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Fenton L, Isenberg AL, Aslanyan V, Albrecht D, Contreras JA, Stradford J, Monreal T, Pa J. Variability in objective sleep is associated with Alzheimer's pathology and cognition. Brain Commun 2023; 5:fcad031. [PMID: 36895954 PMCID: PMC9989141 DOI: 10.1093/braincomms/fcad031] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/28/2022] [Accepted: 02/09/2023] [Indexed: 02/17/2023] Open
Abstract
Both sleep duration and sleep efficiency have been associated with risk of Alzheimer's disease, suggesting that interventions to promote optimal sleep may be a way to reduce Alzheimer's disease risk. However, studies often focus on average sleep measures, usually from self-report questionnaires, ignoring the role of intra-individual variability in sleep across nights quantified from objective sleep measures. The current cross-sectional study sought to investigate the role of intra-individual variability in accelerometer-based objective sleep duration and sleep efficiency in relation to in vivo Alzheimer's disease pathology (β-amyloid and tau) using positron emission tomography imaging and cognition (working memory, inhibitory control, verbal memory, visual memory and global cognition). To examine these relationships, we evaluated 52 older adults (age = 66.4 ± 6.89, 67% female, 27% apolipoprotein E4 carriers) with objective early mild cognitive impairment. Modifying effects of apolipoprotein E4 status were also explored. Less intra-individual variability in sleep duration was associated with lower β-amyloid burden, higher global cognition and better inhibitory control, with a trend for lower tau burden. Less intra-individual variability in sleep efficiency was associated with lower β-amyloid burden, higher global cognition and better inhibitory control, but not with tau burden. Longer sleep duration was associated with better visual memory and inhibitory control. Apolipoprotein E4 status significantly modified the association between intra-individual variability in sleep efficiency and β-amyloid burden, such that less sleep efficiency variability was associated with lower β-amyloid burden in apolipoprotein E4 carriers only. There was a significant interaction between sleep duration and apolipoprotein E4 status, suggesting that longer sleep duration is more strongly associated with lower β-amyloid burden in apolipoprotein E4 carriers relative to non-carriers. These results provide evidence that lower intra-individual variability in both sleep duration and sleep efficiency and longer mean sleep duration are associated with lower levels of β-amyloid pathology and better cognition. The relationships between sleep duration and intra-individual variability in sleep efficiency with β-amyloid burden differ by apolipoprotein E4 status, indicating that longer sleep duration and more consistent sleep efficiency may be protective against β-amyloid burden in apolipoprotein E4 carriers. Longitudinal and causal studies are needed to better understand these relationships. Future work should investigate factors contributing to intra-individual variability in sleep duration and sleep efficiency in order to inform intervention studies.
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Affiliation(s)
- Laura Fenton
- Alzheimer Disease Research Center, Department of Neurology, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90033, USA
- Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA
| | - A Lisette Isenberg
- Alzheimer’s Disease Cooperative Study (ADCS), Department of Neurosciences, University of California, San Diego, CA 92037, USA
| | - Vahan Aslanyan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - Daniel Albrecht
- Alzheimer’s Disease Cooperative Study (ADCS), Department of Neurosciences, University of California, San Diego, CA 92037, USA
| | - Joey A Contreras
- Alzheimer’s Disease Cooperative Study (ADCS), Department of Neurosciences, University of California, San Diego, CA 92037, USA
| | - Joy Stradford
- Alzheimer’s Disease Cooperative Study (ADCS), Department of Neurosciences, University of California, San Diego, CA 92037, USA
| | - Teresa Monreal
- Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Judy Pa
- Alzheimer Disease Research Center, Department of Neurology, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90033, USA
- Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA
- Alzheimer’s Disease Cooperative Study (ADCS), Department of Neurosciences, University of California, San Diego, CA 92037, USA
- Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
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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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Increased physical activity improves gut microbiota composition and reduces short-chain fatty acid concentrations in older adults with insomnia. Sci Rep 2022; 12:2265. [PMID: 35145140 PMCID: PMC8831598 DOI: 10.1038/s41598-022-05099-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 12/17/2021] [Indexed: 12/18/2022] Open
Abstract
Physical activity (PA) can improve functional abilities, well-being, and independence in older adults with insomnia. Studies have shown that PA may be linked to changes in the gut microbiota composition and its metabolites' concentrations. This association among older adults with insomnia, however, is yet to be determined. We explored the relationships between physical activity (PA) levels, gut microbiota composition, and short-chain fatty acid (SCFA) levels in this population. Forty-nine community-dwelling adults with insomnia symptoms, aged 65 and older, participated in this study. Their average daily step-count and sleep continuity measures over a two-week period were calculated based on Actigraphic recordings. Each participant provided fecal samples for the microbiome and SCFA analyses, anthropometric measures, and information via questionnaires on medical history and food consumption. The gut microbiota composition and SCFA concentrations were determined by next-generation sequencing and Gas chromatography-mass spectrometry, respectively. Participants were divided into two groups (more and less active) according to their median step/day count. We compared the microbiota abundance and SCFA concentrations between groups and performed correlation analysis between gut microbiota abundances and study variables. Different microbiota taxa in each PA group and increased SCFAs in feces of less active individuals were found. Changes in step counts were positively or negatively associated with the relative abundance of 19 ASVs, 3 microorganisms at the family level, and 11 microorganisms at the genus level. Furthermore, significant associations were discovered among physical activity, gut microbiota, SCFAs, and sleep parameters. Our findings provide new insights on the relationship between PA, gut microbiota composition, and primary metabolites in older adults with insomnia.
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Dhurandhar NV, Petersen KS, Webster C. Key Causes and Contributors of Obesity: A Perspective. Nurs Clin North Am 2021; 56:449-464. [PMID: 34749887 DOI: 10.1016/j.cnur.2021.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Obesity is a disease with several potential causes and contributors. This article provides a focused overview of key known causes of obesity and factors that contribute to obesity. Obesity ultimately results from impaired energy storage mechanisms, such as dysregulation of hunger, satiety, digestion, fat storage, and metabolic rate. In addition, myriad contributors promote its expression, including dietary factors, sleep quality and duration, psychological health and well-being, and tobacco cessation, among others. This article concludes with a discussion of the clinical relevance of causes and contributors in obesity prevention and treatment, which is paramount to providing effective, individualized clinical management.
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Affiliation(s)
- Nikhil V Dhurandhar
- Department of Nutritional Sciences, Texas Tech University, 1301 Akron Avenue, P.O. Box 41270, Lubbock, TX 79409, USA.
| | - Kristina S Petersen
- Department of Nutritional Sciences, Texas Tech University, 1301 Akron Avenue, P.O. Box 41270, Lubbock, TX 79409, USA
| | - Chelsi Webster
- Department of Nutritional Sciences, Texas Tech University, 1301 Akron Avenue, P.O. Box 41270, Lubbock, TX 79409, USA
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Blankenship JM, Rosenberg RC, Rynders CA, Melanson EL, Catenacci VA, Creasy SA. Examining the Role of Exercise Timing in Weight Management: A Review. Int J Sports Med 2021; 42:967-978. [PMID: 34034354 PMCID: PMC8591839 DOI: 10.1055/a-1485-1293] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Many adults cite exercise as a primary strategy for losing weight, yet exercise alone is modestly effective for weight loss and results in variable weight loss responses. It is possible that some of the variability in weight loss may be explained by the time of day that exercise is performed. Few studies have directly compared the effects of exercise performed at different times of the day (i. e., morning versus evening exercise). Results from these existing studies are mixed with some studies demonstrating superior weight and fat mass loss from morning exercise, while other studies have found that evening exercise may be better for weight management. Exercise timing may alter modifiable lifestyle behaviors involved in weight management, such as non-exercise physical activity, energy intake, and sleep. The purpose of this review is to summarize evidence for and against time-of-day dependent effects of exercise on weight management. Although limited, we also review studies that have examined the effect of exercise timing on other lifestyle behaviors linked to body weight regulation. While exercise at any time of day is beneficial for health, understanding whether there is an optimal time of day to exercise may advance personalized treatment paradigms for weight management.
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Affiliation(s)
- Jennifer M. Blankenship
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | | | - Corey A. Rynders
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Edward L. Melanson
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Department of Geriatrics, VA Eastern Colorado Health Care System, Aurora, CO
| | - Victoria A. Catenacci
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Seth A. Creasy
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO
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Atoui S, Chevance G, Romain AJ, Kingsbury C, Lachance JP, Bernard P. Daily associations between sleep and physical activity: A systematic review and meta-analysis. Sleep Med Rev 2021; 57:101426. [PMID: 33571893 DOI: 10.1016/j.smrv.2021.101426] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/22/2020] [Accepted: 10/01/2020] [Indexed: 02/07/2023]
Abstract
The day-to-day variations of sleep and physical activity are associated with various health outcomes in adults, and previous studies suggested a bidirectional association between these behaviors. The daily associations between sleep and physical activity have been examined in observational or interventional contexts. The primary goal of the current systematic review and meta-analysis was to summarize existing evidence about daily associations between sleep and physical activity outcomes at inter- and intra-individual level in adults. A systematic search of records in eight databases from inception to July 2019 identified 33 peer-reviewed empirical publications that examined daily sleep-physical activity association in adults. The qualitative and quantitative analyses of included studies did not support a bidirectional daily association between sleep outcomes and physical activity. Multilevel meta-analyses showed that three sleep parameters were associated with physical activity the following day: sleep quality, sleep efficiency, and wake after sleep onset. However, the associations were small, and varied in terms of direction and level of variability (e.g., inter- or intra-individual). Daytime physical activity was associated with lower total sleep time the following night at an inter-person level with a small effect size. From a clinical perspective, care providers should monitor the effects of better sleep promotion on physical activity behaviors in their patients. Future studies should examine sleep and physical activity during a longer period and perform additional sophisticated statistical analyses. SYSTEMATIC REVIEW REGISTRATION: https://osf.io/w6uy5/.
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Affiliation(s)
- Sarah Atoui
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, Québec, Canada; Research Center, University Institute of Mental Health at Montreal, Montréal, Quebec, Canada
| | - Guillaume Chevance
- Center for Wireless & Population Health Systems, Department of Family Medicine and Public Health, UC San Diego, San Diego, CA 92093, USA
| | - Ahmed-Jérôme Romain
- Research Center, University Institute of Mental Health at Montreal, Montréal, Quebec, Canada; École de kinésiologie et des sciences de l'activité physique, Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada
| | - Célia Kingsbury
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, Québec, Canada; Research Center, University Institute of Mental Health at Montreal, Montréal, Quebec, Canada
| | - Jean-Philippe Lachance
- Research Center, University Institute of Mental Health at Montreal, Montréal, Quebec, Canada
| | - Paquito Bernard
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, Québec, Canada; Research Center, University Institute of Mental Health at Montreal, Montréal, Quebec, Canada.
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Kubala AG, Buysse DJ, Brindle RC, Krafty RT, Thayer JF, Hall MH, Kline CE. The association between physical activity and a composite measure of sleep health. Sleep Breath 2020; 24:1207-1214. [PMID: 31900885 PMCID: PMC7332370 DOI: 10.1007/s11325-019-02007-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 11/13/2019] [Accepted: 12/20/2019] [Indexed: 12/24/2022]
Abstract
PURPOSE Physical activity has been associated with several individual dimensions of sleep. However, the association between physical activity and sleep health, a construct that emphasizes the multidimensional nature of sleep, has not been explored. This analysis examined the relationship between physical activity and a composite measure of sleep health. METHODS A total of 114 adults (66% female, 60.3 ± 9.2 years) were included in the analyses. Participants reported daily light-intensity physical activity (LPA) and moderate- and vigorous-intensity physical activity (MVPA) via diary, while wearing a pedometer (Omron HJ-720ITC) to measure daily steps. Sleep health was measured using the RU_SATED questionnaire, which addresses regularity of sleep patterns, satisfaction with sleep, daytime alertness, and sleep timing, efficiency, and duration. Multiple linear regression, binary logistic regression, and analysis of covariance (ANCOVA) were utilized for analyses. RESULTS Mean sleep health score was 9.6 ± 2.4 (0 [poor]-12 [good]). Participants reported 62.9 ± 66.0 and 51.2 ± 51.2 min/day of LPA and MVPA, respectively, and took 5585.5 ± 2806.7 steps/day. Greater MVPA was associated with better sleep health (β = 0.27, P = 0.005) and sleep health scores differed between those reporting < 30 min/day and ≥ 60 min/day of MVPA (P = 0.004). Greater MVPA was associated with higher odds of having good sleep satisfaction (OR = 1.58 [1.14-2.20], P < 0.01), timing (OR = 2.07 [1.24-3.46], P < 0.01), and duration (OR = 1.48 [1.02-2.18], P = 0.04). Pedometer-based physical activity and LPA were not related to sleep health or its individual dimensions. CONCLUSIONS In middle- to older-aged adults, higher-intensity activity, but not lower-intensity or volume of activity, was associated with greater sleep health. These data suggest that physical activity intensity may be important for sleep health.
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Affiliation(s)
- Andrew G Kubala
- Physical Activity and Weight Management Research Center, Department of Health and Physical Activity, University of Pittsburgh, 32 Oak Hill Court, Pittsburgh, PA, 15261, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ryan C Brindle
- Department of Cognitive and Behavioral Science & Neuroscience Program, Washington and Lee University, Lexington, VA, USA
| | - Robert T Krafty
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Julian F Thayer
- Department of Psychological Science, University of California, Irvine, CA, USA
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Christopher E Kline
- Physical Activity and Weight Management Research Center, Department of Health and Physical Activity, University of Pittsburgh, 32 Oak Hill Court, Pittsburgh, PA, 15261, USA.
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Sonnega A, Leggett A, Pepin R, Assari S. Physical Activity and Insomnia Symptoms Over 10 Years in a U.S. National Sample of Late-Middle-Age and Older Adults: Age Matters. J Aging Phys Act 2020; 28:613-622. [PMID: 31896077 PMCID: PMC7326645 DOI: 10.1123/japa.2018-0337] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 05/30/2019] [Accepted: 11/14/2019] [Indexed: 01/04/2023]
Abstract
Research suggests that physical activity may influence sleep, yet more research is needed before it can be considered a frontline treatment for insomnia. Less is known about how this relationship is moderated by age. Using multilevel modeling, we examined self-reported physical activity and insomnia symptoms in 18,078 respondents from the U.S. nationally representative Health and Retirement Study (2004-2014). The mean baseline age was 64.7 years, with 53.9% female. Individuals who reported more physical activity (B = -0.005, p < .001) had fewer insomnia symptoms. Over 10 years, the respondents reported fewer insomnia symptoms at times when they reported more physical activity than was average for them (B = -0.003, p < .001). Age moderated this relationship (B = 0.0002, p < .01). Although modest, these findings concur with the literature, suggesting moderate benefits of physical activity for sleep in older adults. Future research should aim to further elucidate this relationship among adults at advanced ages.
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Jung AR, Park JI, Kim HS. Physical Activity for Prevention and Management of Sleep Disturbances. SLEEP MEDICINE RESEARCH 2020. [DOI: 10.17241/smr.2020.00542] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Intra-individual variability of sleep and nocturnal cardiac autonomic activity in elite female soccer players during an international tournament. PLoS One 2019; 14:e0218635. [PMID: 31527865 PMCID: PMC6748428 DOI: 10.1371/journal.pone.0218635] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 08/29/2019] [Indexed: 01/12/2023] Open
Abstract
Purpose To describe individual sleeping patterns and nocturnal cardiac autonomic activity of National team female soccer players during an international tournament. Materials and methods Twenty elite female soccer players (aged 25.2±3.1 years) wore wrist actigraph units and heart rate (HR) monitors during night-sleep throughout 9 consecutive days (6 day-time training sessions [DT], 2 day-time matches [DM], and 1 evening-time match [EM]) of an international tournament. Training and match loads were monitored using the session-rating of perceived exertion (s-RPE) and wearable 18-Hz GPS (total distance covered [TD], training and match exposure time, and high-speed running [HSR]) to characterize training and match loads. Results Individually, s-RPE, TD, exposure time, and HSR during training sessions ranged from 20 to 680 arbitrary units (AU), 892 to 5176 m, 20 to 76 min, and 80 to 1140 m, respectively. During matches, s-RPE, TD, exposure time, and HSR ranged from 149 to 876 AU, 2236 to 11210 m, 20 to 98 min, and 629 to 3213 m, respectively. Individually, players slept less than recommended (<7 hours) on several days of the tournament, especially after EM (n = 8; TST ranging between 6:00–6:54 h). Total sleep time coefficient of variation (CV) ranged between 3.1 and 18.7%. However, all players presented good sleep quality (i.e., sleep efficiency ≥75%; individual range between: 75–98%) on each day of the tournament. Most of the players presented small fluctuations in nocturnal cardiac autonomic activity (individual nocturnal heart rate variability [HRV] ranged from 3.91–5.37 ms and HRV CV ranged from 2.8–9.0%), while two players presented higher HRV CV (11.5 and 11.7%; respectively). Conclusion Overall, this study highlights the substantial individual variability in sleep and HRV measures, suggesting the adoption of an individual approach to monitor sleep, training and match loads and recovery, to better understand how players cope with highly demanding competitions.
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Breneman CB, Kline CE, West DS, Sui X, Porter RR, Bowyer KP, Custer S, Wang X. The effect of moderate-intensity exercise on nightly variability in objectively measured sleep parameters among older women. Behav Sleep Med 2019; 17:459-469. [PMID: 29053410 PMCID: PMC6157002 DOI: 10.1080/15402002.2017.1395337] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objective/Background: Exercise training has been demonstrated to beneficially influence mean-level measures of sleep; however, few studies have examined the impact of an exercise intervention on night-to-night variability in sleep. This study investigated whether four months of moderate-intensity exercise impacted night-to-night variability in sleep among older women. Methods: Participants (n = 49) were randomized to one of two moderate-intensity walking programs with different doses of energy expenditure: low-dose (n = 23: 8 kcal/kg of body weight per week) or high-dose (n = 26: 14 kcal/kg of body weight per week). Sleep parameters were assessed objectively via actigraphy at baseline, mid- (2 months), and postintervention (4 months). Nightly variability in each of the sleep parameters was calculated using the seven-day standard deviation (SD) and a coefficient of variation (SD/mean x 100%). Cardiorespiratory fitness (VO2peak) was measured at baseline and postintervention using a graded treadmill test. Results: Both measures of nightly variability demonstrated a borderline to significantly lower amount of night-to-night variability in wake time after sleep onset (WASO) and number of awakenings at postintervention in comparison to baseline (p ≤ 0.05). Higher VO2peak levels at baseline were associated with less time in bed and lower total sleep time variability throughout the exercise intervention (p < 0.05). Conclusion: Overall, participation in moderate-intensity exercise was observed to reduce the amount of nightly variability for WASO and number of awakenings over time in older women.
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Affiliation(s)
- Charity B. Breneman
- South Carolina Rural Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Christopher E. Kline
- Department of Health & Physical Activity, School of Education, University of Pittsburgh, Pittsburgh, PA, USA
| | - Delia S. West
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Ryan R. Porter
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Kimberly P. Bowyer
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Sabra Custer
- College of Nursing, University of South Carolina, Columbia, SC, USA
| | - Xuewen Wang
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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The Sleep Inbred Panel, a Collection of Inbred Drosophila melanogaster with Extreme Long and Short Sleep Duration. G3-GENES GENOMES GENETICS 2018; 8:2865-2873. [PMID: 29991508 PMCID: PMC6118319 DOI: 10.1534/g3.118.200503] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Understanding how genomic variation causes differences in observable phenotypes remains a major challenge in biology. It is difficult to trace the sequence of events originating from genomic variants to changes in transcriptional responses or protein modifications. Ideally, one would conduct experiments with individuals that are at either extreme of the trait of interest, but such resources are often not available. Further, advances in genome editing will enable testing of candidate polymorphisms individually and in combination. Here we have created a resource for the study of sleep with 39 inbred lines of Drosophila-the Sleep Inbred Panel (SIP). SIP lines have stable long- and short-sleeping phenotypes developed from naturally occurring polymorphisms. These lines are fully sequenced, enabling more accurate targeting for genome editing and transgenic constructs. This panel facilitates the study of intermediate transcriptional and proteomic correlates of sleep, and supports genome editing studies to verify polymorphisms associated with sleep duration.
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Wu KJ, Kumar S, Serrano Negron YL, Harbison ST. Genotype Influences Day-to-Day Variability in Sleep in Drosophila melanogaster. Sleep 2018; 41:zsx205. [PMID: 29228366 PMCID: PMC6018780 DOI: 10.1093/sleep/zsx205] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 10/27/2017] [Indexed: 12/22/2022] Open
Abstract
Patterns of sleep often vary among individuals. But sleep and activity may also vary within an individual, fluctuating in pattern across time. One possibility is that these daily fluctuations in sleep are caused by the underlying genotype of the individual. However, differences attributable to genetic causes are difficult to distinguish from environmental factors in outbred populations such as humans. We therefore employed Drosophila as a model of intra-individual variability in sleep using previously collected sleep and activity data from the Drosophila Genetic Reference Panel, a collection of wild-derived inbred lines. Individual flies had significant daily fluctuations in their sleep patterns, and these fluctuations were heritable. Using the standard deviation of sleep parameters as a metric, we conducted a genome-wide association study. We found 663 polymorphisms in 104 genes associated with daily fluctuations in sleep. We confirmed the effects of 12 candidate genes on the standard deviation of sleep parameters. Our results suggest that daily fluctuations in sleep patterns are due in part to gene activity.
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Affiliation(s)
- Katherine J Wu
- Laboratory of Systems Genetics, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Shailesh Kumar
- Laboratory of Systems Genetics, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Yazmin L Serrano Negron
- Laboratory of Systems Genetics, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Susan T Harbison
- Laboratory of Systems Genetics, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
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Chan WS, Williams J, Dautovich ND, McNamara JPH, Stripling A, Dzierzewski JM, Berry RB, McCoy KJM, McCrae CS. Night-to-Night Sleep Variability in Older Adults With Chronic Insomnia: Mediators and Moderators in a Randomized Controlled Trial of Brief Behavioral Therapy (BBT-I). J Clin Sleep Med 2017; 13:1243-1254. [PMID: 28992829 DOI: 10.5664/jcsm.6790] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 08/17/2017] [Indexed: 01/06/2023]
Abstract
STUDY OBJECTIVES Sleep variability is a clinically significant variable in understanding and treating insomnia in older adults. The current study examined changes in sleep variability in the course of brief behavioral therapy for insomnia (BBT-I) in older adults who had chronic insomnia. Additionally, the current study examined the mediating mechanisms underlying reductions of sleep variability and the moderating effects of baseline sleep variability on treatment responsiveness. METHODS Sixty-two elderly participants were randomly assigned to either BBT-I or self-monitoring and attention control (SMAC). Sleep was assessed by sleep diaries and actigraphy from baseline to posttreatment and at 3-month follow-up. Mixed models were used to examine changes in sleep variability (within-person standard deviations of weekly sleep parameters) and the hypothesized mediation and moderation effects. RESULTS Variabilities in sleep diary-assessed sleep onset latency (SOL) and actigraphy-assessed total sleep time (TST) significantly decreased in BBT-I compared to SMAC (Pseudo R2 = .12, .27; P = .018, .008). These effects were mediated by reductions in bedtime and wake time variability and time in bed. Significant time × group × baseline sleep variability interactions on sleep outcomes indicated that participants who had higher baseline sleep variability were more responsive to BBT-I; their actigraphy-assessed TST, SOL, and sleep efficiency improved to a greater degree (Pseudo R2 = .15 to .66; P < .001 to .044). CONCLUSIONS BBT-I is effective in reducing sleep variability in older adults who have chronic insomnia. Increased consistency in bedtime and wake time and decreased time in bed mediate reductions of sleep variability. Baseline sleep variability may serve as a marker of high treatment responsiveness to BBT-I. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, Identifier: NCT02967185.
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Affiliation(s)
- Wai Sze Chan
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
| | | | | | | | - Ashley Stripling
- College of Psychology, Nova Southeastern University, Fort Lauderdale, Florida
| | | | - Richard B Berry
- College of Medicine, University of Florida, Gainesville, Florida
| | - Karin J M McCoy
- Neuropsychology Service, South Texas Veterans Health Care System, San Antonio, Texas
| | - Christina S McCrae
- Department of Health Psychology, University of Missouri-Columbia, Columbia, Missouri
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15
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Gloster AT, Meyer AH, Witthauer C, Lieb R, Mata J. 'I feel better when…': An analysis of the memory-experience gap for peoples' estimates of the relationship between health behaviours and experiences. Psychol Health 2017; 32:1152-1166. [PMID: 28498009 DOI: 10.1080/08870446.2017.1327586] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE People often overestimate how strongly behaviours and experiences are related. This memory-experience gap might have important implications for health care settings, which often require people to estimate associations, such as "my mood is better when I exercise". This study examines how subjective correlation estimates between health behaviours and experiences relate to calculated correlations from online reports and whether subjective estimates are associated with engagement in actual health behaviour. DESIGN Seven-month online study on physical activity, sleep, affect and stress, with 61 online assessments. MAIN OUTCOME MEASURES University students (N = 168) retrospectively estimated correlations between physical activity, sleep, positive affect and stress over the seven-month study period. RESULTS Correlations between experiences and behaviours (online data) were small (r = -.12-.14), estimated correlations moderate (r = -.35-.24). Correspondence between calculated and estimated correlations was low. Importantly, estimated correlations of physical activity with stress, positive affect and sleep were associated with actual engagement in physical activity. CONCLUSION Estimation accuracy of relations between health behaviours and experiences is low. However, association estimates could be an important predictor of actual health behaviours. This study identifies and quantifies estimation inaccuracies in health behaviours and points towards potential systematic biases in health settings, which might seriously impair intervention efficacy.
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Affiliation(s)
- Andrew T Gloster
- a Division of Clinical Psychology and Epidemiology, Department of Psychology , University of Basel , Basel , Switzerland.,b Division of Clinical Psychology and Intervention Science, Department of Psychology , University of Basel , Basel , Switzerland
| | - Andrea H Meyer
- a Division of Clinical Psychology and Epidemiology, Department of Psychology , University of Basel , Basel , Switzerland
| | - Cornelia Witthauer
- a Division of Clinical Psychology and Epidemiology, Department of Psychology , University of Basel , Basel , Switzerland
| | - Roselind Lieb
- a Division of Clinical Psychology and Epidemiology, Department of Psychology , University of Basel , Basel , Switzerland
| | - Jutta Mata
- a Division of Clinical Psychology and Epidemiology, Department of Psychology , University of Basel , Basel , Switzerland.,c Division of Health Psychology, Department of Psychology , University of Mannheim , Mannheim , Germany
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16
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Baron KG, Reid KJ, Malkani RG, Kang J, Zee PC. Sleep Variability Among Older Adults With Insomnia: Associations With Sleep Quality and Cardiometabolic Disease Risk. Behav Sleep Med 2017; 15:144-157. [PMID: 26745754 PMCID: PMC5584781 DOI: 10.1080/15402002.2015.1120200] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Sleep variability has been linked to poor subjective sleep quality, but few studies have investigated effects on physical health. In this study, we evaluated cross sectional associations and change over time in objective sleep variability of adults with insomnia and short sleep duration who were participating in a non-pharmacologic intervention study. Results indicated greater variability in objective sleep measures were associated with poorer subjective sleep quality (p < 0.05). Higher sleep duration variability was associated with higher HbA1c (p < 0.01) and sleep onset time variability was associated with higher BMI (p < 0.05). Sleep efficiency and WASO variability decreased with intervention (p < 0.05). These results indicate that objective sleep variability may be an important feature for the assessment of insomnia outcomes.
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Affiliation(s)
| | - Kathryn J. Reid
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Roneil G. Malkani
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Joseph Kang
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Phyllis C. Zee
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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17
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Leisure-Time Physical Activity and Sedentary Behavior and Their Cross-Sectional Associations with Excessive Daytime Sleepiness in the French SU.VI.MAX-2 Study. Int J Behav Med 2016; 23:143-52. [PMID: 26249724 DOI: 10.1007/s12529-015-9501-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND The potential benefit of physical activity in terms of decreasing excessive daytime sleepiness (EDS) prevalence is unclear, especially in aging adults. PURPOSE We aimed to elucidate the associations among physical activity, sedentariness, and EDS in middle-aged and older adults. METHODS We conducted a cross-sectional analysis using data from a subsample of participants in the SU.VI.MAX-2 observational study (2007-2009; N = 4179; mean age = 61.9 years). EDS was defined as a score >10 on the Epworth Sleepiness Scale. Leisure-time physical activity and different types of sedentary behavior were assessed with the Modifiable Activity Questionnaire. The associations were examined with multivariable logistic regression models. RESULTS In the adjusted multivariable model, total leisure-time physical activity (modeled in quartiles, Q) was significantly, inversely associated with EDS (odds ratios (OR)Q4 vs Q1 = 0.70, 95 % confidence interval (CI) = 0.54-0.89). The association persisted in analyses restricted to individuals not taking sleep medication (ORQ4 vs Q1 = 0.72, 95 % CI = 0.54-0.95). In turn, time spent watching television and time spent reading appeared protective against EDS (ORQ4 vs Q1 = 0.73, 95 % CI = 0.57-0.94; ORQ4 vs Q1 = 0.76, 95 % CI = 0.60-0.97, respectively), whereas time spent on a computer appeared to confer an increased risk for EDS (ORQ4 vs Q1 = 1.30, 95 % CI = 1.05-1.62). When physical activity and sedentariness were modeled jointly, using WHO recommendation-based cutoffs for high/low levels, no significant associations were observed in the fully adjusted models. CONCLUSIONS The findings reinforce public health recommendations promoting behavior modification and specifically moderate-intensity exercise in middle-aged and older adults. The association of high physical activity/low sedentariness with EDS, which was not supported by the data, merits further investigation before firm conclusions could be drawn.
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18
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St-Onge MP, Grandner MA, Brown D, Conroy MB, Jean-Louis G, Coons M, Bhatt DL. Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health: A Scientific Statement From the American Heart Association. Circulation 2016; 134:e367-e386. [PMID: 27647451 DOI: 10.1161/cir.0000000000000444] [Citation(s) in RCA: 536] [Impact Index Per Article: 67.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Sleep is increasingly recognized as an important lifestyle contributor to health. However, this has not always been the case, and an increasing number of Americans choose to curtail sleep in favor of other social, leisure, or work-related activities. This has resulted in a decline in average sleep duration over time. Sleep duration, mostly short sleep, and sleep disorders have emerged as being related to adverse cardiometabolic risk, including obesity, hypertension, type 2 diabetes mellitus, and cardiovascular disease. Here, we review the evidence relating sleep duration and sleep disorders to cardiometabolic risk and call for health organizations to include evidence-based sleep recommendations in their guidelines for optimal health.
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19
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Duncan MJ, Vandelanotte C, Trost SG, Rebar AL, Rogers N, Burton NW, Murawski B, Rayward A, Fenton S, Brown WJ. Balanced: a randomised trial examining the efficacy of two self-monitoring methods for an app-based multi-behaviour intervention to improve physical activity, sitting and sleep in adults. BMC Public Health 2016; 16:670. [PMID: 27473327 PMCID: PMC4967346 DOI: 10.1186/s12889-016-3256-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 07/01/2016] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Many adults are insufficiently physically active, have prolonged sedentary behaviour and report poor sleep. These behaviours can be improved by interventions that include education, goal setting, self-monitoring, and feedback strategies. Few interventions have explicitly targeted these behaviours simultaneously or examined the relative efficacy of different self-monitoring methods. METHODS/DESIGN This study aims to compare the efficacy of two self-monitoring methods in an app-based multi-behaviour intervention to improve objectively measured physical activity, sedentary, and sleep behaviours, in a 9 week 2-arm randomised trial. Participants will be adults (n = 64) who report being physically inactive, sitting >8 h/day and frequent insufficient sleep (≥14 days out of last 30). The "Balanced" intervention is delivered via a smartphone 'app', and includes education materials (guidelines, strategies to promote change in behaviour), goal setting, self-monitoring and feedback support. Participants will be randomly allocated to either a device-entered or user-entered self-monitoring method. The device-entered group will be provided with a activity tracker to self-monitor behaviours. The user-entered group will recall and manually record behaviours. Assessments will be conducted at 0, 3, 6, and 9 weeks. Physical activity, sedentary behaviour and sleep-wake behaviours will be measured using the wrist worn Geneactiv accelerometer. Linear mixed models will be used to examine differences between groups and over time using an alpha of 0.01. DISCUSSION This study will evaluate an app-based multi-behavioural intervention to improve physical activity, sedentary behaviour and sleep; and the relative efficacy of two different approaches to self-monitoring these behaviours. Outcomes will provide information to inform future interventions and self-monitoring targeting these behaviours. TRIAL REGISTRATION ACTRN12615000182594 (Australian New Zealand Clinical Trials Registry. Registry URL: www.anzctr.org.au ; registered prospectively on 25 February 2015).
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Affiliation(s)
- Mitch J. Duncan
- School of Medicine & Public Health; Priority Research Centre for Physical Activity and Nutrition, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
| | - Corneel Vandelanotte
- School of Human Health and Social Science; Physical Activity Research Group, Central Queensland University, Building 18, Bruce Highway, Rockhampton, QLD 4702 Australia
| | - Stewart G. Trost
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD 4059 Australia
| | - Amanda L. Rebar
- School of Human Health and Social Science; Physical Activity Research Group, Central Queensland University, Building 18, Bruce Highway, Rockhampton, QLD 4702 Australia
| | - Naomi Rogers
- Sydney Medical School, The University of Sydney, Sydney, NSW 2050 Australia
| | - Nicola W. Burton
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD 4072 Australia
| | - Beatrice Murawski
- School of Medicine & Public Health; Priority Research Centre for Physical Activity and Nutrition, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
| | - Anna Rayward
- School of Medicine & Public Health; Priority Research Centre for Physical Activity and Nutrition, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
| | - Sasha Fenton
- School of Medicine & Public Health; Priority Research Centre for Physical Activity and Nutrition, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
| | - Wendy J. Brown
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD 4072 Australia
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20
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Baldursdottir B, Taehtinen RE, Sigfusdottir ID, Krettek A, Valdimarsdottir HB. Impact of a physical activity intervention on adolescents' subjective sleep quality: a pilot study. Glob Health Promot 2016; 24:14-22. [PMID: 27173502 DOI: 10.1177/1757975915626112] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND The aim of this pilot study was to examine the impact of a brief physical activity intervention on adolescents' subjective sleep quality. Cross-sectional studies indicate that physically active adolescents have better subjective sleep quality than those with more sedentary habits. However, less is known about the effectiveness of physical activity interventions in improving adolescents' subjective sleep quality. METHODS In a three-week physical activity intervention, four Icelandic upper secondary schools were randomized to either an intervention group with pedometers and step diaries or a control group without pedometers and diaries. Out of 84, a total of 53 students, aged 15-16 years, provided complete data or a minimum of two days step data (out of three possible) as well as sleep quality measures at baseline and follow-up. Subjective sleep quality, the primary outcome in this study, was assessed with four individual items: sleep onset latency, nightly awakenings, general sleep quality, and sleep sufficiency. Daily steps were assessed with Yamax CW-701 pedometers. RESULTS The intervention group ( n = 26) had significantly higher average step-count ( p = 0.03, partial η2 = 0.093) compared to the control group ( n = 27) at follow-up. Subjective sleep quality improved ( p = 0.02, partial η2 = 0.203) over time in the intervention group but not in the control group. CONCLUSIONS Brief physical activity interventions based on pedometers and step diaries may be effective in improving adolescents' subjective sleep quality. This has important public health relevance as the intervention can easily be disseminated and incorporated into school curricula.
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Affiliation(s)
- Birna Baldursdottir
- 1. Department of Psychology, School of Business, Reykjavik University, Iceland.,2. Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden
| | - Richard E Taehtinen
- 1. Department of Psychology, School of Business, Reykjavik University, Iceland.,3. ICSRA (Icelandic Centre for Social Research and Analysis), Reykjavik University, Iceland
| | - Inga Dora Sigfusdottir
- 1. Department of Psychology, School of Business, Reykjavik University, Iceland.,3. ICSRA (Icelandic Centre for Social Research and Analysis), Reykjavik University, Iceland.,7. Department of Health & Behavior Studies, Teachers College, Columbia University, New York, NY, USA
| | - Alexandra Krettek
- 2. Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden.,5. Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, Sweden.,6. Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Heiddis B Valdimarsdottir
- 1. Department of Psychology, School of Business, Reykjavik University, Iceland.,4. Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY, USA
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21
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Brand S, Colledge F, Beeler N, Pühse U, Kalak N, Sadeghi Bahmani D, Mikoteit T, Holsboer-Trachsler E, Gerber M. The current state of physical activity and exercise programs in German-speaking, Swiss psychiatric hospitals: results from a brief online survey. Neuropsychiatr Dis Treat 2016; 12:1309-17. [PMID: 27350748 PMCID: PMC4902243 DOI: 10.2147/ndt.s107313] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Physical activity and exercise programs (PAEPs) are an important factor in increasing and maintaining physical and mental health. This holds particularly true for patients with psychiatric disorders undergoing treatment in a psychiatric hospital. To understand whether the benefits reported in the literature are mirrored in current treatment modalities, the aim of the present study was to assess the current state of PAEPs in psychiatric hospitals in the German-speaking part of Switzerland. METHODS All psychiatric hospitals (N=55) in the German-speaking part of Switzerland were contacted in spring 2014. Staff responsible for PAEPs were asked to complete an online questionnaire covering questions related to PAEPs such as type, frequency, staff training, treatment rationale, importance of PAEPs within the treatment strategy, and possible avenues to increase PAEPs. RESULTS Staff members of 48 different psychiatric hospitals completed the survey. Hospitals provided the following therapeutic treatments: relaxation techniques (100%), sports therapy (97%), activity-related psychotherapeutic interventions (95%), physiotherapy (85%), body therapies (59%), far-east techniques (57%), and hippotherapy (22%). Frequencies ranged from once/week to five times/week. Approximately 25% of patients participated in the PAEPs. Interventions were offered irrespective of psychiatric disorders. PAEP providers wanted and needed more vocational training. CONCLUSION All participating psychiatric hospitals offer a broad variety of PAEPs in their treatment curricula. However, the majority of inpatients do not participate in PAEPs. Furthermore, those who do participate cannot continue to do so following discharge. PAEP providers need specific extended vocational trainings and believe that the potential of PA should be improved.
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Affiliation(s)
- Serge Brand
- Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland; Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland
| | - Flora Colledge
- Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland
| | - Nadja Beeler
- Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland
| | - Uwe Pühse
- Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland
| | - Nadeem Kalak
- Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland
| | - Dena Sadeghi Bahmani
- Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland
| | - Thorsten Mikoteit
- Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland
| | - Edith Holsboer-Trachsler
- Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland
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22
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Sleep and physical activity as modifiable risk factors in age-associated cognitive decline. Sleep Biol Rhythms 2015. [DOI: 10.1007/s41105-015-0002-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Varrasse M, Li J, Gooneratne N. Exercise and Sleep in Community-Dwelling Older Adults. CURRENT SLEEP MEDICINE REPORTS 2015; 1:232-240. [PMID: 27088071 DOI: 10.1007/s40675-015-0028-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Insomnia and other sleep complaints are highly prevalent in community-dwelling older adults yet often go under detected. Age-related physiological changes may affect sleep, but sleep disturbances and complaints should not be considered normal in this population. Various physiological, psychological, and social consequences have been associated with insomnia and sleep complaints. Treatment options are available so it is imperative to diagnose and treat these individuals to promote healthy aging. Exercise is known to have a wide variety of health benefits, but unfortunately most older adults engage in less exercise with advancing age. This paper describes age-related changes in sleep, clinical correlates of insomnia, consequences of untreated insomnia, and nonpharmacological treatments for insomnia in older adults, with a focus on the relationship between exercise and sleep in community-dwelling older adults with insomnia or sleep complaints. Possible mechanisms explaining the relationship between exercise and sleep are discussed. While the research to date shows promising evidence for exercise as a safe and effective treatment for insomnia and sleep complaints in community-dwelling older adults, future research is needed before exercise can be a first-line treatment for insomnia and sleep complaints in this population.
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Affiliation(s)
- Miranda Varrasse
- NewCourtland Center for Transitions and Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA; Center for Integrative Science in Aging, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Junxin Li
- Center for Integrative Science in Aging, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA; Center for Sleep and Circadian Neurobiology, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Nalaka Gooneratne
- Center for Sleep and Circadian Neurobiology, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Division of Geriatric Medicine, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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24
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Interactions between sleep, stress, and metabolism: From physiological to pathological conditions. ACTA ACUST UNITED AC 2015; 8:143-52. [PMID: 26779321 PMCID: PMC4688585 DOI: 10.1016/j.slsci.2015.09.002] [Citation(s) in RCA: 223] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 09/15/2015] [Accepted: 09/16/2015] [Indexed: 11/28/2022]
Abstract
Poor sleep quality due to sleep disorders and sleep loss is highly prevalent in the modern society. Underlying mechanisms show that stress is involved in the relationship between sleep and metabolism through hypothalamic–pituitary–adrenal (HPA) axis activation. Sleep deprivation and sleep disorders are associated with maladaptive changes in the HPA axis, leading to neuroendocrine dysregulation. Excess of glucocorticoids increase glucose and insulin and decrease adiponectin levels. Thus, this review provides overall view of the relationship between sleep, stress, and metabolism from basic physiology to pathological conditions, highlighting effective treatments for metabolic disturbances.
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25
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Dekker K, Benjamins JS, Van Straten A, Hofman WF, Van Someren EJW. Effectiveness of internet-supported cognitive behavioral and chronobiological interventions and effect moderation by insomnia subtype: study protocol of a randomized controlled trial. Trials 2015; 16:292. [PMID: 26141682 PMCID: PMC4490722 DOI: 10.1186/s13063-015-0790-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 06/01/2015] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND DSM-V criteria for insomnia disorder are met by 6 to 10% of the adult population. Insomnia has severe consequences for health and society. One of the most common treatments provided by primary caregivers is pharmacological treatment, which is far from optimal and has not been recommended since a 2005 consensus report of the National Institutes of Health. The recommended treatment is Cognitive Behavioral Therapy for Insomnia. Effectiveness, however, is still limited. Only a few studies have evaluated the effectiveness of chronobiological treatments, including the timed application of bright light, physical activity and body warming. Another opportunity for optimization of treatment is based on the idea that the people suffering from insomnia most likely represent a heterogeneous mix of subtypes, with different underlying causes and expected treatment responses. The present study aims to evaluate the possibility for optimizing insomnia treatment along the principles of personalized and stratified medicine. It evaluates the following: 1. The relative effectiveness of internet-supported cognitive behavioral therapy, bright light, physical activity and body warming; 2. Whether the effectiveness of internet-supported cognitive behavioral therapy for insomnia can be augmented by simultaneous or prior application of bright light, physical activity and body warming; and 3. Whether the effectiveness of the interventions and their combination are moderated by the insomnia subtype. METHODS/DESIGN In a repeated measures, placebo-controlled, randomized clinical trial that included 160 people diagnosed with insomnia disorder, we are evaluating the relative effectiveness of 4 intervention weeks. Primary outcome is subjective sleep efficiency, quantified using a sleep diary. Secondary outcomes include other complaints of sleep and daytime functioning, health-related cost estimates and actigraphic objective sleep estimates. Compliance will be monitored both subjectively and objectively using activity, light and temperature sensors. Insomnia subtypes will be assessed using questionnaires. Mixed effect models will be used to evaluate intervention effects and moderation by insomnia subtype ratings. DISCUSSION The current study addresses multiple opportunities to optimize and personalize treatment of insomnia disorder. TRIAL REGISTRATION Netherlands National Trial Register NTR4010, 4 June 2013.
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Affiliation(s)
- Kim Dekker
- Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Meibergdreef 47, 1105 BA, Amsterdam, The Netherlands.
| | - Jeroen S Benjamins
- Department of Clinical and Health Psychology, Department of Experimental Psychology, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands.
| | - Annemieke Van Straten
- Department of Clinical Psychology, VU University Amsterdam & EMGO Institute for Health Care and Research, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands.
| | - Winni F Hofman
- Department of Psychology, Brain and Cognition group, University of Amsterdamy, Weesperplein 4, 1018 XA, Amsterdam, The Netherlands.
- Personal Health Institute International, Lobo-Braakensiekstraat 94, 1065 HP, Amsterdam, The Netherlands.
| | - Eus J W Van Someren
- Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Meibergdreef 47, 1105 BA, Amsterdam, The Netherlands.
- Departments of Integrative Neurophysiology and Medical Psychology, Center for Neurogenomics and Cognitive Research (CNCR), Neuroscience Campus Amsterdam, VU University and Medical Center, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands.
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26
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Bei B, Wiley JF, Trinder J, Manber R. Beyond the mean: A systematic review on the correlates of daily intraindividual variability of sleep/wake patterns. Sleep Med Rev 2015; 28:108-24. [PMID: 26588182 DOI: 10.1016/j.smrv.2015.06.003] [Citation(s) in RCA: 262] [Impact Index Per Article: 29.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Revised: 06/23/2015] [Accepted: 06/23/2015] [Indexed: 11/20/2022]
Abstract
Features of an individual's sleep/wake patterns across multiple days are governed by two dimensions, the mean and the intraindividual variability (IIV). The existing literature focuses on the means, while the nature and correlates of sleep/wake IIV are not well understood. A systematic search of records in five major databases from inception to November 2014 identified 53 peer-reviewed empirical publications that examined correlates of sleep/wake IIV in adults. Overall, this literature appeared unsystematic and post hoc, with under-developed theoretical frameworks and inconsistent methodologies. Correlates most consistently associated with greater IIV in one or more aspects of sleep/wake patterns were: younger age, non-White race/ethnicity, living alone, physical health conditions, higher body mass index, weight gain, bipolar and unipolar depression symptomatology, stress, and evening chronotype; symptoms of insomnia and poor sleep were associated with higher sleep/wake IIV, which was reduced following sleep interventions. The effects of experimentally reduced sleep/wake IIV on daytime functioning were inconclusive. In extending current understanding of sleep/wake patterns beyond the mean values, IIV should be incorporated as an additional dimension when sleep is examined across multiple days. Theoretical and methodological shortcomings in the existing literature, and opportunities for future research are discussed.
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Affiliation(s)
- Bei Bei
- Monash Institute of Cognitive and Clinical Neurosciences, Monash School of Psychological Sciences, Faculty of Biomedical and Psychological Sciences, Monash University, Australia; Centre for Women's Mental Health, Royal Women's Hospital, Australia.
| | - Joshua F Wiley
- Centre for Primary Care and Prevention, Mary MacKillop Institute for Health Research, Australian Catholic University, Australia
| | - John Trinder
- Melbourne School of Psychological Sciences, University of Melbourne, Australia
| | - Rachel Manber
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Science, USA
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Sleep depth and continuity before and after chronic exercise in older men: Electrophysiological evidence. Physiol Behav 2015; 140:203-8. [DOI: 10.1016/j.physbeh.2014.12.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 12/17/2014] [Accepted: 12/19/2014] [Indexed: 10/24/2022]
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Pa J, Goodson W, Bloch A, King AC, Yaffe K, Barnes DE. Effect of exercise and cognitive activity on self-reported sleep quality in community-dwelling older adults with cognitive complaints: a randomized controlled trial. J Am Geriatr Soc 2015; 62:2319-26. [PMID: 25516028 DOI: 10.1111/jgs.13158] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVES To compare the effects of different types of physical and mental activity on self-reported sleep quality over 12 weeks in older adults with cognitive and sleep complaints. DESIGN Randomized controlled trial. SETTING General community. PARTICIPANTS Seventy-two inactive community-dwelling older adults with self-reported sleep and cognitive problems (mean age 73.3 ± 6.1; 60% women). INTERVENTION Random allocation to four arms using a two-by-two factorial design: aerobic+cognitive training, aerobic+educational DVD, stretching+cognitive training, and stretching+educational DVD arms (60 min/d, 3 d/wk for physical and mental activity for 12 weeks). MEASUREMENTS Change in sleep quality using seven questions from the Sleep Disorders Questionnaire on the 2005 to 2006 National Health and Nutrition Examination Survey (range 0-28, with higher scores reflecting worse sleep quality). Analyses used intention-to-treat methods. RESULTS Sleep quality scores did not differ at baseline, but there was a significant difference between the study arms in change in sleep quality over time (P < .005). Mean sleep quality scores improved significantly more in the stretching+educational DVD arm (5.1 points) than in the stretching+cognitive training (1.2 points), aerobic+educational DVD (1.1 points), or aerobic+cognitive training (0.25 points) arms (all P < .05, corrected for multiple comparisons). Differences between arms were strongest for waking at night (P = .02) and taking sleep medications (P = .004). CONCLUSION Self-reported sleep quality improved significantly more with low-intensity physical and mental activities than with moderate- or high-intensity activities in older adults with self-reported cognitive and sleep difficulties. Future longer-term studies with objective sleep measures are needed to corroborate these results.
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Affiliation(s)
- Judy Pa
- Department of Neurology, University of California at San Francisco, San Francisco, California; Department of Neurology, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles, California
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García-Soidán JL, Giraldez VA, Zagalaz JC, Lara-Sánchez AJ. Does Pilates Exercise Increase Physical Activity, Quality of Life, Latency, and Sleep Quantity in Middle-Aged People? Percept Mot Skills 2014; 119:838-50. [DOI: 10.2466/29.25.pms.119c30z9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
This prospective study assessed the effects of a 12-wk. exercise program based on the Pilates method (2 one-hr. sessions per week) on 99 sedentary middle-aged volunteers ( M age = 47.6 yr., SD = 0.8), using an accelerometry, the Pittsburgh Sleep Quality Index, and the SF-36 questionnaire to measure changes in physical activity, quality of life, sleep latency, and quantity. The variables (quality of life, sleep latency, and quantity) were compared before and after applying the Pilates program. All of the physical and emotional components of the SF-36 questionnaire showed significant improvement, and the latency and sleep quantity also showed significant increases. The results indicate that Pilates is an accessible, interesting exercise program that can generate important changes in middle age.
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Affiliation(s)
- J. L. García-Soidán
- Faculty of Education and Sport Sciences and College of Physical Therapy, University of Vigo
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30
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Exercise and sleep in aging: emphasis on serotonin. ACTA ACUST UNITED AC 2014; 62:276-83. [PMID: 25104243 DOI: 10.1016/j.patbio.2014.07.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 07/09/2014] [Indexed: 11/23/2022]
Abstract
Reductions in central serotonin activity with aging might be involved in sleep-related disorders in later life. Although the beneficial effects of aerobic exercise on sleep are not new, sleep represents a complex recurring state of unconsciousness involving many lines of transmitters which remains only partly clear despite intense ongoing research. It is known that serotonin released into diencephalon and cerebrum might play a key inhibitory role to help promote sleep, likely through an active inhibition of supraspinal neural networks. Several lines of evidence support the stimulatory effects of exercise on higher serotonergic pathways. Hence, exercise has proved to elicit acute elevations in forebrain serotonin concentrations, an effect that waned upon cessation of exercise. While adequate exercise training might lead to adaptations in higher serotonergic networks (desensitization of forebrain receptors), excessive training has been linked to serious brain serotonergic maladaptations accompanied by insomnia. Dietary supplementation of tryptophan (the only serotonin precursor) is known to stimulate serotonergic activity and promote sleep, whereas acute tryptophan depletion causes deleterious effects on sleep. Regarding sleep-wake regulation, exercise has proved to accelerate resynchronization of the biological clock to new light-dark cycles following imposition of phase shifts in laboratory animals. Noteworthy, the effect of increased serotonergic transmission on wake state appears to be biphasic, i.e. promote wake and thereafter drowsiness. Therefore, it might be possible that acute aerobic exercise would act on sleep by increasing activity of ascending brain serotonergic projections, though additional work is warranted to better understand the implication of serotonin in the exercise-sleep axis.
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31
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Sleep and exercise: a reciprocal issue? Sleep Med Rev 2014; 20:59-72. [PMID: 25127157 DOI: 10.1016/j.smrv.2014.06.008] [Citation(s) in RCA: 374] [Impact Index Per Article: 37.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 06/17/2014] [Accepted: 06/20/2014] [Indexed: 12/18/2022]
Abstract
Sleep and exercise influence each other through complex, bilateral interactions that involve multiple physiological and psychological pathways. Physical activity is usually considered as beneficial in aiding sleep although this link may be subject to multiple moderating factors such as sex, age, fitness level, sleep quality and the characteristics of the exercise (intensity, duration, time of day, environment). It is therefore vital to improve knowledge in fundamental physiology in order to understand the benefits of exercise on the quantity and quality of sleep in healthy subjects and patients. Conversely, sleep disturbances could also impair a person's cognitive performance or their capacity for exercise and increase the risk of exercise-induced injuries either during extreme and/or prolonged exercise or during team sports. This review aims to describe the reciprocal fundamental physiological effects linking sleep and exercise in order to improve the pertinent use of exercise in sleep medicine and prevent sleep disorders in sportsmen.
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Predictors of adherence to a brief behavioral insomnia intervention: daily process analysis. Behav Ther 2014; 45:430-42. [PMID: 24680236 DOI: 10.1016/j.beth.2014.01.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 01/08/2014] [Accepted: 01/18/2014] [Indexed: 11/23/2022]
Abstract
Behavioral interventions for insomnia are effective in improving sleep, yet adherence is variable, and predictors of adherence have not been consistently replicated. The relationships between daily variations in state factors at the initiation of treatment and adherence have not been investigated. Using 2-week, self-report online logs, this study determined, among 53 college students with probable insomnia, the associations of pretreatment factors and daily factors during treatment on daily variations in adherence to one session of behavioral treatments for insomnia. These treatments included stimulus control therapy (SCT), sleep restriction therapy (SRT), and sleep hygiene (SH). Low self-efficacy was associated with poorer SCT and SH adherence. Participants with a "bed partner or pet" at least some of the time had better SCT adherence. Greater total sleep time and poorer sleep quality were associated with poor SCT and SRT adherence the following night. Greater sleep efficiency was related to greater next night SCT and SRT adherence. Alcohol consumption was related to poorer SRT and SH adherence the following night. Future studies should test the replicability of these findings. Adherence trials may want to test whether discouraging alcohol intake, enhancing treatment-related self-efficacy, and monitoring and providing feedback on sleep, early in treatment, affects adherence.
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Hekler EB, Buman MP, Poothakandiyil N, Rivera DE, Dzierzewski JM, Morgan AA, McCrae CS, Roberts BL, Marsiske M, Giacobbi PR. Exploring behavioral markers of long-term physical activity maintenance: a case study of system identification modeling within a behavioral intervention. HEALTH EDUCATION & BEHAVIOR 2013; 40:51S-62S. [PMID: 24084400 PMCID: PMC3806212 DOI: 10.1177/1090198113496787] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Efficacious interventions to promote long-term maintenance of physical activity are not well understood. Engineers have developed methods to create dynamical system models for modeling idiographic (i.e., within-person) relationships within systems. In behavioral research, dynamical systems modeling may assist in decomposing intervention effects and identifying key behavioral patterns that may foster behavioral maintenance. The Active Adult Mentoring Program was a 16-week randomized controlled trial of a group-based, peer-delivered physical activity intervention targeting older adults. Time-intensive (i.e., daily) physical activity reports were collected throughout the intervention. We explored differential patterns of behavior among participants who received the active intervention (N = 34; 88% women, 64.1 ± 8.3 years of age) and either maintained 150 minutes/week of moderate to vigorous intensity physical activity (MVPA; n = 10) or did not (n = 24) at 18 months following the intervention period. We used dynamical systems modeling to explore whether key intervention components (i.e., self-monitoring, access to an exercise facility, behavioral initiation training, behavioral maintenance training) and theoretically plausible behavioral covariates (i.e., indoor vs. outdoor activity) predicted differential patterns of behavior among maintainers and nonmaintainers. We found that maintainers took longer to reach a steady-state of MVPA. At week 10 of the intervention, nonmaintainers began to drop whereas maintainers increased MVPA. Self-monitoring, behavioral initiation training, percentage of outdoor activity, and behavioral maintenance training, but not access to an exercise facility, were key variables that explained patterns of change among maintainers. Future studies should be conducted to systematically explore these concepts within a priori idiographic (i.e., N-of-1) experimental designs.
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Davidson CL, Babson KA, Bonn-Miller MO, Souter T, Vannoy S. The impact of exercise on suicide risk: examining pathways through depression, PTSD, and sleep in an inpatient sample of veterans. Suicide Life Threat Behav 2013; 43:279-89. [PMID: 23901428 DOI: 10.1111/sltb.12014] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Suicide has a large public health impact. Although effective interventions exist, the many people at risk for suicide cannot access these interventions. Exercise interventions hold promise in terms of reducing suicide because of their ease of implementation. While exercise reduces depression, and reductions in depressive symptoms are linked to reduced suicidal ideation, no studies have directly linked exercise and suicide risk. The current study examined this association, including potential mediators (i.e., sleep disturbance, posttraumatic stress symptoms, and depression), in a sample of Veterans. SEM analyses revealed that exercise was directly and indirectly associated with suicide risk. Additionally, exercise was associated with fewer depressive symptoms and better sleep patterns, each of which was, in turn, related to lower suicide risk.
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Rethorst CD, Sunderajan P, Greer TL, Grannemann BD, Nakonezny PA, Carmody TJ, Trivedi MH. Does exercise improve self-reported sleep quality in non-remitted major depressive disorder? Psychol Med 2013; 43:699-709. [PMID: 23171815 DOI: 10.1017/s0033291712001675] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Sleep disturbances are persistent residual symptoms following remission of major depressive disorder (MDD) and are associated with an increased risk of MDD recurrence. The purpose of the current study was to examine the effect of exercise augmentation on self-reported sleep quality in participants with non-remitted MDD. Method Participants were randomized to receive selective serotonin reuptake inhibitor (SSRI) augmentation with one of two doses of exercise: 16 kilocalories per kilogram of body weight per week (KKW) or 4 KKW for 12 weeks. Depressive symptoms were assessed using the clinician-rated Inventory of Depressive Symptomatology (IDS-C). The four sleep-related items on the IDS-C (Sleep Onset Insomnia, Mid-Nocturnal Insomnia, Early Morning Insomnia, and Hypersomnia) were used to assess self-reported sleep quality. RESULTS Significant decreases in total insomnia (p < 0.0001) were observed, along with decreases in sleep onset, mid-nocturnal and early-morning insomnia (p's <0.002). Hypersomnia did not change significantly (p = 0.38). Changes in total, mid-nocturnal and early-morning insomnia were independent of changes in depressive symptoms. Higher baseline hypersomnia predicted a greater decrease in depression severity following exercise treatment (p = 0.0057). No significant moderating effect of any baseline sleep on change in depression severity was observed. There were no significant differences between exercise treatment groups on total insomnia or any individual sleep item. CONCLUSIONS Exercise augmentation resulted in improvements in self-reported sleep quality in patients with non-remitted MDD. Given the prevalence of insomnia as a residual symptom following MDD treatment and the associated risk of MDD recurrence, exercise augmentation may have an important role in the treatment of MDD.
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Affiliation(s)
- C D Rethorst
- University of Texas Southwestern Medical Center, Dallas, TX 75390-9119, USA.
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36
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St-Onge MP. The role of sleep duration in the regulation of energy balance: effects on energy intakes and expenditure. J Clin Sleep Med 2013; 9:73-80. [PMID: 23319909 DOI: 10.5664/jcsm.2348] [Citation(s) in RCA: 148] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Short sleep duration and obesity are common occurrence in today's society. An extensive literature from cross-sectional and longitudinal epidemiological studies shows a relationship between short sleep and prevalence of obesity and weight gain. However, causality cannot be inferred from such studies. Clinical intervention studies have examined whether reducing sleep in normal sleepers, typically sleeping 7-9 h/night, can affect energy intake, energy expenditure, and endocrine regulators of energy balance. The aim of this review is to evaluate studies that have assessed food intake, energy expenditure, and leptin and ghrelin levels after periods of restricted and normal sleep. Most studies support the notion that restricting sleep increases food intake, but the effects on energy expenditure are mixed. Differences in methodology and component of energy expenditure analyzed may account for the discrepancies. Studies examining the effects of sleep on leptin and ghrelin have provided conflicting results with increased, reduced, or unchanged leptin and ghrelin levels after restricted sleep compared to normal sleep. Energy balance of study participants and potential sex differences may account for the varied results. Studies should strive for constant energy balance and feeding schedules when assessing the role of sleep on hormonal profile. Although studies suggest that restricting sleep may lead to weight gain via increased food intake, research is needed to examine the impact on energy expenditure and endocrine controls. Also, studies have been of short duration, and there is little knowledge on the reverse question: does increasing sleep duration in short sleepers lead to negative energy balance?
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Affiliation(s)
- Marie-Pierre St-Onge
- New York Obesity Nutrition Research Center, St. Luke's/Roosevelt Hospital, New York, NY, USA.
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Santos R, Viana V, Boscolo R, Marques V, Santana M, Lira F, Tufik S, de Mello M. Moderate exercise training modulates cytokine profile and sleep in elderly people. Cytokine 2012; 60:731-5. [DOI: 10.1016/j.cyto.2012.07.028] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2012] [Revised: 07/21/2012] [Accepted: 07/24/2012] [Indexed: 10/28/2022]
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SÁNCHEZ-ORTUÑO MARÍAM, EDINGER JACKD. Internight sleep variability: its clinical significance and responsiveness to treatment in primary and comorbid insomnia. J Sleep Res 2012; 21:527-34. [DOI: 10.1111/j.1365-2869.2012.01010.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Passos GS, Poyares DLR, Santana MG, Tufik S, Mello MTD. Is exercise an alternative treatment for chronic insomnia? Clinics (Sao Paulo) 2012; 67:653-60. [PMID: 22760906 PMCID: PMC3370319 DOI: 10.6061/clinics/2012(06)17] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Accepted: 02/13/2012] [Indexed: 11/18/2022] Open
Abstract
The purposes of this systematic/critical review are: 1) to identify studies on the effects of exercise on chronic insomnia and sleep complaints in middle-aged and older adults and to compare the results of exercise with those obtained with hypnotic medications and 2) to discuss potential mechanisms by which exercise could promote sleep in insomniac patients. We identified studies from 1983 through 2011 using MEDLINE, SCOPUS and Web of Science. For systematic analyses, only studies assessing the chronic effects of exercise on sleep in people with sleep complaints or chronic insomnia were considered. We used the following keywords when searching for articles: insomnia, sleep, sleep complaints, exercise and physical activity. For a critical review, studies were selected on the effects of exercise and possible mechanisms that may explain the effects of exercise on insomnia. We identified five studies that met our inclusion criteria for systematic review. Exercise training is effective at decreasing sleep complaints and insomnia. Aerobic exercise has been more extensively studied, and its effects are similar to those observed after hypnotic medication use. Mechanisms are proposed to explain the effects of exercise on insomnia. There is additional documented evidence on the antidepressant and anti-anxiety effects of exercise. Exercise is effective to decrease sleep complaints and to treat chronic insomnia. Exercise presented similar results when compared with hypnotics; however, prospective studies comparing the effects of exercise with medical and non-medical treatments are warranted before including exercise as a first-line treatment for chronic insomnia are necessary.
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Affiliation(s)
- Giselle Soares Passos
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil
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Lira FS, Pimentel GD, Santos RV, Oyama LM, Damaso AR, Oller do Nascimento CM, Viana VA, Boscolo RA, Grassmann V, Santana MG, Esteves AM, Tufik S, de Mello MT. Exercise training improves sleep pattern and metabolic profile in elderly people in a time-dependent manner. Lipids Health Dis 2011; 10:1-6. [PMID: 21733182 PMCID: PMC3154859 DOI: 10.1186/1476-511x-10-113] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Accepted: 07/06/2011] [Indexed: 11/22/2022] Open
Abstract
Aging and physical inactivity are two factors that favors the development of cardiovascular disease, metabolic syndrome, obesity, diabetes, and sleep dysfunction. In contrast, the adoption a habitual of moderate exercise may present a non-pharmacological treatment alternative for sleep and metabolic disorders. We aimed to assess the effects of moderate exercise training on sleep quality and on the metabolic profile of elderly people with a sedentary lifestyle. Fourteen male sedentary, healthy, elderly volunteers performed moderate training for 60 minutes/day, 3 days/week for 24 wk at a work rate equivalent to the ventilatory aerobic threshold. The environment was kept at a temperature of 23 ± 2°C, with an air humidity 60 ± 5%. Blood and polysomnographs analysis were collected 3 times: at baseline (1 week before training began), 3 and 6 months (after 3 and 6 months of training). Training promoted increasing aerobic capacity (relative VO2, time and velocity to VO2max; p < 0.05), and reduced serum NEFA, and insulin concentrations as well as improved HOMA index (p < 0.05), and increased adiponectin levels (p < 0.05), after 3 months of training when compared with baseline data. The sleep parameters, awake time and REM sleep latency were decreased after 6 months exercise training (p < 0.05) in relation baseline values. Our results demonstrate that the moderate exercise training protocol improves the sleep profile in older people, but the metabolism adaptation does not persist. Suggesting that this population requires training strategy modifications as to ensure consistent alterations regarding metabolism.
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Affiliation(s)
- Fábio S Lira
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Brasil
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Dijk DJ. Sleep for all ages: at home or in the laboratory? J Sleep Res 2011; 20:1-2. [DOI: 10.1111/j.1365-2869.2011.00908.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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