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Qin Z, Zhu Y, Shi DD, Chen R, Li S, Wu J. The gap between statistical and clinical significance: time to pay attention to clinical relevance in patient-reported outcome measures of insomnia. BMC Med Res Methodol 2024; 24:177. [PMID: 39118002 PMCID: PMC11308508 DOI: 10.1186/s12874-024-02297-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 07/25/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Appropriately defining and using the minimal important change (MIC) and the minimal clinically important difference (MCID) are crucial for determining whether the results are clinically significant. The aim of this study is to survey the status of randomized controlled trials (RCTs) for insomnia interventions to assess the inclusion and interpretation of MIC/MCID values. METHODS We conducted a cross-sectional study to survey the status of RCTs for insomnia interventions to assess the inclusion and appropriate interpretation of MIC/MCID values. A literature search was conducted by searching the main sleep medicine journals indexed in PubMed, the Excerpta Medica Database (EMBASE), and the Cochrane Central Register of Controlled Trials (CENTRAL) to identify a broad range of search terms. We included RCTs with no restriction on the intervention. The included studies used the Insomnia Severity Index (ISI) or the Pittsburgh Sleep Quality Index (PSQI) questionnaire as the outcome measures. RESULTS 81 eligible studies were identified, and more than one-third of the included studies used MIC/MCID (n = 31, 38.3%). Among them, 21 studies with ISI as the outcome used MIC defined as a relative decrease ranging from 3 to 8 points. The most frequently used MIC value was a 6-point decrease (n = 7), followed by 8-point (n = 6) and 7-point decrease (n = 4), a 4 to 5-points decrease (n = 3), and a 30% reduction from baseline; 6 studies used MCID values, ranging from 2.8 to 4 points. The most frequently used MCID value was a 4-point decrease in the ISI (n = 4). 4 studies with PSQI as the outcome used a 3-point change as the MIC (n = 2) and a 2.5 to 2.7-point difference as MCID (n = 2). 4 non-inferiority design studies considered interval estimation when drawing clinically significant conclusions in their MCID usage. CONCLUSIONS The lack of consistent MIC/MCID interpretation and usage in outcome measures for insomnia highlights the urgent need for further efforts to address this issue and improve reporting practices.
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Affiliation(s)
- Zongshi Qin
- Clinical Research Institute, Institute of Advanced Clinical Medicine, Peking University, Beijing, China.
| | - Yidan Zhu
- Clinical Research Institute, Institute of Advanced Clinical Medicine, Peking University, Beijing, China
| | - Dong-Dong Shi
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rumeng Chen
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Sen Li
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China.
| | - Jiani Wu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
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Albalak G, Noordam R, van der Elst M, Kervezee L, Exadaktylos V, van Bodegom D, van Heemst D. Older adults exercising ON TIME: protocol for a randomized controlled cross-over study to assess the effect of physical activity timing on insomnia severity. Trials 2024; 25:523. [PMID: 39103937 DOI: 10.1186/s13063-024-08310-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 07/03/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND There are increased indications that physical activity timing, irrespective of intensity, impacts insomnia and circadian clock function. Here, we describe the rationale and design of a randomized cross-over study, called ON TIME, to examine the effects of (changing) physical activity timing on insomnia severity and on multiple exploratory outcomes that are linked to circadian clock function. METHODS We will conduct a randomized cross-over trial in 40 healthy older adults (aged 65 to 75 years) with subclinical or clinical insomnia (Insomnia Severity Index (ISI) scores of ≥ 10) from the Dutch municipality of Leiden and surroundings. Participants will undergo 3 intervention periods (14 days each) consecutively: one sedentary period and two periods of increased physical activity (one period with morning activity and one period with evening activity). The intervention periods are separated by a wash-out period of 1 week. In both active intervention arms, participants will follow coached or uncoached outdoor physical exercise sessions comprising endurance, strength, and flexibility exercises for 14 days. The primary outcome is change in insomnia severity as measured by the ISI. Additional exploratory outcomes include multiple components of objective sleep quality measured with tri-axial accelerometry and subjective sleep quality assessed by questionnaires as well as dim light melatonin onset and 24-h rhythms in heart rate, heart rate variability, breathing rate, oxygen saturation, mood, and objective emotional arousal and stress. Additionally, we will collect diary data on eating patterns (timing and composition). Finally, fasting blood samples will be collected at baseline and after each intervention period for measurements of biomarkers of metabolic and physiological functioning and expression of genes involved in regulation of the biological clock. DISCUSSION We anticipate that this study will make a significant contribution to the limited knowledge on the effect of physical activity timing. Optimizing physical activity timing has the potential to augment the health benefits of increased physical exercise in the aging population. TRIAL REGISTRATION Trial was approved by the Medical Ethics Committee Leiden, The Hague, Delft, The Netherlands (June, 2023). The trial was registered in the CCMO-register https://www.toetsingonline.nl/to/ccmo_search.nsf/Searchform?OpenForm under study ID NL82335.058.22 and named ("Ouderen op tijd in beweging" or in English "Older adults exercising on time"). At time of manuscript submission, the trial was additionally registered at ClinicalTrials.gov under study ID: NL82335.058.22 and is awaiting approval.
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Affiliation(s)
- Gali Albalak
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, PO Box 9600, Albinusdreef 2, Leiden, 2300 RC, The Netherlands.
| | - Raymond Noordam
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, PO Box 9600, Albinusdreef 2, Leiden, 2300 RC, The Netherlands
| | - Marjan van der Elst
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, PO Box 9600, Albinusdreef 2, Leiden, 2300 RC, The Netherlands
| | - Laura Kervezee
- Department of Cell and Chemical Biology, Leiden University Medical Center, PO Box 9600, Albinusdreef 2, Leiden, 2300 RC, The Netherlands
| | | | - David van Bodegom
- Department of Public Health and Primary Care, Leiden University Medical Center, PO Box 9600, Albinusdreef 2, Leiden, 2300 RC, The Netherlands
- Leyden Academy on Vitality and Ageing, Rijnsburgerweg 10, Leiden, 2333 AA, The Netherlands
| | - Diana van Heemst
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, PO Box 9600, Albinusdreef 2, Leiden, 2300 RC, The Netherlands
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Riedel A, Benz F, Deibert P, Barsch F, Frase L, Johann AF, Riemann D, Feige B. The effect of physical exercise interventions on insomnia: A systematic review and meta-analysis. Sleep Med Rev 2024; 76:101948. [PMID: 38749363 DOI: 10.1016/j.smrv.2024.101948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 04/05/2024] [Accepted: 04/26/2024] [Indexed: 07/26/2024]
Abstract
6-10 % of Europeans suffer from chronic insomnia. They have a higher risk to develop mental and cardiovascular diseases. Treatment of insomnia primarily recommended by the European guideline is cognitive behavioral therapy for insomnia (CBT-I). A quarter of patients treated with CBT-I do not respond sufficiently. The objective of this paper is to examine the influence of exercise interventions on insomnia by conducting a systematic review and meta-analysis. A database search was conducted, including randomized controlled trials (RCT) in which participants had received a diagnosis of insomnia or experienced symptoms thereof. Exercise interventions had to meet the definition of the World Health Organization (WHO), and their implementation was reported according to the FITT (Frequency, Intensity, Time and Type) principle. There was an inactive control and subjective or objective sleep parameters as outcomes. Nineteen studies were included. Results showed a significant improvement for objective (standardized mean difference, SMD = 0.37; confidence interval, CI = [0.17; 0.57]) as well as subjective (SMD = 0.90; CI = [0.61; 1.19]) sleep parameters. Meta-regression showed that the effect increased with intensity of intervention, mean age of participants and percentage of females, but showed high heterogeneity across studies. These results suggest great potential for treating insomnia. Conducting larger trials is advisable to provide precise recommendations.
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Affiliation(s)
- Anuschka Riedel
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Fee Benz
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Peter Deibert
- Institute for Exercise and Occupational Medicine, Department of Medicine, Faculty of Medicine, Medical Center University of Freiburg, University of Freiburg, Freiburg Im Breisgau, Germany
| | - Friedrich Barsch
- Institute for Exercise and Occupational Medicine, Department of Medicine, Faculty of Medicine, Medical Center University of Freiburg, University of Freiburg, Freiburg Im Breisgau, Germany
| | - Lukas Frase
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Anna F Johann
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Institute of Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Bernd Feige
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
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Ryu H, Ju S, Lee HE, Cho SS. Commuting time, working time, and their link to insomnia symptoms among Korean employees: A cross-sectional study. Sleep Health 2024; 10:434-440. [PMID: 38879398 DOI: 10.1016/j.sleh.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 04/15/2024] [Accepted: 05/14/2024] [Indexed: 08/10/2024]
Abstract
OBJECTIVE Although commuting time is an extension of working hours, few studies have examined the relationship between commuting time and insomnia symptoms in relation to working time. Thus, this study investigated the relationship between commuting time and working time and their link to sleep disturbance. METHODS This study included employees with ≥35 weekly working hours (n = 30,458) using data from the Sixth Korean Working Conditions Survey conducted in Korea between October 2020 and April 2021. The association between commuting time (≤60, 61-120, and >120 minutes) and insomnia symptoms based on working hours (35-40, 41-52, and >52 h/wk) or shift work was investigated using survey-weighted logistic regression analysis. RESULTS Long commuting time (>120 min/d) combined with >52 working hours/week (OR: 7.88, 95% CI: 2.51-24.71) or combined with 41-52 h/wk (OR: 3.64, 95% CI: 2.15-6.14) was associated with a higher risk of insomnia symptoms compared with the reference group (working hours: 35-40 h/wk; daily commuting time: ≤60 minutes), after controlling for sex, age, socioeconomic factors, and work-related factors. Among shift workers, those with daily commuting time ≤60 minutes (OR: 1.71, 95% CI: 1.39-2.09), 61-120 minutes (OR: 2.63, 95% CI: 1.21-5.74), and >120 minutes (OR: 5.16, 95% CI: 2.14-12.44) had higher odds of insomnia symptoms than nonshift workers with ≤60 minutes daily commuting time. CONCLUSION Long working hours and shift work are associated with greater risk of insomnia symptoms.
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Affiliation(s)
- Hoje Ryu
- Department of Occupational and Environmental Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea; Department of Occupational and Environmental Medicine, Dong-A University Hospital, Busan, Republic of Korea
| | - Suhwan Ju
- Department of Occupational and Environmental Medicine, Dong-A University Hospital, Busan, Republic of Korea
| | - Hye-Eun Lee
- Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon-si, Gangwon-do, Republic of Korea; Institute of Social Medicine, Hallym University College of Medicine, Chuncheon-si, Gangwon-do, Republic of Korea.
| | - Seong-Sik Cho
- Department of Occupational and Environmental Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea; Department of Occupational and Environmental Medicine, Dong-A University Hospital, Busan, Republic of Korea.
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Xu Z, Zheng X, Ding H, Zhang D, Cheung PMH, Yang Z, Tam KW, Zhou W, Chan DCC, Wang W, Wong SYS. The Effect of Walking on Depressive and Anxiety Symptoms: Systematic Review and Meta-Analysis. JMIR Public Health Surveill 2024; 10:e48355. [PMID: 39045858 PMCID: PMC11287235 DOI: 10.2196/48355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 07/25/2024] Open
Abstract
Background Previous literature lacks summative information on the mental health benefits achieved from different forms of walking. Objective The aim of this study was to assess the effectiveness of different forms of walking in reducing symptoms of depression and anxiety. Methods This was a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the effects of walking on depressive and anxiety symptoms. MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, PsycINFO, Allied and Complementary Medicine Database (AMED), CINAHL, and Web of Science were searched on April 5, 2022. Two authors independently screened the studies and extracted the data. Random-effects meta-analysis was used to synthesize the data. Results were summarized as standardized mean differences (SMDs) with 95% CIs in forest plots. The risk of bias was assessed by using the Cochrane Risk of Bias tool. Results This review included 75 RCTs with 8636 participants; 68 studies reported depressive symptoms, 39 reported anxiety symptoms, and 32 reported both as the outcomes. One study reported the results for adolescents and was not included in the meta-analysis. The pooled results for adults indicated that walking could significantly reduce depressive symptoms (RCTs: n=44; SMD -0.591, 95% CI -0.778 to -0.403; I2=84.8%; τ2=0.3008; P<.001) and anxiety symptoms (RCTs: n=26; SMD -0.446, 95% CI -0.628 to -0.265; I2=81.1%; τ2=0.1530; P<.001) when compared with the inactive controls. Walking could significantly reduce depressive or anxiety symptoms in most subgroups, including different walking frequency, duration, location (indoor or outdoor), and format (group or individual) subgroups (all P values were <.05). Adult participants who were depressed (RCTs: n=5; SMD -1.863, 95% CI -2.764 to -0.962; I2=86.4%; τ2=0.8929) and those who were not depressed (RCTs: n=39; SMD -0.442, 95% CI -0.604 to -0.280; I2=77.5%; τ2=0.1742) could benefit from walking effects on their depressive symptoms, and participants who were depressed could benefit more (P=.002). In addition, there was no significant difference between walking and active controls in reducing depressive symptoms (RCTs: n=17; SMD -0.126, 95% CI -0.343 to 0.092; I2=58%; τ2=0.1058; P=.26) and anxiety symptoms (14 RCTs, SMD -0.053, 95% CI -0.311 to 0.206, I2=67.7%, τ2=0.1421; P=.69). Conclusions Various forms of walking can be effective in reducing symptoms of depression and anxiety, and the effects of walking are comparable to active controls. Walking can be adopted as an evidence-based intervention for reducing depression and anxiety. More evidence on the effect of low-intensity walking is needed in the future.
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Affiliation(s)
- Zijun Xu
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Xiaoxiang Zheng
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Hanyue Ding
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Dexing Zhang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Peter Man-Hin Cheung
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Zuyao Yang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - King Wa Tam
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Weiju Zhou
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Dicken Cheong-Chun Chan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Wenyue Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Samuel Yeung-Shan Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
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Mohammad A, Elham H, Andreas K. A scoping review of the effect of chronic stretch training on sleep quality in people with sleep disorders. Eur J Appl Physiol 2024:10.1007/s00421-024-05541-z. [PMID: 38918221 DOI: 10.1007/s00421-024-05541-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 06/14/2024] [Indexed: 06/27/2024]
Abstract
PURPOSE The widespread and health-detrimental sleep disorders have resulted in stretching exercises being investigated as a non-drug solution for enhanced sleep quality. However, a comprehensive understanding of the impact of stretching exercises on individuals with sleep disorders is lacking. METHODS This scoping review systematically maps the existing literature and identifies research gaps on the impact of stretching exercises on sleep quality in individuals with sleep disorders. RESULTS Sixteen eligible studies were included, where the weighted mean changes indicate a positive trend in sleep quality improvement, ranging from trivial to very large magnitudes. However, concerning the individual study results only 5 out of 16 studies reported significant improvements. Notable enhancements include a small 1.22% overall sleep quality improvement, a large 6.51% reduction in insomnia severity, a large 8.88% increase in sleep efficiency, a moderate 4.36% decrease in sleep onset latency, a large 8.27% decrease in wake after sleep onset, and a very large 14.70% improvement in total sleep time. Trivial changes are noted in sleep duration (0.58%), sleep disturbance reduction (0.07%), and daytime dysfunction reduction (0.19%). Likely mechanisms for the improvement of sleep include autonomic nervous system modulation, muscle tension relief, cortisol regulation, enhanced blood circulation, and psychological benefits such as stress reduction and mood enhancement. CONCLUSION There is little evidence that stretching exercises positively impact sleep quality in individuals with sleep disorders. Additionally, further research is vital for designing optimal protocols, understanding of the long-term effects, and clarification of the mechanisms.
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Affiliation(s)
- Alimoradi Mohammad
- Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, University of Shahid Bahonar Kerman, Kerman, Iran
| | - Hosseini Elham
- Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, University of Shahid Bahonar Kerman, Kerman, Iran
| | - Konrad Andreas
- Institute of Human Movement Science, Sport and Health, Graz University, Mozartgasse 14, 8010, Graz, Austria.
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Cholerzyńska H, Zasada W, Tselios K, Grygiel-Górniak B. Sleep Disorders in Connective Tissue Diseases-Coexisting Diseases or Disease Components? J Clin Med 2024; 13:3656. [PMID: 38999222 PMCID: PMC11242285 DOI: 10.3390/jcm13133656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/17/2024] [Accepted: 06/20/2024] [Indexed: 07/14/2024] Open
Abstract
This comprehensive review examines the complex relationship between sleep disorders and rheumatic diseases, supported by findings from the latest research articles. It encompasses various rheumatic conditions, including rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis. The review reveals the bidirectional relationship between sleep disorders and these diseases, emphasizing their impact on disease progression and quality of life. Conventional and alternative therapeutic interventions for connective tissue diseases are presented, focusing on improving sleep quality and alleviating rheumatic symptoms. The role of pro-inflammatory cytokines and their potential modulation through pharmacological agents is also discussed. In the treatment of sleep disorders, various options are proposed, such as cognitive behavioral therapy for insomnia, physical activity, dietary modifications, and alternative approaches like reflexology and acupuncture. Thus, this review offers a nuanced understanding of the connection between sleep disorders and rheumatic diseases, supported by evidence from diverse studies. Such an approach is particularly important because it enhances sleep quality for overall patient well-being in the holistic management of rheumatic conditions.
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Affiliation(s)
- Hanna Cholerzyńska
- Department of Rheumatology, Rehabilitation and Internal Diseases, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Wiktoria Zasada
- Department of Rheumatology, Rehabilitation and Internal Diseases, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | | | - Bogna Grygiel-Górniak
- Department of Rheumatology, Rehabilitation and Internal Diseases, Poznan University of Medical Sciences, 61-701 Poznan, Poland
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Xie W, Lu D, Liu S, Li J, Li R. The optimal exercise intervention for sleep quality in adults: A systematic review and network meta-analysis. Prev Med 2024; 183:107955. [PMID: 38641082 DOI: 10.1016/j.ypmed.2024.107955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/11/2024] [Accepted: 04/12/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND The impact of various exercise modalities on the improvement of sleep quality in adults remains controversial. OBJECTIVE This study aimed to perform a network meta-analysis to analyze the effects of different exercise interventions on sleep quality in adults. METHODS The PubMed, Cochrane, Embase, Web of Science, and EBSCO databases were searched for studies published from March 18, 1993, to March 18, 2023. The Cochrane risk of bias tool was used to assess the quality of the included studies. Then, a random-effects network meta-analysis was conducted within a frequentist framework. RESULTS A total of 2142 participants from 27 randomized controlled trials were included in the analysis. Exercise modalities such as Pilates, yoga, and traditional Chinese exercises were found to significantly improve sleep quality when compared to a no-exercise control group, with Pilates exhibiting the most potent effect at a 95.3% improvement level. CONCLUSION This study demonstrates that exercise interventions are effective in enhancing sleep quality in adults. Adapting exercise to individual preferences and needs may maximize the sleep-related benefits of the activity. REGISTRATION The review was registered with PROSPERO, registration number CRD42023434565.
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Affiliation(s)
- Wenjie Xie
- Beijing Sport University, Laboratory of Sports Stress and Adaptation of General Administration of Sport, Beijing 100084, China
| | - Dan Lu
- Beijing Sport University, Laboratory of Sports Stress and Adaptation of General Administration of Sport, Beijing 100084, China
| | - Siyou Liu
- Beijing Sport University, Laboratory of Sports Stress and Adaptation of General Administration of Sport, Beijing 100084, China
| | - Junping Li
- Beijing Sport University, Laboratory of Sports Stress and Adaptation of General Administration of Sport, Beijing 100084, China.
| | - Rui Li
- Beijing Sport University, College of Education,Beijing 100084, China
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9
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Cammalleri A, Perrault AA, Hillcoat A, Carrese-Chacra E, Tarelli L, Patel R, Baltzan M, Chouchou F, Dang-Vu TT, Gouin JP, Pepin V. A Pilot Randomized Trial of Combined Cognitive-Behavioral Therapy and Exercise Training Versus Exercise Training Alone for the Management of Chronic Insomnia in Obstructive Sleep Apnea. JOURNAL OF SPORT & EXERCISE PSYCHOLOGY 2024; 46:125-136. [PMID: 38663849 DOI: 10.1123/jsep.2023-0139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 03/07/2024] [Accepted: 03/12/2024] [Indexed: 05/24/2024]
Abstract
Insomnia treatment among individuals with comorbid insomnia and obstructive sleep apnea is suboptimal. In a pilot randomized controlled trial, 19 individuals with comorbid insomnia and obstructive sleep apnea were allocated to one of two arms: EX + EX, consisting of two 8-week phases of exercise training (EX), or RE + CBTiEX, encompassing 8 weeks of relaxation training (RE) followed by 8 weeks of combined cognitive-behavioral therapy and exercise (CBTiEX). Outcomes included Insomnia Severity Index (ISI), polysomnography, and cardiorespiratory fitness measures. A mixed-model analysis of variance revealed a Group × Time interaction on peak oxygen consumption change, F(1, 14) = 10.1, p = .007, and EX increased peak oxygen consumption (p = .03, g' = -0.41) and reduced ISI (p = .001, g' = 0.82) compared with RE (p = .49, g = 0.16) post-8 weeks. Post-16 weeks, there was a significant Group × Time interaction (p = .014) driven by RE + CBTiEX yielding a larger improvement in ISI (p = .023, g' = 1.48) than EX + EX (p = .88, g' < 0.1). Objective sleep was unchanged. This study showed promising effects of regular EX alone and combined with cognitive-behavioral therapy for insomnia on ISI in comorbid insomnia and obstructive sleep apnea.
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Affiliation(s)
- Amanda Cammalleri
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Aurore A Perrault
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, Montreal, QC, Canada
| | - Alexandra Hillcoat
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Emily Carrese-Chacra
- Department of Psychology, Center for Clinical Research in Health, Concordia University, Montreal, QC, Canada
| | - Lukia Tarelli
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, Montreal, QC, Canada
- Department of Psychology, Center for Clinical Research in Health, Concordia University, Montreal, QC, Canada
| | - Rahul Patel
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Marc Baltzan
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
- Axe Maladies chroniques, Centre de Recherche du CIUSSS du Nord-de-l'Ⓘle-de-Montréal, Montreal, QC, Canada
| | - Florian Chouchou
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
- EA4075 IRISSE-Département STAPS, Université de La Réunion, Saint-Denis, France
| | - Thien Thanh Dang-Vu
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, Montreal, QC, Canada
- PERFORM Center, Concordia University, Montreal, QC, Canada
| | - Jean-Philippe Gouin
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, Montreal, QC, Canada
- Department of Psychology, Center for Clinical Research in Health, Concordia University, Montreal, QC, Canada
- PERFORM Center, Concordia University, Montreal, QC, Canada
| | - Veronique Pepin
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
- Axe Maladies chroniques, Centre de Recherche du CIUSSS du Nord-de-l'Ⓘle-de-Montréal, Montreal, QC, Canada
- PERFORM Center, Concordia University, Montreal, QC, Canada
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Garcia MC, Paravidino VB, Lopes CDS, Mediano MFF, Gonçalves TR, de Oliveira AJ, Sichieri R. Sleep duration and quality during the COVID-19 pandemic and the association with physical activity and screen time among Brazilian college students. Am J Hum Biol 2024; 36:e24035. [PMID: 38174842 DOI: 10.1002/ajhb.24035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/25/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND As a result of social isolation during the COVID-19 pandemic, changes in sleep patterns have been observed in many countries, as well as changes in physical activity and screen time. The objective was to investigate sleep duration and quality during the COVID-19 pandemic and its association with physical activity and screen time. METHODS Cross-sectional study with students from a University in Rio de Janeiro who answered an online questionnaire between August 2020 and March 2021. Physical activity was assessed using IPAQ-SF. Sleep was investigated based on questions about duration and sleep quality change, and screen time through self-reported questions. Multinomial logistic regression was performed to assess the association between physical activity and screen time with sleep duration and quality. Secondary analyses investigated the influence of the isolation time on this association. The confounding factors used were diagnosis of COVID-19, time of isolation, anxiety, depression, skin color, and gender. RESULTS A total of 771 college students with a mean age of 24.5 years (±8.6) answered the questionnaire. About 75% reported more than 8 h of screen time per day and 49.8% were physically inactive. Regarding sleep, 54.9% had worsening sleep, while 40.6% had inadequate sleep duration during the pandemic. Physical activity was associated with improved sleep quality (Odds ratio (OR) 1.72; confidence interval (95% CI) 1.05-2.97). Also, physically active students who spent more than 14 weeks in social isolation demonstrated improved sleep quality (OR 1.99; 95% CI 1.02-3.78) compared to physically inactive individuals. No association was observed for sleep duration. No association was observed between screen time and sleep quality, or sleep duration. CONCLUSION During the COVID-19 pandemic, there was considerable worsening of sleep quality, and physical activity was positively associated with improved sleep quality.
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Affiliation(s)
- Magno Conceição Garcia
- Department of Epidemiology, Institute of Social Medicine Hésio Cordeiro, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Vitor Barreto Paravidino
- Department of Epidemiology, Institute of Social Medicine Hésio Cordeiro, State University of Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Physical Education and Sports, Naval School, Brazilian Navy, Rio de Janeiro, Brazil
| | - Claudia de Souza Lopes
- Department of Epidemiology, Institute of Social Medicine Hésio Cordeiro, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Tatiana Rehder Gonçalves
- Institute of Public Health Studies, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Aldair José de Oliveira
- Department of Physical Education and Sports, Federal Rural University of Rio de Janeiro, Seropédica, Brazil
| | - Rosely Sichieri
- Department of Epidemiology, Institute of Social Medicine Hésio Cordeiro, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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11
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Odriozola A, González A, Álvarez-Herms J, Corbi F. Sleep regulation and host genetics. ADVANCES IN GENETICS 2024; 111:497-535. [PMID: 38908905 DOI: 10.1016/bs.adgen.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/24/2024]
Abstract
Due to the multifactorial and complex nature of rest, we focus on phenotypes related to sleep. Sleep regulation is a multifactorial process. In this chapter, we focus on those phenotypes inherent to sleep that are highly prevalent in the population, and that can be modulated by lifestyle, such as sleep quality and duration, insomnia, restless leg syndrome and daytime sleepiness. We, therefore, leave in the background those phenotypes that constitute infrequent pathologies or for which the current level of scientific evidence does not favour the implementation of practical approaches of this type. Similarly, the regulation of sleep quality is intimately linked to the regulation of the circadian rhythm. Although this relationship is discussed in the sections that require it, the in-depth study of circadian rhythm regulation at the molecular level deserves a separate chapter, and this is how it is dealt with in this volume.
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Affiliation(s)
- Adrián Odriozola
- Hologenomiks Research Group, Department of Genetics, Physical Anthropology and Animal Physiology, University of the Basque Country (UPV/EHU), Leioa, Spain.
| | - Adriana González
- Hologenomiks Research Group, Department of Genetics, Physical Anthropology and Animal Physiology, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Jesús Álvarez-Herms
- Phymo® Lab, Physiology, and Molecular Laboratory, Collado Hermoso, Segovia, Spain
| | - Francesc Corbi
- Institut Nacional d'Educació Física de Catalunya (INEFC), Centre de Lleida, Universitat de Lleida (UdL), Lleida, Spain
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12
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Moussiopoulou J, Pross B, Handrack M, Keeser D, Pogarell O, Halle M, Falkai P, Scherr J, Hasan A, Roeh A. The influence of marathon running on resting-state EEG activity: a longitudinal observational study. Eur J Appl Physiol 2024; 124:1311-1321. [PMID: 38019317 PMCID: PMC10954932 DOI: 10.1007/s00421-023-05356-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 10/28/2023] [Indexed: 11/30/2023]
Abstract
Physical activity (PA) has positive effects on various health aspects and neuronal functions, including neuronal plasticity. Exceeding a certain exercise frequency and duration has been associated with negative effects. Our study investigated the effects of excessive PA with a marathon run (MA) and regular PA (training and recovery phases) on electrocortical activity, as measured by electroencephalography (EEG). Thirty healthy marathon runners (26 male, 45 ± 9 yrs) were enrolled in the study. Four resting-state 32 channel EEG recordings were conducted: 12-8 weeks before MA (T-1), 14-4 days prior to MA (T0), 1-6 days after (T2), and 13-15 weeks after MA (T3). Power spectrum analyses were conducted using standardized Low-Resolution Electromagnetic Tomography (sLORETA) and included the following frequency bands: delta (1.5-6 Hz), theta (6.5-8.0 Hz), alpha1 (8.5-10 Hz), alpha2 (10.5-12.0 Hz), beta1 (12.5-18.0 Hz), beta2 (18.5-21.0 Hz), beta3 (21.5-30.0 Hz), and total power (1.5-30 Hz). Statistical nonparametric mapping showed reduced power both in the alpha-2 (log-F ratio = - 0.705, threshold log-F ratio = ± 0.685, p < 0.05) and in the delta frequency band (log-F ratio = -0.699, threshold log-F ratio = ± 0.685, p < 0.05) in frontal cortical areas after MA (T2 vs. T0). These effects diminished at long-term follow-up (T3). The results can be interpreted as correlates for subacute neuroplasticity induced by strenuous and prolonged PA. Although previous studies reported an increase in alpha frequency during and directly postexercise, the adverse observation a few days after exercise cessation suggests counterregulatory mechanisms, whose complex origin can be suspected in subcortical circuits, changes in neurotransmitter systems and modulation of affectivity.
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Affiliation(s)
- Joanna Moussiopoulou
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nußbaumstraße 7, 80336, Munich, Germany.
| | - Benjamin Pross
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nußbaumstraße 7, 80336, Munich, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Medical Faculty, Bezirkskrankenhaus Augsburg, University of Augsburg, Augsburg, Germany
| | - Mirjam Handrack
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nußbaumstraße 7, 80336, Munich, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nußbaumstraße 7, 80336, Munich, Germany
- NeuroImaging Core Unit Munich (NICUM), Ludwig Maximilian University Munich, Nußbaumstraße 7, 80336, Munich, Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nußbaumstraße 7, 80336, Munich, Germany
| | - Martin Halle
- Department of Prevention and Sports Medicine, University Hospital Klinikum Rechts Der Isar, Technical University Munich, Georg-Brauchle-Ring 56, 80992, Munich, Germany
- DZHK (German Center for Cardiovascular Research, Partner Site Munich Heart Alliance), Potsdamer Str. 58, 10785, Berlin, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nußbaumstraße 7, 80336, Munich, Germany
| | - Johannes Scherr
- Department of Prevention and Sports Medicine, University Hospital Klinikum Rechts Der Isar, Technical University Munich, Georg-Brauchle-Ring 56, 80992, Munich, Germany
- University Center for Preventive and Sports Medicine, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Alkomiet Hasan
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nußbaumstraße 7, 80336, Munich, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Medical Faculty, Bezirkskrankenhaus Augsburg, University of Augsburg, Augsburg, Germany
| | - Astrid Roeh
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nußbaumstraße 7, 80336, Munich, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Medical Faculty, Bezirkskrankenhaus Augsburg, University of Augsburg, Augsburg, Germany
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13
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Tian C, Wei Y, Xu M, Liu J, Tong B, Ning J, Wang Y, Wang Y, Estill J, Ge L. The effects of exercise on insomnia disorders: An umbrella review and network meta-analysis. Sleep Med 2024; 115:66-75. [PMID: 38335829 DOI: 10.1016/j.sleep.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/29/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE To summarize the evidence of various exercise modalities on population with insomnia disorders. METHOD PubMed, Embase, Cochrane Library, and Web of Science were searched for eligible studies published from inception to October 2022 and updated on September 2023. Systematic reviews with meta-analyses and randomized controlled trials designed to investigate the effect of various exercise modalities on population with insomnia were eligible. RESULTS A total of 4 SRs with (very) low methodological quality and 1034 participants in 10 network meta-analyses explored the association between different types and intensity exercise modalities with insomnia disorders. Various exercise modalities could significantly improve total sleep time and sleep quality and alleviate insomnia severity. Compared to passive control, moderate aerobic exercise, moderate aerobic exercise combined with light intensity strength and mind-body exercise can improve sleep efficiency and reduce wake after sleep onset by objectively measured. Moderate intensity strength, light intensity strength and mind-body exercise can improve sleep efficiency subjectively measured; mind-body exercise can reduce sleep onset latency and wake time after sleep onset, and increase total sleep time; moderate aerobic exercise can reduce sleep onset latency. Moderate intensity strength, light intensity strength, mind body exercise and moderate aerobic exercise combined with light intensity strength can the severity of insomnia and improv sleep quality. CONCLUSION Exercise had a positive effect on relief insomnia and improve sleep quality. Moderate aerobic exercise, mind-body exercise and moderate aerobic exercise combined with light intensity strength play an important role in improving the sleep quality in people with insomnia disorders.
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Affiliation(s)
- Chen Tian
- Evidence-Based Social Sciences Research Centre, School of Public Health, Lanzhou University, Lanzhou, China; Depertment of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Yuanyuan Wei
- Nursing School of Lanzhou University, Lanzhou, China; Department of VIP Outpatient/Chronic Disease Management, First Hospital of Lanzhou University, Lanzhou, China
| | - Meng Xu
- Evidence-Based Social Sciences Research Centre, School of Public Health, Lanzhou University, Lanzhou, China; Depertment of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Jianing Liu
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, China
| | - Bo Tong
- Depertment of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Jinling Ning
- Evidence-Based Social Sciences Research Centre, School of Public Health, Lanzhou University, Lanzhou, China; Depertment of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yong Wang
- First Clinical School of Medicine, Lanzhou University, Lanzhou, China
| | - Yiyun Wang
- Depertment of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland; School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Long Ge
- Evidence-Based Social Sciences Research Centre, School of Public Health, Lanzhou University, Lanzhou, China; Depertment of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.
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14
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Tuomi AK, Rebane K, Arnstad ED, Berntson L, Fasth A, Glerup M, Herlin T, Kautiainen H, Nordal E, Peltoniemi S, Rygg M, Rypdal V, Zak M, Aalto K. Body mass index is associated with health-related quality of life and disease characteristics in young adults with juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2024; 22:25. [PMID: 38308280 PMCID: PMC10837959 DOI: 10.1186/s12969-023-00931-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/15/2023] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND There is a growing interest concerning the relationship between obesity and several medical conditions and inflammation. Nevertheless, there is a lack of studies regarding body mass index (BMI) among patients with juvenile idiopathic arthritis (JIA). Our aim was to investigate the impact of BMI on health-related quality of life (HRQoL) measured with a 36-Item Short Form Survey (SF-36), disease activity, and disability in young adults with JIA. METHODS This study is a part of the population-based Nordic JIA cohort study. All newly diagnosed patients with JIA were recruited consecutively between 1997-2000 in specific regions in the Nordic countries. Patients in this sub-study were enrolled from 434 patients who attended their 18-year follow-up visit. Patients were classified according to the World Health Organization (WHO) into four groups based on their BMI. HRQoL, disease characteristics, disability, fatigue, sleep quality, physical activity, pain, comorbidities, and social status were assessed. RESULTS Three hundred fifty-five patients from the original study cohort were enrolled in this study and 72% of them were female. Mean age was 23.9 (± SD 4.4) years. A significant relationship was found between the JIA categories and BMI groups (p = 0.014). A significant relationship was also found between BMI and disease activity scores (DAS28) (p = 0.028), disability (p < 0.001), pain (p = 0.013), fatigue (p = 0.035), and sleep quality (p = 0.044). Moreover, a significant relationship between BMI and HRQoL regarding bodily pain (p = 0.010) and general health (p = 0.048) was revealed when adjusted for sex, age, and JIA subtype. CONCLUSION We discovered that BMI was significantly related to HRQoL, disease activity, and disability. BMI deserves more attention considering the treatment options and outcome of JIA in young adults.
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Affiliation(s)
- Anna-Kaisa Tuomi
- Pediatric Research Center, New Children's Hospital, University of Helsinki and Helsinki University Hospital, Stenbackinkatu 9, P.O. Box 347, FIN-00029 HUS, 00290, Helsinki, Finland.
| | - Katariina Rebane
- Pediatric Research Center, New Children's Hospital, University of Helsinki and Helsinki University Hospital, Stenbackinkatu 9, P.O. Box 347, FIN-00029 HUS, 00290, Helsinki, Finland
| | - Ellen Dalen Arnstad
- Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
- Department of Clinical and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
| | - Lillemor Berntson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Anders Fasth
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mia Glerup
- Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Troels Herlin
- Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Hannu Kautiainen
- Kuopio University Hospital, Primary Health Care Unit Kuopio, Pohjois-Savo, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Ellen Nordal
- Department of Pediatrics, University Hospital of North Norway and Pediatric Research Group, Tromsø, Norway
- Department of Clinical Medicine, UIT the Arctic University of Norway, Tromsø, Norway
| | - Suvi Peltoniemi
- Helsinki University Central Hospital, HUS Inflammation Center, Rheumatology and University of Helsinki, Helsinki, Finland
| | - Marite Rygg
- Department of Clinical and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- Department of Pediatrics, St. Olavs University Hospital, Trondheim, Norway
| | - Veronika Rypdal
- Department of Pediatrics, University Hospital of North Norway and Pediatric Research Group, Tromsø, Norway
| | - Marek Zak
- Department of Pediatrics, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark
| | - Kristiina Aalto
- Pediatric Research Center, New Children's Hospital, University of Helsinki and Helsinki University Hospital, Stenbackinkatu 9, P.O. Box 347, FIN-00029 HUS, 00290, Helsinki, Finland
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15
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Jung J, Lim J, Cho YH, Park JB, Jeong I. The changing dynamics of work from home and its association with sleep disturbance through work-family conflict during the COVID-19 pandemic. J Occup Health 2024; 66:uiae014. [PMID: 38569527 PMCID: PMC11060341 DOI: 10.1093/joccuh/uiae014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/29/2024] [Accepted: 03/05/2024] [Indexed: 04/05/2024] Open
Abstract
OBJECTIVES Work from home (WFH) can increase sleep disturbances. However, only few studies have examined the connection between WFH and sleep disturbance while considering work-family conflict (WFC) and the changes brought about by the COVID-19 pandemic. This study aimed to examine the association between WFH and sleep disturbance, considering WFC, and assess how this association changed during the COVID-19 pandemic. METHODS We used data from the fifth and sixth Korean Working Conditions Survey. WFH workers and a control group were selected using propensity score matching. Conditional logistic regression analysis was used to estimate the odds ratios (ORs) with 95% CIs for sleep disturbance in the WFH and control groups. RESULTS The workers working from home showed significantly higher ORs for sleep disturbance before (4.26; 95% CI, 3.59-5.05) and during (1.52; 95% CI, 1.26-1.83) the COVID-19 pandemic. When stratified by WFC, the association was significant only in the workers with WFC before COVID-19. However, the association was not significant during COVID-19 among the workers with WFC. CONCLUSIONS WFH was significantly associated with sleep disturbance among workers before COVID-19, but this association was not observed during the COVID-19 pandemic. Considering the significant role that WFC plays in this association, companies should provide a family-friendly WFH environment when adopting WFH practices.
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Affiliation(s)
- Jaehyuk Jung
- Department of Occupational and Environmental Medicine, Ajou University School of Medicine, Suwon, 16499, Korea
- Department of Occupational and Environmental Medicine, Ajou University Hospital, Suwon, 16499, Korea
| | - Jiyoung Lim
- Department of Occupational and Environmental Medicine, Ajou University Hospital, Suwon, 16499, Korea
| | - Yong Hyuk Cho
- Department of Psychiatry, Ajou University School of Medicine, Suwon, 16499, Korea
| | - Jae Bum Park
- Department of Occupational and Environmental Medicine, Ajou University School of Medicine, Suwon, 16499, Korea
- Department of Occupational and Environmental Medicine, Ajou University Hospital, Suwon, 16499, Korea
| | - Inchul Jeong
- Department of Occupational and Environmental Medicine, Ajou University School of Medicine, Suwon, 16499, Korea
- Department of Occupational and Environmental Medicine, Ajou University Hospital, Suwon, 16499, Korea
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16
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Rai A, Aldabbas M, Veqar Z. Effect of physical activity on sleep problems in sedentary adults: a scoping systematic review. Sleep Biol Rhythms 2024; 22:13-31. [PMID: 38476845 PMCID: PMC10899995 DOI: 10.1007/s41105-023-00494-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 10/06/2023] [Indexed: 03/14/2024]
Abstract
This systematic review was steered forward with the aim of analyzing how different forms of exercise could influence the objective and subjective sleep outcome among sedentary adults with sleep problems. A pre-detailed study protocol (PROSPERO ID: CRD42021229649) was used to search for RCTs through five databases. The methodological quality of the included RCTs was assessed by PEDro and studies were included if they scored > 5. Effect size of all outcome measures were calculated using Cohen's d. Of the 4154 studies, 19 studies met the inclusion criteria and underwent quality assessment using 11-point PEDRO scale. 9 studies with PEDro score > 5 were finally included in this systematic review out of which, participants of 4 studies had insomnia (nrange = 37-48, agerange = 44-60 years), 3 studies had poor sleep quality (nrange = 80-275, agerange = 52-70 years) and 2 studies had obstructive sleep apnea syndrome (nrange = 26-68, agerange = 51 years). Majority of studies revealed that physical activity seems to have greater improvement with a large effect size on subjective sleep outcomes among sedentary adults with sleep problems like insomnia, poor sleep quality and OSAS, whereas limited studies and non-significant results were observed on objective sleep outcomes. Physical activity improves sleep outcomes especially among sedentary middle-aged and older adults. More research is needed to examine the effect of physical activity programs on objective sleep outcomes especially in younger sedentary adults with different sleep problems. Supplementary Information The online version contains supplementary material available at 10.1007/s41105-023-00494-w.
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Affiliation(s)
- Anushree Rai
- SGT University, Gurugram, Haryana 110025 India
- Al-Azhar University, Faculty of Applied Medical Sciences, Department of Physical Therapy, Gaza, Palestine
| | - Mosab Aldabbas
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (Central University), New Delhi, 110025 India
| | - Zubia Veqar
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (Central University), New Delhi, 110025 India
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17
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Jensen S, Abeler K, Friborg O, Rosner A, Olsborg C, Mellgren SI, Müller KI, Rosenberger AD, Vold ML, Arntzen KA. Insomnia and sleep-disordered breathing in FKRP-related limb-girdle muscular dystrophy R9. The Norwegian LGMDR9 cohort study (2020). J Neurol 2024; 271:274-288. [PMID: 37695533 PMCID: PMC10770197 DOI: 10.1007/s00415-023-11978-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 08/25/2023] [Accepted: 08/28/2023] [Indexed: 09/12/2023]
Abstract
Limb-girdle muscular dystrophy R9 (LGMDR9) is a progressive and disabling genetic muscle disease. Sleep is relevant in the patient care as it impacts on health, functioning, and well-being. LGMDR9 may potentially affect sleep by physical or emotional symptoms, myalgia, or sleep-disordered breathing (SDB) through cardiorespiratory involvement. The objective was to investigate the occurrence of insomnia and unrecognized or untreated SDB in LGMDR9, associated factors, and relationships with fatigue and health-related quality of life (HRQoL). All 90 adults in a Norwegian LGMDR9 cohort received questionnaires on sleep, fatigue, and HRQoL. Forty-nine of them underwent clinical assessments and 26 without mask-based therapy for respiration disorders additionally underwent polysomnography (PSG) and capnometry. Among 77 questionnaire respondents, 31% received mask-based therapy. The prevalence of insomnia was 32% of both those with and without such therapy but was significantly increased in fatigued respondents (54% vs 21%). Insomnia levels correlated inversely with mental HRQoL. Among 26 PSG candidates, an apnea-hypopnea index (AHI) ≥ 5/h was observed in 16/26 subjects (≥ 15/h in 8/26) with median 6.8 obstructive apneas and 0.2 central apneas per hour of sleep. The AHI was related to advancing age and an ejection fraction < 50%. Sleep-related hypoventilation was detected in one subject. Fatigue severity did not correlate with motor function or nocturnal metrics of respiration or sleep but with Maximal Inspiratory Pressure (r = - 0.46). The results indicate that insomnia and SDB are underrecognized comorbidities in LGMDR9 and associated with HRQoL impairment and heart failure, respectively. We propose an increased attention to insomnia and SDB in the interdisciplinary care of LGMDR9. Insomnia and pulmonary function should be examined in fatigued patients.
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Affiliation(s)
- Synnøve Jensen
- National Neuromuscular Centre Norway and Department of Neurology, University Hospital of North Norway, 9038, Tromsø, Norway.
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø-The Artic University of Norway, Tromsø, Norway.
| | - Karin Abeler
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø-The Artic University of Norway, Tromsø, Norway
- Department of Neurology and Neurophysiology, University Hospital of North Norway, Tromsø, Norway
| | - Oddgeir Friborg
- Department of Psychology, Faculty of Health Sciences, University of Tromsø-The Artic University of Norway, Tromsø, Norway
| | - Assami Rosner
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø-The Artic University of Norway, Tromsø, Norway
- Department of Cardiology, University Hospital of North Norway, Tromsø, Norway
| | - Caroline Olsborg
- Department of Neurology and Neurophysiology, University Hospital of North Norway, Tromsø, Norway
| | - Svein Ivar Mellgren
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø-The Artic University of Norway, Tromsø, Norway
| | - Kai Ivar Müller
- Department of Neurology, Sørlandet Hospital Trust, Kristiansand, Norway
| | - Andreas Dybesland Rosenberger
- National Neuromuscular Centre Norway and Department of Neurology, University Hospital of North Norway, 9038, Tromsø, Norway
| | - Monica L Vold
- Department of Respiratory Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Kjell Arne Arntzen
- National Neuromuscular Centre Norway and Department of Neurology, University Hospital of North Norway, 9038, Tromsø, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø-The Artic University of Norway, Tromsø, Norway
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18
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Slipsager A, Andersen LK, Voermans NC, Lucia A, Karazi W, Santalla A, Vissing J, Løkken N. Fatigue and associated factors in 172 patients with McArdle disease: An international web-based survey. Neuromuscul Disord 2024; 34:19-26. [PMID: 38042739 DOI: 10.1016/j.nmd.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 11/05/2023] [Accepted: 11/08/2023] [Indexed: 12/04/2023]
Abstract
McArdle disease is an autosomal recessive inherited disease caused by pathogenic variants in the PYGM gene, resulting in virtual absence of the myophosphorylase enzyme in skeletal muscle. Patients experience physical activity intolerance, muscle pain, and muscle fatigue. This study aimed to investigate other fatigue domains with the Multidimensional Fatigue Inventory (MFI-20) along with an investigation of potential contributing factors, including relevant disease and lifestyle-related factors. We conducted a survey in an international cohort of patients with McArdle disease. The survey included questions on demographics and McArdle disease-related symptoms, and the questionnaires: MFI-20, Insomnia Severity Index (ISI), and International Physical Activity Questionnaire Short-Form (IPAQ-SF). One hundred seventy-four responses were included in the data analyses. We found relatively high fatigue scores in all five domains (general fatigue (12.9 ± 2.2), mental fatigue (10.1 ± 4.1), physical fatigue (13.7 ± 4.1), reduced activity (12.1 ± 4.1), and reduced motivation (10.4 ± 3.4)). Fatigue associated with McArdle symptom severity (p < 0.005), lower levels of physical activity (assessed by IPAQ-SF) (p < 0.05), and poor sleep (assessed by ISI) (p < 0.05). These findings call for clinical focus and future research into fatigue, sleep and mental health in patients with McArdle disease.
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Affiliation(s)
- Anna Slipsager
- Copenhagen Neuromuscular Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Linda Kahr Andersen
- Copenhagen Neuromuscular Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Nicol Cornelia Voermans
- The Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, The Netherlands
| | - Alejandro Lucia
- Physical Activity Health Research Group (PaHerg), Research Institute of Hospital 12 de Octubre ('i+12'). Madrid, Spain; Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Walaa Karazi
- The Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, The Netherlands
| | | | - John Vissing
- Copenhagen Neuromuscular Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Nicoline Løkken
- Copenhagen Neuromuscular Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
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19
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Shimamoto H, Eastwood P, Anderson M, Mizuno K. Prevalence of excessive daytime sleepiness and its association with daily life factors in Japanese first-year university students. Sleep Biol Rhythms 2024; 22:33-40. [PMID: 38476855 PMCID: PMC10899967 DOI: 10.1007/s41105-023-00470-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 06/12/2023] [Indexed: 03/14/2024]
Abstract
As lifestyles have shifted to favor nighttime activities, daytime sleepiness and sleep-related problems have become increasingly common in Japan. Excessive daytime sleepiness (EDS) is an adverse consequence of sleep loss and an important public health concern. EDS may cause academic difficulties, behavioral abnormalities, and psychological dysfunction; therefore, it is a particularly important issue among university students. We conducted a cross-sectional study to investigate the prevalence of EDS and its associated lifestyle factors among Japanese university students. A questionnaire was completed by 1470 first-year university students, aged 19.0 (± 1.0) years. Using the questionnaire, we collected information on (1) demographic variables, (2) lifestyle variables, and (3) sleep habits and daytime sleepiness. Daytime sleepiness was measured using the Japanese version of the Epworth Sleepiness Scale, a frequently used subjective scale for assessing sleepiness. The overall prevalence of EDS was 57% (53% in men and 61% in women). Multivariate logistic regression analysis revealed that the following factors were associated with EDS: female sex, exercise habits, long commuting times, later wake-up times, and shorter sleep duration. Given that more than 50% of first-year university students reported having EDS, interventions should be considered to decrease its risk, including educational programs that provide strategies to extend sleep duration and delay wake-up time. Such strategies may also be valuable for students with other potential risk factors, such as exercise habits or long commute times, that are associated with EDS.
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Affiliation(s)
- Hideki Shimamoto
- Center for Education in Liberal Arts and Sciences, Osaka University, 1-16 Machikaneyama-cho, Toyonaka, Osaka 560-0043 Japan
| | - Peter Eastwood
- Health Futures Institute, Murdoch University, Perth, WA Australia
| | - Martin Anderson
- School of Human Sciences (Sport Science, Exercise and Health), University of Western Australia, Perth, WA Australia
| | - Koh Mizuno
- Faculty of Education, Tohoku Fukushi University, Sendai, Miyagi Japan
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20
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Knobbe TJ, Kremer D, Eisenga MF, van Londen M, Annema C, Bültmann U, Kema IP, Navis GJ, Berger SP, Bakker SJL. Sleep quality, fatigue, societal participation and health-related quality of life in kidney transplant recipients: a cross-sectional and longitudinal cohort study. Nephrol Dial Transplant 2023; 39:74-83. [PMID: 37418245 PMCID: PMC10730797 DOI: 10.1093/ndt/gfad148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Fatigue and impaired health-related quality of life (HRQoL) are common among kidney transplant recipients (KTR). We hypothesized that both may partially be attributable to poor sleep. METHODS Cross-sectional and longitudinal data of KTR enrolled in the TransplantLines Biobank and Cohort Study were used. Sleep quality was assessed using the Pittsburgh Sleep Quality Index questionnaire. Individual strength (i.e. a composite of fatigue, concentration, motivation and physical activity), societal participation and HRQoL were assessed using validated questionnaires. RESULTS We included 872 KTR (39% female, age 56 ± 13 years) and 335 healthy controls. In total, 33% of male KTR and 49% of female KTR reported poor sleep quality, which was higher compared with male and female healthy controls (19% and 28%, respectively, P < .001 for both). In logistic regression analyses, female sex, anxiety, active smoking, low protein intake, physically inactive lifestyle, low plasma magnesium concentration, using calcineurin inhibitors, not using mTOR inhibitors and using benzodiazepine agonists were associated with poor sleep quality. In adjusted linear regression analyses, poor sleep was strongly and independently associated with lower individual strength [standardized β (st.β) = 0.59, 95% confidence interval (CI) 0.45 to 0.74, P < .001], poorer societal participation (frequency: st.β = -0.17, 95% CI -0.32 to -0.01, P = .04; restrictions: st.β = -0.36, 95% CI -0.51 to -0.21, P < .001; satisfaction: st.β = -0.44, 95% CI -0.59 to -0.28, P < .001) and lower HRQoL (physical: st.β = -0.53, 95% CI -0.68 to -0.38, P < .001; mental: st.β = -0.64, 95% CI -0.78 to -0.50, P < .001). The associations with poorer societal participation and lower HRQoL were strongly mediated by individual strength (P < .001 for all), yet the suggested direct effects of poor sleep quality on HRQoL remained significant (Pphysical = .03, Pmental = .002). Longitudinal data of 292 KTR showed that sleep quality improves after kidney transplantation in males (P < .001), but not in females (P = .9). CONCLUSIONS Poor sleep quality is common among KTR, and may be a potential target to improve fatigue, societal participation and HRQoL among KTR.
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Affiliation(s)
- Tim J Knobbe
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Daan Kremer
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Michele F Eisenga
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marco van Londen
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Coby Annema
- Department of Health Sciences, Section of Nursing Science, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ute Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ido P Kema
- Department of Laboratory Medicine Research, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gerjan J Navis
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Stefan P Berger
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Stephan J L Bakker
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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21
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Oh A, Koehler A, Yonker M, Troester M. Sleep Disorders and Chronic Pain Syndromes in the Pediatric Population. Semin Pediatr Neurol 2023; 48:101085. [PMID: 38065632 DOI: 10.1016/j.spen.2023.101085] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/18/2023] [Accepted: 09/13/2023] [Indexed: 12/18/2023]
Abstract
Sleep problems are widespread in children and adolescents suffering from chronic pain disorders. Sleep loss intensifies the experience of pain and is detrimental to the budding self-efficacy of a young individual with limitless horizons. Addressing sleep disorders may prevent the chronification of pain and prevent adverse health outcomes, such as functional impairment, psychiatric comorbidities and overall poor quality of life. This review will explore the cyclical nature between sleep, pain and mood, as well as the functional impact of this relationship on children and adolescents. There will be a discussion about sleep assessment and diagnostic testing, followed by a description of sleep disturbances found in specific pain conditions, ranging from headache, musculoskeletal/abdominal pain, to rheumatologic disorders. Finally, there will be a brief review of pharmacologic and behavioral interventions designed to improve sleep quality, and when possible, to alleviate pain.
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Affiliation(s)
- Ann Oh
- Division of Neurology, UCSF Pediatric Headache Center, University of California, San Francisco, UCSF Benioff Children's Hospital, Mission Hall, 550 16th Street, 5th Floor, San Francisco, CA 94158, USA.
| | - Angelina Koehler
- Division of Neurology, Pediatric Headache Program, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado
| | - Marcy Yonker
- Division of Neurology, Pediatric Headache Program, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado
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22
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Altena E, Ellis J, Camart N, Guichard K, Bastien C. Mechanisms of cognitive behavioural therapy for insomnia. J Sleep Res 2023; 32:e13860. [PMID: 36866434 DOI: 10.1111/jsr.13860] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/03/2023] [Accepted: 02/03/2023] [Indexed: 03/04/2023]
Abstract
Although much is known now about behavioural, cognitive and physiological consequences of insomnia, little is known about changes after cognitive behavioural therapy for insomnia on these particular factors. We here report baseline findings on each of these factors in insomnia, after which we address findings on their changes after cognitive behavioural therapy. Sleep restriction remains the strongest determinant of insomnia treatment success. Cognitive interventions addressing dysfunctional beliefs and attitudes about sleep, sleep-related selective attention, worry and rumination further drive effectiveness of cognitive behavioural therapy for insomnia. Future studies should focus on physiological changes after cognitive behavioural therapy for insomnia, such as changes in hyperarousal and brain activity, as literature on these changes is sparse. We introduce a detailed clinical research agenda on how to address this topic.
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Affiliation(s)
| | - Jason Ellis
- Northumbria Centre for Sleep Research, Northumbria University, Newcastle, UK
| | - Nathalie Camart
- UR CLIPSYD, UFR SPSE, Département de psychologie, Université Paris Nanterre, Nanterre, France
- Cabinet Pôle Psy République, Bordeaux, France
- Nouvelle Clinique Bel Air- PEAS, Bordeaux, France
| | - Kelly Guichard
- Nouvelle Clinique Bel Air- PEAS, Bordeaux, France
- CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Célyne Bastien
- Ecole de Psychologie, Université Laval, Québec, Québec, Canada
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23
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Aakre JA, Schulz J, Ballard C, Corbett A, Bjorvatn B, Aarsland D, Creese B, Hampshire A, Brooker H, Testad I. Self-reported sleep fragmentation and sleep duration and their association with cognitive function in PROTECT, a large digital community-based cohort of people over 50. Int J Geriatr Psychiatry 2023; 38:e6022. [PMID: 37929864 DOI: 10.1002/gps.6022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/17/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE Sleep is vital for normal cognitive function in daily life, but is commonly disrupted in older adults. Poor sleep can be detrimental to mental and physical health, including cognitive function. This study assessed the association between self-reported short (<6 h) and long (>9 h) sleep duration and sleep fragmentation (3≥ nightly awakenings) in cognitive function. METHODS Cross-sectional data from 8508 individuals enroled in the PROTECT study aged 50 and above formed the basis of the univariate linear regression analysis conducted on four cognitive outcomes assessing visuospatial episodic memory (VSEM), spatial working memory, verbal working memory (VWM), and verbal reasoning (VR). RESULTS Short (ß = -0.153, 95% CI [-0.258, -0.048], p = 0.004) and long sleep duration (ß = -0.459, 95% CI [-0.826, -0.091], p = 0.014) were significantly associated with poorer cognitive performance in VWM. Long sleep duration (ß = -2.986, 95% CI [-5.453, -0.518], p = 0.018) was associated with impaired VR. Short sleep (ß = -0.133, 95% CI [-0.196, -0.069], p = <0.001) and sleep fragmentation (ß = -0.043, 95% CI [-0.085, -0.001], p = 0.043) were associated with reduced VSEM. These associations remained significant when including other established risk factors for dementia and cognitive decline (e.g., depression, hypertension). CONCLUSIONS Our findings suggest that short and long sleep durations and fragmented sleep, may be risk factors for a decline in cognitive processes such as working memory, VR and episodic memory thus might be potential targets for interventions to maintain cognitive health in ageing.
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Affiliation(s)
- Jon Arild Aakre
- Centre for Age-Related Medicine - SESAM, Stavanger University Hospital, Stavanger, Norway
- Department of Health & Community Sciences, Faculty of Health & Life Sciences, University of Exeter, Exeter, UK
| | - Jörn Schulz
- Department of Mathematics and Physics, University of Stavanger, Stavanger, Norway
| | - Clive Ballard
- Department of Clinical Biosciences, Faculty of Health & Life Sciences, University of Exeter, Exeter, UK
| | - Anne Corbett
- Department of Health & Community Sciences, Faculty of Health & Life Sciences, University of Exeter, Exeter, UK
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Dag Aarsland
- Centre for Age-Related Medicine - SESAM, Stavanger University Hospital, Stavanger, Norway
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Byron Creese
- Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
- Division of Psychology, Department of Life Sciences, Brunel University London, London, UK
| | - Adam Hampshire
- Department of Brain Sciences, Imperial College London, London, UK
| | | | - Ingelin Testad
- Centre for Age-Related Medicine - SESAM, Stavanger University Hospital, Stavanger, Norway
- Department of Health & Community Sciences, Faculty of Health & Life Sciences, University of Exeter, Exeter, UK
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24
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Eigl ES, Hauser T, Topalidis PI, Schabus M. On the Efficacy of a CBT-I-Based Online Program for Sleep Problems: A Randomized Controlled Trial. Clocks Sleep 2023; 5:590-603. [PMID: 37873840 PMCID: PMC10594462 DOI: 10.3390/clockssleep5040039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/02/2023] [Accepted: 10/06/2023] [Indexed: 10/25/2023] Open
Abstract
There is an urgent need for easily accessible treatment options for sleep problems to reduce the current treatment gap in receiving cognitive behavioral therapy for insomnia (CBT-I). Using a randomized controlled trial, we evaluated the efficacy of a CBT-I-based online program on sleep. Fifty-three volunteers (21-71 years; MAge = 44.6 ± 12.5; 27 female) suffering from impaired sleep were randomly allocated either to the experimental group (EG, n = 27) or to an active control group (CG, n = 26). The EG participated in a 6-week CBT-I-based online program, while the CG received psychoeducation and sleep hygiene instructions. Sleep was assessed both objectively via ambulatory polysomnography (PSG) as well as subjectively via questionnaires at three time points (baseline, pre- and post-intervention). A one-month follow-up assessment was performed using questionnaires. The EG showed small but reliable improvements from pre- to post-intervention in PSG-derived wake after sleep onset (from 58.6 min to 42.5 min; p < 0.05) and sleep efficiency (from 86.0% to 89.2%; p < 0.05). Furthermore, subjective sleep quality (assessed via Pittsburgh Sleep Quality Index) improved significantly during intervention (p = 0.011) and follow-up (p = 0.015) in the EG alone. The Insomnia Severity Index decreased from pre- to post-intervention in both groups (EG: p = 0.003, CG: p = 0.008), while it further improved during follow-up (p = 0.035) in the EG alone. We show that a CBT-I-based online program can improve sleep not only subjectively but also objectively and can be a viable alternative when face-to-face interventions are not available.
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Affiliation(s)
- Esther-Sevil Eigl
- Laboratory for Sleep, Cognition & Consciousness Research, Department of Psychology, Paris-Lodron University of Salzburg, 5020 Salzburg, Austria; (E.-S.E.)
| | - Theresa Hauser
- Laboratory for Sleep, Cognition & Consciousness Research, Department of Psychology, Paris-Lodron University of Salzburg, 5020 Salzburg, Austria; (E.-S.E.)
| | - Pavlos I. Topalidis
- Laboratory for Sleep, Cognition & Consciousness Research, Department of Psychology, Paris-Lodron University of Salzburg, 5020 Salzburg, Austria; (E.-S.E.)
| | - Manuel Schabus
- Laboratory for Sleep, Cognition & Consciousness Research, Department of Psychology, Paris-Lodron University of Salzburg, 5020 Salzburg, Austria; (E.-S.E.)
- Centre for Cognitive Neuroscience Salzburg (CCNS), Paris-Lodron University of Salzburg, 5020 Salzburg, Austria
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25
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Drager LF, Assis M, Bacelar AFR, Poyares DLR, Conway SG, Pires GN, de Azevedo AP, Carissimi A, Eckeli AL, Pentagna Á, Almeida CMO, Franco CMR, Sobreira EST, Stelzer FG, Mendes GM, Minhoto GR, Linares IMP, Sousa KMM, Gitaí LLG, Sukys-Claudino L, Sobreira-Neto MA, Zanini MA, Margis R, Martinez SCG. 2023 Guidelines on the Diagnosis and Treatment of Insomnia in Adults - Brazilian Sleep Association. Sleep Sci 2023; 16:507-549. [PMID: 38370879 PMCID: PMC10869237 DOI: 10.1055/s-0043-1776281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Abstract
Chronic insomnia disorder (simplified in this document as insomnia) is an increasingly common clinical condition in society and a frequent complaint at the offices of different areas of health practice (particularly Medicine and Psychology). This scenario has been accompanied by a significant evolution in treatment, as well as challenges in approaching patients in an appropriately way. This clinical guideline, coordinated by the Brazilian Sleep Association and the Brazilian Association of Sleep Medicine and counting on the active participation of various specialists in the area, encompasses an update on the diagnosis and treatment of insomnia in adults. To this end, it followed a structured methodology. Topics of interest related to diagnosis were written based on theoretical framework, evidence in the literature, and professional experience. As for the topics related to the treatment of insomnia, a series of questions were developed based on the PICO acronym (P - Patient, problem, or population; I - Intervention; C - Comparison, control, or comparator; O - Outcome). The work groups defined the eligible options within each of these parameters. Regarding pharmacological interventions, only the ones currently available in Brazil or possibly becoming available in the upcoming years were considered eligible. Systematic reviews were conducted to help prepare the texts and define the level of evidence for each intervention. The final result is an objective and practical document providing recommendations with the best scientific support available to professionals involved in the management of insomnia.
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Affiliation(s)
- Luciano Ferreira Drager
- Associação Brasileira do Sono, São Paulo, SP, Brazil.
- Unidades de HipertenSão, Instituto do Coração (InCor) e Disciplina de Nefrologia, Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Márcia Assis
- Associação Brasileira do Sono, São Paulo, SP, Brazil.
- Clínica do Sono de Curitiba, Hospital São Lucas, Curitiba, Brazil.
| | - Andrea Frota Rego Bacelar
- Associação Brasileira do Sono, São Paulo, SP, Brazil.
- Clínica Bacelar - Neuro e Sono, Rio de Janeiro, RJ, Brazil.
| | - Dalva Lucia Rollemberg Poyares
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.
- Instituto do Sono, São Paulo, SP, Brazil.
| | - Silvia Gonçalves Conway
- Instituto de Psiquiatria (IPq), Universidade de São Paulo, São Paulo, SP, Brazil.
- Departamento de Otoneurologia, Universidade de São Paulo, São Paulo, SP, Brazil.
- AkasA - Formação e Conhecimento, São Paulo, SP, Brazil.
| | - Gabriel Natan Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.
- Instituto do Sono, São Paulo, SP, Brazil.
| | | | - Alicia Carissimi
- Faculdade Dom Bosco, Porto Alegre, RS, Brazil.
- Cronosul Clínica de Psicologia do Sono, Psicoterapia e Neuropsicologia, Porto Alegre, RS, Brazil.
| | - Allan Luiz Eckeli
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
| | - Álvaro Pentagna
- Hospital das Clínicas (HCFMUSP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
| | | | | | - Emmanuelle Silva Tavares Sobreira
- AkasA - Formação e Conhecimento, São Paulo, SP, Brazil.
- Universidade Federal do Ceará, Fortaleza, CE, Brazil.
- Clínica Sinapse Diagnóstico, Fortaleza, CE, Brazil.
| | - Fernando Gustavo Stelzer
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
| | | | | | - Ila Marques Porto Linares
- Instituto de Psiquiatria (IPq), Universidade de São Paulo, São Paulo, SP, Brazil.
- Instituto da Criança, Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
| | - Ksdy Maiara Moura Sousa
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.
- SleepUp Tecnologia e Saúde LTDA, São Paulo, SP, Brazil.
| | | | - Lucia Sukys-Claudino
- Disciplina de Neurologia, Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil.
| | | | - Marcio Andrei Zanini
- Instituto de Assistência Médica ao Servidor Público Estadual (IAMPSE), São Paulo, SP, Brazil.
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26
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Hughes ME, Chico TJA. How Could Sensor-Based Measurement of Physical Activity Be Used in Cardiovascular Healthcare? SENSORS (BASEL, SWITZERLAND) 2023; 23:8154. [PMID: 37836984 PMCID: PMC10575134 DOI: 10.3390/s23198154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/27/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023]
Abstract
Physical activity and cardiovascular disease (CVD) are intimately linked. Low levels of physical activity increase the risk of CVDs, including myocardial infarction and stroke. Conversely, when CVD develops, it often reduces the ability to be physically active. Despite these largely understood relationships, the objective measurement of physical activity is rarely performed in routine healthcare. The ability to use sensor-based approaches to accurately measure aspects of physical activity has the potential to improve many aspects of cardiovascular healthcare across the spectrum of healthcare, from prediction, prevention, diagnosis, and treatment to disease monitoring. This review discusses the potential of sensor-based measurement of physical activity to augment current cardiovascular healthcare. We highlight many factors that should be considered to maximise the benefit and reduce the risks of such an approach. Because the widespread use of such devices in society is already a reality, it is important that scientists, clinicians, and healthcare providers are aware of these considerations.
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Affiliation(s)
- Megan E. Hughes
- Clinical Medicine, School of Medicine and Population Health, The Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK
| | - Timothy J. A. Chico
- Clinical Medicine, School of Medicine and Population Health, The Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK
- British Heart Foundation Data Science Centre, Health Data Research, London WC1E 6BP, UK
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27
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Rani S, Shelyag S, Angelova M. Patterns of sedentary behaviour in adults with acute insomnia derived from actigraphy data. PLoS One 2023; 18:e0291095. [PMID: 37733680 PMCID: PMC10513233 DOI: 10.1371/journal.pone.0291095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/22/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Sleep disorders, such as insomnia, have been associated with extended periods of inactive, sedentary behaviour. Many factors contribute to insomnia, including stress, irregular sleep patterns, mental health issues, inadequate sleeping schedules, diseases, neurological disorders and prescription medications. OBJECTIVES Identification of the patterns of sedentary time and its duration in adults with acute insomnia and healthy controls to determine the statistically significant sedentary bouts; comparison of the sedentary behaviour patterns in acute insomnia adults with healthy controls. METHODS We investigate the daytime actigraphy data and identify temporal patterns of inactivity among adults with acute insomnia and healthy adults. Seven days of actigraphy data were utilised to calculate sedentary time and bouts of variable duration based on a threshold of activity counts (<100 counts per minute). Statistical analysis was applied to investigate sedentary bouts and total sedentary time during weekdays and weekend. A logistic regression model has been used to determine the significance of sedentary bouts. RESULTS We found that individuals with acute insomnia accumulate a significant amount of their sedentary time in medium (6-30 minutes and 31-60 minutes) and longer (more than 60 minutes) duration bouts in comparison to healthy adults. Furthermore, a low p value for total sedentary time (2.54 ⋅ 10-4) association with acute insomnia supports the finding that acute insomnia individuals are significantly more engaged in sedentary activities compared to healthy controls. Also, as shown by the weekend vs weekday analysis, the physical and sedentary activity patterns of acute insomnia adults demonstrate higher variability during the weekdays in comparison to the weekend. CONCLUSION The results of the present study demonstrate that adults with acute insomnia spend more time in low-intensity daily physical activities compared to healthy adults.
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Affiliation(s)
- Sunita Rani
- School of IT, Deakin University, Melbourne, Victoria, Australia
| | - Sergiy Shelyag
- School of IT, Deakin University, Melbourne, Victoria, Australia
- College of Science and Engineering, Flinders University, Adelaide, South Australia, Australia
| | - Maia Angelova
- School of IT, Deakin University, Melbourne, Victoria, Australia
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Lin CY, Lin KP, Hsueh MC, Liao Y. Associations of accelerometer-measured sedentary behavior and physical activity with sleep in older adults. J Formos Med Assoc 2023:S0929-6646(23)00296-6. [PMID: 37586972 DOI: 10.1016/j.jfma.2023.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/03/2023] [Accepted: 08/01/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Few studies have examined the non-linear relationships of objectively-measured sedentary behavior and physical activity with insomnia symptoms in older adults. We investigated such relationships of sedentary and physically-active behaviors with total sleep time and nocturnal wakefulness. METHODS We recruited adults aged 60 years and above who have received health check-ups or been to geriatric outpatient services from a hospital setting. Sedentary and physically-active behaviors, total sleep time, and wakefulness time after sleep onset were measured by Actigraphy, and their relationships were estimated using generalized additive models. RESULTS The 157 older adults receiving health-related services slept 7.5 h (20.8 min awake) on average per day. Total sleep time was negatively associated with sedentary and physically-active behaviors. By contrast, a U-shape relationship was found between sedentary behavior and wakefulness time after sleep onset, with a turning point at a daily sedentary time of 10.9 h. CONCLUSION Longer high-intensity physical activity time was related to a shorter wakefulness time after sleep onset. By contrast, daily sedentary time longer than 10.9 h was related to shorter total sleep time but more nocturnal wakefulness time. Future nonpharmacological strategies for sleep improvement should consider the sedentary threshold.
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Affiliation(s)
- Chien-Yu Lin
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Kun-Pei Lin
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
| | - Ming-Chun Hsueh
- Graduate Institute of Sport Pedagogy, University of Taipei, Taipei, Taiwan
| | - Yung Liao
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan; Graduate Institute of Sport, Leisure and Hospitality Management, College of Sports and Recreation, National Taiwan Normal University, Taipei, Taiwan
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Yang F, Liu R, He S, Ruan S, He B, Li J, Pan L. Being a morning man has causal effects on the cerebral cortex: a Mendelian randomization study. Front Neurosci 2023; 17:1222551. [PMID: 37547136 PMCID: PMC10400340 DOI: 10.3389/fnins.2023.1222551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 07/05/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction Numerous studies have suggested a connection between circadian rhythm and neurological disorders with cognitive and consciousness impairments in humans, yet little evidence stands for a causal relationship between circadian rhythm and the brain cortex. Methods The top 10,000 morningness-related single-nucleotide polymorphisms of the Genome-wide association study (GWAS) summary statistics were used to filter the instrumental variables. GWAS summary statistics from the ENIGMA Consortium were used to assess the causal relationship between morningness and variates like cortical thickness (TH) or surficial area (SA) on the brain cortex. The inverse-variance weighted (IVW) and weighted median (WM) were used as the major estimates whereas MR-Egger, MR Pleiotropy RESidual Sum and Outlier, leave-one-out analysis, and funnel-plot were used for heterogeneity and pleiotropy detecting. Results Regionally, morningness decreased SA of the rostral middle frontal gyrus with genomic control (IVW: β = -24.916 mm, 95% CI: -47.342 mm to -2.490 mm, p = 0.029. WM: β = -33.208 mm, 95% CI: -61.933 mm to -4.483 mm, p = 0.023. MR Egger: β < 0) and without genomic control (IVW: β = -24.581 mm, 95% CI: -47.552 mm to -1.609 mm, p = 0.036. WM: β = -32.310 mm, 95% CI: -60.717 mm to -3.902 mm, p = 0.026. MR Egger: β < 0) on a nominal significance, with no heterogeneity or no outliers. Conclusions and implications Circadian rhythm causally affects the rostral middle frontal gyrus; this sheds new light on the potential use of MRI in disease diagnosis, revealing the significance of circadian rhythm on the progression of disease, and might also suggest a fresh therapeutic approach for disorders related to the rostral middle frontal gyrus-related.
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Affiliation(s)
- Fan Yang
- Department of Anesthesiology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi Province, China
- Department of Anesthesiology, Central Hospital of Shaoyang, Shaoyang, Hunan Province, China
- Guangxi Key Laboratory for Basic Science and Prevention of Perioperative Organ Disfunction, Nanning, Guangxi Province, China
- Guangxi Clinical Research Center for Anesthesiology, Nanning, Guangxi Province, China
- Guangxi Engineering Research Center for Tissue and Organ Injury and Repair Medicine, Nanning, Guangxi Province, China
| | - Ru Liu
- Department of Anesthesiology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi Province, China
| | - Sheng He
- Department of Anesthesiology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi Province, China
- Department of Anesthesiology, The First Affiliated Hospital of Southern China University, Hengyang, China
| | - Sijie Ruan
- Department of Anesthesiology, Central Hospital of Shaoyang, Shaoyang, Hunan Province, China
| | - Binghua He
- Department of Anesthesiology, Central Hospital of Shaoyang, Shaoyang, Hunan Province, China
| | - Junda Li
- Department of Anesthesiology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi Province, China
| | - Linghui Pan
- Department of Anesthesiology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi Province, China
- Guangxi Key Laboratory for Basic Science and Prevention of Perioperative Organ Disfunction, Nanning, Guangxi Province, China
- Guangxi Clinical Research Center for Anesthesiology, Nanning, Guangxi Province, China
- Guangxi Engineering Research Center for Tissue and Organ Injury and Repair Medicine, Nanning, Guangxi Province, China
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Carreño A, Fontdecaba E, Izquierdo A, Enciso O, Daunis-i-Estadella P, Mateu-Figueras G, Palarea-Albaladejo J, Gascon M, Vendrell C, Lloveras M, San J, Gómez S, Minuto S, Lloret J. Blue prescription: A pilot study of health benefits for oncological patients of a short program of activities involving the sea. Heliyon 2023; 9:e17713. [PMID: 37483694 PMCID: PMC10362171 DOI: 10.1016/j.heliyon.2023.e17713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 06/12/2023] [Accepted: 06/26/2023] [Indexed: 07/25/2023] Open
Abstract
Performing outdoor activities in blue spaces can help improve human health and mental well-being by reducing stress and promoting social relationships. The number of people surviving cancer has increased globally to experience this disease as a life-changing and chronic condition with physical and psychosocial symptoms that have negative impacts on their quality of life. While there has been a growth of programs in green spaces to meet the needs of cancer patients, such as follow-up post-treatment care, support groups and physical activity programs, very few studies have examined the effects of activities involving the sea for the health and well-being of oncology patients. This is the first study to evaluate whether different outdoor activities in blue spaces can benefit oncological patients' physical and mental health using smartwatches, sphygmomanometers and Profile of Mood States (POMS) questionnaires. We assessed changes in blood pressure, heart rate, sleep quality and mental health of 16 patients after twelve sessions of three different activities (walking, beach and snorkelling) and four sessions of a control activity. While no significant differences between activities were observed in terms of the data gathered by the smartwatches, a gradient of positive results for human mental health was observed towards exposure to a blue space, assessed through POMS questionnaires. Results show that exposure to blue spaces contributes to tension and anger reduction and improves the vigour mood state of oncology patients. No significant increases in patients' heart rate were recorded after the beach and snorkelling activities, with results similar to the control activity, suggesting that the contribution may be to participants' relaxation.
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Affiliation(s)
- Arnau Carreño
- Sea Health, Oceans and Human Health Chair, Institute of Aquatic Ecology, University of Girona, C/ Maria Aurèlia Capmany 69, 17003, Girona, Spain
| | - Eva Fontdecaba
- Medicina de Familia, CAP Castelló D’Empúries, Donostia-San Sebastian, Spain
| | - Angel Izquierdo
- Institut Català D'Oncologia, Hospital de Girona Dr. Josep Trueta, Avinguda de França S/n, 17007, Girona, Spain
| | - Olga Enciso
- Medicina de Familia, CAP Tossa de Mar, Corporació de Salut Del Maresme I La Selva, Girona, Spain
| | - Pepus Daunis-i-Estadella
- Dept. of Computer Science, Applied Mathematics and Statistics, University of Girona, Girona, Spain
| | - Gloria Mateu-Figueras
- Dept. of Computer Science, Applied Mathematics and Statistics, University of Girona, Girona, Spain
| | | | - Mireia Gascon
- Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park (PRBB) Doctor Aiguader, 88 08003, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | | | - Joan San
- Sea Health, Oceans and Human Health Chair, Institute of Aquatic Ecology, University of Girona, C/ Maria Aurèlia Capmany 69, 17003, Girona, Spain
| | - Sílvia Gómez
- Dep. Social Anthropology, Autonomous University of Barcelona, Building B-Campus UAB, 08193, Bellaterra, (Cerdanyola Del Vallès) Barcelona, Spain
| | - Stefania Minuto
- Sea Health, Oceans and Human Health Chair, Institute of Aquatic Ecology, University of Girona, C/ Maria Aurèlia Capmany 69, 17003, Girona, Spain
| | - Josep Lloret
- Sea Health, Oceans and Human Health Chair, Institute of Aquatic Ecology, University of Girona, C/ Maria Aurèlia Capmany 69, 17003, Girona, Spain
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Schamilow S, Santonja I, Weitzer J, Strohmaier S, Klösch G, Seidel S, Schernhammer E, Papantoniou K. Time Spent Outdoors and Associations with Sleep, Optimism, Happiness and Health before and during the COVID-19 Pandemic in Austria. Clocks Sleep 2023; 5:358-372. [PMID: 37489436 PMCID: PMC10366917 DOI: 10.3390/clockssleep5030027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/06/2023] [Accepted: 06/14/2023] [Indexed: 07/26/2023] Open
Abstract
Social restriction measures (SRM) implemented during the COVID-19 pandemic led to a reduction in time spent outdoors (TSO). The aim of this study was to describe TSO and evaluate its association with sleep outcomes, optimism, happiness and health-status before and during SRM. Two online surveys were conducted in 2017 (N = 1004) and 2020, during SRM (N = 1010), in samples representative of the age, sex and region of the Austrian population. Information on the duration of TSO, sleep, optimism, happiness and health-status was collected. Multivariable-adjusted logistic regression models were used to study the association of TSO with chronic insomnia, short sleep, late chronotype, optimism, happiness and self-rated health-status. The mean TSO was 3.6 h (SD: 2.18) in 2017 and 2.6 h (SD: 1.87) during times of SRM. Men and participants who were older, married or in a partnership and lived in a rural area reported longer TSO. Participants who spent less time outdoors were more likely to report short sleep or a late chronotype in both surveys and, in 2020, also chronic insomnia. Less TSO was associated with lower happiness and optimism levels and poor health-status. Our findings suggest that TSO may be a protective factor for sleep, mood and health, particularly during stressful and uncertain times.
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Affiliation(s)
- Simon Schamilow
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Isabel Santonja
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Jakob Weitzer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria
- Department of Health Promotion and Prevention, Federal Ministry of the Republic of Austria for Social Affairs, Health, Care and Consumer Protection, 1030 Vienna, Austria
| | - Susanne Strohmaier
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Gerhard Klösch
- Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria
| | - Stefan Seidel
- Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria
| | - Eva Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Kyriaki Papantoniou
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria
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Berger E, Bolstad I, Lien L, Bramness JG. The Association Between Regular Physical Activity and Depressive Symptoms Among Patients in Treatment of Alcohol and Substance Use Disorders. Subst Abuse 2023; 17:11782218231175813. [PMID: 37223087 PMCID: PMC10201145 DOI: 10.1177/11782218231175813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/27/2023] [Indexed: 05/25/2023]
Abstract
Background Alcohol and other substance use disorders and major depression often co-occur. A sedentary lifestyle is related to major depression and even moderate exercise may prevent and contribute to the treatment of depression. Studies have found an effect of physical activity on depression in alcohol and other substance use disorder patients even in clinical settings. Aim To investigate the relationship between level of physical activity and depressive symptoms over time in alcohol and substance use disorder inpatients. Methods Eighty-nine substance use disorder inpatients were followed for 6 months during treatment. The International Physical Activity Questionnaire was used to categorize 3 groups of low, moderate, or high level of physical activity. In addition to background variables and alcohol and drug use measures, data on biometric measures and on sleep were gathered. Becks Depression Inventory version II (BDI-II) measured depressive symptoms. A multilevel logistic regression was used to analyze the longitudinal relationship between physical activity and depressive symptoms. Results Most patients (57%) reported low activity, while 24% reported moderate and 19% high activity. Few changed their activity level during treatment. Moderate physical activity was related to lower score on BDI-II (P = .029). Level of physical activity was closely related to insomnia (P = .024). In the multivariate analysis the relationship between depressive symptoms and physical activity did not withstand the adjustment for insomnia. However, in the multilevel logistic regression higher physical activity was related to lower BDI-II score in a dose dependent manner. Conclusions Among these alcohol and other substance use disorders patients in treatment, there was a relationship between depressive symptoms and physical activity. The low level of physical activity identified among these patients was related to a high level of depressive symptoms. The level of depressive symptoms declined over time; but this change was not related to an increase in physical activity.
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Affiliation(s)
| | - Ingeborg Bolstad
- Norwegian National Advisory Unit on
Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust,
Brumunddal, Norway
- Department of Health and Social
Science, Innlandet University of Applied Science, Elverum, Norway
| | - Lars Lien
- Norwegian National Advisory Unit on
Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust,
Brumunddal, Norway
- Department of Health and Social
Science, Innlandet University of Applied Science, Elverum, Norway
| | - Jørgen G Bramness
- Norwegian National Advisory Unit on
Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust,
Brumunddal, Norway
- Department of Clinical Medicine,
UiT—Norway’s Arctic University, Tromsø, Norway
- Norwegian Institute of Public Health,
Oslo, Norway
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Huang HH, Stubbs B, Chen LJ, Ku PW, Hsu TY, Lin CW, Weng YM, Wu SH. The effect of physical activity on sleep disturbance in various populations: a scoping review of randomized clinical trials. Int J Behav Nutr Phys Act 2023; 20:44. [PMID: 37069626 PMCID: PMC10107572 DOI: 10.1186/s12966-023-01449-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 04/04/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Promoting physical activity (PA) in different populations experiencing sleep disturbance may increase population PA levels and improve sleep. This scoping review aimed to examine the effect of various PA intervention strategies on sleep across different populations, identify key sleep outcomes, and analyze knowledge gaps by mapping the relevant literature. METHODS For this study, we systematically searched articles published till March 2022 from PubMed, Web of Science, Cochrane Library, and Embase databases for randomized clinical trials (RCTs) regarding the effect of physical activity on sleep. Two authors extracted key data and descriptively analyzed the data. Thematic analysis was used to categorize the results into themes by all authors. Arksey and O'Malley's scoping review framework was used to present the findings. RESULTS Twenty-one randomized controlled trials out of 3052 studies were finally included with 3677 participants (2852 females (78%)). Five trials were conducted in healthy working-age adults with sleep disturbance but without the diagnosis of insomnia, five in healthy older adults, two in perinatal women, four in patients with cancer, three in mental illness related subjects, and another two in other disease-related areas. PA interventions were diverse, including walking, resistance training, aerobic exercise, housework, water exercise, basketball, smartphone/tablet "apps", web, online videos or wearable actigraphy, and self-determined exercise. Three major themes were identified: (1) Sleep environment may be important to address prior to instituting PA interventions, (2) All types of PA were effective for improving sleep in all populations studied, (3) Self-tolerated PA is safe for improving sleep in the elderly and in co-morbid or perinatal populations. CONCLUSIONS PA is effective and safe for improving sleep in both healthy and co-morbid populations with sleep disturbance by increasing daily activity levels using a variety of strategies, even low intensity, such as housekeeping, sit-to-stand repetitions, along with encouraging PA through web pages, videos, and self-goal setting apps. In addition, this scoping review identifies the need for further therapeutic research and future exploration in populations with sleep initiation or sleep maintenance disturbance.
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Affiliation(s)
- Hung-Hsin Huang
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, Box, UK
| | - Li-Jung Chen
- Department of Exercise Health Science, National Taiwan University of Sport, 271, Lixing Road, Taichung City, 404, Taiwan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Po-Wen Ku
- Graduate Institute of Sports and Health Management, National Chung Hsing University, 145 Xingda Rd., South Dist, Taichung City, 402, Taiwan
- Department of Kinesiology, National Tsing Hua University, Hsinchu, 300, Taiwan
| | - Tai-Yi Hsu
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Chia-Wei Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- Doctoral Degree Program in Artificial Intelligence, Asia University, Taichung, Taiwan
| | - Yi-Ming Weng
- Emergency department of Taoyuan General Hospital, MOHW, Taoyuan, Taiwan
| | - Shih-Hao Wu
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan.
- Department of Exercise Health Science, National Taiwan University of Sport, 271, Lixing Road, Taichung City, 404, Taiwan.
- Attending Physician of Emergency Department, China Medical University Hospital, Taichung, 404, Taiwan.
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Baron P, Hermand É, Bourlois V, Pezé T, Aron C, Lombard R, Hurdiel R. Effect of Aerobic Exercise Training on Sleep and Core Temperature in Middle-Aged Women with Chronic Insomnia: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085452. [PMID: 37107734 PMCID: PMC10138891 DOI: 10.3390/ijerph20085452] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/30/2023] [Accepted: 04/04/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND Exercise represents a viable non-pharmacological intervention to help treating insomnia but the interaction mechanisms between sleep and physical activity still remain poorly understood. The aim of this study was to investigate the effect of a aerobic exercise training intervention on sleep and core temperature. METHODS Twenty-four adult women suffering from insomnia participated in this study. They were randomized into an exercise group and a control group. Aerobic exercise training consisted in moderate to vigorous aerobic exercise training for 12 weeks. Outcome measures included both subjective (Insomnia Severity Index, ISI) and objective (actigraphy recordings) sleep quality assessments, and core body temperature continuously recorded for a minimum 24 h. RESULTS The exercise group showed a decrease in ISI (p < 0.001) and in various objective sleep parameters. The core temperature batyphase value was lowered (p = 0.037) whereas its amplitude was larger (p = 0.002). We also found a tight correlation between the evolution of insomnia and the evolution of mean night-time core temperature and batyphase values. CONCLUSIONS A moderate to vigorous aerobic exercise program appears to be an effective non-drug therapy for improving sleep in women with insomnia. In addition, exercise programs should aim to increase core body temperature during practice to induce sleep-promoting adaptations and rebound.
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Affiliation(s)
- Pauline Baron
- Univ. Littoral Côte d’Opale, Univ. Artois, Univ. Lille, ULR 7369—URePSSS—Unité de Recherche Pluridisciplinaire Sport Santé Société, F-59140 Dunkerque, France
- Correspondence: ; Tel.: +33-6-73-68-11-25
| | - Éric Hermand
- Univ. Littoral Côte d’Opale, Univ. Artois, Univ. Lille, ULR 7369—URePSSS—Unité de Recherche Pluridisciplinaire Sport Santé Société, F-59140 Dunkerque, France
| | - Valentin Bourlois
- Univ. Littoral Côte d’Opale, Univ. Artois, Univ. Lille, ULR 7369—URePSSS—Unité de Recherche Pluridisciplinaire Sport Santé Société, F-59140 Dunkerque, France
| | - Thierry Pezé
- Univ. Littoral Côte d’Opale, Univ. Artois, Univ. Lille, ULR 7369—URePSSS—Unité de Recherche Pluridisciplinaire Sport Santé Société, F-59140 Dunkerque, France
| | - Christophe Aron
- Centre Sommeil Morphée, Polyclinique de Grande Sysnthe, 59760 Grande Synthe, France
| | - Remi Lombard
- Clinique de Flandre, 59210 Coudekerque-Branche, France
| | - Rémy Hurdiel
- Univ. Littoral Côte d’Opale, Univ. Artois, Univ. Lille, ULR 7369—URePSSS—Unité de Recherche Pluridisciplinaire Sport Santé Société, F-59140 Dunkerque, France
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Gratsia S, Cocos A, Matsangas P, Shattuck N, Vastardis H. Cervical headgear therapy and sleep-related attributes. Am J Orthod Dentofacial Orthop 2023:S0889-5406(23)00104-X. [PMID: 37002113 DOI: 10.1016/j.ajodo.2022.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 12/01/2022] [Accepted: 12/01/2022] [Indexed: 06/19/2023]
Abstract
INTRODUCTION The study aimed to assess (1) the effect of the treatment with cervical headgear on patients' sleep-related attributes and well-being and (2) whether these sleep-related parameters (ie, sleep quality and quantity) were associated with patients' compliance during the orthodontic treatment. METHODS The study protocol was based on a prospective longitudinal quasi-experimental design. Participants (n = 26; 9 males; mean age, 12.4 ± 1.68 years) were patients in the Postgraduate Orthodontic Clinic, National and Kapodistrian University of Athens. All patients received treatment with a cervical headgear having an embedded TheraMon microsensor. Sleep was assessed by wrist-worn actigraphy for 59 ± 19 days. The Epworth Sleepiness Scale was used to assess average daytime sleepiness, whereas we used the Athens Insomnia Scale for insomnia symptoms. Oral health-related quality of life (OHRQOL) was assessed by the Oral Health Impact Profile (OHIP-14). RESULTS Patients slept on average 7.35 ± 0.42 h/d. Compared with the lowest sleep duration recommended for their age group, patients had an average chronic sleep deficit of 1.40 ± 0.49 h/d. Patients wore the headgear 90.9% of the days for 10.40 ± 4.17 h/d. However, only 7 (28%) patients reached or exceeded the wear-time recommendation of 12 h/d. In contrast, 2 (8%) patients wore headgear <5 h/d, 11 (44%) 5-10 h/d, and 12 (48%) patients wore headgear >10 h/d. Aggregated by participants, the median Epworth Sleepiness Scale score during the study was 3.40 (interquartile range [IQR], 4.85; range, 0.2-13.6), the median Athens Insomnia Scale score was 3.00 (IQR, 4.25; range, 0-7), and the median Oral Health Impact Profile score was 1.40 (IQR, 4.17; range, 0.0-20.8). Compared with patients who wore the orthodontic appliance >7.8 h/d, patients who wore it <7.8 h/d had worse average daytime sleepiness (P = 0.050) and worse OHRQOL (P = 0.019). CONCLUSIONS Orthodontic treatment with cervical headgear has no substantive negative effect on sleep attributes (quantity and quality), average daytime sleepiness and OHRQOL. However, poor compliance with orthodontic treatment seems to be associated with higher levels of daytime sleepiness.
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Affiliation(s)
- Sofia Gratsia
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
| | | | | | | | - Heleni Vastardis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
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You Y, Chen Y, Zhang Q, Yan N, Ning Y, Cao Q. Muscle quality index is associated with trouble sleeping: a cross-sectional population based study. BMC Public Health 2023; 23:489. [PMID: 36918831 PMCID: PMC10012435 DOI: 10.1186/s12889-023-15411-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 03/09/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Trouble sleeping is one of the major health issues nowadays. Current evidence on the correlation between muscle quality and trouble sleeping is limited. METHODS A cross-sectional study design was applied and participants aged from 18 to 60 years in the National Health and Nutrition Examination Survey (NHANES) 2011-2014 was used for analysis. Muscle quality index (MQI) was quantitatively calculated as handgrip strength (HGS, kg) sum/ arm and appendicular skeletal muscle mass (ASM, kg) by using the sum of the non-dominant hand and dominant hand. Sleeping data was obtained by interviews and self-reported by individuals. The main analyses utilized weighted multivariable logistic regression models according to the complex multi-stage sampling design of NHANES. Restricted cubic spline model was applied to explore the non-linear relationship between MQI and trouble sleeping. Moreover, subgroup analyses concerning sociodemographic and lifestyle factors were conducted in this study. RESULTS 5143 participants were finally included in. In the fully adjusted model, an increased level of MQI was significantly associated with a lower odds ratio of trouble sleeping, with OR = 0.765, 95% CI: (0.652,0.896), p = 0.011. Restricted cubic spline showed a non-linear association between MQI and trouble sleeping. However, it seemed that the prevalence of trouble sleeping decreased with increasing MQI until it reached 2.362, after which the odds ratio of trouble sleeping reached a plateau. Subgroup analyses further confirmed that the negative association between the MQI and trouble sleeping was consistent and robust across groups. CONCLUSION Overall, this study revealed that MQI can be used as a reliable predictor in odds ratio of trouble sleeping. Maintaining a certain level of muscle mass would be beneficial to sleep health. However, this was a cross-sectional study, and causal inference between MQI and trouble sleeping was worthy of further exploration.
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Affiliation(s)
- Yanwei You
- grid.12527.330000 0001 0662 3178Division of Sports Science and Physical Education, Tsinghua University, 100084 Beijing, China
| | - Yuquan Chen
- grid.506261.60000 0001 0706 7839Institute of Medical Information/Medical Library, Chinese Academy of Medical Sciences & Peking Union Medical College, 100020 Beijing, China
| | - Qi Zhang
- grid.464446.00000 0000 9830 5259Undergraduate Department, Taishan University, 250111 Taian, China
| | - Ning Yan
- grid.413385.80000 0004 1799 1445Heart Centre, Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, 750004 Yinchuan, China
| | - Yi Ning
- grid.411491.8Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, 150001 Harbin, China
| | - Qiang Cao
- grid.259384.10000 0000 8945 4455School of Pharmacy, Macau University of Science and Technology, 999078 Macau, China
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Zhang B, Wang X, Liu S, Zhang M, He X, Zhu W, Ding H. The relationship between self-assessment living standard and mental health among the older in rural China: the mediating role of sleep quality. BMC Public Health 2023; 23:449. [PMID: 36890457 PMCID: PMC9993696 DOI: 10.1186/s12889-023-15157-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 01/30/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Mental health imbalance are the main cause of anxiety, depression and happiness reduction in the older. Self-assessment living standard and sleep quality are both influencing factors of mental health. Meantime, self-assessment living standard has an impact on sleep quality. But there's no research on the relationship between the three, we conducted this study to explore the relationship between self-assessment living standard and mental health and the mediating role of sleep quality among the older in rural areas of China. METHODS Using typical field sampling method, M County, Anhui Province was selected as the investigation site, and a total of 1223 respondents were selected. With the help of questionnaires enclosing respondents' sociodemographics information, 12 Items General Health Questionnaire (GHQ-12) and Pittsburgh Sleep Quality Scale (PSQI), face-to-face interviews were used to collect data. Bootstrap test was used for data analysis. RESULTS The results showed that the age of the respondents ranged from 60 to 99 years, with an average age of (66.53 ± 6.77) years, the proportion of the older with a tendency to mental health problems was 24.7%. Most of the older people's self-assessment living standard was normal (average score was 2.89 ± 0.726), accounting for 59.3% of the total. The average sleep quality score was (6.97 ± 4.066), and 2.5% of the respondents reported serious sleep problems. older with low self- assessment living standards were more likely to report a higher propensity for psychological problems (β = 0.420, P < 0.001) and poorer sleep quality (β = 0.608, P < 0.001) than older with high self- assessment living standards. Mental health of the older may be related to sleep quality (β = 0.117, P < 0.001). In addition, the effect of self- assessment living standard on mental health was significantly mediated by sleep quality (β = 0.071, P < 0.001). CONCLUSION Mental health is associated with self-assessment living standard, with this association mediated by sleep quality. A reasonable mechanism needs to be established to improve self-assessment living standard and sleep quality.
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Affiliation(s)
- Beibei Zhang
- Department of Health Service Management, School of Health Management, Anhui Medical University, Hefei, Anhui, China
| | - Xianwen Wang
- School of Public Health and Health Management, Anhui Medical College, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Song Liu
- Department of Health Service Management, School of Health Management, Anhui Medical University, Hefei, Anhui, China
| | - Min Zhang
- Department of Health Service Management, School of Health Management, Anhui Medical University, Hefei, Anhui, China
| | - Xinran He
- Department of Health Service Management, School of Health Management, Anhui Medical University, Hefei, Anhui, China
| | - Weizheng Zhu
- Department of Health Service Management, School of Health Management, Anhui Medical University, Hefei, Anhui, China
| | - Hong Ding
- Department of Health Service Management, School of Health Management, Anhui Medical University, Hefei, Anhui, China.
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Exercise as an Adjunct Treatment to Cognitive Behavior Therapy for Insomnia. Sleep Med Clin 2023; 18:39-47. [PMID: 36764785 DOI: 10.1016/j.jsmc.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
The question that guided this review is whether exercise can add to the improvements in insomnia in patients treated with cognitive behavioral therapy for insomnia (CBT-I). CBT-I has long been recommended as the first-line treatment of chronic insomnia. However, CBT-I is not effective for as many as 30% to 40% of patients with insomnia. There is accumulating evidence for positive effects on insomnia following acute and chronic exercise. However, to the best of our knowledge, the effects of CBT-I combined with exercise have not been explored in clinical trials. In this article, we develop a rationale for combining CBT-I with exercise.
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Borges-Vieira JG, Cardoso CKS. Efficacy of B-vitamins and vitamin D therapy in improving depressive and anxiety disorders: a systematic review of randomized controlled trials. Nutr Neurosci 2023; 26:187-207. [PMID: 35156551 DOI: 10.1080/1028415x.2022.2031494] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES This systematic review aimed to evaluate the efficacy of B vitamins and vitamin D therapy in improving the standard treatment of depression and anxiety disorders. We also aimed to gather the evidence supporting the recommendations for supplementation in clinical practice. METHODS Performed between March 2020 and September 2021, the main inclusion criteria were randomized controlled trials (RCTs), with patients ≥ 18 years old, both sexes, fulfilling target diagnoses of major depressive disorder (MDD), generalized anxiety disorder (GAD), or mild to severe depressive and anxiety symptoms. In addition, the RCTs were included if the scales to assess the severity of the symptoms were standardized rating scales in psychiatric. Trials that reported diagnoses of schizophrenia, perinatal depression, bipolar depression, sleep disorders, eating disorders, cancer, and multiple sclerosis in association with any of the mentioned diagnoses were excluded. RESULTS We identified 20 RCTs that matched all eligibility criteria, totaling 2,256 subjects, diagnosed with MDD, GAD, and depressive or anxiety symptoms. Supplementation with folic acid or L-methylfolate, B1, B12 or methylcobalamin, and vitamin D (in different doses and study duration) significantly decreased depression score scales by increasing response to standard pharmacological treatment or as monotherapy, including partial or complete remission. As for anxiety symptoms, the availability of results is limited to adjuvant vitamin D therapy. DISCUSSION B vitamins and vitamin D associated with other compounds also showed significant results, so the improvement in symptoms cannot be attributed strictly to those. Our results suggest that intervention with B vitamins and/or vitamin D may be an effective and well-tolerated adjuvant strategy for improving the symptoms of depression and anxiety, according to the patient's clinical status and nutritional biomarkers.
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Affiliation(s)
- Jaqueline G Borges-Vieira
- Biomedical Scientist, Genetics Specialization. Bachelor of Science in Nutrition, Department of Nutrition, School of Social and Health Sciences, Pontifical Catholic University of Goiás, Goiânia, Brazil
| | - Camila K Souza Cardoso
- Ph.D. in Health Sciences, School of Medicine, Federal University of Goiás. Professor of Nutrition, Department of Nutrition, School of Social and Health Sciences, Pontifical Catholic University of Goiás, Goiânia, Brazil
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Deng MG, Liu F, Liang Y, Chen Y, Nie JQ, Chai C, Wang K. Associations of serum zinc, copper, and selenium with sleep disorders in the American adults: Data from NHANES 2011-2016. J Affect Disord 2023; 323:378-385. [PMID: 36464094 DOI: 10.1016/j.jad.2022.11.088] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/21/2022] [Accepted: 11/25/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Even though various studies have been conducted to investigate the relationship between trace metals and sleep, few epidemiological studies have evaluated the relationship between trace metals and sleep disorders in American adults. OBJECTIVE This study intended to evaluate the associations of serum zinc (Zn), copper (Cu), selenium (Se), Zn/Cu, Zn/Se, and Cu/Se ratios with sleep disorders in American adults. METHODS We conducted a cross-sectional analysis of 3660 adults aged ≥18 years old who participated in the National Health and Nutrition Examination Survey (NHANES) 2011-2016. Binary logistic regression was employed to calculate the odds ratio (OR) and 95 % confidence interval (CI) of either serum trace metals or serum trace metals ratios with risks among sleep disorder phenotypes. The restricted cubic spline (RCS) model was additionally utilized to check the dose-response relationships between serum trace metals, serum trace metals ratios, and sleep disorders. RESULTS Logistic regression demonstrated that higher serum Zn (OR: 0.70, 95 % CI: 0.51-0.97, p = 0.035), Zn/Cu (OR: 0.62, 95 % CI: 0.45-0.87, p = 0.007), and Zn/Se (OR: 0.68, 95 % CI: 0.49-0.95, p = 0.025) were related to a decreased likelihood of self-reported sleep disorders, and dose-response relationships were detected by the RCS models, after adjustment for sociodemographic, behavioral, and health characteristics. No associations between serum Cu, Se, Cu/Se, and sleep disorders were observed. The findings in the sensitivity analyses were consistent with these results. CONCLUSION Our study revealed that serum Zn, Zn/Cu, and Zn/Se were inversely associated with the risk of self-reported sleep disorders in US adults.
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Affiliation(s)
- Ming-Gang Deng
- Department of Epidemiology, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Fang Liu
- Department of Nutrition and Food Hygiene, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Yuehui Liang
- Department of Nutrition and Food Hygiene, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Yanling Chen
- Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Jia-Qi Nie
- Department of Nutrition and Food Hygiene, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Chen Chai
- China Emergency Center, Hubei Clinical Research Center for Emergency and Resuscitation, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Kai Wang
- Department of Public Health, Wuhan Fourth Hospital, Wuhan 430033, China.
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Ferreira MF, Bos SC, Macedo AF. The impact of physical activity on objective sleep of people with insomnia. Psychiatry Res 2023; 320:115019. [PMID: 36577233 DOI: 10.1016/j.psychres.2022.115019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 12/14/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022]
Abstract
The aim of our study was to investigate if physical activity has a beneficial impact on insomnia. A systematic literature review was conducted in PubMed database using the terms "Physical activity" and "Insomnia" and 591 records were retrieved. The preferred reporting items for systematic reviews and meta-analyses guidelines were followed and fifteen articles were considered eligible for further analysis. Participants were mainly female, between 40 and 60 years; design studies were variable and most studies involved long-term interventions; insomnia definition was mainly based on diagnostic criteria or considered a specific cut-off point of well-known insomnia questionnaires; sleep was mostly assessed with polysomnography (PSG) or actigraphy; physical activity interventions included different methodologies (predominantly treadmill exercise). A beneficial effect of physical activity on insomnia was observed in most studies when sleep was evaluated with PSG or actigraphy. Sleep efficiency was the objective sleep parameter that mainly provided statistically significant results, as expected, followed by sleep onset latency, wake after sleep onset and, less frequently, total sleep time. Using objective methods to assess sleep in insomnia might be useful to support subjective insomnia complaints and to evaluate the efficacy of physical activity interventions in ameliorating sleep of people with insomnia.
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Affiliation(s)
| | - Sandra Carvalho Bos
- Institute of Medical Psychology, Faculty of Medicine, University of Coimbra, Portugal.
| | - António Ferreira Macedo
- Institute of Medical Psychology, Faculty of Medicine, University of Coimbra, Portugal; Department of Psychiatry, Coimbra Hospital and University Centre, Portugal
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42
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Franklin BA. Cardiorespiratory Fitness and Hypnotic Drug Use for Sleep Problems: Unraveling the Array of Potential Confounders. Mayo Clin Proc 2023; 98:216-219. [PMID: 36737110 DOI: 10.1016/j.mayocp.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 12/20/2022] [Indexed: 02/04/2023]
Affiliation(s)
- Barry A Franklin
- Preventive Cardiology and Cardiac Rehabilitation, Beaumont Health (now Corewell Health), Royal Oak, MI, Oakland University William Beaumont School of Medicine, Rochester, MI.
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43
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Scheer JK, Costa F, Janela D, Molinos M, Areias AC, Moulder RG, Lains J, Bento V, Yanamadala V, Correia FD. Sleep Disturbance in Musculoskeletal Conditions: Impact of a Digital Care Program. J Pain Res 2023; 16:33-46. [PMID: 36636267 PMCID: PMC9830709 DOI: 10.2147/jpr.s394421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 12/16/2022] [Indexed: 01/06/2023] Open
Abstract
Background Musculoskeletal (MSK) pain is highly prevalent worldwide, resulting in significant disability, and comorbid sleep disturbances. Digital therapy for MSK pain can provide significant improvements in care access, alongside pain and disability reductions. However, studies on the effect of such programs on sleep are lacking. Purpose To evaluate the impact on pain-related sleep impairment after a 12-week remote multimodal digital care program (DCP) for MSK conditions. Patients and Methods This is an ad-hoc analysis of a decentralized single-arm study into engagement and clinical outcomes after a DCP for MSK rehabilitation. Patients were stratified by baseline sleep disturbance, based on sleep questions in the questionnaires: Oswestry Disability Index, Neck Disability Index, and the Quick Disabilities of the Arm, Shoulder and Hand questionnaire. Additional outcomes were pain, Generalized Anxiety Disorder 7-item scale, Patient Health 9-item questionnaire, Work Productivity, and Activity Impairment, and program engagement. Results At baseline, 5749 patients reported sleep disturbance (78.0% of eligible patients). These reported significantly worse clinical outcomes at baseline than patients without sleep disturbance (all p<0.001). Patients with comorbid sleep disturbance showed improvements in sleep, with a significant proportion reporting full recovery at program completion: 56% of patients with upper limb conditions (including 10% of patients with severe sleep disturbance at baseline), and 24% with spine conditions. These patients also reported significant improvements in all clinical outcomes at program completion. Engagement and satisfaction were high, and also higher than in patients without sleep impairment. Conclusion This is the first study of its kind investigating the effect of a completely remote DCP for MSK pain on sleep. Patients reporting comorbid sleep disturbance had significant improvement in sleep, alongside pain, mental health and work productivity at program completion. The results suggest that a DCP for MSK pain can improve sleep disturbances in patients with upper limb and spine conditions.
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Affiliation(s)
- Justin K Scheer
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | | | | | | | | | - Robert G Moulder
- Institute for Cognitive Science, University of Colorado Boulder, Boulder, CO, USA
| | - Jorge Lains
- Rovisco Pais Medical and Rehabilitation Centre, Tocha, Portugal,Faculty of Medicine, Coimbra University, Coimbra, Portugal
| | | | - Vijay Yanamadala
- Sword Health, Inc, Draper, UT, USA,Department of Surgery, Quinnipiac University Frank H. Netter School of Medicine, Hamden, CT, USA,Department of Neurosurgery, Hartford Healthcare Medical Group, Westport, CT, USA
| | - Fernando Dias Correia
- Sword Health, Inc, Draper, UT, USA,Neurology Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal,Correspondence: Fernando Dias Correia, Sword Health Inc, 13937 Sprague Lane Ste 100, Draper, UT, 84020, USA, Tel +1 385-308-8034, Fax +1 801-206-3433, Email
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Chen P, Zhang L, Sha S, Lam MI, Lok KI, Chow IHI, Si TL, Su Z, Cheung T, Feng Y, Jackson T, Xiang YT. Prevalence of insomnia and its association with quality of life among Macau residents shortly after the summer 2022 COVID-19 outbreak: A network analysis perspective. Front Psychiatry 2023; 14:1113122. [PMID: 36873201 PMCID: PMC9978518 DOI: 10.3389/fpsyt.2023.1113122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/26/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND The latest wave of the coronavirus disease 2019 (COVID-19) pandemic in Macau began on 18 June 2022 and was more serious than previous waves. Ensuing disruption from the wave is likely to have had a variety of negative mental health consequences for Macau residents including increased risk for insomnia. This study investigated the prevalence and correlates of insomnia among Macau residents during this wave as well as its association with quality of life (QoL) from a network analysis perspective. METHODS A cross-sectional study was conducted between 26 July and 9 September 2022. Univariate and multivariate analyses explored correlates of insomnia. Analysis of covariance (ANCOVA) examined the relationship between insomnia and QoL. Network analysis assessed the structure of insomnia including "Expected influence" to identify central symptoms in the network, and the flow function to identify specific symptoms that were directly associated with QoL. Network stability was examined using a case-dropping bootstrap procedure. RESULTS A total of 1,008 Macau residents were included in this study. The overall prevalence of insomnia was 49.0% (n = 494; 95% CI = 45.9-52.1%). A binary logistic regression analysis indicated people with insomnia were more likely to report depression (OR = 1.237; P < 0.001) and anxiety symptoms (OR = 1.119; P < 0.001), as well as being quarantined during the COVID-19 pandemic (OR = 1.172; P = 0.034). An ANCOVA found people with insomnia had lower QoL (F(1,1,008) = 17.45, P < 0.001). "Sleep maintenance" (ISI2), "Distress caused by the sleep difficulties" (ISI7) and "Interference with daytime functioning" (ISI5) were the most central symptoms in the insomnia network model, while "Sleep dissatisfaction" (ISI4), "Interference with daytime functioning" (ISI5), and "Distress caused by the sleep difficulties" (ISI7) had the strongest negative associations with QoL. CONCLUSION The high prevalence of insomnia among Macau residents during the COVID-19 pandemic warrants attention. Being quarantined during the pandemic and having psychiatric problems were correlates of insomnia. Future research should target central symptoms and symptoms linked to QoL observed in our network models to improve insomnia and QoL.
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Affiliation(s)
- Pan Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China.,Centre for Cognitive and Brain Sciences, University of Macau, Macao, Macao SAR, China
| | - Ling Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University & Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Sha Sha
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University & Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Mei Ieng Lam
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China.,Kiang Wu Nursing College of Macau, Macao, Macao SAR, China
| | - Ka-In Lok
- Kiang Wu Nursing College of Macau, Macao, Macao SAR, China
| | - Ines Hang Iao Chow
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China
| | - Tong Leong Si
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Yuan Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University & Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao, Macao SAR, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China.,Centre for Cognitive and Brain Sciences, University of Macau, Macao, Macao SAR, China
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Ai JY, Kuan G, Juang LYT, Lee CH, Kueh YC, Chu IH, Geng XL, Chang YK. Effects of Multi-Component Exercise on Sleep Quality in Middle-Aged Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15472. [PMID: 36497548 PMCID: PMC9737228 DOI: 10.3390/ijerph192315472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/28/2022] [Accepted: 11/10/2022] [Indexed: 06/17/2023]
Abstract
Sleep is a crucial factor in healthy aging. However, most middle-aged adults experience high levels of sleep disorders. While previous findings have suggested exercise training could benefit the quality of sleep, the effects of multi-component exercise on sleep quality are less examined. Accordingly, the current study aimed to assess the effectiveness of a multi-component exercise program on the quality of sleep among middle-aged adults. Twenty-four middle-aged adults were randomly assigned either to a multi-component exercise (MCE) group or a control group. The participants in the MCE group attended a 90-min session per week for 12 weeks. The control group was instructed to maintain their daily routine for 12 weeks. The primary outcome was the sleep quality evaluated by the Pittsburgh Sleep Quality Index (PSQI). The secondary outcome was physical fitness, including muscular strength and endurance, balance, and flexibility. Regarding sleep quality, the global mean score (p = 028), sleep disturbances (p = 011), and sleep efficiency (p = 035) of the PSQI scores were significantly reduced in the MCE group after the 12-week intervention. Regarding physical fitness, the flexibility of the MCE group improved significantly after the intervention (p = 028), yet, no significant change was observed in the control group. Additionally, the muscular strength of the control group declined significantly after the 12-week period (p = 034). Our results revealed the effectiveness of the MCE intervention in improving sleep quality and physical fitness in middle-aged adults. Further studies using larger sample sizes, objective measures of sleep quality, different types of exercise training, as well as different populations, are warranted to extend our current findings.
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Affiliation(s)
- Jing-Yi Ai
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei 106209, Taiwan
| | - Garry Kuan
- Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Linda Ya-Ting Juang
- Lifestyles of Health and Sustainability Executive Master of Business Administration, National Taiwan Normal University, Taipei 106209, Taiwan
| | - Ching-Hsiu Lee
- Lifestyles of Health and Sustainability Executive Master of Business Administration, National Taiwan Normal University, Taipei 106209, Taiwan
| | - Yee-Cheng Kueh
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - I-Hua Chu
- Department of Sports Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
- College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Xiao-Ling Geng
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei 106209, Taiwan
- Department of Wushu, Hong Kong Sports Institute, Hong Kong 999077, China
| | - Yu-Kai Chang
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei 106209, Taiwan
- Institute for Research Excellence in Learning Science, National Taiwan Normal University, Taipei 106209, Taiwan
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Immich G, Frisch D, Oberhauser C, Schuh A, Stier-Jarmer M. Effekte einer ambulanten Kneippkur als multimodale
Lebensstilintervention für die primäre Insomnie: eine
randomisierte kontrollierte Studie. PHYSIKALISCHE MEDIZIN, REHABILITATIONSMEDIZIN, KURORTMEDIZIN 2022. [DOI: 10.1055/a-1954-5007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Zusammenfassung
Einleitung In Deutschland leiden 6–10% der Menschen an
klinisch relevanten Schlafstörungen, insbesondere unter der arbeitenden
Bevölkerung. Werden diese chronisch, können sie zu
schwerwiegenden Erkrankungen führen und einen beträchtlichen
Teil der Abwesenheit vom Arbeitsplatz ausmachen. Deshalb wurde ein
Kneippkurprogramm für nicht-organische Schlafstörungen als ein
nicht-medikamentöses Behandlungskonzept im Kurort Füssen
entwickelt und überprüft.
Methodik Randomisierte monozentrische klinische Studie mit 5
Erhebungszeitpunkten (prä-/post-Intervention, 1, 3 und 6 Monate
nach Intervention). Intervention: 19-tägiges multimodales Kneippprogramm
(Ordnungstherapie, Hydro- und Thermotherapie, Bewegungstherapie).
Primäre Zielgröße: Subjektive Schlafqualität
(PSQI-Gesamtscore von 0–21 Punkte:≤5 Punkte=gesunder
Schlaf, PSQI-Wert 5–10 Punkte=schlechte Schlafqualität,
PSQI-Gesamtscore>10 Punkte=chronische Schlafstörung).
Sekundäre Zielgrößen: Allgemeines Wohlbefinden
(WHO-5-Wellbeing-Index), chronische Stressbelastung (TICS), dysfunktionale
Überzeugungen zum Schlaf (DAB-16), Teilnehmerzufriedenheit.
Ergebnisse 96 Erwachsene mit Schlafstörungen (mittleres Alter 56
Jahre, 83% weiblich) wurden in eine Interventionsgruppe IG
(N=47) und Wartekontrollgruppe WG (N=49) randomisiert. Zu
Studienbeginn gab es keine relevanten Gruppenunterschiede (PSQI-Gesamtwerte: IG
11,7±3,1, WG: 10,6±3,0). Nach 1, 3 und 6 Monaten erhöhte
sich der Anteil guter Schläfer deutlich stärker in IG versus WG:
34 vs. 10% nach 1 Monat, 40 vs. 12% nach 3 Monaten sowie 28 vs.
14% nach 6 Monaten. Nach 1, 3 und 6 Monaten reduzierte sich der mittlere
PSQI-Gesamtscore deutlich stärker in IG als in der WG:
− 4,44 Pkt. vs. − 1,14 Pkt. nach 1 Monat
(p=0,001), − 4,19 Pkt. vs. − 1,14 Pkt.
nach 3 Monaten (p=0,014]) und − 3,53 Pkt. vs.
− 1,28 Pkt. nach sechs Monaten (p=0,111). Dabei erzielte
die IG eine klinisch relevante Reduktion des PSQI-Scores von minus 3 Punkten zu
allen Messzeitpunkten im Follow-up. Vergleichbare positive Effekte zeigten sich
bei der IG bzgl. des allgemeinen Wohlbefindens, der chronischen Stressbelastung
und den dysfunktionalen Gedanken zum Schlaf.
Schlussfolgerung Die ambulante multimodale Kneippkur erzielte signifikante
Verbesserungen bei Schlafqualität und Wohlbefinden sowie eine Reduktion
der chronischen Stressbelastung bei Erwachsenen mit nicht-organischen
Schlafstörungen. Die Nachhaltigkeit der Effekte über 6 Monate
hinaus müssten in weiteren Studien untersucht werden.
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Affiliation(s)
- Gisela Immich
- Lehrstuhl für Public Health und Versorgungsforschung (IBE),
Pettenkofer School of Public Health, Ludwig-Maximilians-Universität,
München, Germany
| | - Dieter Frisch
- Institut für Evidenzbasierte Kurortmedizin und
Gesundheitsförderung (IKOM), Sachgebiet GE8, Bayerisches Landesamt
für Gesundheit und Lebensmittelsicherheit, Bad Kissingen, Germany
| | - Cornelia Oberhauser
- Lehrstuhl für Public Health und Versorgungsforschung (IBE),
Pettenkofer School of Public Health, Ludwig-Maximilians-Universität,
München, Germany
| | - Angela Schuh
- Lehrstuhl für Public Health und Versorgungsforschung (IBE),
Pettenkofer School of Public Health, Ludwig-Maximilians-Universität,
München, Germany
| | - Marita Stier-Jarmer
- Lehrstuhl für Public Health und Versorgungsforschung (IBE),
Pettenkofer School of Public Health, Ludwig-Maximilians-Universität,
München, Germany
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47
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Shiri R, Väänänen A, Mattila-Holappa P, Kauppi K, Borg P. The Effect of Healthy Lifestyle Changes on Work Ability and Mental Health Symptoms: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13206. [PMID: 36293787 PMCID: PMC9603567 DOI: 10.3390/ijerph192013206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/07/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE The effects of lifestyle interventions on the prevention of a decline in work ability and mental health are not well known. The aim of this randomized controlled trial was to examine the effects of healthy lifestyle changes on work ability, sleep, and mental health. METHODS Workers aged 18-65 years, who were free from cardiovascular diseases, diabetes, and malignant diseases, and did not use medication for obesity or lipids were included (N = 319). Based on their cholesterol balance, participants were classified into medium-risk and high-risk groups and were randomized into four arms: group lifestyle coaching (N = 107), individual lifestyle coaching (N = 53), the control group for group coaching (N = 106), and the control group for individual coaching (N = 53). The intervention groups received eight sessions of mostly remote coaching for 8 weeks about healthy diet, physical activity, other lifestyle habits, and sources/management of stress and sleep problems, and the control groups received no intervention. In individual coaching, the coach focused more on individual problem solving and the possibilities for motivation and change. The intention-to-treat principle was applied, and missing data on the outcomes were imputed using multiple imputation. RESULTS After the completion of the intervention, the risk of depressive symptoms was lower by 53% (95% CI 1-77%) in participants who received individual lifestyle coaching compared with the control group. The intervention had no beneficial effects on anxiety, work ability, sleep duration, or daily stress. In subgroup analyses, group lifestyle coaching had beneficial effects on depressive symptoms and work ability in participants with less tight schedules or less stretching work, whereas individual lifestyle coaching lowered the risk of depressive symptoms in those with fewer overlapping jobs, less tight schedules, or less stretching work. CONCLUSION Short but intensive remote lifestyle coaching can reduce depressive symptoms and improve work ability, and time-related resources at work may improve mental health in the context of individual lifestyle intervention. However, further randomized controlled trials are needed to confirm the findings.
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Affiliation(s)
- Rahman Shiri
- Finnish Institute of Occupational Health, Työterveyslaitos, P.O. Box 40, FI-00032 Helsinki, Finland
| | - Ari Väänänen
- Finnish Institute of Occupational Health, Työterveyslaitos, P.O. Box 40, FI-00032 Helsinki, Finland
| | - Pauliina Mattila-Holappa
- Finnish Institute of Occupational Health, Työterveyslaitos, P.O. Box 40, FI-00032 Helsinki, Finland
| | | | - Patrik Borg
- Aisti Health Ltd., FI-00120 Helsinki, Finland
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48
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Frange C, Franco AM, Brasil E, Hirata RP, Lino JA, Mortari DM, Ykeda DS, Leocádio-Miguel MA, D’Aurea CVR, Silva LOE, Telles SCL, Furlan SF, Peruchi BB, Leite CF, Yagihara FT, Campos LD, Ulhôa MA, Cruz MGDR, Beidacki R, Santos RB, de Queiroz SS, Barreto S, Piccin VS, Coelho FMS, Studart L, Assis M, Drager LF. Practice recommendations for the role of physiotherapy in the management of sleep disorders: the 2022 Brazilian Sleep Association Guidelines. Sleep Sci 2022; 15:515-573. [PMID: 36419815 PMCID: PMC9670776 DOI: 10.5935/1984-0063.20220083] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 09/19/2022] [Indexed: 08/13/2024] Open
Abstract
This clinical guideline supported by the Brazilian Sleep Association comprises a brief history of the development of Brazilian sleep physiotherapy, outlines the role of the physiotherapist as part of a sleep health team, and describes the clinical guidelines in respect of the management of some sleep disorders by the physiotherapist (including sleep breathing disorders, i.e., obstructive sleep apnea, central sleep apnea, upper airway resistance syndrome, hypoventilation syndromes and overlap syndrome, and pediatric sleep breathing disorders; sleep bruxism; circadian rhythms disturbances; insomnia; and Willis-Ekbom disease/periodic limb movement disorder. This clinical practice guideline reflects the state of the art at the time of publication and will be reviewed and updated as new information becomes available.
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Affiliation(s)
- Cristina Frange
- Departamento de Neurologia e Neurocirurgia, Escola Paulista de
Medicina (EPM), Universidade Federal de São Paulo (UNIFESP) - São
Paulo - SP - Brazil
- Associação Brasileira do Sono - São Paulo - SP
- Brazil
| | - Aline Marques Franco
- Associação Brasileira do Sono - São Paulo - SP
- Brazil
- Departamento de Neurociências e Ciências do
Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de
São Paulo (FMRP-USP) - Ribeirão Preto - SP - Brazil
| | - Evelyn Brasil
- Associação Brasileira do Sono - São Paulo - SP
- Brazil
- Departamento de Terapia Intensiva, Hospital Israelita Albert
Einstein (HIAE) - São Paulo - SP - Brazil
| | - Raquel Pastrello Hirata
- Associação Brasileira do Sono - São Paulo - SP
- Brazil
- Laboratório de Pesquisa em Fisioterapia Pulmonar,
Departamento de Fisioterapia, Universidade Estadual de Londrina (UEL) - Londrina -
PR - Brazil
| | - Juliana Arcanjo Lino
- Associação Brasileira do Sono - São Paulo - SP
- Brazil
- Ciências Médicas, Universidade Federal do
Ceará (UFC) - Fortaleza - CE - Brazil
| | - Daiana Moreira Mortari
- Associação Brasileira do Sono - São Paulo - SP
- Brazil
- Universidade Federal do Rio Grande do Sul - Porto Alegre - RS -
Brazil
| | - Daisy Satomi Ykeda
- Associação Brasileira do Sono - São Paulo - SP
- Brazil
- Curso de Fisioterapia, Universidade Estadual do Piauí
(UESPI) - Teresina - PI - Brazil
| | - Mario André Leocádio-Miguel
- Associação Brasileira do Sono - São Paulo - SP
- Brazil
- Departamento de Fisiologia e Comportamento, Universidade Federal do
Rio Grande do Norte - Natal - RN - Brazil
| | | | - Luciana Oliveira e Silva
- Associação Brasileira do Sono - São Paulo - SP
- Brazil
- Departamento de Ciências da Saúde, Universidade
Federal de Uberlândia (UFU) - Uberlândia - MG - Brazil
| | | | - Sofia Fontanello Furlan
- Associação Brasileira do Sono - São Paulo - SP
- Brazil
- Unidade de Hipertensão, Instituto do Coração
(InCor), Faculdade de Medicina, Universidade de São Paulo (USP) - São
Paulo - SP - Brazil
| | - Bruno Búrigo Peruchi
- Associação Brasileira do Sono - São Paulo - SP
- Brazil
- Laboratório de Neurociência, Universidade do Estado
de Santa Catarina (UNESC) - Criciúma - SC - Brazil
| | - Camila Ferreira Leite
- Associação Brasileira do Sono - São Paulo - SP
- Brazil
- Departamento de Fisioterapia, UFC; Programas de Mestrado em
Fisioterapia e Funcionalidade, e Mestrado em Ciências Cardiovasculares, UFC -
Fortaleza - CE - Brazil
| | - Fabiana Tokie Yagihara
- Associação Brasileira do Sono - São Paulo - SP
- Brazil
- Setor de Neurofisiologia Clínica, Departamento de
Neurologia e Neurocirurgia, EPM, UNIFESP - São Paulo - SP - Brazil
| | | | - Melissa Araújo Ulhôa
- Associação Brasileira do Sono - São Paulo - SP
- Brazil
- Instituto Metropolitano de Ensino Superior, Faculdade de Medicina
do Vale do Aço (UNIVAÇO) - Ipatinga - MG - Brazil
| | | | - Ricardo Beidacki
- Associação Brasileira do Sono - São Paulo - SP
- Brazil
- Faculdade Inspirar, Unidade Porto Alegre - Porto Alegre - RS -
Brazil
| | - Ronaldo Batista Santos
- Associação Brasileira do Sono - São Paulo - SP
- Brazil
- Departamento de Fisioterapia, Hospital Universitário, USP -
São Paulo - Brazil
| | | | - Simone Barreto
- Associação Brasileira do Sono - São Paulo - SP
- Brazil
- Instituto do Sono, Associação Fundo Incentivo
à Pesquisa - São Paulo - Brazil
| | - Vivien Schmeling Piccin
- Associação Brasileira do Sono - São Paulo - SP
- Brazil
- Laboratório do Sono, Divisão de Pneumologia do
Instituto do Coração (InCor), FMUSP, USP - São Paulo - SP -
Brazil
| | - Fernando Morgadinho Santos Coelho
- Departamento de Neurologia e Neurocirurgia, Escola Paulista de
Medicina (EPM), Universidade Federal de São Paulo (UNIFESP) - São
Paulo - SP - Brazil
- Associação Brasileira do Sono - São Paulo - SP
- Brazil
- Departamento de Psicobiologia, EPM, UNIFESP - São Paulo -
SP - Brazil
| | - Luciana Studart
- Associação Brasileira do Sono - São Paulo - SP
- Brazil
- Universidade Federal de Pernambuco - Recife - PE - Brazil
| | - Marcia Assis
- Associação Brasileira do Sono - São Paulo - SP
- Brazil
- Clínica do Sono de Curitiba, Hospital São Lucas -
Curitiba - PR - Brazil
| | - Luciano F. Drager
- Associação Brasileira do Sono - São Paulo - SP
- Brazil
- Unidade de Hipertensão, Instituto do Coração
(InCor), Faculdade de Medicina, Universidade de São Paulo (USP) - São
Paulo - SP - Brazil
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49
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Liao YG, Huang FZ, Ni XH, Ke HY, Tian Y, Yu M, Jin G, Chen GH. Effects of schedule exercise therapy on chronic insomnia. Medicine (Baltimore) 2022; 101:e30792. [PMID: 36197264 PMCID: PMC9509080 DOI: 10.1097/md.0000000000030792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Schedule exercise therapy (SET) is a novel nonpharmacological intervention for the treatment of chronic insomnia disorder (CID). The aim of this study was to explore the effects of SET on CID. Methods: One hundred and eighteen CID were recruited and randomized into medication (MED) or medication combined with SET (MSET) groups. Over 12 observational weeks, sleep and mood status were evaluated using the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Self-rating Depression Scale (SDS), and Self-rating Anxiety Scale (SAS). At the end of the observational period, the rates of clinically effective hypnotic use were calculated. At 12 weeks, the PSQI progressively decreased for all subjects combined (P < .001) as well as ISI (P < .001), ESS (P < .001), SDS (P < .001), and SAS (P < .001). The decreases in PSQI (P < .05), ISI (P < .05), SDS (P < .01), and SAS (P < .05) in the MSET group were significantly larger than those in the MED group, but not the same as those in the ESS group (P > .05). At the trial endpoint, the clinically effective rate was significantly higher (P < .05) and the hypnotic usage rate was lower (P < .05) in the MSET group than in the MED group. SET may be an effective treatment for insomnia in patients with CID.
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Affiliation(s)
- Yuan-Gao Liao
- Sleep Medical Center and Department of Neurology, Huanggang Central Hospital, Huanggang, China
| | - Feng-Zhen Huang
- Institute of Transitional Medicine at University of South China, Chenzhou, China
- Department of Neurology, the First People’s Hospital of Chenzhou, Chenzhou, China
| | - Xiao-Hong Ni
- Sleep Medical Center and Department of Neurology, Huanggang Central Hospital, Huanggang, China
| | - Hong-Yan Ke
- Sleep Medical Center and Department of Neurology, Huanggang Central Hospital, Huanggang, China
| | - Yu Tian
- Sleep Medical Center and Department of Neurology, Huanggang Central Hospital, Huanggang, China
| | - Mei Yu
- Sleep Medical Center and Department of Neurology, Huanggang Central Hospital, Huanggang, China
| | - Guo Jin
- Sleep Medical Center and Department of Neurology, Huanggang Central Hospital, Huanggang, China
| | - Gui-Hai Chen
- Department of Neurology (Sleep Disorders), the Affliated Chaohu Hospital of Anhui Medical University, Hefei (Chaohu), China
- *Correspondence: Gui-Hai Chen, Department of Neurology (Sleep Disorders), the Affliated Chaohu Hospital of Anhui Medical University, Hefei (Chaohu), 238000, China (e-mail: )
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50
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Aguilar-Latorre A, Pérez Algorta G, Navarro-Guzmán C, Serrano-Ripoll MJ, Oliván-Blázquez B. Effectiveness of a lifestyle modification programme in the treatment of depression symptoms in primary care. Front Med (Lausanne) 2022; 9:954644. [PMID: 35957845 PMCID: PMC9361711 DOI: 10.3389/fmed.2022.954644] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/07/2022] [Indexed: 11/19/2022] Open
Abstract
Background Depression symptoms are prevalent in the general population, and their onset and continuation may be related to biological and psychosocial factors, many of which are related to lifestyle aspects. Health promotion and lifestyle modification programmes (LMPs) may be effective on reducing the symptoms. The objective of this study was to analyse the clinical effectiveness of a LMP and a LMP plus Information and Communication Technologies, when compared to Treatment as Usual (TAU) over 6 months. The interventions were offered as an adjuvant treatment delivered in Primary Healthcare Centers (PHCs) for people with depression symptoms. Methods We conducted an open-label, multicentre, pragmatic, randomized clinical trial. Participants were recruited from several PHCs. Those participants visiting general practitioner for any reason, who also met the inclusion criteria (scoring 10 to 30 points on the Beck II Self-Applied Depression Inventory) were invited to take part in the study. TAU+LMP consisted of six weekly 90-min group sessions focused on improving lifestyle. TAU+LMP + ICTs replicated the TAU+LMP format, plus the addition of a wearable smartwatch to measure daily minutes walked and sleep patterns. A total of 188 participants consented to participate in the study and were randomized. We used linear mixed models, with a random intercept and an unstructured covariance to evaluate the impact of the interventions compared to TAU. Results Both interventions showed a statistically significant reduction on depressive symptoms compared to TAU (TAU+LMP vs. TAU slope difference, b = −3.38, 95% CI= [−5.286, −1.474] p = 0.001 and TAU+LMP+ICTs vs. TAU slope difference, b = −4.05, 95% CI = [−5.919, −2.197], p < 0.001). These reductions imply a moderate effect size. In the TAU+LMP+ICTs there was a significant increase regarding minutes walking per week (b = 99.77) and adherence to Mediterranean diet (b = 0.702). In the TAU+LMP there was a significant decrease regarding bad sleep quality (b = −1.24). Conclusion TAU+LMPs administered in PHCs to people experiencing depression symptoms were effective on reducing these symptoms compared to TAU. They also have a positive impact on changing several lifestyle factors. These findings indicate that these interventions can be promising strategies for PHCs.
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Affiliation(s)
- Alejandra Aguilar-Latorre
- Primary Healthcare Center Arrabal, Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
| | - Guillermo Pérez Algorta
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
| | | | - María J. Serrano-Ripoll
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Spain
- Research in Preventive Activities and Promotion and in Cancer Illes Balears (GRAPP-CAIB), Balearic Islands Health Research Institute (IdISBa), Palma, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
- *Correspondence: María J. Serrano-Ripoll
| | - Bárbara Oliván-Blázquez
- Primary Healthcare Center Arrabal, Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
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