Centre du Sommeil- Département de Physiologie Clinique, Assistance Publique des Hôpitaux de Paris, GHU Paris Nord, DMU DREAM, Hôpital Bichat, 46 rue Henri Huchard, 75018, Paris, France
| | - Hélène Benzaquen
- Explorations Fonctionnelles et Centre du Sommeil- Département de Physiologie Clinique, Assistance Publique des Hôpitaux de Paris, GHU Paris Nord, DMU DREAM, Hôpital Bichat, 46 rue Henri Huchard, 75018, Paris, France
| | - Sophie Kalamarides
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Beaujon, 100 boulevard Général Leclerc, 92110, Clichy, France
| | - Karine Sauvage
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France
| | - Michel Lejoyeux
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France
- GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, 75014, Paris, France
| | - Marie-Pia d’Ortho
- Université de Paris, NeuroDiderot, Inserm, U1141, 48 boulevard Sérurier, 75019, Paris, France
- Explorations Fonctionnelles et Centre du Sommeil- Département de Physiologie Clinique, Assistance Publique des Hôpitaux de Paris, GHU Paris Nord, DMU DREAM, Hôpital Bichat, 46 rue Henri Huchard, 75018, Paris, France
| | - Pierre A. Geoffroy
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France
- GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, 75014, Paris, France
- Université de Paris, NeuroDiderot, Inserm, U1141, 48 boulevard Sérurier, 75019, Paris, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, 5 rue Blaise Pascal, 67000, Strasbourg, France
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Beaujon, 100 boulevard Général Leclerc, 92110, Clichy, France
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11
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Shriane AE, Rigney G, Ferguson SA, Bin YS, Vincent GE. Healthy sleep practices for shift workers: consensus sleep hygiene guidelines using a Delphi methodology. Sleep 2023; 46:zsad182. [PMID: 37429599 PMCID: PMC10710992 DOI: 10.1093/sleep/zsad182] [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: 11/27/2022] [Revised: 06/19/2023] [Indexed: 07/12/2023] Open
Abstract
STUDY OBJECTIVES The unique requirements of shift work, such as sleeping and working at variable times, mean that current sleep hygiene guidelines may be inappropriate for shift workers. Current guidelines may also contradict fatigue management advice (e.g. advising against daytime napping). The present study utilized a Delphi methodology to determine expert opinion regarding the applicability of current guidelines for shift workers, the appropriateness of the term "sleep hygiene," and develop tailored guidelines for shift workers. METHODS The research team reviewed current guidelines and existing evidence to draft tailored guidelines. Seventeen individual guidelines, covering sleep scheduling, napping, sleep environment, bedtime routine, substances, light exposure, diet, and exercise were drafted. Experts from sleep, shift work, and occupational health fields (n = 155) were invited to review the draft guidelines using a Delphi methodology. In each round, experts voted on individual guidelines, with 70% agreement considered consensus. Where consensus was not reached, written feedback from experts was discussed and incorporated into subsequent iterations. RESULTS Of the experts invited, 68 (44%) agreed to participate, with 55 (35%) completing the third (final) round. Most experts (84%) agreed that tailored guidelines were required for shift workers. Consensus was reached on all guidelines after three rounds. One additional guideline (sleep inertia) and an introductory statement were developed, resulting in a final set of 18 individual guidelines, termed "healthy sleep practices for shift workers." CONCLUSIONS This is the first study to develop tailored sleep hygiene guidelines for shift workers. Future research should investigate the acceptability and effectiveness of these guidelines amongst shift workers.
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Affiliation(s)
- Alexandra E Shriane
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, SA, Australia
| | - Gabrielle Rigney
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, SA, Australia
| | - Sally A Ferguson
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, SA, Australia
| | - Yu Sun Bin
- Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
- Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Grace E Vincent
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, SA, Australia
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12
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Baldassarri SR, Chu JH, Deng A, Xu Z, Blohowiak RF, Byrne S, Kushida C, Yaggi HK, Zinchuk A. Nicotine, alcohol, and caffeine use among individuals with untreated obstructive sleep apnea. Sleep Breath 2023; 27:2479-2490. [PMID: 37058215 PMCID: PMC10576010 DOI: 10.1007/s11325-023-02830-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/22/2023] [Accepted: 04/07/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND Psychoactive substance use (i.e., nicotine, alcohol, and caffeine) has substantial effects on sleep architecture in healthy individuals, but their effects in those with obstructive sleep apnea (OSA) have not been well described. We aimed to describe the association between psychoactive substance use and sleep characteristics and daytime symptoms in individuals with untreated OSA. METHODS We performed a secondary, cross-sectional analysis of The Apnea Positive Pressure Long-term Efficacy Study (APPLES). Exposures included current smoking, alcohol and caffeine use in individuals with untreated OSA. Outcome domains included subjective and objective sleep characteristics, daytime symptoms, and comorbid conditions. Linear or logistic regression assessed the association between substance use and each domain (e.g., self-reported sleep duration, total polysomnographic sleep time, sleepiness, and anxiety). RESULTS Of the 919 individuals with untreated OSA, 116 (12.6%) were current cigarette smokers, 585 (63.7%) were moderate or heavy alcohol users, and 769 (83.7%) were moderate or heavy caffeine users. Participants were on average 52.2±11.9 years old, 65.2% were male with a median BMI of 30.6 (IQR: 27.2, 35.9, kg/m2). Current smokers exhibited lower sleep duration (0.3 h), longer sleep latency (5 min) compared with non-smokers (all p-values < 0.05). People with heavy or moderate alcohol use exhibited more REM sleep (2.5 and 5% of total sleep time respectively), as did those with moderate caffeine use (2%, p-values < 0.05). The combined smoker plus caffeine group exhibited shorter sleep duration (0.4 h, p-value < 0.05) and higher risk for chronic pain [Odds Ratio (95%CI) = 4.83 (1.57, 14.9) compared with non-users. CONCLUSIONS Psychoactive substance use is associated with sleep characteristics and clinically relevant correlates in people with untreated OSA. Further investigation into the effects that various substances have on this population may present opportunities to understand disease mechanisms more fully and increase the effectiveness of treatment in OSA.
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Affiliation(s)
- Stephen R Baldassarri
- Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, 300 Cedar Street, TAC-455E South, New Haven, CT, 06520, USA.
- Program in Addiction Medicine, Yale School of Medicine, New Haven, CT, USA.
- Program in Sleep Medicine, Yale School of Medicine, New Haven, CT, USA.
| | - Jen-Hwa Chu
- Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, 300 Cedar Street, TAC-455E South, New Haven, CT, 06520, USA
| | - Annan Deng
- Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, 300 Cedar Street, TAC-455E South, New Haven, CT, 06520, USA
| | - Zhichao Xu
- Department of Biostatistics, Yale University School of Public Health, New Haven, CT, USA
| | - Reagan F Blohowiak
- Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, 300 Cedar Street, TAC-455E South, New Haven, CT, 06520, USA
| | - Sean Byrne
- Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, 300 Cedar Street, TAC-455E South, New Haven, CT, 06520, USA
- Program in Sleep Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Clete Kushida
- Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Palo Alto, CA, USA
| | - H Klar Yaggi
- Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, 300 Cedar Street, TAC-455E South, New Haven, CT, 06520, USA
- Program in Addiction Medicine, Yale School of Medicine, New Haven, CT, USA
- Program in Sleep Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Andrey Zinchuk
- Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, 300 Cedar Street, TAC-455E South, New Haven, CT, 06520, USA
- Program in Sleep Medicine, Yale School of Medicine, New Haven, CT, USA
- Advanced Apnea Management Program, Yale School of Medicine, New Haven, CT, USA
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13
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Singh N, Wanjari A, Sinha AH. Effects of Nicotine on the Central Nervous System and Sleep Quality in Relation to Other Stimulants: A Narrative Review. Cureus 2023; 15:e49162. [PMID: 38130519 PMCID: PMC10733894 DOI: 10.7759/cureus.49162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023] Open
Abstract
Nicotine is used extensively across the globe despite the common awareness of the fact that it might stimulate the neurological system in those who indulge in its consumption. Nicotine can be consumed in a wide number of various forms and can also be delivered in a wide variety of different ways. After it has been heated, it can be smoked, consumed sublingually, or brought into touch with mucosal surfaces, with the buccal mucosa being the most popular one. These three methods of consumption account for the vast majority of its use. It has been demonstrated without a reasonable doubt that people who partake in nicotine do, in fact, experience an increase in their levels of alertness, wakefulness, attention, and focus. The half-life of the substance, in addition to its effects, is highly variable depending on the forms in which it is consumed, viz. cigarettes, tobacco, gums, lozenges, and the manner in which it is administered. This is the case regardless of whether the chemical is administered orally or intravenously. It is common for a person to require multiple "hits" of the chemical throughout the course of the day, though the frequency of these needs and the intervals between them can vary greatly. The time interval between each of these "hits" can range anywhere from a few hours to a few minutes. The user has the potential to develop a tolerance to the neurostimulatory and systemic effects of nicotine, as well as a heightened sensitivity to those effects, and even hereditary predispositions to specific adverse consequences. There is also a possibility that the user will develop an addiction to nicotine. This literature review aims to explore the relationship between nicotine consumption and its effects on the central nervous system, especially on sleep.
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Affiliation(s)
- Nihaal Singh
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anil Wanjari
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Arya Harshyt Sinha
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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14
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Goyal P, Kattula D, Rao R, Bhad R, Mishra AK, Dhawan A. Trazodone for sleep disturbance in opioid dependent patients maintained on buprenorphine: A double blind, placebo-controlled trial. Drug Alcohol Depend 2023; 250:110891. [PMID: 37478501 DOI: 10.1016/j.drugalcdep.2023.110891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/01/2023] [Accepted: 07/04/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Sleep disturbances are seen even in individuals on opioid agonist treatment (OAT). Established pharmacotherapy for sleep disturbances such as benzodiazepines have misuse potential and increased mortality risk in patients with OAT. No study has explored the role of trazodone on sleep disturbance in individuals maintained on buprenorphine. We aimed to assess the efficacy of trazodone in improving sleep disturbance among individuals maintained on buprenorphine. METHODS The study was a double-blind, placebo-controlled, parallel, randomised trial. Adult males (18-60 years) stabilised on buprenorphine with Pittsburgh Sleep Quality Index (PSQI) score of above five, without other psychiatric comorbidity were randomised to receive either trazodone (50-150mg per day) or placebo. Sleep-50 questionnaire, Epworth Sleepiness Scale (ESS), Brief Pain Inventory (BPI), Clinical Opiate Withdrawal Scale (COWS), Depression, Anxiety and Stress Scale (DASS)-21, Visual Analogue Scale (VAS) for opioid craving, and PSQI were assessed at baseline and at the end of six weeks. RESULTS Fifty-one patients were allocated to trazodone arm and 49 to placebo arm. Side-effects of trazodone were minimal and well-tolerated with comparable discontiuation rates between both groups. Significantly greater proportion of patients on trazodone (82%, mean dose 101.9 mg) had PSQI scores five or less than those on placebo (16%) at the end of six weeks. Sleep improvement was in various components like sleep quality, latency, efficiency, and duration of sleep. CONCLUSION Trazodone is well-tolerated and effective in improving sleep disturbances in individuals with opioid dependence maintained on buprenorphine over a six-week period.
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Affiliation(s)
- Piyush Goyal
- National Drug Dependence Treatment Centre, Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Dheeraj Kattula
- National Drug Dependence Treatment Centre, Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Ravindra Rao
- National Drug Dependence Treatment Centre, Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
| | - Roshan Bhad
- National Drug Dependence Treatment Centre, Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Ashwani Kumar Mishra
- National Drug Dependence Treatment Centre, Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Anju Dhawan
- National Drug Dependence Treatment Centre, Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
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15
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Duo L, Yu X, Hu R, Duan X, Zhou J, Wang K. Sleep disorders in chronic pain and its neurochemical mechanisms: a narrative review. Front Psychiatry 2023; 14:1157790. [PMID: 37324825 PMCID: PMC10267346 DOI: 10.3389/fpsyt.2023.1157790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
Abstract
Chronic pain (CP) is a prevalent problem, and more than half of patients with CP have sleep disorders. CP comorbidity with sleep disorders imposes immense suffering and seriously affects the patient's quality of life, which is a challenging issue encountered by clinicians. Although the reciprocal interactions between pain and sleep have been studied to some degree, there is still a lack of awareness and comprehensive description of CP comorbidity with sleep disorders. In this narrative review article, we summarize the current knowledge about the present estimates of the prevalence of comorbid sleep disorders in CP patients, sleep detection methods, sleep characterization in CP, and the effect of sleep disorders on CP and current therapies. We also summarize current knowledge of the neurochemical mechanisms of CP comorbidity with sleep disorders. In conclusion, insufficient attention has been paid to the role of sleep disorders in CP patients, and CP patients should be screened for sleep disorders in the clinic. Special attention should be given to a possible risk of drug-drug interaction when using two types of drugs targeting pain and sleep simultaneously. The current insight into the neurobiological mechanisms underlying CP comorbidity with sleep disorders is still rather limited.
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16
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Meneo D, Bacaro V, Curati S, Russo PM, Martoni M, Gelfo F, Baglioni C. A systematic review and meta-analysis of the association between young adults' sleep habits and substance use, with a focus on self-medication behaviours. Sleep Med Rev 2023; 70:101792. [PMID: 37269785 DOI: 10.1016/j.smrv.2023.101792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/05/2023] [Accepted: 05/10/2023] [Indexed: 06/05/2023]
Abstract
Young adults (18-30 years) are vulnerable to sleep-wake disturbances and substance use, which are bi-directionally associated. The present work aims to organise the literature that deals with the association between sleep and substance use in young adults, also considering self-medication behaviours. We adopted a framework that accounts for the multidimensionality of sleep and the effect of different substances. We considered sleep disturbances (insomnia symptoms, sleep quality), sleep health dimensions (duration, satisfaction, efficiency, timing, daytime alertness), circadian characteristics (chronotype). Substances were alcohol, caffeine, nicotine, cannabis, others. We included 46 studies. The use of caffeine and nicotine was associated with higher odds of sleep disturbances. No significant effect was detected for sleep duration. In narrative findings, daytime dysfunction was associated with alcohol and caffeine use, and poor sleep satisfaction with nicotine use. Few evidence were available for the other sleep health dimensions. Evening chronotype was associated with alcohol, caffeine, and nicotine use. Few studies focused on cannabis or self-medication. Longitudinal results were inconclusive. We found a distinct pattern of associations between different substances and different sleep outcomes. Further investigation considering the multidimensionality of sleep would create a better understanding of the complex relationship between substance use and sleep health in young adults.
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Affiliation(s)
- Debora Meneo
- Department of Human Sciences, Guglielmo Marconi University, Rome, Italy.
| | - Valeria Bacaro
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Sara Curati
- Department of Human Sciences, Guglielmo Marconi University, Rome, Italy
| | - Paolo Maria Russo
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Monica Martoni
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Francesca Gelfo
- Department of Human Sciences, Guglielmo Marconi University, Rome, Italy; IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Chiara Baglioni
- Department of Human Sciences, Guglielmo Marconi University, Rome, Italy; Department of Clinical Psychology and Psychophysiology/Sleep, Medicine, Centre for Mental Disorders, University Medical Centre, Freiburg, Germany
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17
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Xu H, Xu C, Guo Y, Hu Y, Bai G, Du M. Abnormal neuroanatomical patterns as potential diagnostic biomarkers for cocaine use disorder. Addict Biol 2023; 28:e13348. [PMID: 37855070 DOI: 10.1111/adb.13348] [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: 06/11/2023] [Revised: 09/07/2023] [Accepted: 09/26/2023] [Indexed: 10/20/2023]
Abstract
Cocaine use disorder (CUD) is a global health problem with serious consequences for both individuals and society. Previous studies on abnormal anatomical patterns in CUD have mainly used voxel-based morphometry to investigate grey matter volume changes, while surface-based morphometry (SBM) has been found to provide detail information on cortical thickness (CT), surface area and cortical meancurve, which can contribute to a better understanding of structural brain changes associated with CUD. In this study, SBM was conducted to investigate abnormal neuroanatomical patterns in CUD and whether these abnormal patterns could be used as potential diagnostic biomarkers for CUD. Sixty-eight CUD individuals and 52 matched healthy controls were enrolled, and all participants performed once MRI scanning and clinical assessments. We found that CUD individuals exhibited altered morphological indicators across widespread brain regions and these abnormal anatomical alterations were significantly predictive of CUD status. Furthermore, the CT reduction of right insula was significantly associated with years of cocaine use in CUD. These findings revealed the association of abnormal anatomical patterns in specific brain regions in CUD, which further improve the understanding of CUD pathophysiology and provide the alternative diagnostic biomarkers for CUD.
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Affiliation(s)
- Hui Xu
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Cheng Xu
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Yunyu Guo
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yike Hu
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Guanghui Bai
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Meimei Du
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
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18
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Graupensperger S, Hultgren BA, Fairlie AM, Lee CM, Larimer ME. Using Alcohol and Cannabis as Sleep Aids: Associations with Descriptive Norms Among College Students. Behav Sleep Med 2023; 21:84-96. [PMID: 35156478 PMCID: PMC9372229 DOI: 10.1080/15402002.2022.2040505] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE Young adults may use alcohol and cannabis as sleep aids, a risky behavior that can worsen sleep health over time and lead to substance dependence. Perceived norms for such risky behaviors are often overestimated and related to one's own use. This cross-sectional study examined: (a) the extent to which college students overestimated the prevalence of alcohol and cannabis use as sleep aids (i.e., perceived descriptive norms), and (b) the extent to which perceived descriptive norms were associated with students' own use of alcohol and cannabis as sleep aids. METHODS 2,642 undergraduate college students (Mage = 18.84 years) reported past 30-day use of alcohol and cannabis as sleep aids. Participants also estimated the percent of college students who use alcohol and cannabis as sleep aids (i.e., perceived descriptive norms). RESULTS One-sample t-tests revealed participants, on average, overestimated the norms for using alcohol and cannabis as sleep aids. Participants who endorsed past 30-day use of these substances as sleep aids overestimated these norms to an even greater extent. Count regression models showed perceived descriptive norms were associated with students' use of alcohol and of cannabis as sleeps aids, in respective models, even when controlling for sleep difficulties. CONCLUSIONS College students may overestimate the prevalence of using alcohol and cannabis as sleep aids, and students who believe these behaviors are more normative report more frequent use of these substances as sleep aids. Taken together, findings may highlight the potential for norm-correcting strategies as a prudent approach to reducing/preventing the use of alcohol and cannabis as sleep aids.
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Affiliation(s)
- Scott Graupensperger
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Brittney A Hultgren
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Anne M Fairlie
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Christine M Lee
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Mary E Larimer
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
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19
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Cederlöf E, Holm M, Ahti J, Lähteenvuo M, Hietala J, Häkkinen K, Isometsä E, Kampman O, Lahdensuo K, Lönnqvist J, Suvisaari J, Tiihonen J, Wegelius A, Veijola J, Palotie A, Kieseppä T, Niemelä S, Paunio T. Substance Use and Sleep Problems in Patients With Psychotic Disorders. SCHIZOPHRENIA BULLETIN OPEN 2023; 4:sgac073. [PMID: 39145344 PMCID: PMC11207820 DOI: 10.1093/schizbullopen/sgac073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
Background Substance use and sleep problems are common in patients with psychotic disorders, but their associations in these patients have not been evaluated. We aimed to investigate associations between substance use and sleep problems in a large nationwide cohort of patients with a psychotic disorder. Study Design This study is part of the Finnish SUPER study, which belongs to the Stanley Global Neuropsychiatric Genomics Initiative. In this cross-sectional, multicenter study, participants (N = 8616) were recruited from primary and specialized healthcare. Patients with schizophrenia, schizoaffective disorder, bipolar disorder, and psychotic depression were included. Information on current alcohol (Alcohol Use Disorders Identification Test-Concise) and cigarette use as well as on lifetime illicit drug use, including cannabis, benzodiazepines, amphetamines, and opioids, was collected using questionnaires. The sleep outcomes in our logistic regression analysis were short (≤6 h) and long sleep (≥10 h) duration, difficulties initiating asleep, early morning awakenings, fatigue, and poor sleep quality (SQ). Results Self-reported substance use was associated with a higher prevalence of sleep problems. After adjustments with age, gender, diagnostic group, and living status, hazardous alcohol use (eg, poor SQ odds ratio [OR] = 1.80, 95% CI: 1.49 to 2.16, P < .001), current smoking (short sleep duration OR = 1.28, 95% CI: 1.08 to 1.52, P = .005), and lifetime benzodiazepine misuse (difficulties initiating sleep OR = 2.00, 95% CI: 1.55 to 2.48, P < .001) were associated with sleep problems. Conclusions Substance use was associated with sleep problems. Our findings underline the potential benefits of screening substance use when treating sleep problems in patients with psychotic disorders.
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Affiliation(s)
- Erik Cederlöf
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Minna Holm
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Johan Ahti
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | | | - Katja Häkkinen
- Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
| | - Erkki Isometsä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Olli Kampman
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
- Department of Psychiatry, University of Tampere, Tampere, Finland
| | - Kaisla Lahdensuo
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | | | - Jari Tiihonen
- Niuvanniemi Hospital, University of Eastern, Kuopio,
Finland
- Karolinska Institutet, Solna, Sweden
| | - Asko Wegelius
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Juha Veijola
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
- Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
| | - Tuula Kieseppä
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | - Tiina Paunio
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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20
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Belloir JA, Kidd JD, Dworkin JD, Bockting WO. Examining the role of problematic drug use in the relationship between discrimination and sleep disturbance in transgender and nonbinary individuals. Addict Behav 2022; 135:107459. [PMID: 35986953 DOI: 10.1016/j.addbeh.2022.107459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 07/19/2022] [Accepted: 08/02/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Transgender and nonbinary (TGNB) individuals are a health disparity population at high risk for sleep disturbance (e.g., insomnia). Recent evidence suggests minority stress (e.g., discrimination) is associated with sleep disturbance in TGNB adults. However, investigators have yet to identify factors that might explain this relationship. In this study, we investigated the role of problematic drug use (PDU) in the relationship between discrimination and sleep disturbance in TGNB individuals. METHODS The study sample included 194 TGNB participants from Wave 5 (2021) of Project AFFIRM, a multi-site longitudinal study of transgender health. Discrimination, PDU, and sleep disturbance were measured using the Everyday Discrimination Scale, Drug Use Disorders Identification Test (DUDIT), and PROMIS Sleep Disturbance measures, respectively. Individuals were classified as having PDU using established DUDIT criteria that were applied based on sex assigned at birth. Regression analyses were used to estimate the associations of study variables, and subsequently, mediation analysis was used to determine whether PDU partially mediated the association between discrimination and sleep disturbance. RESULTS Nearly half of participants reported PDU, of which 83.2% reported cannabis use. Higher levels of discrimination were associated with worse self-reported sleep disturbance scores. Additionally, participants with greater discrimination were more likely to have PDU. Surprisingly, participants with PDU had lower sleep disturbance scores. CONCLUSIONS Our cross-sectional findings suggest that PDU partially suppressed the association between discrimination and sleep disturbance in TGNB people. Efforts to address PDU in TGNB adults may consider assessing sleep disturbance as a motivating factor for drug use and the potential role of discrimination in perpetuating PDU.
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Affiliation(s)
- Joseph A Belloir
- Columbia University School of Nursing, 560 West 168(th) Street, New York, NY 10032, USA.
| | - Jeremy D Kidd
- Columbia University and the New York State Psychiatric Institute, USA.
| | - Jordan D Dworkin
- Columbia University and the New York State Psychiatric Institute, USA.
| | - Walter O Bockting
- Columbia University and the New York State Psychiatric Institute, USA.
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21
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Ouellet J, Spinney S, Assaf R, Boers E, Livet A, Potvin S, Conrod P. Sleep as a Mediator Between Cannabis Use and Psychosis Vulnerability: A Longitudinal Cohort Study. SCHIZOPHRENIA BULLETIN OPEN 2022; 4:sgac072. [PMID: 36756192 PMCID: PMC9894023 DOI: 10.1093/schizbullopen/sgac072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Objectives Increasing evidence implicates cannabis consumption as a key risk factor in the development of psychosis, but the mechanisms underpinning this relationship remain understudied. This study proposes to determine whether sleep disruption acts as a mediator of the cannabis-to-psychosis relationship. Study Design This longitudinal study assessed measures of cannabis use frequency, sleep quality (SQ), and psychotic-like experiences (PLEs) were collected using self-reported questionnaires. Data were collected from September 2012 to September 2018. Data were collected from a general population sample of adolescents who entered the seventh grade in 31 schools in the Greater Montreal area. The study uses data collected on an annual basis from 3801 high school students from grades 7 to 11. The aforementioned measures were measured using the Detection of Alcohol and Drug Problems in Adolescents questionnaire, a SQ Likert scale, and measures the Psychotic-Like Experiences Questionnaire for Children. Study Results Results show a reciprocal 1-year cross-lagged effect of cannabis use and sleep (β = -0.076, 95% CI = -0.037 to -0.018, P = .000), of sleep on cannabis use (β = -.016, 95% CI = -0.025 to -0.006, P = .007), of sleep on PLEs (β = -0.077, 95%CI = -0.014 to -0.051, P = .000), and of PLEs on sleep (β = -0.027, 95% CI = -0.037 to -0.018, P = .000). We additionally found a 2 years indirect lagged-effect of cannabis use on PLEs (β = 0.068, 95% CI = 0.024 to 0.113, P = .011) mediated by 1-year sleep (β = 0.006, 95% CI = 0.003 to 0.009, P = .001). Conclusions Our results suggest sleep disruptions simultaneously aggravate, and are aggravated by, cannabis addiction and PLEs. The longitudinal sleep-mediated effect of cannabis use on PLEs encourages further research into the role of sleep as a potential therapeutic target in the prevention of cannabis-related psychosis.
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Affiliation(s)
- Julien Ouellet
- To whom correspondence should be addressed; tel: 514-833-5026, e-mail:
| | - Sean Spinney
- CHU Sainte-Justine Research Center, Montreal, QC, Canada,Department of Computer Science and Operations Research, Université de Montréal, Montreal, QC, Canada
| | - Roxane Assaf
- CHU Sainte-Justine Research Center, Montreal, QC, Canada,Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
| | - Elroy Boers
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
| | - Audrey Livet
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
| | - Stéphane Potvin
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada,Institut Universitaire en Santé Mentale de Montréal Research Center, Montreal, QC, Canada
| | - Patricia Conrod
- CHU Sainte-Justine Research Center, Montreal, QC, Canada,Department of Psychiatry, Université de Montréal, Montreal, QC, Canada,Department of Pediatrics, Université de Montréal, Montreal, QC, Canada
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22
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Keen L, Turner AD, George L, Lawrence K. Cannabis use disorder severity and sleep quality among undergraduates attending a Historically Black University. Addict Behav 2022; 134:107414. [PMID: 35810645 DOI: 10.1016/j.addbeh.2022.107414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 06/09/2022] [Accepted: 06/15/2022] [Indexed: 11/20/2022]
Abstract
Nearly one third of Americans experience poor sleep, which is associated with numerous deleterious health outcomes. Poor sleep may be exacerbated when an individual attends college, as they experience drastic shifts in lifestyle and sleep patterns. Previous research suggests cannabis has therapeutic potential for sleep disorders but may also impair sleep quality long-term. However, no study has examined the differences in sleep quality within individuals who meet criteria for Cannabis Use Disorder (CUD). The purpose of the current study was to determine differences in sleep quality among undergraduate students who met criteria for mild CUD (n = 18), moderate CUD (n = 22), severe CUD (n = 16) and students who did not meet criteria for CUD (n = 244). Participants included 300 predominantly Black/African American undergraduate students (79% female), aged between 18 and 25 years. Each participant completed an online survey that included measures assessing sleep quality and CUD criteria. Employing analysis of covariance, the moderate CUD subgroup (M = 9.00, SD = 3.32) reported poorer sleep quality than individuals who did not meet criteria for CUD (M = 6.93, SD = 3.03). Interestingly, the severe CUD subgroup (M = 6.75, SD = 2.52) reported similar sleep quality to individuals who did not meet criteria for CUD (M = 6.93, SD = 3.03). Individuals meeting criteria for mild and moderate CUD reported the poorest sleep quality among the groups, suggesting a differentiation within CUD severity. Future research should assess withdrawal and cannabis use frequency among individuals who meet criteria for CUD to further elucidate disturbances in sleep quality among those with CUD.
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Affiliation(s)
- Larry Keen
- Psychology Department, Virginia State University, USA
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23
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Yousefzadehfard Y, Wechsler B, DeLorenzo C. Human circadian rhythm studies: Practical guidelines for inclusion/exclusion criteria and protocol. Neurobiol Sleep Circadian Rhythms 2022; 13:100080. [PMID: 35989718 PMCID: PMC9382328 DOI: 10.1016/j.nbscr.2022.100080] [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: 04/08/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 11/03/2022] Open
Abstract
As interest in circadian rhythms and their effects continues to grow, there is an increasing need to perform circadian studies in humans. Although the constant routine is the gold standard for these studies, there are advantages to performing more naturalistic studies. Here, a review of protocols for such studies is provided along with sample inclusion and exclusion criteria. Sleep routines, drug use, shift work, and menstrual cycle are addressed as screening considerations. Regarding protocol, best practices for measuring melatonin, including light settings, posture, exercise, and dietary habits are described. The inclusion/exclusion recommendations and protocol guidelines are intended to reduce confounding variables in studies that do not involve the constant routine. Given practical limitations, a range of recommendations is provided from stringent to lenient. The scientific rationale behind these recommendations is discussed. However, where the science is equivocal, recommendations are based on empirical decisions made in previous studies. While not all of the recommendations listed may be practical in all research settings and with limited potential participants, the goal is to allow investigators to make well informed decisions about their screening procedures and protocol techniques and to improve rigor and reproducibility, in line with the objectives of the National Institutes of Health.
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Affiliation(s)
- Yashar Yousefzadehfard
- Center for Understanding Biology Using Imaging Technology, Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA.,Department of Psychiatry, Texas Tech University Health Science Center, Midland, TX, USA
| | - Bennett Wechsler
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Christine DeLorenzo
- Center for Understanding Biology Using Imaging Technology, Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
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24
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Puig S, Shelton MA, Barko K, Seney ML, Logan RW. Sex-specific role of the circadian transcription factor NPAS2 in opioid tolerance, withdrawal and analgesia. GENES, BRAIN, AND BEHAVIOR 2022; 21:e12829. [PMID: 36053258 PMCID: PMC9744556 DOI: 10.1111/gbb.12829] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 08/09/2022] [Accepted: 08/09/2022] [Indexed: 02/05/2023]
Abstract
Opioids like fentanyl remain the mainstay treatment for chronic pain. Unfortunately, opioid's high dependence liability has led to the current opioid crisis, in part, because of side-effects that develop during long-term use, including analgesic tolerance and physical dependence. Both tolerance and dependence to opioids may lead to escalation of required doses to achieve previous therapeutic efficacy. Additionally, altered sleep and circadian rhythms are common in people on opioid therapy. Opioids impact sleep and circadian rhythms, while disruptions to sleep and circadian rhythms likely mediate the effects of opioids. However, the mechanisms underlying these bidirectional relationships between circadian rhythms and opioids remain largely unknown. The circadian protein, neuronal PAS domain protein 2 (NPAS2), regulates circadian-dependent gene transcription in structure of the central nervous system that modulate opioids and pain. Here, male and female wild-type and NPAS2-deficient (NPAS2-/-) mice were used to investigate the role of NPAS2 in fentanyl analgesia, tolerance, hyperalgesia and physical dependence. Overall, thermal pain thresholds, acute analgesia and tolerance to a fixed dose of fentanyl were largely similar between wild-type and NPAS2-/- mice. However, female NPAS2-/- exhibited augmented analgesic tolerance and significantly more behavioral symptoms of physical dependence to fentanyl. Only male NPAS2-/- mice had increased fentanyl-induced hypersensitivity, when compared with wild-type males. Together, our findings suggest sex-specific effects of NPAS2 signaling in the regulation of fentanyl-induced tolerance, hyperalgesia and dependence.
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Affiliation(s)
- Stephanie Puig
- Department of Pharmacology and Experimental TherapeuticsBoston University School of MedicineBostonMassachusettsUSA
- Translational Neuroscience Program, Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Micah A. Shelton
- Translational Neuroscience Program, Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Kelly Barko
- Translational Neuroscience Program, Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Marianne L. Seney
- Translational Neuroscience Program, Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Ryan W. Logan
- Department of Pharmacology and Experimental TherapeuticsBoston University School of MedicineBostonMassachusettsUSA
- Translational Neuroscience Program, Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
- Center for Systems NeuroscienceBoston UniversityBostonMassachusettsUSA
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25
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Objective sleep outcomes in randomized-controlled trials in persons with substance use disorders: A systematic review. Drug Alcohol Depend 2022; 237:109509. [PMID: 35660222 DOI: 10.1016/j.drugalcdep.2022.109509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 05/16/2022] [Accepted: 05/18/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Improving sleep health is an important target for substance use disorder (SUD) research. However, there is little guidance for SUD researchers regarding the use of technologies to objectively assess sleep outcomes in randomized-controlled trials (RCTs). This systematic review aimed to describe the use of technologies to objectively measure sleep outcomes in RCTs conducted in persons with SUDs, in order to inform future sleep intervention studies in SUD populations. METHODS This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) on May 7th, 2020 (CRD42020182004). RCTs were reviewed here if they were peer-reviewed manuscripts that included objective measures of sleep in RCTs that sought to improve sleep in persons with SUDs. RESULTS The initial search yielded 13,403 potential articles, with 27 meeting a priori criteria to be included in this review. The most common SUD was alcohol use disorder (59%). The most common technology used to assess sleep was polysomnography (41%), followed by actigraphy (37%), ambulatory polysomnography or components of polysomnography (e.g., electroencephalography; 19%), and at-home sleep apnea testing (7%). The most common sleep outcome reported was total sleep time (96%). CONCLUSIONS There are a range of options to assess objective sleep outcomes. Polysomnography or ambulatory devices that directly measure brain activity are critical to advance medications through the regulatory process for the indication of improving sleep duration, continuity, and/or sleep onset latency outcomes. Actigraphy is also useful in preliminary investigations and in detecting the relationship between diurnal and SUD-related behaviors.
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26
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Associations between comorbid anxiety and sleep disturbance in people with bipolar disorder: Findings from actigraphy and subjective sleep measures. J Affect Disord 2022; 309:165-171. [PMID: 35427709 PMCID: PMC9225955 DOI: 10.1016/j.jad.2022.04.065] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 02/03/2022] [Accepted: 04/10/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Studies show that comorbid anxiety disorders are common in people with bipolar disorder. However, little is known about whether this anxiety is associated with sleep disturbance. We investigated, in individuals with bipolar disorder, whether comorbid anxiety disorder is associated with sleep disturbance. METHODS Participants were 101 (64% female) currently euthymic individuals with a history of bipolar disorder. Sleep disturbances were assessed using self-report measures of sleep quality (Pittsburgh Sleep Quality Index, PSQI) and six weeks of sleep monitoring using actigraphy. Bipolar disorder and comorbid anxiety diagnoses were assessed using the Mini International Neuropsychiatric Interview. Multiple regression analyses examined associations between comorbid anxiety and sleep disturbance, whilst controlling for confounding covariates known to impact on sleep. RESULTS A comorbid anxiety disorder was associated with increased sleep disturbance as measured using the PSQI global score (B = 3.58, 95% CI 1.85-5.32, P < 0.001) but was not associated with sleep metrics (total sleep time, sleep onset latency, sleep efficiency, and wake after sleep onset) derived using actigraphy. LIMITATIONS Objective measures of sleep were limited to actigraphy, therefore we were not able to examine differences in sleep neurophysiology. CONCLUSIONS Clinicians should be aware that comorbid anxiety may increase the risk of experiencing subjective sleep disturbance in people with bipolar disorder. Research should assess for evidence of comorbid anxiety when examining associations between sleep and bipolar disorder. Future research should explore the mechanisms by which comorbid anxiety may contribute to subjective sleep disturbances in bipolar disorder using neurophysiological measures of sleep (i.e., polysomnography).
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27
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Hammad A, Grinbaum E, Chezar A, Israeli A, Rozen N, Rubin G. The correlation between shoulder pathologies and sleep disorders. J Int Med Res 2022; 50:3000605221103543. [PMID: 35676774 PMCID: PMC9189537 DOI: 10.1177/03000605221103543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To assess and characterize the correlation between shoulder pathologies and sleep disturbances. METHODS Participants enrolled into this case-control study were divided into two groups: patients with an established clinical diagnosis of active shoulder pathology (study group), and patients without any shoulder pathology (control group). All patients completed the Insomnia Severity Index (ISI) questionnaire, in addition to questions related to participant demographics, health status, medication, and other known insomnia risk factors. RESULTS A total of 98 patients were included (46 in the study group and 52 controls). Mean ISI score was significantly higher (indicating more severe insomnia) in the study group versus control group (t[96] = -9.67), even after correcting for confounders (t[53.1] = -8.61). Additionally, in patients with shoulder pathology, those with comorbidities experienced more sleep disturbances than those without comorbidities (β = 0.36). Lastly, the shoulder pathology group was at a higher risk of having sleep disturbances compared with controls (relative risk 4.86, 95% confidence interval 2.24, 10.55). CONCLUSIONS Sleep disturbances are more common among patients with shoulder pathologies. Comorbidities and a shorter duration of pathology may predict more severe sleep disturbances.
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Affiliation(s)
- Ali Hammad
- Orthopaedic Department, Emek Medical Centre, Afula, Israel.,Faculty of Medicine, Technion, Haifa, Israel
| | - Erez Grinbaum
- Orthopaedic Department, Emek Medical Centre, Afula, Israel
| | - Avi Chezar
- Orthopaedic Department, Emek Medical Centre, Afula, Israel
| | - Asaf Israeli
- Orthopaedic Department, Emek Medical Centre, Afula, Israel
| | - Nimrod Rozen
- Orthopaedic Department, Emek Medical Centre, Afula, Israel.,Faculty of Medicine, Technion, Haifa, Israel
| | - Guy Rubin
- Orthopaedic Department, Emek Medical Centre, Afula, Israel.,Faculty of Medicine, Technion, Haifa, Israel
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28
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Xue X, Zong W, Glausier JR, Kim SM, Shelton MA, Phan BN, Srinivasan C, Pfenning AR, Tseng GC, Lewis DA, Seney ML, Logan RW. Molecular rhythm alterations in prefrontal cortex and nucleus accumbens associated with opioid use disorder. Transl Psychiatry 2022; 12:123. [PMID: 35347109 PMCID: PMC8960783 DOI: 10.1038/s41398-022-01894-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 03/03/2022] [Accepted: 03/10/2022] [Indexed: 11/21/2022] Open
Abstract
Severe and persistent disruptions to sleep and circadian rhythms are common in people with opioid use disorder (OUD). Preclinical evidence suggests altered molecular rhythms in the brain modulate opioid reward and relapse. However, whether molecular rhythms are disrupted in the brains of people with OUD remained an open question, critical to understanding the role of circadian rhythms in opioid addiction. Using subjects' times of death as a marker of time of day, we investigated transcriptional rhythms in the brains of subjects with OUD compared to unaffected comparison subjects. We discovered rhythmic transcripts in both the dorsolateral prefrontal cortex (DLPFC) and nucleus accumbens (NAc), key brain areas involved in OUD, that were largely distinct between OUD and unaffected subjects. Fewer rhythmic transcripts were identified in DLPFC of subjects with OUD compared to unaffected subjects, whereas in the NAc, nearly double the number of rhythmic transcripts was identified in subjects with OUD. In NAc of subjects with OUD, rhythmic transcripts peaked either in the evening or near sunrise, and were associated with an opioid, dopamine, and GABAergic neurotransmission. Associations with altered neurotransmission in NAc were further supported by co-expression network analysis which identified OUD-specific modules enriched for transcripts involved in dopamine, GABA, and glutamatergic synaptic functions. Additionally, rhythmic transcripts in DLPFC and NAc of subjects with OUD were enriched for genomic loci associated with sleep-related GWAS traits, including sleep duration and insomnia. Collectively, our findings connect transcriptional rhythm changes in opioidergic, dopaminergic, GABAergic signaling in the human brain to sleep-related traits in opioid addiction.
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Affiliation(s)
- Xiangning Xue
- grid.21925.3d0000 0004 1936 9000Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA 15261 USA
| | - Wei Zong
- grid.21925.3d0000 0004 1936 9000Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA 15261 USA
| | - Jill R. Glausier
- grid.21925.3d0000 0004 1936 9000Translational Neuroscience Program, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15219 USA
| | - Sam-Moon Kim
- grid.21925.3d0000 0004 1936 9000Translational Neuroscience Program, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15219 USA ,grid.21925.3d0000 0004 1936 9000Center for Adolescent Reward, Rhythms, and Sleep, University of Pittsburgh, Pittsburgh, PA 15219 USA
| | - Micah A. Shelton
- grid.21925.3d0000 0004 1936 9000Translational Neuroscience Program, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15219 USA
| | - BaDoi N. Phan
- grid.147455.60000 0001 2097 0344Department of Computational Biology, Carnegie Mellon University, Pittsburgh, PA 15213 USA
| | - Chaitanya Srinivasan
- grid.147455.60000 0001 2097 0344Department of Computational Biology, Carnegie Mellon University, Pittsburgh, PA 15213 USA
| | - Andreas R. Pfenning
- grid.147455.60000 0001 2097 0344Department of Computational Biology, Carnegie Mellon University, Pittsburgh, PA 15213 USA ,grid.147455.60000 0001 2097 0344Neuroscience Institute, Carnegie Mellon University, Pittsburgh, PA 15213 USA
| | - George C. Tseng
- grid.21925.3d0000 0004 1936 9000Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA 15261 USA
| | - David A. Lewis
- grid.21925.3d0000 0004 1936 9000Translational Neuroscience Program, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15219 USA
| | - Marianne L. Seney
- grid.21925.3d0000 0004 1936 9000Translational Neuroscience Program, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15219 USA ,grid.21925.3d0000 0004 1936 9000Center for Adolescent Reward, Rhythms, and Sleep, University of Pittsburgh, Pittsburgh, PA 15219 USA
| | - Ryan W. Logan
- grid.189504.10000 0004 1936 7558Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA 02118 USA ,grid.189504.10000 0004 1936 7558Center for Systems Neuroscience, Boston University, Boston, MA 02118 USA
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Tubbs AS, Ghani SB, Naps M, Grandner MA, Stein MD, Chakravorty S. Past-year use or misuse of an opioid is associated with use of a sedative-hypnotic medication: a US National Survey on Drug Use and Health (NSDUH) study. J Clin Sleep Med 2022; 18:809-816. [PMID: 34666879 PMCID: PMC8883103 DOI: 10.5664/jcsm.9724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Prescription use and misuse of opioids are linked to greater sleep disturbance. However, there are limited data on the prevalence of sedative-hypnotic medication use among persons who use opioids. Therefore, this study examined whether past-year sedative-hypnotic use among persons who used/misused opioids was higher than among individuals who did not use opioids. METHODS Data were acquired from the US National Survey on Drug Use and Health for 2015-2018. Use of a sedative benzodiazepine (temazepam, flurazepam, triazolam) or a Z-drug (eszopiclone, zaleplon, zolpidem) was examined in relation to use/misuse of an opioid within the past year. Logistic regression models estimated the associations between opioids and sedative-hypnotics using inverse probability of treatment weighting. A secondary machine learning analysis tested 6 binary classifiers to predict sedative-hypnotic use based on opioid use/misuse and other covariates. RESULTS Of 171,766 respondents, 24% used a prescription opioid whereas 3.6% misused an opioid in the past year. Among those who used a prescription opioid, 1.9% received a sedative benzodiazepine and 9% received a Z-drug during the same time frame. Use of an opioid was associated with greater odds of sedative benzodiazepine use (odds ratio, 4.4; 95% confidence interval, 3.61-5.4) and Z-drug use (odds ratio, 3.8; 95% confidence interval, 3.51-4.09), and stronger associations were noted for misuse of an opioid. Machine learning models accurately classified sedative-hypnotic medication use for > 70% of respondents based on opioid use/misuse. CONCLUSIONS Sedative-hypnotic use is common among persons who use opioids, which is of concern given the elevated mortality risk with concurrent use of these substances. CITATION Tubbs AS, Ghani SB, Naps M, Grandner MA, Stein MD, Chakravorty S. Past-year use or misuse of an opiod is associated with use of a sedative-hypnotic medication: a US National Survey on Drug Use and Health (NSDUH) study. J Clin Sleep Med. 2022;18(3):809-816.
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Affiliation(s)
- Andrew S. Tubbs
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine–Tucson, Tucson, Arizona,Address correspondence to: Andrew S. Tubbs, BSc, Department of Psychiatry, University of Arizona College of Medicine–Tucson, P.O. Box 245002, Tucson, AZ 85724-5002; Tel: (661) 742-6123;
| | - Sadia B. Ghani
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine–Tucson, Tucson, Arizona
| | - Michelle Naps
- School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michael A. Grandner
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine–Tucson, Tucson, Arizona
| | - Michael D. Stein
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts,Behavioral Medicine and Addictions Research Unit, Butler Hospital, Providence, Rhode Island
| | - Subhajit Chakravorty
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania,Departments of Psychiatry and Research and Development, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
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30
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Winegar R. Maladaptive coping mechanisms of sleep. Nurse Pract 2022; 47:30-38. [PMID: 35171865 DOI: 10.1097/01.npr.0000819624.10897.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Patients with insomnia have been shown to use many maladaptive coping mechanisms. This article examines the effect of such coping mechanisms on sleep quality by reviewing results of polysomnography and the Epworth Sleepiness Scale among 137 patients. The study showed that sleep quality was affected by these mechanisms.
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Affiliation(s)
- Rhonda Winegar
- Rhonda Winegar is Pre-Licensure BSN Program Director at Aspen University, Austin, Tex
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31
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Xu Y, Ning Y, Zhao Y, Peng Y, Luo F, Zhou Y, Li P. Caffeine Functions by Inhibiting Dorsal and Ventral Hippocampal Adenosine 2A Receptors to Modulate Memory and Anxiety, Respectively. Front Pharmacol 2022; 13:807330. [PMID: 35185566 PMCID: PMC8847668 DOI: 10.3389/fphar.2022.807330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/11/2022] [Indexed: 11/16/2022] Open
Abstract
As a nonspecific antagonist of the adenosine A2A receptor (A2AR), caffeine enhances learning and improves memory impairment. Simultaneously, the consumption of caffeine correlates with a feeling of anxiety. The hippocampus is functionally differentiated along its dorsal/ventral axis and plays a crucial role both in memory and anxiety. Whether caffeine exerts its regulation by inhibiting A2ARs in different subregions of the hippocampus is still unknown. In the present study, we found that after chronic intake of drinking water containing caffeine (1 g/L, 3 weeks), mice exhibited aggravated anxiety-like behavior and enhanced memory function. Tissue-specific, functional disruption of dorsal hippocampal A2ARs by the CRE-LoxP system prevented the memory-enhancing effect of caffeine, while selective disruption of ventral hippocampal A2ARs blocked the impact of caffeine on anxiety. These results, together with the enhanced memory of dorsal hippocampus A2AR knockout mice and greater anxiety-like behavior of ventral hippocampus A2AR knockout mice without caffeine, indicates a dissociation between the roles of ventral and dorsal hippocampal A2A receptors in caffeine’s effects on anxiety-like and memory-related behavioral measures, respectively. Furthermore, optogenetic activation of dorsal or ventral hippocampal A2ARs reversed the behavioral alterations caused by drinking caffeine, leading to impaired memory or decreased anxiety-like behaviors, respectively. Taken together, our findings suggest that the memory- and anxiety-enhancing effects of caffeine are related to the differential effects of inhibiting A2ARs in the dorsal and ventral hippocampus, respectively.
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Affiliation(s)
- Yawei Xu
- State Key Laboratory of Trauma, Department of Army Occupational Disease, The Molecular Biology Center, Burn and Combined Injury, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Yalei Ning
- State Key Laboratory of Trauma, Department of Army Occupational Disease, The Molecular Biology Center, Burn and Combined Injury, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Yan Zhao
- State Key Laboratory of Trauma, Department of Army Occupational Disease, The Molecular Biology Center, Burn and Combined Injury, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Yan Peng
- State Key Laboratory of Trauma, Department of Army Occupational Disease, The Molecular Biology Center, Burn and Combined Injury, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Fen Luo
- State Key Laboratory of Trauma, Department of Army Occupational Disease, The Molecular Biology Center, Burn and Combined Injury, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Yuanguo Zhou
- State Key Laboratory of Trauma, Department of Army Occupational Disease, The Molecular Biology Center, Burn and Combined Injury, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Ping Li
- State Key Laboratory of Trauma, Department of Army Occupational Disease, The Molecular Biology Center, Burn and Combined Injury, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
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Federico G, Alfano V, Garramone F, Mele G, Salvatore M, Aiello M, Cavaliere C. Self-Reported Sleep Quality Across Age Modulates Resting-State Functional Connectivity in Limbic and Fronto-Temporo-Parietal Networks: An Exploratory Cross-Sectional fMRI Study. Front Aging Neurosci 2022; 14:806374. [PMID: 35197843 PMCID: PMC8859450 DOI: 10.3389/fnagi.2022.806374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 01/12/2022] [Indexed: 11/13/2022] Open
Abstract
Sleep problems are increasingly present in the general population at any age, and they are frequently concurrent with—or predictive of—memory disturbances, anxiety, and depression. In this exploratory cross-sectional study, 54 healthy participants recruited in Naples (Italy; 23 females; mean age = 37.1 years, range = 20–68) completed the Pittsburgh Sleep Quality Index (PSQI) and a neurocognitive assessment concerning both verbal and visuospatial working memory as well as subjective measures of anxiety and depression. Then, 3T fMRI images with structural and resting-state functional sequences were acquired. A whole-brain seed-to-seed functional connectivity (FC) analysis was conducted by contrasting good (PSQI score <5) vs. bad (PSQI score ≥5) sleepers. Results highlighted FC differences in limbic and fronto-temporo-parietal brain areas. Also, bad sleepers showed an anxious/depressive behavioural phenotype and performed worse than good sleepers at visuospatial working-memory tasks. These findings may help to reveal the effects of sleep quality on daily-life cognitive functioning and further elucidate pathophysiological mechanisms of sleep disorders.
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Leger D, Andler R, Richard JB, Nguyen-Thanh V, Collin O, Chennaoui M, Metlaine A. Sleep, substance misuse and addictions: a nationwide observational survey on smoking, alcohol, cannabis and sleep in 12,637 adults. J Sleep Res 2022; 31:e13553. [PMID: 35088480 DOI: 10.1111/jsr.13553] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 11/30/2021] [Accepted: 01/12/2022] [Indexed: 11/29/2022]
Abstract
For a good night's sleep, we consensually recommend avoiding alcohol, smoking and drugs. However, these addictions are highly prevalent in the general population, and it is difficult to estimate their real impact on sleep. The aim of this study is to clarify the association between sleep habits and disorders, and addictions. The design was a telephone crossover national recurrent health poll survey (Santé publique France, Baromètre santé, 2017; Questionnaire, pp. 53; Saint Maurice) in a representative sample of French adults. There were 12,367 subjects (18-75 years old) who answered the survey. Sleep log items assessed sleep schedules (total sleep time) on work and leisure days: at night, while napping, and over 24 hr using a sleep log. Retained items include: (1) short sleep (≤ 6 hr/24 hr); (2) chronic insomnia (International Classification of Sleep Disorders, 3rd edition criteria); and (3) chronotype (evening-morning-neutral). Psychoactive substances retained included tobacco (current or former users), alcohol (daily consumption and weekly binge drinking), cannabis (Cannabis Abuse Screening Test), and other drugs (consumption during the past year). We found that: (1) daily smokers (lightly or heavily dependent) were more frequently short sleepers than occasional smokers and non-smokers; (2) heavily dependent daily smokers were more likely to suffer from insomnia than other smokers or non-smokers; (3) short sleep and insomnia were not significantly associated with the consumption of alcohol, cannabis or any other drug; (4) the evening chronotype was significantly associated with the consumption of tobacco, alcohol and cannabis. In conclusion, our study highlights significant relationships between the use of psychoactive substances and sleep characteristics among adults, emphasizing the need to take into account each subject individually.
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Affiliation(s)
- Damien Leger
- Université de Paris, EA 7330 VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Paris, France.,APHP, Hôtel-Dieu, Consultation de pathologie professionnelle Sommeil Vigilance et Travail, Centre du Sommeil et de la Vigilance, Paris, France
| | - Raphaël Andler
- Direction de la prévention et de la promotion de la santé, Santé publique France, Saint Maurice, France
| | - Jean-Baptiste Richard
- Direction Appui, Traitements et Analyses des données, Santé publique France, Saint Maurice, France
| | - Viêt Nguyen-Thanh
- Direction Appui, Traitements et Analyses des données, Santé publique France, Saint Maurice, France
| | - Olivier Collin
- Université de Paris, EA 7330 VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Paris, France.,APHP, Hôtel-Dieu, Consultation de pathologie professionnelle Sommeil Vigilance et Travail, Centre du Sommeil et de la Vigilance, Paris, France
| | - Mounir Chennaoui
- Université de Paris, EA 7330 VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Paris, France.,APHP, Hôtel-Dieu, Consultation de pathologie professionnelle Sommeil Vigilance et Travail, Centre du Sommeil et de la Vigilance, Paris, France.,Direction de la prévention et de la promotion de la santé, Santé publique France, Saint Maurice, France.,Direction Appui, Traitements et Analyses des données, Santé publique France, Saint Maurice, France.,Institut de Recherche Biomédical des Armées (IRBA), Brétigny, France
| | - Arnaud Metlaine
- Université de Paris, EA 7330 VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Paris, France.,APHP, Hôtel-Dieu, Consultation de pathologie professionnelle Sommeil Vigilance et Travail, Centre du Sommeil et de la Vigilance, Paris, France
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Murillo-Rodríguez E, Carreón C, Acosta-Hernández ME, García-García F. Stimulants and Depressor Drugs in the Sleep-Wake Cycle Modulation: The case of alcohol and cannabinoids. Curr Top Med Chem 2022; 22:1270-1279. [PMID: 34986773 DOI: 10.2174/1568026622666220105105054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/26/2021] [Accepted: 12/05/2021] [Indexed: 11/22/2022]
Abstract
A complex neurobiological network drives the sleep-wake cycle. In addition, external stimuli, including stimulants or depressor drugs, also influence the control of sleep. Here we review the recent advances that contribute to the comprehensive understanding of the actions of stimulants and depressor compounds, such as alcohol and cannabis, in sleep regulation. The objective of this review is to highlight the neurobiological mechanism engaged by alcohol and cannabis in sleep control.
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Affiliation(s)
- Eric Murillo-Rodríguez
- Laboratorio de Neurociencias Moleculares e Integrativas. Escuela de Medicina, División Ciencias de la Salud Universidad Anáhuac Mayab. Mérida, Yucatán. México
| | - Cristina Carreón
- Laboratorio de Neurociencias Moleculares e Integrativas. Escuela de Medicina, División Ciencias de la Salud Universidad Anáhuac Mayab. Mérida, Yucatán. México
| | | | - Fabio García-García
- Biomedicine Department, Health Science Institute, Veracruzana University. Xalapa, Veracruz. México
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Kolla BP, Hayes L, Cox C, Eatwell L, Deyo-Svendsen M, Mansukhani MP. The Effects of Cannabinoids on Sleep. J Prim Care Community Health 2022; 13:21501319221081277. [PMID: 35459406 PMCID: PMC9036386 DOI: 10.1177/21501319221081277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
The use of cannabis products to help with sleep and various other medical conditions by the public has increased significantly in recent years. Withdrawal from cannabinoids can lead to sleep disturbance. Here, we describe a patient who developed significant insomnia leading to worsening anxiety, mood, and suicidal ideation in the setting of medical cannabis withdrawal, prompting presentation to the Emergency Department and inpatient admission. There is a limited evidence base for the use of cannabis products for sleep. We provide a comprehensive review evaluating the literature on the use of cannabis products on sleep, including an overview of cannabis and related psychoactive compounds, the current state of the law as it pertains to the prescribing and use of these substances, and potential side effects and drug interactions. We specifically discuss the impact of cannabis products on normal sleep and circadian sleep-wake rhythms, insomnia, excessive daytime sleepiness, sleep apnea, parasomnias, and restless legs syndrome. We also describe the effects of cannabis withdrawal on sleep and how this increases relapse to cannabis use. Most of the studies are observational but the few published randomized controlled trials are reviewed. Our comprehensive review of the effects of cannabis products on normal sleep and sleep disorders, relevant to primary care providers and other clinicians evaluating and treating patients who use these types of products, shows that cannabis products have minimal to no effects on sleep disorders and may have deleterious effects in some individuals. Further research examining the differential impact of the various types of cannabinoids that are currently available on each of these sleep disorders is required.
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Affiliation(s)
| | - Lisa Hayes
- Mayo Clinic Health System Southwest Minnesota, Mankato, MN, USA
| | - Chaun Cox
- Mayo Clinic Health System Southwest Minnesota, Mankato, MN, USA
| | - Lindy Eatwell
- Mayo Clinic Health System Southwest Minnesota, Mankato, MN, USA
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Segon T, Kerebih H, Gashawu F, Tesfaye B, Nakie G, Anbesaw T. Sleep quality and associated factors among nurses working at comprehensive specialized hospitals in Northwest, Ethiopia. Front Psychiatry 2022; 13:931588. [PMID: 36051547 PMCID: PMC9425912 DOI: 10.3389/fpsyt.2022.931588] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/26/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Poor sleep quality is common among nurses. This problem possibly results in negative emotional and psychological consequences in nurses which secondary affect their work performances. However, in Ethiopia, there is a paucity of information about poor sleep quality and associated factors among nurses. This study aimed to assess the prevalence of poor sleep quality and associated factors among nurses working at comprehensive specialized hospitals in Northwest Ethiopia. METHODS An institutional-based cross-sectional study was conducted among 542 nurses who worked at University of Gondar (UOG), Tibebe Ghion, Felege Hiwot Comprehensive Specialized Hospitals, Ethiopia, who were incorporated into the study through a simple random sampling technique from 1 May to 2 June 2021. The Pittsburgh sleep quality index (PSQI) with a cut score of above 5 was used to assess sleep quality using a structured self-administered questionnaire. Other tools used are Depression Anxiety Stress Scales (DASS-21), Shift Work sleep disorders (SWSD), and Oslo-3 social support scales. Epi-Data version 3.1 was used for data entry and SPSS version 25 was used for data analysis. A multivariable logistic regression analysis was performed to identify variables that have a significant association with poor sleep quality among nurse professionals. The degree of association was assessed using an odds ratio (OR) with a 95% confidence interval (CI) at a two-tailed p-value of <0.05. RESULTS A total of 510 nurses were included in the study with a response rate of 94%. The study showed that the overall prevalence of poor sleep quality among nurses was 75.5% (95% CI (71.8, 79.1). Being female (AOR = 1.72:95% CI = 1.19, 2.28), depressive symptoms (AOR = 2.24:95% CI = 1.24, 3.85), anxiety symptoms (AOR = 2.12: 95% CI = 1.23, 3.62), stress (AOR = 2.85: 95% CI = 1.67, 4.82) and current alcohol drinking (AOR = 1.84 :95% CI = 1.27, 3.13) were significantly associated with poor sleep quality. CONCLUSION The overall prevalence of poor sleep quality among nurses was high. Being female, depressive symptoms, anxiety symptoms, stress, and current alcohol drinking had been significantly associated with poor sleep quality. Therefore, it is essential to institute effective intervention strategies emphasizing contributing factors to poor sleep quality.
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Affiliation(s)
- Tesfaye Segon
- Department of Psychiatry, College of Health Science, Mettu University, Mettu, Ethiopia
| | - Habtamu Kerebih
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Fanuel Gashawu
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Bizuneh Tesfaye
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Girum Nakie
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tamrat Anbesaw
- Department of Psychiatry, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
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Cederlöf E, Holm M, Lähteenvuo M, Haaki W, Hietala J, Häkkinen K, Isometsä E, Jukuri T, Kajanne R, Kampman O, Kieseppä T, Lahdensuo K, Lönnqvist J, Männynsalo T, Niemi-Pynttäri J, Suokas K, Suvisaari J, Tiihonen J, Turunen H, Wegelius A, Veijola J, Palotie A, Paunio T. Sleep in Psychotic Disorders: Results From Nationwide SUPER Finland Study. SCHIZOPHRENIA BULLETIN OPEN 2022; 3:sgac011. [PMID: 39144769 PMCID: PMC11206061 DOI: 10.1093/schizbullopen/sgac011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
Objective Characterizing sleep in patients with schizophrenia, schizoaffective disorder, bipolar disorder, and psychotic depression. Methods This cross-sectional questionnaire study is based on the SUPER study sample, which is part of the Stanley Global Neuropsychiatric Genomics Initiative. The study is a multicentre, nationwide Finnish study consisting of patients (N = 8 623) both in primary and specialized health care. The main measurements were sleep duration, difficulties initiating sleep, early morning awakenings, and fatigue. These results were compared with a nationally representative sample of the Finnish population from the Health 2000 survey (N = 7 167) with frequency and logistic regression analyses. Results Patients had more sleep problems compared with the general population, especially young and middle-aged patients (Difficulties initiating sleep in young patients odds ratio = 12.3, 95% CI 9.8-15.4). Long sleep duration was the most deviating property of the sleep characteristics, being particularly common among young patients with schizophrenia (odds ratio = 27.9, 95% CI 22.1-35.2, 47.4% vs 3.3% prevalence). All sleep problems were associated with worse subjective health. We also conducted a latent class analysis, resulting in a cluster relatively free of sleep problems (58% of patients), an insomnia symptom cluster (26%), and a hypersomnia symptom cluster (15%). Conclusions In our sample, patients with psychotic disorders have more sleep problems-especially long sleep duration but also insomnia symptoms-compared with the general population. The patients can in a latent class analysis of their sleep symptoms be divided into groups with differing sleep profiles.
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Affiliation(s)
- Erik Cederlöf
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Minna Holm
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Markku Lähteenvuo
- Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
- Niuvanniemi Hospital, University of Eastern Finland, Finland
| | - Willehard Haaki
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Jarmo Hietala
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Katja Häkkinen
- Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
| | - Erkki Isometsä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tuomas Jukuri
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Risto Kajanne
- Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
| | - Olli Kampman
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
- Department of Psychiatry, University of Tampere, Tampere, Finland
| | - Tuula Kieseppä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Kaisla Lahdensuo
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jouko Lönnqvist
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Teemu Männynsalo
- Social Services and Health Care Sector; City of Helsinki, Helsinki, Finland
| | | | - Kimmo Suokas
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
- Social Services and Health Care Sector; City of Helsinki, Helsinki, Finland
| | - Jaana Suvisaari
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jari Tiihonen
- Niuvanniemi Hospital, University of Eastern Finland, Finland
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden
| | - Hannu Turunen
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Asko Wegelius
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Juha Veijola
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
- Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
| | - Tiina Paunio
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Martin CE, Dzierzewski JM, Keyser-Marcus L, Donovan EK, Ramey T, Svikis DS, Moeller FG. Sex Specific Sleep Parameters Among People With Substance Use Disorder. Front Psychiatry 2022; 13:905332. [PMID: 35722562 PMCID: PMC9199851 DOI: 10.3389/fpsyt.2022.905332] [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: 03/26/2022] [Accepted: 05/05/2022] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Sleep can have substantial impacts in substance use disorder (SUD) pathogenesis, treatment, and recovery. Sex differences exist in both sleep and SUD, but how sleep is uniquely associated with SUD by sex is not known. The study objective was to compare, within sex, sleep parameters between individuals with SUD and non-substance misusing controls. METHODS Secondary analyses of a parent cross-sectional study examining the feasibility and acceptability of a novel neurocognitive phenotyping assessment battery were completed. SUD and control subjects were recruited through local advertising and an established research registry. Subjects with SUD were also recruited through a university-based outpatient SUD treatment clinic. Self-reported sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Sex-stratified t-tests compared sleep between SUD and control subjects while Crosstab analyses explored group differences in the proportion of individuals reporting poor sleep (defined as PSQI ≥ 5). RESULTS Data from 162 males (44 controls, 118 SUD) and 146 females (64 controls, 82 SUD) were included in the present study. For females only, a significantly lower proportion of controls reported PSQI-defined poor sleep than individuals with any SUD or specifically with opioid use disorder. Male, but not female, controls reported shorter sleep latency, longer sleep duration, and less sleep disturbance than males with each SUD type. DISCUSSION/IMPLICATIONS Sleep holds promise as an avenue to address SUD within a biopsychosocial model. Future work at the intersection of SUD and sleep should prioritize investigations of their interplay with sex to identify targets for tailored SUD interventions.
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Affiliation(s)
- Caitlin E Martin
- Department of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States.,Division of Therapeutics and Medical Consequences, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, United States
| | - Joseph M Dzierzewski
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States
| | - Lori Keyser-Marcus
- Division of Therapeutics and Medical Consequences, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, United States
| | - Emily K Donovan
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States
| | - Tatiana Ramey
- Department of Psychiatry, National Institute on Drug Abuse, Bethesda, MD, United States
| | - Dace S Svikis
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States
| | - F Gerard Moeller
- Division of Therapeutics and Medical Consequences, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, United States
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Catoire S, Nourredine M, Lefebvre S, Couraud S, Gronfier C, Rey R, Peter-Derex L, Geoffroy PA, Rolland B. Tobacco-induced sleep disturbances: A systematic review and meta-analysis. Sleep Med Rev 2021; 60:101544. [PMID: 34597890 DOI: 10.1016/j.smrv.2021.101544] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/23/2021] [Accepted: 08/26/2021] [Indexed: 12/26/2022]
Abstract
Even though tobacco-induced sleep disturbances (TISDs) have been reported in previous studies, the present article is the first meta-analysis quantitatively assessing the impact of tobacco on sleep parameters. We conducted a systematic review and meta-analysis of the studies comparing objective (i.e. polysomnography and actigraphy) and/or subjective sleep parameters in chronic tobacco smokers without comorbidities versus healthy controls. Studies were retrieved using PubMed, PsycINFO, and Web of Science. Differences are expressed as standardized mean deviations (SMD) and their 95% confidence intervals (95%CI). Fourteen studies were finally included into the review, among which ten were suitable for meta-analysis. Compared to healthy controls, chronic tobacco users displayed increased N1 percentage (SMD = 0.65, 95%CI: 0.22 to 1.07), N2 percentage (SMD = 1.45, 95%CI: 0.26 to 2.63), wake time after sleep onset (SMD = 6.37, 95%CI: 2.48 to 10.26), and decreased slow-wave sleep (SMD = -2.00, 95%CI: -3.30 to -0.70). Objective TISDs preferentially occurred during the first part of the night. Regarding subjective parameters, only the Pittsburgh Sleep Quality Index (PSQI) total score could be analyzed, with no significant between-groups difference (SMD = 0.53, 95%CI: -0.18 to 1.23). Smoking status should be carefully assessed in sleep medicine, while TISDs should be regularly explored in chronic tobacco users.
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Affiliation(s)
- Sébastien Catoire
- Service Universitaire d'Addictologie de Lyon (SUAL), Pôle MOPHA, CH Le Vinatier, 69500, Bron, France; Unité Michel Jouvet, 69Z19, Pôle Est, CH Le Vinatier, 69500, Bron, France; Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Hôpital Lyon-Sud, CHU Lyon, 69310 Pierre Bénite, France.
| | - Mikail Nourredine
- Service Hospitalo-Universitaire de pharmacotoxicologie, Service de recherche et épidémiologie clinique Hospices Civils de Lyon, 69424, Lyon, France; Faculté de Médecine Lyon-Sud, 69921, Oullins, France
| | - Stéphanie Lefebvre
- Service Universitaire d'Addictologie de Lyon (SUAL), Pôle MOPHA, CH Le Vinatier, 69500, Bron, France; Centre de Recherche en Neuroscience de Lyon (CRNL), Inserm UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, 69000, Lyon, France
| | - Sébastien Couraud
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Hôpital Lyon-Sud, CHU Lyon, 69310 Pierre Bénite, France; EMR 3738 Ciblage thérapeutique en Oncologie, Faculté de médecine et de maïeutique Lyon Sud Charles - Mérieux, Université Lyon 1, France
| | - Claude Gronfier
- Centre de Recherche en Neuroscience de Lyon (CRNL), Inserm UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, 69000, Lyon, France
| | - Romain Rey
- Unité Michel Jouvet, 69Z19, Pôle Est, CH Le Vinatier, 69500, Bron, France; Centre de Recherche en Neuroscience de Lyon (CRNL), Inserm UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, 69000, Lyon, France
| | - Laure Peter-Derex
- Centre de Recherche en Neuroscience de Lyon (CRNL), Inserm UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, 69000, Lyon, France; Centre de Médecine du Sommeil et des Maladies Respiratoires, Hospices Civils de Lyon, Université Lyon 1, Lyon, France
| | - Pierre A Geoffroy
- Service de Psychiatrie et d'Addictologie, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Bichat, Paris, France; Université de Paris, NeuroDiderot, Inserm, Paris, France; GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, 75014, Paris, France
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), Pôle MOPHA, CH Le Vinatier, 69500, Bron, France; Centre de Recherche en Neuroscience de Lyon (CRNL), Inserm UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, 69000, Lyon, France; Service d'Addictologie, Hôpital Édouard Herriot, CHU Lyon, 69003, Lyon, France
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Steele VR, Maxwell AM. Treating cocaine and opioid use disorder with transcranial magnetic stimulation: A path forward. Pharmacol Biochem Behav 2021; 209:173240. [PMID: 34298030 PMCID: PMC8445657 DOI: 10.1016/j.pbb.2021.173240] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 06/19/2021] [Accepted: 07/16/2021] [Indexed: 12/15/2022]
Abstract
Developing new, effective treatments for substance use disorders (SUDs), especially cocaine and opioid use disorders (CUD and OUD), are of immense importance. These are chronic, relapsing brain diseases characterized by dysregulated circuits manifesting from neuroplastic change brought on by repeated exposure to substances of abuse. A potential treatment is therapeutically inducing neuroplastic change in targeted dysregulated circuits. One such intervention, repetitive transcranial magnetic stimulation (rTMS) has gained traction over the past two decades as a method of noninvasively stimulating cortical structures in order to induce subcortical neuroplastic change. By doing so, rTMS ameliorates symptoms that are consequent of dysregulations in disease-related circuits, such as craving, and reduces drug use. Although rTMS has been successfully applied as a treatment for other clinical disorders, progress toward treatment applications for SUDs has been stymied by what we dub "known unknowns". These are fundamental lines of research within the rTMS-SUD field that have yet to be systematically understood which could help to optimize TMS as an intervention for SUDs. Because progress in treatment for CUD and OUD is imperative given the widespread severity of OUD and the lack of treatment for CUD, it is necessary to critically reflect on the ways in which rTMS research for these disorders can most effectively move forward to help patients. We articulate six "known unknowns" and outline a direction of research to address each. Briefly, the "known unknowns" in the field are: 1) Cortical target selection, 2) subcortical circuit engagement, 3) optimizing rTMS sequences, 4) rTMS as an adjuvant to existing interventions, 5) manipulating brain state, and 6) selecting outcome measures. We also outline research design approaches to address these "known unknowns" in the rTMS-SUDs field. Unification of efforts across research laboratories is necessary to develop empirically validated treatments that will benefit patients in a timely fashion.
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Affiliation(s)
- Vaughn R Steele
- Yale University, School of Medicine, Department of Psychiatry, New Haven CT, USA.
| | - Andrea M Maxwell
- Medical Scientist Training Program, University of Minnesota, Minneapolis MN, USA
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Dunican IC, Walsh JH. Comment on Gratwicke et al. Nutritional Interventions to Improve Sleep in Team-Sport Athletes: A Narrative Review. Nutrients 2021, 13, 1586. Nutrients 2021; 13:nu13093103. [PMID: 34578977 PMCID: PMC8470945 DOI: 10.3390/nu13093103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 08/25/2021] [Indexed: 11/16/2022] Open
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Graupensperger S, Fairlie AM, Vitiello MV, Kilmer JR, Larimer ME, Patrick ME, Lee CM. Daily-level effects of alcohol, marijuana, and simultaneous use on young adults' perceived sleep health. Sleep 2021; 44:6325450. [PMID: 34291803 DOI: 10.1093/sleep/zsab187] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 06/16/2021] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES Simultaneous alcohol and marijuana (SAM) use is increasingly prevalent among young adults but has adverse health consequences. The current study examined daily-level associations between perceived sleep health and SAM use, relative to non-substance-use days and alcohol- or marijuana-only days. We also estimated linear associations between alcohol/marijuana use and perceived sleep health and explored whether effects were moderated by combined use of alcohol and marijuana. METHODS A community sample of SAM-using young adults (N=409; Mage=21.61, SD=2.17; 50.9% female; 48.2% White; 48.9% college students) completed twice-daily surveys for five 14-day sampling bursts. Daily measurements assessed substance use and perceived sleep health in terms of subjective sleep quality, negative impact of sleep on functioning, and symptoms of insomnia. RESULTS Multilevel models indicated that, relative to non-substance-use days, participants reported poorer perceived sleep health on alcohol-only days, better perceived sleep health on marijuana-only days, and mixed evidence regarding SAM use (i.e., fewer perceived symptoms of insomnia, but poorer perceived next day functioning attributed to sleep). Daily-level estimates showed increased alcohol use was associated with poorer perceived sleep health, while stronger effects from marijuana were associated with better perceived sleep health. Across all indices of sleep health, only one linear association was moderated by combined use: The adverse association between alcohol and next day functioning was weaker on days alcohol was combined with marijuana. CONCLUSIONS Findings provide additional evidence for daily-level effects of alcohol and marijuana use on perceived sleep health and address an important literature gap regarding potential adverse effects of SAM use.
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Affiliation(s)
- Scott Graupensperger
- Department of Psychiatry and Behavioral Sciences, University of Washington - Seattle, WA, USA
| | - Anne M Fairlie
- Department of Psychiatry and Behavioral Sciences, University of Washington - Seattle, WA, USA
| | - Michael V Vitiello
- Department of Psychiatry and Behavioral Sciences, University of Washington - Seattle, WA, USA
| | - Jason R Kilmer
- Department of Psychiatry and Behavioral Sciences, University of Washington - Seattle, WA, USA
| | - Mary E Larimer
- Department of Psychiatry and Behavioral Sciences, University of Washington - Seattle, WA, USA
| | - Megan E Patrick
- Institute for Social Research, University of Michigan - Ann Arbor, MI, USA
| | - Christine M Lee
- Department of Psychiatry and Behavioral Sciences, University of Washington - Seattle, WA, USA
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Associations Among Sleep Disturbance, Pain Catastrophizing, and Pain Intensity for Methadone-maintained Patients With Opioid Use Disorder and Chronic Pain. Clin J Pain 2021; 36:641-647. [PMID: 32482968 DOI: 10.1097/ajp.0000000000000848] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE This study examined the cross-sectional associations among pain intensity, pain catastrophizing, and sleep disturbance among patients receiving methadone maintenance treatment (MMT) for opioid use disorder (OUD) and reporting co-occurring chronic pain. MATERIALS AND METHODS Participants were 89 individuals with OUD and chronic pain drawn from a larger cross-sectional study of 164 MMT patients who completed a battery of self-report measures. The authors conducted 6 mediation models to test all possible pathways (ie, each variable tested as an independent variable, mediator, or dependent variable). RESULTS The only significant mediation effect was an indirect effect of sleep disturbance on pain intensity through pain catastrophizing. That is, greater sleep disturbance was associated with greater pain catastrophizing, which in turn was associated with greater pain intensity. DISCUSSION Altogether, findings suggest that the sleep disturbance to pain catastrophizing to pain intensity pathway may be a key mechanistic pathway exacerbating pain issues among MMT patients with OUD and chronic pain. These results suggest that interventions targeting sleep disturbance may be warranted among MMT patients with OUD and chronic pain. Future work in this area with longitudinal data is warranted.
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Khalid S, Almalki FA, Hadda TB, Bader A, Abu-Izneid T, Berredjem M, Elsharkawy ER, Alqahtani AM. Medicinal Applications of Cannabinoids Extracted from Cannabis sativa (L.): A New Route in the Fight Against COVID-19? Curr Pharm Des 2021; 27:1564-1578. [PMID: 33267756 DOI: 10.2174/1381612826666201202125807] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/22/2020] [Accepted: 11/04/2020] [Indexed: 11/22/2022]
Abstract
Cannabis sativa is a well-known plant that has been recognized for its benefits since ancient times by several medicinal systems, including those of China, India, Greece, and Egypt. Although C. sativa is one of the most investigated medicinal plants in the world, it faces some of the greatest controversies surrounding its legalization and use as a medication. C. sativa contains several hundred phytoconstituents, including the infamous "cannabinoids". It is necessary to properly understand the medicinal importance of these phytochemicals and spread awareness among the countries where cannabis is still facing legal obstacles. The current review focuses on the most recent literature pertaining to various applications of cannabinoids, with a special focus on the medicinal aspect of these phytochemicals. Peer-reviewed articles focusing on the importance of cannabis and cannabinoids are the target of this review. Articles were selected based on the relevance to the general scope of the work, i.e., application of cannabinoids. Cannabinoids can truly be regarded as wonder drugs, considering their immense diversity of usage. Unfortunately, however, many of the mares have never been researched biologically or pharmacologically due to their low yield in the plant. However, the approval of some cannabinoids by the FDA (along with other recognized national medical health systems) has opened the horizon for the use of these natural drugs in medicines such as Epidiolex® (cannabidiol, used for the treatment of severe forms of epilepsy) and Sativex®(Δ9-tetrahydrocannabinol and cannabidiol, used for the treatment of spasticity caused by multiple sclerosis). Many pharmacological properties of C. sativa are attributed to cannabidiol (CBD), a non-psychoactive component, along with Δ9-tetrahydrocannabinol (Δ9-THC), a psychoactive component. This review addresses the most important applications or current utilization of cannabinoids in a variety of treatments such as chronic pain, cancer, emesis, anorexia, irritable bowel syndrome, communicable diseases, glaucoma, and central nervous system disorders. The biosynthetic pathway of cannabinoids is also discussed. In short, cannabis has a myriad of bioactive compounds that have the potential to increase the list of approved cannabinoids suitable for therapy.
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Affiliation(s)
- Shah Khalid
- Department of Botany, Islamia College, Peshawar, Pakistan
| | - Faisal A Almalki
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Umm Al-Qura University, Makkah Almukkarramah, Saudi Arabia
| | - Taibi Ben Hadda
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Umm Al-Qura University, Makkah Almukkarramah, Saudi Arabia
| | - Ammar Bader
- Department of Pharmacognosy, Faculty of Pharmacy, Umm Al-Qura University, Makkah Almukkarramah, Saudi Arabia
| | - Tareq Abu-Izneid
- Pharmaceutical Sciences, Collage of Pharmacy, Al Ain University, Al Ain, United Arab Emirates
| | - Malika Berredjem
- Laboratory of Applied Organic Chemistry LCOA, Synthesis of Biomolecules and Molecular Modelling Group, Badji-Mokhtar - Annaba University, Box 12, 23000 Annaba, Algeria
| | - Eman R Elsharkawy
- Chemistry Department, Faculty of Science, Northern Borders University, Arar, Saudi Arabia
| | - Ali M Alqahtani
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha, 62529, Saudi Arabia
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Combustible and electronic cigarette use and insufficient sleep among U.S. high school students. Prev Med 2021; 147:106505. [PMID: 33667467 PMCID: PMC8096720 DOI: 10.1016/j.ypmed.2021.106505] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 12/27/2020] [Accepted: 02/27/2021] [Indexed: 12/28/2022]
Abstract
The study aimed to investigate the relationships between current exclusive e-cigarette use, exclusive combustible cigarette smoking, and dual use of e-cigarettes and combustible cigarettes, and insufficient sleep among U.S. adolescents. We conducted a secondary data analysis of the 2017 Youth Risk Behavior Survey including 11,296 U.S. high school students. Current (past 30-day) tobacco use groups included exclusive e-cigarette users, exclusive combustible cigarette smokers, and dual-product users. We performed weighted unadjusted and adjusted logistic regression analyses. Insufficient sleep was defined as <8 h/night and < 7 h/night. Overall, 73.4% of adolescents reported insufficient sleep <8 h/night. Compared with non-tobacco users, exclusive e-cigarette users were more likely to report insufficient sleep <8 h/night (odds ratio [OR] = 1.55, 95%CI = 1.12-2.14; adjusted OR [aOR] = 1.57, 95%CI = 1.01-2.43) and < 7 h/night (OR = 1.55, 95%CI = 1.19-2.01; aOR = 1.61, 95%CI = 1.16-2.24). Dual-product users were at increased odds to report insufficient sleep <8 h/night (OR = 3.15, 95%CI = 1.87-5.32) and < 7 h/night (OR = 2.64, 95%CI = 1.87-3.72; aOR = 1.73, 95%CI = 1.14-2.62) than non-tobacco users. Exclusive combustible cigarette smokers were less likely to report insufficient sleep <8 h/night (aOR = 0.49, 95%CI = 0.29-0.84) than non-tobacco users, but no differences were found based on insufficient sleep <7 h/night. When comparing current use groups, exclusive e-cigarette users were at 3.20 increased odds (95%CI = 1.65-6.22) and dual-product users were at 3.26 increased odds (95%CI = 1.51-7.03) to report insufficient sleep <8 h/night when compared with exclusive combustible cigarette smokers after covariate adjustment. Dual-product users were 1.89 times more likely (95%CI = 1.01-3.51) to report insufficient sleep <7 h/night when compared with exclusive combustible cigarette smokers. School-based prevention efforts for tobacco use may promote sufficient sleep in youth.
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Characterization of the GHB Withdrawal Syndrome. J Clin Med 2021; 10:jcm10112333. [PMID: 34073640 PMCID: PMC8199158 DOI: 10.3390/jcm10112333] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/23/2021] [Accepted: 05/25/2021] [Indexed: 12/01/2022] Open
Abstract
The gamma-hydroxybutyric acid (GHB) withdrawal syndrome can have a fulminant course, complicated by severe complications such as delirium or seizures. Detoxification by tapering with pharmaceutical GHB is a safe way to manage GHB withdrawal. However, a detailed description of the course of the GHB withdrawal syndrome is currently lacking. This study aimed to (1) describe the course of GHB withdrawal symptoms over time, (2) assess the association between vital signs and withdrawal symptoms, and (3) explore sex differences in GHB withdrawal. In this observational multicenter study, patients with GHB use disorder (n = 285) were tapered off with pharmaceutical GHB. The most reported subjective withdrawal symptoms (SWS) were related to cravings, fatigue, insomnia, sweating and feeling gloomy. The most prevalent objective withdrawal symptoms (OWS) were related to cravings, fatigue, tremors, sweating, and sudden cold/warm feelings. No association between vital signs and SWS/OWS was found. Sex differences were observed in the severity and prevalence of specific withdrawal symptoms. Our results suggest that the GHB withdrawal syndrome under pharmaceutical GHB tapering does not strongly differ from withdrawal syndromes of other sedative drugs. The lack of association between vital signs and other withdrawal symptoms, and the relative stability of vitals over time suggest that vitals are not suitable for withdrawal monitoring. The reported sex differences highlight the importance of a personalized approach in GHB detoxification.
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Paterson A, Khundakar M, Young A, Ling J, Chakraborty S, Rathbone AP, Watson S, Donaldson T, Anderson KN. The Smarter Sleep educational interventions: an initiative to reduce hypnotic prescribing in in-patient psychiatric care. BJPsych Bull 2021; 46:1-9. [PMID: 33949304 PMCID: PMC9768515 DOI: 10.1192/bjb.2021.41] [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: 09/28/2020] [Revised: 03/31/2021] [Accepted: 04/09/2021] [Indexed: 12/31/2022] Open
Abstract
AIMS AND METHOD In-patients on mental health wards are commonly prescribed hypnotics for the long-term management of disturbed sleep. Specific sleep disorders remain underdiagnosed and effective behavioural interventions are underused. We developed a suite of three educational interventions (a video, poster and handbook) about sleep, sleep disorders, the safe prescribing of hypnotics and use of psychological strategies (sleep hygiene and cognitive-behavioural therapy for insomnia, CBTi) using co-design and multiprofessional stakeholder involvement. This controlled before-and-after study evaluated the effectiveness of these interventions across seven in-patient psychiatric wards, examining their impact on hypnotic prescribing rates and staff confidence scores (data collected by retrospective drug chart analysis and survey respectively). RESULTS A marked reduction was seen in the percentage of patients prescribed hypnotics on in-patient prescription charts (-24%), with a 41% reduction in the number of hypnotics administered per patient (mean reduction -1.142 administrations/patient). CLINICAL IMPLICATIONS These simple educational strategies about the causes and treatment of insomnia can reduce hypnotic prescribing rates and increase staff confidence in both the medical and psychological management of insomnia.
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Affiliation(s)
- Alastair Paterson
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Martina Khundakar
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Anthony Young
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
- Faculty of Health Sciences and Wellbeing, University of Sunderland, UK
| | - Jonathan Ling
- Faculty of Health Sciences and Wellbeing, University of Sunderland, UK
| | | | - Adam Pattison Rathbone
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
| | - Stuart Watson
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Inpatient Services, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Tim Donaldson
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Kirstie N. Anderson
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Regional Sleep Disorders Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
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Bjorness TE, Greene RW. Interaction between cocaine use and sleep behavior: A comprehensive review of cocaine's disrupting influence on sleep behavior and sleep disruptions influence on reward seeking. Pharmacol Biochem Behav 2021; 206:173194. [PMID: 33940055 DOI: 10.1016/j.pbb.2021.173194] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 04/20/2021] [Accepted: 04/27/2021] [Indexed: 12/21/2022]
Abstract
Dopamine, orexin (hypocretin), and adenosine systems have dual roles in reward and sleep/arousal suggesting possible mechanisms whereby drugs of abuse may influence both reward and sleep/arousal. While considerable variability exists across studies, drugs of abuse such as cocaine induce an acute sleep loss followed by an immediate recovery pattern that is consistent with a normal response to loss of sleep. Under more chronic cocaine exposure conditions, an abnormal recovery pattern is expressed that includes a retention of sleep disturbance under withdrawal and into abstinence conditions. Conversely, experimentally induced sleep disturbance can increase cocaine seeking. Thus, complementary, sleep-related therapeutic approaches may deserve further consideration along with development of non-human models to better characterize sleep disturbance-reward seeking interactions across drug experience.
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Affiliation(s)
- Theresa E Bjorness
- Research Service, VA North Texas Health Care System, Dallas, TX 75126, USA; Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390-9111, USA.
| | - Robert W Greene
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390-9111, USA; Department of Neuroscience, Peter O'Donnell Jr. Brain Institute, University of Texas Southwestern Medical Center, Dallas, TX 75390-9111, USA; International Institute for Integrative Sleep Medicine, University of Tsukuba, Tsukuba, 305-8577, Japan
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49
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Roswall N, Poulsen AH, Thacher JD, Hvidtfeldt UA, Raaschou-Nielsen O, Jensen SS, Overvad K, Tjønneland A, Sørensen M. Nighttime road traffic noise exposure at the least and most exposed façades and sleep medication prescription redemption-a Danish cohort study. Sleep 2021; 43:5739759. [PMID: 32083664 DOI: 10.1093/sleep/zsaa029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 01/28/2020] [Indexed: 12/27/2022] Open
Abstract
STUDY OBJECTIVES Traffic noise has been associated with poor sleep quality and short sleep duration. This study investigates the association between nighttime road traffic noise at the least and most exposed façades of the residence and redemption of sleep medication. METHODS In a cohort of 44,438 Danes, aged 50-64 at baseline (1993-1997), we identified all addresses from 1987 to 2015 from a national registry and calculated nighttime road traffic noise at the most and least exposed façades. Using Cox Proportional Hazard Models we investigated the association between residential traffic noise over 1, 5, and 10 years before redemption of the first sleep medication prescription in the Danish National Prescription Registry. During a median follow-up time of 18.5 years, 13,114 persons redeemed a prescription. RESULTS We found that 10-year average nighttime exposure to road traffic noise at the most exposed façade was associated with a hazard ratio (HR) of 1.05, 95% confidence interval (CI) (1.00 to 1.10) for Ln greater than 55 as compared to not more than 45 dB, which when stratified by sex was confined to men (HR 1.16, 95% CI 1.08 to 1.25). For the least exposed façade the HR for Ln >45 vs ≤35 dB was 1.00, 95% CI (0.95 to 1.05). For the most exposed façade, the overall association was strongest in smokers and physically inactive. CONCLUSIONS Long-term residential nighttime noise exposure at the most exposed façade may be associated with a higher likelihood of redeeming prescriptions for sleep medication, especially among men, smokers, and physically inactive.
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Affiliation(s)
- Nina Roswall
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | | | | | - Ole Raaschou-Nielsen
- Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | | | - Kim Overvad
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.,Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Mette Sørensen
- Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark
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50
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Rogers AH, Zvolensky MJ, Ditre JW, Buckner JD, Asmundson GJG. Association of opioid misuse with anxiety and depression: A systematic review of the literature. Clin Psychol Rev 2021; 84:101978. [PMID: 33515811 DOI: 10.1016/j.cpr.2021.101978] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 11/19/2020] [Accepted: 11/29/2020] [Indexed: 12/14/2022]
Abstract
The opioid epidemic is a public health problem associated with a host of negative outcomes. Although clinicians recognize covariation between opioid misuse with anxiety and depressive symptoms and disorders, research on this topic has only recently accumulated. Progress in this domain is impeded by the lack of systematic and integrative research to better understand and treat these co-occurring problems. This paper represents the first attempt to systematically review the empirical literature examining relations between opioid use and misuse, and anxiety and depression. In the first section, we define key terms and describe the article selection strategy. In the second section, we review the prevalence of anxiety and depressive symptoms among individuals who use and misuse prescription and illicit opioids. In the third section, we review the magnitude of associations between anxiety and depressive symptoms and disorders with opioid misuse, as well as highlight studies examining the longitudinal and temporal sequence of the relations between these variables. In the fourth section, we focus on experimental therapeutics, reviewing what is known about individual difference and transdiagnostic vulnerability factors for anxiety and depression that might contribute to opioid misuse and its symptoms. Finally, we discuss current knowledge gaps and present a heuristic model to guide future research.
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Affiliation(s)
- Andrew H Rogers
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, United States; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States; HEALTH Institute, University of Houston, Houston, TX, United States.
| | - Joseph W Ditre
- Department of Psychology, Syracuse University, Syracuse, NY, United States
| | - Julia D Buckner
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
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