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Polasek D, Santhi N, Alfonso-Miller P, Walshe IH, Haskell-Ramsay CF, Elder GJ. Nutritional interventions in treating menopause-related sleep disturbances: a systematic review. Nutr Rev 2024; 82:1087-1110. [PMID: 37695299 PMCID: PMC11233886 DOI: 10.1093/nutrit/nuad113] [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] [Indexed: 09/12/2023] Open
Abstract
CONTEXT Sleep disturbances are a core symptom of menopause, which refers to the permanent cessation of menstrual periods. Nutritional interventions may alleviate menopause-related sleep disturbances, as studies have shown that certain interventions (eg, tart cherry juice, or tryptophan-rich foods) can improve relevant aspects of sleep. OBJECTIVE The aim of this systematic review was to examine the effect of nutritional interventions for menopause-related sleep disturbances, in order to inform the subsequent development of specific interventional trials and assess their potential as a treatment for menopause-related sleep disturbances. DATA SOURCES Published studies in English were located by searching PubMed and PsycArticles databases (until September 15, 2022). DATA EXTRACTION Following full-text review, a final total of 59 articles were included. The search protocol was performed in accordance with PRISMA guidelines. DATA ANALYSIS A total of 37 studies reported that a nutritional intervention improved some aspect of sleep, and 22 studies observed no benefit. Most (n = 24) studies recruited postmenopausal women, 18 recruited menopausal women, 3 recruited perimenopausal women, and 14 recruited women from multiple groups. The majority of the studies were of low methodological quality. Due to the heterogeneity of the studies, a narrative synthesis without meta-analysis is reported. CONCLUSION Despite the large heterogeneity in the studies and choice of intervention, the majority of the identified studies reported that a nutritional intervention did benefit sleep, and that it is mainly subjective sleep that is improved. More high-quality, adequately powered, randomized controlled trials of the identified nutritional interventions are necessary. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42021262367.
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Affiliation(s)
- Dominik Polasek
- Northumbria Sleep Research, Northumbria University, Newcastle upon Tyne, UK
| | - Nayantara Santhi
- Northumbria Sleep Research, Northumbria University, Newcastle upon Tyne, UK
| | | | - Ian H Walshe
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, UK
| | - Crystal F Haskell-Ramsay
- Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Greg J Elder
- Northumbria Sleep Research, Northumbria University, Newcastle upon Tyne, UK
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Bai N, Cao J, Zhang H, Liu X, Yin M. Digital cognitive behavioural therapy for patients with insomnia and depression: A systematic review and meta-analysis. J Psychiatr Ment Health Nurs 2024; 31:654-667. [PMID: 38226714 DOI: 10.1111/jpm.13024] [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: 08/03/2023] [Revised: 12/01/2023] [Accepted: 01/07/2024] [Indexed: 01/17/2024]
Abstract
WHAT IS KNOWN ON THE SUBJECT Sleep problems are common among those with depression, and there is increasing evidence that sleep problems should be addressed during treatment simultaneously rather than treating depression alone. The first-line treatment for insomnia is cognitive behavioural therapy for insomnia (CBT-I), due to a lack of well-trained therapists and patient time constraints (travelling, work), CBT-I has not been popularized. The development of digital cognitive behavioural therapy for insomnia (dCBT-I) is making the treatment more accessible. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE Interventions for dCBT-I were significantly better than other control conditions in both reducing insomnia and improving depression in patients with depression and insomnia comorbidities. The effect was found to be related to the duration of the intervention and the severity of insomnia before the intervention and therapist-involved dCBT-I has less shedding than self-help. WHAT ARE THE IMPLICATIONS FOR PRACTICE It's important for mental health practitioners to realize that insomnia in depressed people needs to be treated. Future trials may explore the effectiveness of therapist-guided dCBT-I in depressed populations and analyse the cost-effectiveness of this treatment. ABSTRACT Aim The aim of the study was to systematically identify and synthesize the evidence for the effectiveness of digital cognitive behavioural therapy in insomnia with comorbid depression. Design Systematic review and metaanalysis. Methods A search was conducted on five English and four non-English databases from the inception of the databases to November 2023. This review adhered to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-analysis Statement 2020 and the included studies were evaluated using version 2 of the Cochrane risk of bias tool. This review examined sleep-related outcomes, including insomnia severity and sleep diaries, along with psychological outcomes, such as depression. We conducted a meta-analysis of each outcome using a random effects model. Heterogeneity was assessed by the I2 statistic. Results A total of seven articles with 1864 participants were included in this review. The results showed that the digital cognitive behavioural therapy group demonstrated a statistically significant amelioration in the severity of insomnia symptoms, as well as a reduction in depressive symptomatology compared with the control groups. The post-intervention effect was found to be related to the duration of the intervention and the severity of insomnia before the intervention. Conclusions Digital cognitive behavioural therapy for insomnia application in patients with depression and insomnia was demonstrated to be effective, less time-consuming and more accessible. Relevance to Clinical Practice We may consider incorporating nurses into treatment plans and conducting nurse-led interventions in specific programs. In the future, nurses may be able to provide exclusive digital behavioural therapy for insomnia to patients with depression to achieve greater effectiveness.
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Affiliation(s)
- Nan Bai
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Juling Cao
- Department of Psychiatry, Lanzhou University Second Hospital, Lanzhou, China
| | - Huiyue Zhang
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Xin Liu
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Min Yin
- School of Nursing, Lanzhou University, Lanzhou, China
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3
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Sarmiento KF, Gomez A, Atwood CW. Time for a unified federal sleep health care workforce? J Clin Sleep Med 2024; 20:847-848. [PMID: 38597894 PMCID: PMC11145038 DOI: 10.5664/jcsm.11158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 04/03/2024] [Indexed: 04/11/2024]
Affiliation(s)
- Kathleen F. Sarmiento
- Department of Medicine, San Francisco VA Health Care System, San Francisco, California
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, University of California San Francisco, San Francisco, California
| | - Alexander Gomez
- Department of Medicine, San Francisco VA Health Care System, San Francisco, California
| | - Charles W. Atwood
- Division of Sleep Medicine, Department of Medicine, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, UPMC, Pittsburgh, Pennsylvania
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4
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Ravyts SG, Dzierzewski JM. Sleep Disturbance, Mental Health Symptoms, and Quality of Life: A Structural Equation Model Assessing Aspects of Caregiver Burden. Clin Gerontol 2024; 47:484-493. [PMID: 32597344 PMCID: PMC7767889 DOI: 10.1080/07317115.2020.1783042] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES The present study sought to examine the association between sleep disturbance, mental health symptoms, and quality of life among informal caregivers. The study also aimed to assess whether greater caregiver demands (i.e., hours spent providing care per week) altered the associations between these physical and mental health outcomes. METHODS 530 informal caregivers participated in an online study of sleep and health across the lifespan. Sleep disturbance was assessed via the Insomnia Severity Index and RU-SATED. Mental health was measured using the PHQ-2, GAD-2, and the PANAS. Quality of life was assessed via the Satisfaction with Life Scale. RESULTS Results revealed an indirect association between sleep disturbance and quality of life via increased mental health symptoms (β = -.21, p =.001). This indirect association was moderated by caregiver demands (β =.33, p =.002), with higher caregiving demands increasing the association between sleep disturbance and quality of life. CONCLUSIONS Findings highlight the adverse outcomes associated with sleep disturbance among caregivers and suggest that higher caregiving demands increases the effect of sleep disturbance on quality of life. CLINICAL IMPLICATIONS Increased caregiving is associated with adverse physical and mental health consequences. Assessing and treating sleep disturbance among caregivers is needed and may lead to improvements in mental health and quality of life.
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Affiliation(s)
- Scott G Ravyts
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Joseph M Dzierzewski
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
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Rolling J, Ligier F, Rabot J, Bourgin P, Reynaud E, Schroder CM. Sleep and circadian rhythms in adolescents with attempted suicide. Sci Rep 2024; 14:8354. [PMID: 38594272 PMCID: PMC11004139 DOI: 10.1038/s41598-024-57921-2] [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: 10/23/2023] [Accepted: 03/22/2024] [Indexed: 04/11/2024] Open
Abstract
Sleep and circadian rhythm disorders are very common in adolescents and have been linked to suicidal ideation. However, little is known about adolescent sleep before a suicide attempt (SA). The objectives of this study were to compare the sleep of adolescents aged 13 to 18 over a period of 4 weeks before a SA compared to a non-SA group, then to analyze the association between sleep, support social and well-being based on information from validated questionnaires. In 2015, 250 adolescents were included, 55 were recruited the day after a SA in French hospitals (before SA evaluations were retrospective). Logistic regression analyzes showed that during school days, bedtime was equivalent in both groups, but sleep onset latency was significantly longer in SA (86 min vs. 52 min, p = 0.016), and wake-up time was earlier (6 h 22 vs. 6 h 47, p = 0.002), resulting in a shorter total sleep time of 44 min (OR = 0.76, CI 95% [0.61-0.93]) the month preceding SA. Adolescents with longer sleep time performed better on perceived psychological well-being (p = 0.005), relationship with parents (p = 0.011) and school environment (p < 0.001). Results indicate a significant change in the quantity and quality of adolescents' subjective sleep in the 4 weeks preceding SA requiring objective measures to study the predictive properties of sleep in SA.
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Affiliation(s)
- Julie Rolling
- Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals, 1 Porte de l'Hôpital, BP 426, 67091, Strasbourg Cedex, Strasbourg, France.
- Regional Center for Psychotraumatism Great East, Strasbourg University Hospital, Strasbourg, France.
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, University of Strasbourg, Strasbourg, France.
- Sleep Disorders Center, International Research Center for ChronoSomnology, Strasbourg University Hospitals, Strasbourg, France.
| | - Fabienne Ligier
- University Center for Child and Adolescent Psychiatry, Nancy Psychotherapeutic Center, University of Lorraine, Nancy, France
- EA4360 APEMAC, MICS, University of Lorraine, Nancy, France
| | - Juliette Rabot
- Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals, 1 Porte de l'Hôpital, BP 426, 67091, Strasbourg Cedex, Strasbourg, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, University of Strasbourg, Strasbourg, France
| | - Patrice Bourgin
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, University of Strasbourg, Strasbourg, France
- Sleep Disorders Center, International Research Center for ChronoSomnology, Strasbourg University Hospitals, Strasbourg, France
| | - Eve Reynaud
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, University of Strasbourg, Strasbourg, France
- Centre de Recherche en Neurosciences de Lyon CRNL U1028, UMR5292, Université Claude Bernard Lyon 1, CNRS, INSERM, Forgetting, Bron, France
| | - Carmen M Schroder
- Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals, 1 Porte de l'Hôpital, BP 426, 67091, Strasbourg Cedex, Strasbourg, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, University of Strasbourg, Strasbourg, France
- Sleep Disorders Center, International Research Center for ChronoSomnology, Strasbourg University Hospitals, Strasbourg, France
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Garcia CC, Richards DK, Tuchman FR, Hallgren KA, Kranzler HR, Aubin HJ, O’Malley SS, Mann K, Aldridge A, Hoffman M, Anton RF, Witkiewitz K. Reductions in World Health Organization risk drinking level are associated with improvements in sleep problems among individuals with alcohol use disorder. Alcohol Alcohol 2024; 59:agae022. [PMID: 38606931 PMCID: PMC11010310 DOI: 10.1093/alcalc/agae022] [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: 10/26/2023] [Revised: 02/19/2024] [Accepted: 03/17/2024] [Indexed: 04/13/2024] Open
Abstract
AIMS Among individuals with alcohol use disorder (AUD), sleep disturbances are pervasive and contribute to the etiology and maintenance of AUD. However, despite increased attention toward the relationship between alcohol use and sleep, limited empirical research has systematically examined whether reductions in drinking during treatment for AUD are associated with improvements in sleep problems. METHODS We used data from a multisite, randomized, controlled trial that compared 6 months of treatment with gabapentin enacarbil extended-release with placebo for adults with moderate-to-severe AUD (N = 346). The Timeline Follow-back was used to assess WHO risk drinking level reductions and the Pittsburgh Sleep Quality Index was used to assess sleep quality over the prior month at baseline and the end of treatment. RESULTS Sleep problem scores in the active medication and placebo groups improved equally. Fewer sleep problems were noted among individuals who achieved at least a 1-level reduction (B = -0.99, 95% confidence interval (CI) [-1.77, -0.20], P = .014) or at least a 2-level reduction (B = -0.80, 95% CI [-1.47, -0.14], P = .018) in WHO risk drinking levels at the end of treatment. Reductions in drinking, with abstainers excluded from the analysis, also predicted fewer sleep problems at the end of treatment (1-level: B = -1.01, 95% CI [-1.83, -0.20], P = .015; 2-level: B = -0.90, 95% CI [-1.59, -0.22], P = .010). CONCLUSIONS Drinking reductions, including those short of abstinence, are associated with improvements in sleep problems during treatment for AUD. Additional assessment of the causal relationships between harm-reduction approaches to AUD and improvements in sleep is warranted.
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Affiliation(s)
- Christian C Garcia
- Center on Alcohol, Substance use, And Addictions (CASAA), University of New Mexico, Albuquerque, NM, 87106, United States
| | - Dylan K Richards
- Center on Alcohol, Substance use, And Addictions (CASAA), University of New Mexico, Albuquerque, NM, 87106, United States
| | - Felicia R Tuchman
- Department of Psychology, University of New Mexico, Albuquerque, NM, 87131, United States
| | - Kevin A Hallgren
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, 98195, United States
| | - Henry R Kranzler
- Center for Studies of Addiction, Perelman School of Medicine, University of Pennsylvania and Mental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, PA, 19104, United States
| | - Henri-Jean Aubin
- Université Paris-Saclay, Unive Paris-Sud, Université de Versailles Saint-Quentin-en-Yvelines, Center for Research in Epidemiology and Population Health, Institut national de la santé et de la recherche médicale, Villejuif, France
- APHP, Hôpitaux Universitaires Paris-Sud, Villejuif, 94800, France
| | - Stephanie S O’Malley
- Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, CT, 06511, United States
| | - Karl Mann
- Zentralinstitut für Seelische Gesundheit (ZI), Mannheim, Baden-Württemberg, 68159, Germany
| | - Arnie Aldridge
- Behavioral Health Financing, Economics and Evaluation Department, Research Triangle Institute International (RTI), Research Triangle Park, NC, 27709, United States
| | - Michaela Hoffman
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, 29425, United States
| | - Raymond F Anton
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, 29425, United States
| | - Katie Witkiewitz
- Center on Alcohol, Substance use, And Addictions (CASAA), University of New Mexico, Albuquerque, NM, 87106, United States
- Department of Psychology, University of New Mexico, Albuquerque, NM, 87131, United States
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Carpi M, Palagini L, Fernandes M, Calvello C, Geoffroy PA, Miniati M, Pini S, Gemignani A, Mercuri NB, Liguori C. Clinical usefulness of dual orexin receptor antagonism beyond insomnia: Neurological and psychiatric comorbidities. Neuropharmacology 2024; 245:109815. [PMID: 38114045 DOI: 10.1016/j.neuropharm.2023.109815] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/21/2023]
Abstract
Orexin is a neurotransmitter produced by a small group of hypothalamic neurons. Besides its well-known role in the regulation of the sleep-wake cycle, the orexin system was shown to be relevant in several physiological functions including cognition, mood and emotion modulation, and energy homeostasis. Indeed, the implication of orexin neurotransmission in neurological and psychiatric diseases has been hypothesized via a direct effect exerted by the projections of orexin neurons to several brain areas, and via an indirect effect through orexin-mediated modulation of sleep and wake. Along with the growing evidence concerning the use of dual orexin receptor antagonists (DORAs) in the treatment of insomnia, studies assessing their efficacy in insomnia comorbid with psychiatric and neurological diseases have been set in order to investigate the potential impact of DORAs on both sleep-related symptoms and disease-specific manifestations. This narrative review aimed at summarizing the current evidence on the use of DORAs in neurological and psychiatric conditions comorbid with insomnia, also discussing the possible implication of modulating the orexin system for improving the burden of symptoms and the pathological mechanisms of these disorders. Target searches were performed on PubMed/MEDLINE and Scopus databases and ongoing studies registered on Clinicaltrials.gov were reviewed. Despite some contradictory findings, preclinical studies seemingly support the possible beneficial role of orexin antagonism in the management of the most common neurological and psychiatric diseases with sleep-related comorbidities. However, clinical research is still limited and further studies are needed for corroborating these promising preliminary results.
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Affiliation(s)
- Matteo Carpi
- Sleep and Epilepsy Centre, Neurology Unit, University Hospital Tor Vergata, Rome, Italy.
| | - Laura Palagini
- Department of Clinical and Experimental Medicine, Unit of Psychiatry, Azienda Ospedaliero Universitaria Pisana AUOP, Pisa, Italy.
| | - Mariana Fernandes
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
| | - Carmen Calvello
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
| | - Pierre Alexis Geoffroy
- Département de Psychiatrie et D'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, F-75018, Paris, France; GHU Paris - Psychiatry & Neurosciences, Paris, France; Université de Paris, NeuroDiderot, Inserm, FHU I2-D2, F-75019, Paris, France.
| | - Mario Miniati
- Department of Clinical and Experimental Medicine, Unit of Psychiatry, Azienda Ospedaliero Universitaria Pisana AUOP, Pisa, Italy.
| | - Stefano Pini
- Department of Clinical and Experimental Medicine, Unit of Psychiatry, Azienda Ospedaliero Universitaria Pisana AUOP, Pisa, Italy.
| | - Angelo Gemignani
- Unit of Psychology, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Azienda Ospedaliero Universitaria Pisana AUOP, Pisa, Italy.
| | | | - Claudio Liguori
- Sleep and Epilepsy Centre, Neurology Unit, University Hospital Tor Vergata, Rome, Italy; Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
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Guerrera CS, Boccaccio FM, Varrasi S, Platania GA, Coco M, Pirrone C, Castellano S, Caraci F, Ferri R, Lanza G. A narrative review on insomnia and hypersomnolence within Major Depressive Disorder and bipolar disorder: A proposal for a novel psychometric protocol. Neurosci Biobehav Rev 2024; 158:105575. [PMID: 38331126 DOI: 10.1016/j.neubiorev.2024.105575] [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: 07/03/2023] [Revised: 01/27/2024] [Accepted: 02/03/2024] [Indexed: 02/10/2024]
Abstract
Sleep disorders have become increasingly prevalent, with many adults worldwide reporting sleep dissatisfaction. Major Depressive Disorder (MDD) and Bipolar Disorder (BD) are common conditions associated with disrupted sleep patterns such as insomnia and hypersomnolence. These sleep disorders significantly affect the progression, severity, treatment, and outcome of unipolar and bipolar depression. While there is evidence of a connection between sleep disorders and depression, it remains unclear if sleep features differ between MDD and BD. In light of this, this narrative review aims to: (1) summarize findings on common sleep disorders like insomnia and hypersomnolence, strongly linked to MDD and BD; (2) propose a novel psychometric approach to assess sleep in individuals with depressive disorders. Despite insomnia seems to be more influent in unipolar depression, while hypersomnolence in bipolar one, there is no common agreement. So, it is essential adopting a comprehensive psychometric protocol for try to fill this gap. Understanding the relationship between sleep and MDD and BD disorders are crucial for effective management and better quality of life for those affected.
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Affiliation(s)
- Claudia Savia Guerrera
- Department of Educational Sciences, University of Catania, Via Biblioteca, 4, 95124 Catania, Italy; Department of Biomedical and Biotechnological Sciences, University of Catania, Torre Biologica, Via Santa Sofia, 97, 95123 Catania, Italy.
| | | | - Simone Varrasi
- Department of Educational Sciences, University of Catania, Via Biblioteca, 4, 95124 Catania, Italy
| | | | - Marinella Coco
- Department of Educational Sciences, University of Catania, Via Biblioteca, 4, 95124 Catania, Italy
| | - Concetta Pirrone
- Department of Educational Sciences, University of Catania, Via Biblioteca, 4, 95124 Catania, Italy
| | - Sabrina Castellano
- Department of Educational Sciences, University of Catania, Via Biblioteca, 4, 95124 Catania, Italy
| | - Filippo Caraci
- Department of Drug and Health Sciences, University of Catania, Cittadella Universitaria, Via Santa Sofia, 95123 Catania, Italy; Unit of Neuropharmacology and Translation Neurosciences, Oasi Research Institute - IRCCS, Via Conte Ruggero 73, 94018 Troina, En, Italy
| | - Raffaele Ferri
- Sleep Research Centre, Department of Neurology IC, Oasi Research Institute - IRCCS, Via Conte Ruggero 73, 94018 Troina, En, Italy
| | - Giuseppe Lanza
- Unit of Neuropharmacology and Translation Neurosciences, Oasi Research Institute - IRCCS, Via Conte Ruggero 73, 94018 Troina, En, Italy; Department of Surgery and Medical-Surgical Specialties, University of Catania, A.O.U. "Policlinico - San Marco", Via Santa Sofia, 78, 95123 Catania, Italy
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Pengsuwankasem N, Sittiprapaporn P, Rattanabun W, Sangmanee N, Wongsuphasawat K, Rintra J, Nararatwanchai T, Sarikaphuti A, Pandii W. The effect of short daytime napping on cognitive function, sleep quality, and quality of life in mild cognitive impairment patients. Neurosci Lett 2023; 817:137499. [PMID: 37838328 DOI: 10.1016/j.neulet.2023.137499] [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: 06/13/2023] [Revised: 09/25/2023] [Accepted: 09/27/2023] [Indexed: 10/16/2023]
Abstract
Mild cognitive impairment (MCI) is a neurological disorder that can increase the risk of Alzheimer's disease (AD) by three to five times more than those with normal cognition. To better understand the effects of daytime napping on MCI patients, a study was conducted to measure the effects of short naps on cognitive function, sleep quality, and quality of life. In total, 38 participants were asked to take 20-minute naps between 1:00p.m. and 3:00p.m. three times a week for eight weeks. The cognitive function of the participants was measured using the Thai version of the Montreal Cognitive Assessment (Thai-MoCA), their sleep quality was measured using the Thai version of the Pittsburgh Sleep Quality Index (Thai-PSQI), and their quality of life was measured using the Thai version of the Quality of Life (Thai-QoL) questionnaire. After the 8-week period, the participants' scores for the Thai-MoCA and the Thai-QoL questionnaire showed a significant improvement (p < 0.001 for both), while the Thai-PSQI decreased significantly (p = 0.012). This suggests that taking short daytime naps can help to improve the cognitive function, sleep quality, and quality of life of MCI patients.
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Affiliation(s)
- Nuttapon Pengsuwankasem
- Neuropsychological Research Laboratory, Neuroscience Research Center, School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok 10110, Thailand; Department of Anti-Aging and Regenerative Science, School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok 10110, Thailand.
| | - Phakkharawat Sittiprapaporn
- Neuropsychological Research Laboratory, Neuroscience Research Center, School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok 10110, Thailand; Department of Anti-Aging and Regenerative Science, School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok 10110, Thailand.
| | - Warongporn Rattanabun
- Neuropsychological Research Laboratory, Neuroscience Research Center, School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok 10110, Thailand; Department of Anti-Aging and Regenerative Science, School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok 10110, Thailand.
| | - Nipapan Sangmanee
- Neuropsychological Research Laboratory, Neuroscience Research Center, School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok 10110, Thailand; Department of Anti-Aging and Regenerative Medicine, School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok 10110, Thailand.
| | - Karnt Wongsuphasawat
- Department of Anti-Aging and Regenerative Science, School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok 10110, Thailand.
| | - Jarasphol Rintra
- Department of Anti-Aging and Regenerative Medicine, School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok 10110, Thailand.
| | - Thamthiwat Nararatwanchai
- Department of Anti-Aging and Regenerative Medicine, School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok 10110, Thailand.
| | - Araya Sarikaphuti
- Department of Anti-Aging and Regenerative Science, School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok 10110, Thailand.
| | - Wongdyan Pandii
- Department of Anti-Aging and Regenerative Science, School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok 10110, Thailand.
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Mlyncekova Z, Hutka P, Visnovcova Z, Ferencova N, Kovacova V, Macejova A, Tonhajzerova I, Ondrejka I. Effects of Vortioxetine on Sleep Architecture of Adolescents with Major Depressive Disorder. Clocks Sleep 2023; 5:627-638. [PMID: 37987393 PMCID: PMC10660849 DOI: 10.3390/clockssleep5040042] [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: 08/25/2023] [Revised: 10/17/2023] [Accepted: 10/22/2023] [Indexed: 11/22/2023] Open
Abstract
The relationship between depression and insomnia is bidirectional and both conditions need to be treated adequately, especially in a vulnerable neurodevelopmental stage of adolescence. This study aimed to evaluate the effects of antidepressant treatment using vortioxetine (VOR) on the sleep architecture of depressed adolescents by using video-polysomnography (v-PSG), which has not been researched before. The v-PSG was performed on 30 adolescent in-patients (mean age of 15.0 years ± 1.5 SD, 21 girls) treated with VOR (dosage of 10/15/20 mg/day) administered orally once a day, before and after VOR treatment. The evaluated parameters were conventional sleep parameters, sleep fragmentation parameters, and selected spectral power indices. Symptoms of depression and insomnia before and after the treatment period were evaluated using valid and reliable questionnaires (the Children´s Depression Inventory and the Athens Insomnia Scale). Depressed adolescents showed higher REM latency and decreased REM sleep percentage after treatment than before the treatment period (p = 0.005, p = 0.009, respectively). Our study revealed REM suppression (increased REM latency and reduced REM sleep percentage), indicating altered sleep architecture as a potential result of VOR treatment, which seems to be dose-dependent.
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Affiliation(s)
- Zuzana Mlyncekova
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, University Hospital Martin, Comenius University in Bratislava, Kollarova 2, 03601 Martin, Slovakia; (Z.M.); (P.H.); (V.K.); (A.M.)
| | - Peter Hutka
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, University Hospital Martin, Comenius University in Bratislava, Kollarova 2, 03601 Martin, Slovakia; (Z.M.); (P.H.); (V.K.); (A.M.)
| | - Zuzana Visnovcova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4D, 03601 Martin, Slovakia; (Z.V.); (N.F.)
| | - Nikola Ferencova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4D, 03601 Martin, Slovakia; (Z.V.); (N.F.)
| | - Veronika Kovacova
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, University Hospital Martin, Comenius University in Bratislava, Kollarova 2, 03601 Martin, Slovakia; (Z.M.); (P.H.); (V.K.); (A.M.)
| | - Andrea Macejova
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, University Hospital Martin, Comenius University in Bratislava, Kollarova 2, 03601 Martin, Slovakia; (Z.M.); (P.H.); (V.K.); (A.M.)
| | - Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 03601 Martin, Slovakia;
| | - Igor Ondrejka
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, University Hospital Martin, Comenius University in Bratislava, Kollarova 2, 03601 Martin, Slovakia; (Z.M.); (P.H.); (V.K.); (A.M.)
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11
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Kim K, Kim H, Kong J, Kim JB. Enhanced functional connectivity in the reward circuitry in healthy adults with weekend catch-up sleep. Hum Brain Mapp 2023; 44:4927-4937. [PMID: 37466297 PMCID: PMC10472906 DOI: 10.1002/hbm.26429] [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: 12/18/2022] [Revised: 05/16/2023] [Accepted: 07/05/2023] [Indexed: 07/20/2023] Open
Abstract
We aimed to identify structural and functional changes in healthy adults with catch-up sleep (CUS), we applied seed-based functional connectivity (FC) analysis using resting-state functional magnetic resonance imaging (MRI). We hypothesized that deficits in reward processing could be a fundamental mechanism underlying the motivation of taking CUS. Then, 55 healthy adults voluntarily (34 with CUS and 21 without CUS) participated in this study. Voxel-based morphometry was performed to explore region of gray matter volume (GMV) difference between CUS and non-CUS groups. Between-group comparison of FC was then carried out using resting-state functional MRI analysis seeding at the region of volume difference. Moreover, the region of volume difference and the strength of FC were correlated with scores of questionnaires for reward-seeking behavior and clinical variables. CUS group had a higher reward-seeking tendency, and increased GMV in the bilateral nucleus accumbens and right superior frontal gyrus relative to non-CUS group. FC analysis seeding at the bilateral accumbens revealed increases of FC in the bilateral medial prefrontal cortex in CUS group compared to non-CUS group. The questionnaire scores reflecting the reward-seeking tendency were correlated with the FC strength between bilateral accumbens and medial prefrontal cortex. Our results indicate that CUS is associated with reward-seeking tendency and increased GMV and FC in regions responsible for reward network. Our findings suggest that enhanced reward network could be the crucial mechanism underlying taking CUS and might be implicated in the detrimental effects of circadian misalignment.
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Affiliation(s)
- Keun‐Tae Kim
- Department of NeurologyKorea University Anam Hospital, Korea University College of MedicineSeoulRepublic of Korea
| | - Hayom Kim
- Department of NeurologyKorea University Anam Hospital, Korea University College of MedicineSeoulRepublic of Korea
| | - Jooheon Kong
- Department of NeurologyKorea University Anam Hospital, Korea University College of MedicineSeoulRepublic of Korea
| | - Jung Bin Kim
- Department of NeurologyKorea University Anam Hospital, Korea University College of MedicineSeoulRepublic of Korea
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12
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Kristbergsdottir H, Schmitz L, Arnardottir ES, Islind AS. Evaluating User Compliance in Mobile Health Apps: Insights from a 90-Day Study Using a Digital Sleep Diary. Diagnostics (Basel) 2023; 13:2883. [PMID: 37761250 PMCID: PMC10528147 DOI: 10.3390/diagnostics13182883] [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: 06/22/2023] [Revised: 08/31/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
Sleep diaries are the gold standard for subjective assessment of sleep variables in clinical practice. Digitization of sleep diaries is needed, as paper versions are prone to human error, memory bias, and difficulties monitoring compliance. METHODS 45 healthy eligible participants (Mage = 50.3 years, range 23-74, 56% female) were asked to use a sleep diary mobile app for 90 consecutive days. Univariate and bivariate analysis was used for group comparison and linear regression for analyzing reporting trends and compliance over time. RESULTS Overall compliance was high in the first two study months but tended to decrease over time (p < 0.001). Morning and evening diary entries were highly correlated (r = 0.932, p < 0.001) and participants significantly answered on average 4.1 days (95% CI [1.7, 6.6]) more often in the morning (M = 60.2, sd = 22.1) than evening ((M = 56.1, sd = 22.2), p < 0.001). CONCLUSION Using a daily diary assessment in a longitudinal sleep study with a sleep diary delivered through a mobile application was feasible, and compliance in this study was satisfactory.
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Affiliation(s)
- Hlín Kristbergsdottir
- Department of Psychology, Reykjavik University, 102 Reykjavík, Iceland
- Reykjavik University Sleep Institute, 102 Reykjavík, Iceland; (E.S.A.); (A.S.I.)
| | - Lisa Schmitz
- Reykjavik University Sleep Institute, 102 Reykjavík, Iceland; (E.S.A.); (A.S.I.)
- Department of Computer Science, Reykjavik University, 102 Reykjavík, Iceland
| | - Erna Sif Arnardottir
- Reykjavik University Sleep Institute, 102 Reykjavík, Iceland; (E.S.A.); (A.S.I.)
| | - Anna Sigridur Islind
- Reykjavik University Sleep Institute, 102 Reykjavík, Iceland; (E.S.A.); (A.S.I.)
- Department of Computer Science, Reykjavik University, 102 Reykjavík, Iceland
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13
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Li Y, Que M, Wang X, Zhan G, Zhou Z, Luo X, Li S. Exploring Astrocyte-Mediated Mechanisms in Sleep Disorders and Comorbidity. Biomedicines 2023; 11:2476. [PMID: 37760916 PMCID: PMC10525869 DOI: 10.3390/biomedicines11092476] [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: 07/07/2023] [Revised: 08/25/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
Astrocytes, the most abundant cells in the brain, are integral to sleep regulation. In the context of a healthy neural environment, these glial cells exert a profound influence on the sleep-wake cycle, modulating both rapid eye movement (REM) and non-REM sleep phases. However, emerging literature underscores perturbations in astrocytic function as potential etiological factors in sleep disorders, either as protopathy or comorbidity. As known, sleep disorders significantly increase the risk of neurodegenerative, cardiovascular, metabolic, or psychiatric diseases. Meanwhile, sleep disorders are commonly screened as comorbidities in various neurodegenerative diseases, epilepsy, and others. Building on existing research that examines the role of astrocytes in sleep disorders, this review aims to elucidate the potential mechanisms by which astrocytes influence sleep regulation and contribute to sleep disorders in the varied settings of brain diseases. The review emphasizes the significance of astrocyte-mediated mechanisms in sleep disorders and their associated comorbidities, highlighting the need for further research.
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Affiliation(s)
- Yujuan Li
- Department of Anesthesiology, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, China; (Y.L.); (M.Q.); (X.W.); (G.Z.); (Z.Z.)
| | - Mengxin Que
- Department of Anesthesiology, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, China; (Y.L.); (M.Q.); (X.W.); (G.Z.); (Z.Z.)
| | - Xuan Wang
- Department of Anesthesiology, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, China; (Y.L.); (M.Q.); (X.W.); (G.Z.); (Z.Z.)
| | - Gaofeng Zhan
- Department of Anesthesiology, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, China; (Y.L.); (M.Q.); (X.W.); (G.Z.); (Z.Z.)
| | - Zhiqiang Zhou
- Department of Anesthesiology, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, China; (Y.L.); (M.Q.); (X.W.); (G.Z.); (Z.Z.)
| | - Xiaoxiao Luo
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Shiyong Li
- Department of Anesthesiology, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, China; (Y.L.); (M.Q.); (X.W.); (G.Z.); (Z.Z.)
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14
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Cao X, Zhou J, Liu J, Chen H, Zheng W. Aromatherapy in anxiety, depression, and insomnia: A bibliometric study and visualization analysis. Heliyon 2023; 9:e18380. [PMID: 37519641 PMCID: PMC10375858 DOI: 10.1016/j.heliyon.2023.e18380] [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: 12/20/2022] [Revised: 06/22/2023] [Accepted: 07/16/2023] [Indexed: 08/01/2023] Open
Abstract
Aromatherapy is a natural treatment method that uses essential oils (EOs) extracted from aromatic plants; EOs and their components exhibit a wide range of pharmacological activities, with a special focus on their implementation toward mental disorders, such as anxiety and depression. This study aimed to identify the scientific output and activity related to aromatherapy in anxiety, depression, and insomnia through bibliometric approaches. In this bibliometric study, we utilized CiteSpace and VOSviewer to evaluate the Web of Science Core Collection publications and to build visualizing maps to analyze the research progress on this topic between 2001 and 2021. A total of 1159 original and review articles in English, published in 578 different peer-reviewed journals by 260 authors, were identified. In the recent two decades, there was a steady increase in the number of published articles, especially in the following five years. All publications were distributed among 88 countries/regions. The United States had the most publications, with 188 (16.22%) articles, followed by China [131 (11.30%)], Brazil [110 (9.49%)], and Japan [85 (7.33%)]. Most studies were published in the Journal of Ethnopharmacology, and Physiology & Behavior was the most cited journal. Hritcu L was the top published scientist and Gupta SC was the most frequently co-cited. The knowledge base of this field research mainly included the related efficacy of aromatherapy/EOs, application status, and biochemical mechanism. And the keyword co-occurrence analysis revealed that the topics "oxidative stress," "chemical composition," "systematic review," and "sleep quality" were research frontiers. In conclusion, this comprehensive bibliometric study provides an updated perspective on research hotspots of aromatherapy in anxiety or depression and developmental tendencies of natural remedies for mental health. In addition, this study could also provide valuable information for research teams, practitioners, and decision-makers when designing and implementing natural treatment methods for mental health-promoting interventions for individuals with mood disorders.
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Affiliation(s)
- Xia Cao
- Health Management Center, The Third Xiangya Hospital of Central South University, China
| | - Jiansong Zhou
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, China
| | - Jiali Liu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, China
| | - Hui Chen
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, China
| | - Wei Zheng
- Department of Radiology, The Third Xiangya Hospital of Central South University, China
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15
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Que M, Li Y, Wang X, Zhan G, Luo X, Zhou Z. Role of astrocytes in sleep deprivation: accomplices, resisters, or bystanders? Front Cell Neurosci 2023; 17:1188306. [PMID: 37435045 PMCID: PMC10330732 DOI: 10.3389/fncel.2023.1188306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/05/2023] [Indexed: 07/13/2023] Open
Abstract
Sleep plays an essential role in all studied animals with a nervous system. However, sleep deprivation leads to various pathological changes and neurobehavioral problems. Astrocytes are the most abundant cells in the brain and are involved in various important functions, including neurotransmitter and ion homeostasis, synaptic and neuronal modulation, and blood-brain barrier maintenance; furthermore, they are associated with numerous neurodegenerative diseases, pain, and mood disorders. Moreover, astrocytes are increasingly being recognized as vital contributors to the regulation of sleep-wake cycles, both locally and in specific neural circuits. In this review, we begin by describing the role of astrocytes in regulating sleep and circadian rhythms, focusing on: (i) neuronal activity; (ii) metabolism; (iii) the glymphatic system; (iv) neuroinflammation; and (v) astrocyte-microglia cross-talk. Moreover, we review the role of astrocytes in sleep deprivation comorbidities and sleep deprivation-related brain disorders. Finally, we discuss potential interventions targeting astrocytes to prevent or treat sleep deprivation-related brain disorders. Pursuing these questions would pave the way for a deeper understanding of the cellular and neural mechanisms underlying sleep deprivation-comorbid brain disorders.
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Affiliation(s)
- Mengxin Que
- Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Department of Anesthesiology, Tongji Medical College, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Yujuan Li
- Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Department of Anesthesiology, Tongji Medical College, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Xuan Wang
- Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Department of Anesthesiology, Tongji Medical College, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Gaofeng Zhan
- Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Department of Anesthesiology, Tongji Medical College, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoxiao Luo
- Department of Oncology, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Zhiqiang Zhou
- Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Department of Anesthesiology, Tongji Medical College, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
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16
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Chang CH, Wu HC, Hsieh YR, Lai WD, Tung TH, Huang JJ, Kao WY, Huang SY. Modulatory effect of n-3 polyunsaturated fatty acids on depressive-like behaviors in rats with chronic sleep deprivation: potential involvement of melatonin receptor pathway and brain lipidome. Food Funct 2023. [PMID: 37334912 DOI: 10.1039/d3fo01452e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Clinical evidence suggests that a bidirectional relationship is present between sleep loss and psychiatric disorders. Both melatonin receptor agonist ramelteon (RMT) and n-3 polyunsaturated fatty acids (n-3 PUFAs) exhibit antidepressant effects, while their underlying molecular mechanisms might be different. Thus, the present study aims to investigate the add-on effects and possible mechanisms of how RMT and different n-3 PUFAs modulate the melatonin receptor pathway as well as brain lipidome to ameliorate the neuropsychiatric behaviors displayed in rats under chronic sleep deprivation. Thirty-one 6-week-old male Wistar rats were divided into five groups: control (C), sleep deprivation (S), sleep deprivation treated with RMT (SR), sleep deprivation treated with RMT and eicosapentaenoic acid (C20:5n-3, EPA) (SRE), and sleep deprivation treated with RMT and docosahexaenoic acid (C22:6n-3, DHA) (SRD) groups. The results reveal that RMT plus EPA alleviated depressive-like behavior when the rats were subjected to the forced swimming test, whereas RMT plus DHA alleviated anxiety-like behavior when the rats were subjected to the elevated plus maze test. The results of a western blot analysis further revealed that compared with the rats in the S group, those in the SRE and SRD groups exhibited a significantly increased expression of MT2 in the prefrontal cortex, with greater benefits observed in the SRE group. In addition, decreased BDNF and TrkB expression levels were upregulated only in the SRE group. Lipidomic analysis further revealed possible involvement of aberrant lipid metabolism and neuropsychiatric behaviors. RMT plus EPA demonstrated promise as having the effects of reversing the levels of the potential biomarkers of depressive-like behaviors. RMT plus EPA or DHA could ameliorate depressive- and anxiety-like behaviors in sleep-deprived rats through the alteration of the lipidome and MT2 receptor pathway in the brain, whereas EPA and DHA exerted a differential effect.
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Affiliation(s)
- Chia-Hsuan Chang
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan.
- Diet and Nutrition Department, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan
| | - Hua-Chien Wu
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yin-Ru Hsieh
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan.
| | - Wen-De Lai
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan.
| | - Te-Hsuan Tung
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan.
| | - Jun-Jie Huang
- Diet and Nutrition Department, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan
| | - Wei-Yu Kao
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, Taipei, Taiwan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Shih-Yi Huang
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan.
- Graduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, Taipei, Taiwan
- TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan
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17
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Boland EM, Goldschmied JR, Gehrman PR. Does insomnia treatment prevent depression? Sleep 2023; 46:zsad104. [PMID: 37029781 PMCID: PMC10262035 DOI: 10.1093/sleep/zsad104] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/21/2023] [Indexed: 04/09/2023] Open
Abstract
Rates of major depressive disorder (MDD) are increasing globally, in part due to the coronavirus disease 2019 pandemic, contributing to disease burden. It has long been known that insomnia is intricately connected with depression as indicated by greater depression severity and lower treatment response. Furthermore, insomnia is a significant risk factor for new-onset depression. Treatment of insomnia is thus a logical target for prevention of incidents and recurrent MDD. This systematic review sought to evaluate the current evidence for the preventive effects of insomnia treatment on depression onset. A database search yielded 186 studies, six of which met criteria for inclusion in this review. All of the studies utilized cognitive behavioral treatment for insomnia (CBT-I) as the target intervention and most delivered treatment via a digital platform. Four of the studies found significantly lower rates of MDD onset in those who received CBT-I compared to a control condition. The two remaining studies failed to confirm these effects in primary analyses but secondary analyses suggested evidence of a preventive effect. There was significant methodologic heterogeneity across studies in terms of sample selection, outcomes, and follow-up periods, limiting the ability to draw firm conclusions. The evidence overall is in the direction of insomnia treatment reducing the risk for onset of MDD, but further research is warranted.
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Affiliation(s)
- Elaine M Boland
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Cpl. Michael J. Crescenz VA Medical Center, Mental Illness Research Education and Clinical Center, Philadelphia, PA, USA
| | - Jennifer R Goldschmied
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Philip R Gehrman
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Cpl. Michael J. Crescenz VA Medical Center, Mental Illness Research Education and Clinical Center, Philadelphia, PA, USA
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18
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Starr LT, Washington K, McPhillips MV, Pitzer K, Demiris G, Oliver DP. Insomnia Symptoms Among Hospice Family Caregivers: Prevalence and Association with Caregiver Mental and Physical Health, Quality of Life, and Caregiver Burden. Am J Hosp Palliat Care 2023; 40:517-528. [PMID: 35620797 PMCID: PMC9699902 DOI: 10.1177/10499091221105882] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Poor sleep exacerbates mental health problems and reduces quality-of-life (QOL) but prevalence of insomnia symptoms among hospice family caregivers and associations of poor sleep with caregiver health and QOL outcomes are not known. OBJECTIVE To describe prevalence of insomnia symptoms among hospice family caregivers and compare anxiety, depression, self-rated health, QOL, and caregiver burden between hospice family caregivers with and without insomnia symptoms. METHODS Descriptive sub-study using data collected during baseline interviews of hospice family caregivers involved in a randomized clinical trial in Midwestern United States (xxxxxxxx). Caregivers were dichotomized based on Insomnia Severity Index (ISI) scores (8+ indicated insomnia symptoms). RESULTS Among 57 hospice family caregivers, the mean ISI score was 8.2; nearly half (49.1%) experienced insomnia symptoms. Compared to caregivers without insomnia symptoms, caregivers with insomnia symptoms reported 2.4 times greater mean anxiety scores (4.7 vs 11.4); 3.5 times greater mean depression scores (3.1 vs 10.7); 2.1 times greater caregiver burden scores (5.6 vs 11.8); and 1.3 times lower self-rated health (3.5 vs 2.8); 1.3 times lower total QOL scores (29.3 vs 22.6); including differences in emotional QOL (7.9 vs 2.2), social QOL (7.2 vs 3.0), and physical QOL (7.4 vs 5.3). CONCLUSIONS Hospice family caregivers experience high prevalence of insomnia symptoms; caregivers with insomnia symptoms report worse anxiety, depression, caregiver burden, QOL, self-rated health. Clinicians must screen hospice caregivers for poor sleep and mental health and offer supportive interventions that improve their sleep and health. Policy makers must expand hospice benefits to better support family caregivers.
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Affiliation(s)
- Lauren T. Starr
- NewCourtland Center for Transitions and Health, Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Philadelphia, PA, USA
| | - Karla Washington
- Division of Palliative Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Miranda V. McPhillips
- NewCourtland Center for Transitions and Health, Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Philadelphia, PA, USA
| | - Kyle Pitzer
- Division of Palliative Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - George Demiris
- NewCourtland Center for Transitions and Health, Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Philadelphia, PA, USA
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Debra Parker Oliver
- Division of Palliative Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
- Goldfarb School of Nursing, Barnes Jewish College, St. Louis, MO, USA
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19
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Ricka N, Pellegrin G, Fompeyrine DA, Lahutte B, Geoffroy PA. Predictive biosignature of major depressive disorder derived from physiological measurements of outpatients using machine learning. Sci Rep 2023; 13:6332. [PMID: 37185788 PMCID: PMC10130089 DOI: 10.1038/s41598-023-33359-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 04/12/2023] [Indexed: 05/17/2023] Open
Abstract
Major Depressive Disorder (MDD) has heterogeneous manifestations, leading to difficulties in predicting the evolution of the disease and in patient's follow-up. We aimed to develop a machine learning algorithm that identifies a biosignature to provide a clinical score of depressive symptoms using individual physiological data. We performed a prospective, multicenter clinical trial where outpatients diagnosed with MDD were enrolled and wore a passive monitoring device constantly for 6 months. A total of 101 physiological measures related to physical activity, heart rate, heart rate variability, breathing rate, and sleep were acquired. For each patient, the algorithm was trained on daily physiological features over the first 3 months as well as corresponding standardized clinical evaluations performed at baseline and months 1, 2 and 3. The ability of the algorithm to predict the patient's clinical state was tested using the data from the remaining 3 months. The algorithm was composed of 3 interconnected steps: label detrending, feature selection, and a regression predicting the detrended labels from the selected features. Across our cohort, the algorithm predicted the daily mood status with 86% accuracy, outperforming the baseline prediction using MADRS alone. These findings suggest the existence of a predictive biosignature of depressive symptoms with at least 62 physiological features involved for each patient. Predicting clinical states through an objective biosignature could lead to a new categorization of MDD phenotypes.
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Affiliation(s)
| | | | | | - Bertrand Lahutte
- Psychiatry Department, Bégin Military Hospital, 94160, Saint-Mandé, France
| | - Pierre A Geoffroy
- Psychiatry and Addictology Service, Assistance Publique-Hôpitaux de Paris, GHU Paris Nord, DMU Neurosciences, Hopital Bichat-Claude Bernard, 75018, Paris, France
- GHU Paris-Psychiatry & Neurosciences, 1 rue Cabanis, 75014, Paris, France
- NeuroDiderot, Inserm, FHU I2-D2, Université de Paris, 75019, Paris, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, 67000, Strasbourg, France
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20
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Effects of sleep quality on suicide risk in COVID-19 patients: The chain mediating of anxiety and depressive symptoms. Heliyon 2023; 9:e15051. [PMID: 37012905 PMCID: PMC10060188 DOI: 10.1016/j.heliyon.2023.e15051] [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: 07/09/2022] [Revised: 03/21/2023] [Accepted: 03/24/2023] [Indexed: 04/03/2023] Open
Abstract
Background Although current studies have identified sleep disorders as an independent risk factor for suicide, the relationship between sleep disorders and suicide risk has not been well established. This study explored whether anxiety and depressive symptoms are used as mediators to participate in the impact of sleep quality on suicide risk. Methods This is a cross-sectional study. We administered a psychological questionnaire to the participants, using a combination of self-assessment and psychiatrist assessment.Sleep quality, suicide risk, level of anxiety and depressive symptoms were assessed by PSQI, NGASR, SAS and SDS.The study subjects were 391 hospitalized COVID-19 patients from Wuhan hospitals. We used model 6 in the PROCESS (version 3.5) plug-in of SPSS software to conduct mediation test with sleep quality as the independent variable, suicide risk as the dependent variable, level of anxiety and depressive symptoms as intermediate variables. Results The severity of anxiety and depressive symptoms and the risk of suicide in the sleep disorder group (63.15 ± 13.71, 59.85 ± 13.38, 6.52 ± 3.67) were higher than those in the non-sleep disorder group (49.83 ± 13.14, 44.87 ± 10.19, 2.87 ± 3.26) (P < 0.001). The mediation model works well, The total indirect effect was 0.22 (95%CI = [0.17, 0.28]), and the direct effect was 0.16 (95%CI = [0.08, 0.24]). Limitations This study used a self-assessment scale. Conclusions Anxiety and depressive symptoms played a chain mediating role between sleep quality and suicide risk.
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21
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Wang J, Zhao H, Shi K, Wang M. Treatment of insomnia based on the mechanism of pathophysiology by acupuncture combined with herbal medicine: A review. Medicine (Baltimore) 2023; 102:e33213. [PMID: 36930068 PMCID: PMC10019201 DOI: 10.1097/md.0000000000033213] [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: 01/24/2023] [Accepted: 02/15/2023] [Indexed: 03/18/2023] Open
Abstract
Insomnia is a sleep disorder which severely affects patients mood, quality of life and social functioning, serves as a trigger or risk factor to a variety of diseases such as depression, cardiovascular and cerebrovascular diseases, obesity and diabetes, and even increases the risk of suicide, and has become an increasingly widespread concern worldwide. Considerable research on insomnia has been conducted in modern medicine in recent years and encouraging results have been achieved in the fields of genetics and neurobiology. Unfortunately, however, the pathogenesis of insomnia remains elusive to modern medicine, and pharmacological treatment of insomnia has been regarded as conventional. However, in the course of treatment, pharmacological treatment itself is increasingly being questioned due to potential dependence and drug resistance and is now being replaced by cognitive behavior therapy as the first-line treatment. As an important component of complementary and alternative medicine, traditional Chinese medicine, especially non-pharmacological treatment methods such as acupuncture, is gaining increasing attention worldwide. In this article, we discuss the combination of traditional Chinese medicine, acupuncture, and medicine to treat insomnia based on neurobiology in the context of modern medicine.
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Affiliation(s)
- Jie Wang
- Department of Pain, Datong Hospital of Traditional Chinese Medicine, Shanxi Province, Datong, China
| | - Haishen Zhao
- Department of Rehabilitation, Luchaogang Community Health Service Center, Pudong New District, Shanghai, China
| | - Kejun Shi
- Department of Rehabilitation, Luchaogang Community Health Service Center, Pudong New District, Shanghai, China
| | - Manya Wang
- Department of Rehabilitation, Luchaogang Community Health Service Center, Pudong New District, Shanghai, China
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22
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Herrero Babiloni A, Baril AA, Charlebois-Plante C, Jodoin M, Sanchez E, De Baets L, Arbour C, Lavigne GJ, Gosselin N, De Beaumont L. The Putative Role of Neuroinflammation in the Interaction between Traumatic Brain Injuries, Sleep, Pain and Other Neuropsychiatric Outcomes: A State-of-the-Art Review. J Clin Med 2023; 12:jcm12051793. [PMID: 36902580 PMCID: PMC10002551 DOI: 10.3390/jcm12051793] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/15/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
Sleep disturbances are widely prevalent following a traumatic brain injury (TBI) and have the potential to contribute to numerous post-traumatic physiological, psychological, and cognitive difficulties developing chronically, including chronic pain. An important pathophysiological mechanism involved in the recovery of TBI is neuroinflammation, which leads to many downstream consequences. While neuroinflammation is a process that can be both beneficial and detrimental to individuals' recovery after sustaining a TBI, recent evidence suggests that neuroinflammation may worsen outcomes in traumatically injured patients, as well as exacerbate the deleterious consequences of sleep disturbances. Additionally, a bidirectional relationship between neuroinflammation and sleep has been described, where neuroinflammation plays a role in sleep regulation and, in turn, poor sleep promotes neuroinflammation. Given the complexity of this interplay, this review aims to clarify the role of neuroinflammation in the relationship between sleep and TBI, with an emphasis on long-term outcomes such as pain, mood disorders, cognitive dysfunctions, and elevated risk of Alzheimer's disease and dementia. In addition, some management strategies and novel treatment targeting sleep and neuroinflammation will be discussed in order to establish an effective approach to mitigate long-term outcomes after TBI.
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Affiliation(s)
- Alberto Herrero Babiloni
- Division of Experimental Medicine, McGill University, Montreal, QC H3A 0C7, Canada
- CIUSSS-NIM, Hôpital du Sacré-Coeur de Montréal, Montreal, QC H4J 1C5, Canada
- Correspondence:
| | - Andrée-Ann Baril
- Douglas Mental Health University Institute, Montreal, QC H4H 1R3, Canada
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3G 2M1, Canada
| | | | - Marianne Jodoin
- CIUSSS-NIM, Hôpital du Sacré-Coeur de Montréal, Montreal, QC H4J 1C5, Canada
- Department of Psychology, University of Montreal, Montreal, QC H3T 1J4, Canada
| | - Erlan Sanchez
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada
| | - Liesbet De Baets
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Faculty of Medicine, University of Montreal, Montreal, QC H3T 1C5, Canada
- Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1050 Brussel, Belgium
| | - Caroline Arbour
- CIUSSS-NIM, Hôpital du Sacré-Coeur de Montréal, Montreal, QC H4J 1C5, Canada
- Faculty of Nursing, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Gilles J. Lavigne
- Division of Experimental Medicine, McGill University, Montreal, QC H3A 0C7, Canada
- CIUSSS-NIM, Hôpital du Sacré-Coeur de Montréal, Montreal, QC H4J 1C5, Canada
- Faculty of Dental Medicine, University of Montreal, Montreal, QC H3T 1C5, Canada
| | - Nadia Gosselin
- CIUSSS-NIM, Hôpital du Sacré-Coeur de Montréal, Montreal, QC H4J 1C5, Canada
| | - Louis De Beaumont
- CIUSSS-NIM, Hôpital du Sacré-Coeur de Montréal, Montreal, QC H4J 1C5, Canada
- Department of Surgery, University of Montreal, Montreal, QC H3T 1J4, Canada
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23
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Palagini L, Geoffroy PA, Balestrieri M, Miniati M, Biggio G, Liguori C, Menicucci D, Ferini-Strambi L, Nobili L, Riemann D, Gemignani A. Current models of insomnia disorder: a theoretical review on the potential role of the orexinergic pathway with implications for insomnia treatment. J Sleep Res 2023:e13825. [PMID: 36786121 DOI: 10.1111/jsr.13825] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/31/2022] [Accepted: 01/01/2023] [Indexed: 02/15/2023]
Abstract
Insomnia disorder is considered as a stress-related disorder associated with hyperarousal, stress and emotion dysregulation and the instability of the 'flip-flop' switch system. The orexinergic system is well known for its key role in sleep and arousal processes but also in the allostatic system regulating stress and emotions and may thus be of major interest for insomnia and its treatment. Accordingly, we discuss the potential role of orexins on sleep processes, brain systems modulating stress and emotions with potential implications for insomnia pathophysiology. We reviewed available data on the effect of dual orexin receptor antagonists (DORAs) on sleep and brain systems modulating stress/emotions with implications for insomnia treatment. We present our findings as a narrative review. Few data in animals and humans have reported that disrupted sleep and insomnia may be related to the overactivation of orexinergic system, while some more consistent data in humans and animals reported the overactivation of orexins in response to acute stress and in stress-related disorders. Taken together these findings may let us hypothesise that an orexins overactivation may be associated with stress-related hyperarousal and the hyperactivation of arousal-promoting systems in insomnia. On the other hand, it is possible that by rebalancing orexins with DORAs we may regulate both sleep and allostatic systems, in turn, contributing to a 'switch off' of hyperarousal in insomnia. Nevertheless, more studies are needed to clarify the role of the orexin system in insomnia and to evaluate the effects of DORAs on sleep, stress and emotions regulating systems.
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Affiliation(s)
- Laura Palagini
- Department of Clinical and Experimental Medicine, Unit of Psychiatry, Azienda Ospedaliero Universitaria Pisana AUOP, Pisa, Italy
| | - Pierre A Geoffroy
- Département de Psychiatrie et D'Addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, Paris, France.,GHU Paris - Psychiatry and Neurosciences, Paris, France.,Université de Paris, NeuroDiderot, Inserm, Paris, France
| | - Matteo Balestrieri
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Mario Miniati
- Department of Clinical and Experimental Medicine, Unit of Psychiatry, Azienda Ospedaliero Universitaria Pisana AUOP, Pisa, Italy
| | - Giovanni Biggio
- Department of Life and Environmental Sciences, Institute of Neuroscience, University of Cagliari, National Research Council (C.N.R.), Cagliari, Italy
| | - Claudio Liguori
- Sleep Medicine Centre, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Neurology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Danilo Menicucci
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Luigi Ferini-Strambi
- Department of Clinical Neurosciences, Neurology Sleep Disorders Centre, RCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lino Nobili
- Sleep Medicine Center, Department of Neuroscience, Niguarda Hospital, Milan, Italy.,Department of Neuroscience (DINOGMI), University of Genoa, Child Neuropsychiatry Unit, IRCCS Istituto G. Gaslini, Genoa, Italy
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, Center for Basics in NeuroModulation (NeuroModulBasics), University of Freiburg, Freiburg, Germany
| | - Angelo Gemignani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
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24
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Christodoulou N, Bertrand L, Palagini L, Frija-Masson J, d'Ortho MP, Lejoyeux M, Riemann D, Maruani J, Geoffroy PA. Factors associated with insomnia symptoms: A cross-sectional study during a Covid-19 fully restrictive lockdown. J Sleep Res 2023; 32:e13752. [PMID: 36217818 DOI: 10.1111/jsr.13752] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 07/05/2022] [Accepted: 09/21/2022] [Indexed: 02/03/2023]
Abstract
Insomnia is the most frequent sleep disorder and a public health concern that increased during the Covid 19 pandemic. Fully restrictive lockdowns during Covid are interesting periods to examine the impact of environmental and behavioural changes on the emergence of insomnia symptoms. In this cross-sectional study we aimed to (1) determine the main factors associated with insomnia symptoms during a Covid-19 fully restrictive lockdown examining the associated daily life alterations and (2) create a predictive model of insomnia symptoms. We used the data drawn from the "Covid-RythmE" study that reached volunteers from the general French population through an online survey during the last 2 weeks of the 2 month full lockdown. Associations with insomnia symptoms were tested and significant associations were entered in a Backward Stepwise Logistic Regression (BSLR) to assess the best combination to classify individuals with or without insomnia symptoms. From the 1624 participants, 50.64% suffered from mild to severe insomnia symptoms as assessed by the ISI. The best combination for explaining insomnia symptoms with 74.26% of accuracy included: age (OR = 1.15), females (OR = 1.26), smaller home sizes (OR = 0.77), environmental noises (OR = 1.59), anxiety symptoms (OR = 1.24), depressive symptoms (OR = 1.15), regularity of sleep-wake schedules (OR = 1.25), exposure to screen during the morning (OR = 1.13), and LED light during the evening (OR = 1.17). Thus, lifestyle schedule and exposure to natural synchronizers such as light, are primordial in considering in insomnia physiopathology, prevention and treatment, as well as the associated mental health status.
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Affiliation(s)
- Nausicaa Christodoulou
- Université Paris Cité, Paris, France.,Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hospital Bichat - Claude Bernard, Paris, France
| | - Léa Bertrand
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hospital Bichat - Claude Bernard, Paris, France
| | - Laura Palagini
- Psychiatry Division, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy - Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Justine Frija-Masson
- Université Paris Cité, Paris, France.,Université de Paris, NeuroDiderot, Inserm, Paris, France.,Département de Physiologie - Explorations Fonctionnelles, AP-HP, Hôpital Bichat - Claude Bernard, Paris, France
| | - Marie-Pia d'Ortho
- Université Paris Cité, Paris, France.,Université de Paris, NeuroDiderot, Inserm, Paris, France.,Département de Physiologie - Explorations Fonctionnelles, AP-HP, Hôpital Bichat - Claude Bernard, Paris, France
| | - Michel Lejoyeux
- Université Paris Cité, Paris, France.,Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hospital Bichat - Claude Bernard, Paris, France.,GHU Paris - Psychiatry & Neurosciences, Paris, France
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Julia Maruani
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hospital Bichat - Claude Bernard, Paris, France.,Université de Paris, NeuroDiderot, Inserm, Paris, France
| | - Pierre A Geoffroy
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hospital Bichat - Claude Bernard, Paris, France.,Université de Paris, NeuroDiderot, Inserm, Paris, France.,GHU Paris - Psychiatry & Neurosciences, Paris, France.,CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, Strasbourg, France
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25
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Habibi Asgarabad M, Doos Ali Vand H, Salehi Yegaei P, Hooman F, Ahmadi R, Baglioni C, Moradi S. The contribution of transdiagnostic vulnerability factors in patients with chronic insomnia. Front Psychiatry 2023; 14:1162729. [PMID: 37077275 PMCID: PMC10106755 DOI: 10.3389/fpsyt.2023.1162729] [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: 02/09/2023] [Accepted: 03/14/2023] [Indexed: 04/21/2023] Open
Abstract
Introduction Various transdiagnostic factors have been associated with insomnia severity. The current study aimed to predict insomnia severity based on a group of transdiagnostic factors including neuroticism, emotion regulation, perfectionism, psychological inflexibility, anxiety sensitivity, and repetitive negative thinking after controlling for depression/anxiety symptoms and demographic characteristics. Methods Two hundred patients with chronic insomnia disorder were recruited from a sleep disorder clinic. Participants completed the Insomnia Severity Index (ISI), Clinical Perfectionism Questionnaire (CPQ), Acceptance and Action Questionnaire-II (AAQ-II), Anxiety Sensitivity Index-3 (ASI-3), Repetitive Thinking Questionnaire (RTQ-10), Big Five Inventory (BFI-10), Emotion Regulation Questionnaire (ERQ), and Depression Anxiety Stress Scale (DASS-21). Results After controlling for the confounding variables (depression/anxiety symptoms and demographic characteristics), hierarchical multiple linear regression suggested the significant association of neuroticism (BFI), cognitive reappraisal (ERQ), personal standards (CPQ), evaluative concerns (CPQ), physical concerns (ASI), cognitive concerns (ASI), and repetitive negative thinking (RTQ) with insomnia severity. Discussion The findings support the role of transdiagnostic factors, especially physical concerns, repetitive negative thinking, and neuroticism in chronic insomnia. Future research using longitudinal designs is required to verify the causal status of transdiagnostic variables.
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Affiliation(s)
- Mojtaba Habibi Asgarabad
- Health Promotion Research Center, Iran University of Medical Science, Tehran, Iran
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Health Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
- Positive Youth Development Lab, Human Development & Family Sciences, Texas Tech University, Texas, TX, United States
- Center of Excellence in Cognitive Neuropsychology, Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Hoda Doos Ali Vand
- Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pardis Salehi Yegaei
- Health Promotion Research Center, Iran University of Medical Science, Tehran, Iran
| | - Farzaneh Hooman
- Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran
| | - Reza Ahmadi
- Health Promotion Research Center, Iran University of Medical Science, Tehran, Iran
- Department of Clinical Psychology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Chiara Baglioni
- Human Sciences Department, University of Rome Guglielmo Marconi Rome, Rome, Italy
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - Shahram Moradi
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway, Porsgrunn, Norway
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26
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Ballesio A, Zagaria A, Salaris A, Terrasi M, Lombardo C, Ottaviani C. Sleep and Daily Positive Emotions – Is Heart Rate Variability a Mediator? J PSYCHOPHYSIOL 2022. [DOI: 10.1027/0269-8803/a000315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Abstract. Sleep quality is considered a basic dimension of emotional health. The psychophysiological mechanisms underlying the associations between sleep quality and positive emotions are still largely unknown, yet autonomic regulation may play a role. This study employed a two-day ecological momentary assessment methodology in a sample of young adults to investigate whether subjective sleep quality reported in the morning was associated with daily positive emotional experience and whether this association was mediated by heart rate variability (HRV), a measure of cardiac vagal tone. Sleep quality was assessed using an electronic sleep diary upon awakening, while resting HRV and positive emotions were inspected at random times throughout the day using photoplethysmography and an electronic diary, respectively. Relevant confounding variables such as smoking, alcohol intake, and physical exercise between each measurement were also assessed. The sample included 121 participants (64.8% females, Mage = 25.97 ± 5.32 years). After controlling for relevant confounders including health behaviors and psychiatric comorbidities, mediation analysis revealed that greater sleep quality positively predicted daily HRV (β = .289, p < .001) which, in turn, had a direct influence on positive emotions (β = .244, p = .006). Also, sleep quality directly predicted positive emotional experience (β = .272, p = .001). Lastly, the model showed an indirect effect between sleep quality and positive emotions via HRV (β = .071, 95% BCI [.011, .146]). Results support the view of HRV as a process variable linking sleep to positive emotions. Experimental data is needed to consolidate the present findings.
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Affiliation(s)
- Andrea Ballesio
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Andrea Zagaria
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Andrea Salaris
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Michela Terrasi
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Caterina Lombardo
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Cristina Ottaviani
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
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27
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Lamport DJ, Breese E, Gião MS, Chandra S, Orchard F. Can air purification improve sleep quality? A 2‐week randomised‐controlled crossover pilot study in healthy adults. J Sleep Res 2022; 32:e13782. [PMID: 36351665 DOI: 10.1111/jsr.13782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 10/24/2022] [Accepted: 10/24/2022] [Indexed: 11/11/2022]
Abstract
Insufficient quantity and quality of sleep is a public health concern that can be addressed by interventions for improving sleep outcomes. Environmental factors such as poor air quality are a potential target for intervention, particularly in light of associations between air pollution and worse sleep. The aim of this pilot study was to investigate the effects of using an air purifier on sleep outcomes and mood in 30 healthy adults. There were two conditions: (i) air purifier with a high-efficiency particulate air filter; (ii) air purifier with a placebo filter. Participants undertook both conditions, each over 2 weeks with a 2-week washout, following a counterbalanced, double-blind design. Daily sleep outcomes were measured with actigraphy watches and sleep diaries, whilst daily mood was assessed with the Positive and Negative Affect Schedule. The Insomnia Severity Index, the Pittsburgh Sleep Quality Index, and symptoms of anxiety and depression were measured pre- and post-. The purifier filter was associated with increased total sleep time for an average of 12 min per night, and increased total time in bed for an average of 19 min per night relative to the placebo. There were several sleep and mood outcomes for which no changes were observed, and time awake after sleep onset was higher for the purifier filter. Air quality was better during the high-efficiency particulate air filter condition. These findings offer positive indications that environmental interventions that improve air quality can have benefits for sleep outcomes in healthy populations who are not exhibiting clinical sleep disturbances.
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Affiliation(s)
- Daniel J. Lamport
- School of Psychology & Clinical Language Science University of Reading Reading Berkshire UK
| | - Emily Breese
- School of Psychology & Clinical Language Science University of Reading Reading Berkshire UK
| | | | | | - Faith Orchard
- School of Psychology University of Sussex Brighton Sussex UK
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28
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Peng Q, Qu B, Sznajder KK, Chen Q, Fu J, He S, Yang X. Exploring the Association Between Resilience and Quality of Life Among Glaucoma Patients: Sleep Disturbance as a Mediating Factor. Front Med (Lausanne) 2022; 9:842864. [PMID: 36438057 PMCID: PMC9682153 DOI: 10.3389/fmed.2022.842864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 03/18/2022] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Patients with glaucoma may experience many symptoms such as blindness, which seriously affect their quality of life (QoL). Resilience is playing a vital role in enhancing the QoL and well-being of patients with chronic diseases. In addition, sleep disturbance is common in patients with glaucoma, leading to a decline in their QoL. However, there is a dearth of research on whether sleep disturbance plays a mediating role between resilience and QoL among glaucoma patients. OBJECTIVE The aim of this study is to explore the role of sleep disturbance in the relationship between resilience and QoL among glaucoma patients. METHODS From July to December 2019, a cross-sectional survey was conducted on 215 glaucoma patients in an ophthalmic hospital in Liaoning Province. Hierarchical multiple regression (HMR) analyses and structural equation modeling (SEM) were conducted to examine the factors related to QoL and to test the hypothesis that sleep disturbance mediates the relationship between resilience and QoL among glaucoma patients. RESULTS The average QoL score among glaucoma patients was 43.85 ± 14.97 as reported by the Glaucoma Quality of Life-15 (GQL-15) scale, where a higher scores indicating a poorer QoL. Resilience was found to be linked with a lower QoL score (P < 0.01), while sleep disturbance was associated with a higher QoL score (P < 0.01). When sleep disturbance was included in the model as partial mediator, the path coefficients for the association between resilience and QoL score was significantly decreased (a*b = -0.1, BCa95% CI: -0.154∼-0.045). CONCLUSION Findings of this study reflected that QoL among glaucoma patients in China was poor. Resilience was found to be an important positive factor, which could result in the improvement of QoL. Furthermore, sleep disturbance mediated the relationship between resilience and QoL among patients with glaucoma, thereby reducing the positive impact of resilience on QoL in glaucoma patients. Efforts to improve QoL among glaucoma patients may benefit from interventions that enhance the levels of resilience and promote healthy sleep.
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Affiliation(s)
- Qinqi Peng
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
| | - Bo Qu
- Department of Ophthalmology, Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Key Laboratory of Lens Research of Liaoning Province, Shenyang, China
| | - Kristin K. Sznajder
- Department of Public Health, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Qiongli Chen
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
| | - Jiahui Fu
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
| | - Shan He
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
| | - Xiaoshi Yang
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
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29
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Walker JL, Vargas I, Drake CL, Ellis JG, Muench A, Perlis ML. The natural history of insomnia: high sleep reactivity interacts with greater life stress to predict the onset of acute insomnia. Sleep 2022; 45:6626044. [PMID: 35776964 PMCID: PMC9453617 DOI: 10.1093/sleep/zsac149] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/10/2022] [Indexed: 11/15/2022] Open
Abstract
STUDY OBJECTIVES Prior research suggests that some individuals have a predisposition to experience insomnia following acute stressors (i.e. sleep reactivity). The present study was a proof of concept and specifically aimed to provide additional empirical evidence that the link between stressful life events and the onset of acute insomnia is moderated by sleep reactivity. METHODS About 1,225 adults with a history of good sleep (Mage = 53.2 years, 68% female, 83% white) were recruited nationwide for an online study on sleep health. Participants completed surveys to assess sleep reactivity (baseline), sleep patterns (daily sleep diary), and stressful life events (weekly survey). All daily and weekly measures were completed for a one-year period. Sleep diary data were used to identify sleep initiation/maintenance difficulties, including whether they met criteria for acute insomnia at any point during the one-year interval. RESULTS Participants with high sleep reactivity compared to low sleep reactivity were at 76% increased odds of developing acute insomnia during the one-year interval. In general, greater weekly stressful life events were associated with greater insomnia during the subsequent week. Those participants with high sleep reactivity demonstrated a stronger relationship between weekly stressful life events and insomnia, such that they reported the greatest levels of insomnia following weeks where they experienced a greater number of stressful life events. CONCLUSIONS These results further support the sleep reactivity model of insomnia, and specifically, provide evidence that sleep reactivity predicts the incidence of acute insomnia in a sample of participants with no history of insomnia.
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Affiliation(s)
- Jamie L Walker
- Corresponding author. Jamie Walker, Department of Psychological Science, University of Arkansas, 106 Memorial Hall, Fayetteville, AR 72701, USA.
| | - Ivan Vargas
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Christopher L Drake
- Department of Medicine, Division of Sleep Medicine, Sleep Disorders and Research Center, Henry Ford Hospital, Novi, MI, USA
| | - Jason G Ellis
- Department of Psychology, Northumbria Center for Sleep Research, Northumbria University, Newcastle, UK
| | - Alexandria Muench
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael L Perlis
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
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Insomnia, sleep loss, and circadian sleep disturbances in mood disorders: a pathway toward neurodegeneration and neuroprogression? A theoretical review. CNS Spectr 2022; 27:298-308. [PMID: 33427150 DOI: 10.1017/s1092852921000018] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The present paper aims at reviewing and commenting on the relationships between sleep and circadian phasing alterations and neurodegenerative/neuroprogressive processes in mood disorder. We carried out a systematic review, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, in PubMed, PsycINFO, and Embase electronic databases for literature related to mood disorders, sleep disturbances, and neurodegenerative/neuroprogressive processes in relation to (1) neuroinflammation, (2) activation of the stress system, (3) oxidative stress, (4) accumulation of neurotoxic proteins, and (5) neuroprotection deficit. Seventy articles were collectively selected and analyzed. Experimental and clinical studies revealed that insomnia, conditions of sleep loss, and altered circadian sleep may favor neurodegeneration and neuroprogression in mood disorders. These sleep disturbances may induce a state of chronic inflammation by enhancing neuroinflammation, both directly and indirectly, via microglia and astrocytes activation. They may act as neurobiological stressors that by over-activating the stress system may negatively influence neural plasticity causing neuronal damage. In addition, sleep disturbances may favor the accumulation of neurotoxic proteins, favor oxidative stress, and a deficit in neuroprotection hence contributing to neurodegeneration and neuroprogression. Targeting sleep disturbances in the clinical practice may hold a neuroprotective value for mood disorders.
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Palagini L, Hertenstein E, Riemann D, Nissen C. Sleep, insomnia and mental health. J Sleep Res 2022; 31:e13628. [PMID: 35506356 DOI: 10.1111/jsr.13628] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 01/23/2023]
Abstract
While sleep serves important regulatory functions for mental health, sleep disturbances, in particular insomnia, may favour a state of allostatic overload impairing brain neuroplasticity and stress immune pathways, hence contributing to mental disorders. In this framework, the aim of this work was to link current understanding about insomnia mechanisms with current knowledge about mental health dysregulatory mechanisms. The focus of the present work was on mood, anxiety, and psychotic disorders, which represent important challenges in clinical practice. Literature searches were conducted on clinical, neurobiological, and therapeutic implications for insomnia comorbid with these mental disorders. Given the complexity and heterogeneity of the existing literature, we ended up with a narrative review. Insomnia may play an important role as a risk factor, a comorbid condition and transdiagnostic symptom for many mental disorders including mood/anxiety disorders and schizophrenia. Insomnia may also play a role as a marker of disrupted neuroplasticity contributing to dysregulation of different neurobiological mechanisms involved in these different mental conditions. In this framework, insomnia treatment may not only foster normal sleep processes but also the stress system, neuroinflammation and brain plasticity. Insomnia treatment may play an important preventive and neuroprotective role with cognitive behavioural therapy for insomnia being the treatment with important new evidence of efficacy for insomnia, psychopathology, and indices of disrupted neuroplasticity. On the other hand, pharmacological pathways for insomnia treatment in these mental conditions are still not well defined. Therapeutic options acting on melatonergic systems and new therapeutic options acting on orexinergic systems may represents interesting pathways of interventions that may open new windows on insomnia treatment in mental disorders.
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Affiliation(s)
- Laura Palagini
- Psychiatry Division, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Elisabeth Hertenstein
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Hauptstraße, Germany.,Center for Basics in NeuroModulation (NeuroModulBasics), Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph Nissen
- Department of Psychiatry, Psychiatric Specialties Division, Geneva University Hospitals (HUG), Geneva, Switzerland
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Rakhimov A, Whibley D, Tang NKY. Cognitive-behavioural pathways from pain to poor sleep quality and emotional distress in the general population: The indirect effect of sleep-related anxiety and sleep hygiene. PLoS One 2022; 17:e0260614. [PMID: 35061683 PMCID: PMC8782309 DOI: 10.1371/journal.pone.0260614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 11/14/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Pain can have a negative impact on sleep and emotional well-being. This study investigated whether this may be partly explained by maladaptive sleep-related cognitive and behavioural responses to pain, including heightened anxiety about sleep and suboptimal sleep hygiene. METHODS This cross-sectional study used data from an online survey that collected information about pain (Brief Pain Inventory), sleep (Pittsburgh Sleep Quality Index; Sleep Hygiene Index; Anxiety and Preoccupation about Sleep Questionnaire) and emotional distress (PROMIS measures; Perceived Stress Scale). Structural equation modelling examined the tenability of a framework linking these factors. RESULTS Of 468 survey respondents (mean age 39 years, 60% female), 29% reported pain (mean severity 1.12), most commonly in the spine or low back (28%). Pain severity correlated with poor sleep quality, poor sleep hygiene, anxiety about sleep and emotional distress. In the first structural equation model, indirect effects were identified between pain severity and sleep quality through anxiety about sleep (β = .08, p < .001) and sleep hygiene (β = .12, p < .001). In the second model, an indirect effect was identified between pain severity and emotional distress through sleep quality (β = .19, p < .01). Combining these models, indirect effects were identified between pain severity and emotional distress through anxiety about sleep, sleep hygiene and sleep quality. CONCLUSIONS This study provides data to support the tenability of a theoretically guided framework linking pain, sleep and emotional distress. If upheld by experimental and/or longitudinal study, this framework holds the potential to inform public health initiatives and more comprehensive pain assessment.
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Affiliation(s)
- Arman Rakhimov
- Department of Psychology, University of Warwick, Coventry, West Midlands, United Kingdom
| | - Daniel Whibley
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, United States of America
- Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, Scotland, United Kingdom
| | - Nicole K. Y. Tang
- Department of Psychology, University of Warwick, Coventry, West Midlands, United Kingdom
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How can light be used to optimize sleep and health in older adults? PROGRESS IN BRAIN RESEARCH 2022; 273:331-355. [DOI: 10.1016/bs.pbr.2022.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Liu Y, Zhang Q, Jiang F, Zhong H, Huang L, Zhang Y, Chen H. Association between sleep disturbance and mental health of healthcare workers: A systematic review and meta-analysis. Front Psychiatry 2022; 13:919176. [PMID: 35966483 PMCID: PMC9372625 DOI: 10.3389/fpsyt.2022.919176] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 07/05/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Sleep disturbance and mental health are challenges for healthcare workers (HCWs). Especially during the COVID-19 pandemic, they experienced more severe sleep and mental health problems. However, the association between sleep disturbance and the mental health of HCWs is still controversial. This study aimed to systematically review the relationship by conducting a systematic review and meta-analysis. METHOD Two researchers retrieved the literature from Web of Science, PubMed, EMBASE, CINAHL, Psyclnfo, and Cochrane Library from the establishment of the databases until November 20, 2021. We used the New Castle-Ottawa Scale (NOS) and Agency for Healthcare Research and Quality (AHRQ) to evaluate the risk of bias in prospective research and cross-sectional research, respectively. The major exposure was HCWs' sleep disturbance, and the major outcome was mental health. The correlation coefficients (r), regression coefficients (β) and odds ratios (OR) of the included studies were integrated. RESULT Fifty-nine studies were included for qualitative analysis, of which 30 studies could be combined and entered into quantitative analysis. There were 23 studies during the COVID-19 pandemic among the 59 included studies. The results of the meta-analysis showed that the correlation coefficient between sleep disturbance and mental health was 0.43 (95% CI: 0.39-0.47). HCWs with sleep disturbance had a 3.74 (95% CI: 2.76-5.07) times higher risk of mental health problems than those without sleep disturbance. The correlation coefficient during the COVID-19 epidemic was 0.45 (95% CI: 0.37-0.53), while it was 0.40 (95% CI: 0.36-0.44) during the non-epidemic period. Subgroup analysis compared the OR results in epidemic and non-epidemic periods of COVID-19, which were 4.48 (95% CI: 2.75-5.07) and 3.74 (95% CI: 2.74-7.32), respectively. CONCLUSION Sleep disturbance and mental health problems were positively correlated among HCWs. Particularly in the COVID-19 pandemic, more attention should be given to this issue.
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Affiliation(s)
- Ying Liu
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, China
| | - Qin Zhang
- Department of Postgraduate Students, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
| | - Fugui Jiang
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
| | - Hua Zhong
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, China
| | - Lei Huang
- Department of Environmental Health and Occupational Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.,Department of Occupational Hazard Assessment, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yang Zhang
- Department of Periodical Press and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.,Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Hong Chen
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, China
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Palagini L, Miniati M, Riemann D, Zerbinati L. Insomnia, Fatigue, and Depression: Theoretical and Clinical Implications of a Self-reinforcing Feedback Loop in Cancer. Clin Pract Epidemiol Ment Health 2021; 17:257-263. [PMID: 35444704 PMCID: PMC8985470 DOI: 10.2174/1745017902117010257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 08/01/2021] [Accepted: 08/09/2021] [Indexed: 11/22/2022]
Abstract
Introduction:
Insomnia is emerging as a modifiable major risk factor for mental and physical problems, including cancer, and it may contribute to cancer-related fatigue and depression. Since both fatigue and depression may favor insomnia as well, we may hypothesize a self-reinforcing feedback loop among these factors in cancer.
Methods:
With the aim of discussing this hypothesis, PubMed, PsycINFO, and Embase electronic databases were searched for literature published according to the PRISMA method with several combinations of terms such as “insomnia” and “cancer” and “fatigue” and “depression”. On this basis, we conducted a narrative review about theoretical aspects of insomnia in the context of cancer and about its role in cancer-related fatigue and depression.
Results:
Twenty-one papers were selected according to inclusion/exclusion criteria. Insomnia is frequent in cancer, and it is associated with cancer-related comorbid conditions such as emotional distress, depressive symptoms, and cancer-related fatigue. The hyperactivation of stress and inflammatory systems, which sustain insomnia, may contribute to cancer-related depression and fatigue. A deleterious feedback loop may be created, and it may perpetuate not only insomnia but also these cancer-related comorbid conditions.
Conclusion:
Although the understanding of the causal relationship between insomnia/ depression/fatigue in individuals with cancer is limited, we may hypothesize that these symptoms can exacerbate and maintain each other. When insomnia is established in cancer, it may lead to a vicious cycle with fatigue and depression and may contribute to adverse cancer outcomes. Interventions targeting insomnia could provide a promising approach not only for insomnia but also for cancer-related symptoms among cancer patients.
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Palagini L, Geoffroy PA, Riemann D. Sleep markers in psychiatry: do insomnia and disturbed sleep play as markers of disrupted neuroplasticity in mood disorders? A proposed model. Curr Med Chem 2021; 29:5595-5605. [PMID: 34906053 DOI: 10.2174/0929867328666211214164907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/31/2021] [Accepted: 09/05/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Since insomnia and disturbed sleep may affect neuroplasticity, we aimed at reviewing their potential role as markers of disrupted neuroplasticity involved in mood disorders. METHOD We performed a systematic review, according to PRIMA, on PubMed, PsycINFO and Embase electronic databases for literature regarding mood disorders, insomnia, sleep loss/deprivation in relation to different pathways involved in the impairment of neuroplasticity in mood disorders such as 1] alterations in neurodevelopment 2] activation of the stress system 3] neuroinflammation 4] neurodegeneration/neuroprogression, 4] deficit in neuroprotection. RESULTS Sixty-five articles were analyzed and a narrative/ theoretical review was conducted. Studies showed that insomnia, sleep loss and sleep deprivation might impair brain plasticity of those areas involved in mood regulation throughout different pathways. Insomnia and disrupted sleep may act as neurobiological stressors that by over-activating the stress and inflammatory systems may affect neural plasticity causing neuronal damage. In addition, disturbed sleep may favor a deficit in neuroprotection hence contributing to impaired neuroplasticity. CONCLUSIONS Insomnia and disturbed sleep may play a role as markers of alteration in brain plasticity in mood disorders. Assessing and targeting insomnia in the clinical practice may potentially play a neuroprotective role, contributing to "repairing" alterations in neuroplasticity or to the functional recovery of those areas involved in mood and emotion regulation.
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Affiliation(s)
- Laura Palagini
- Department of Experimental and Clinic Medicine, Section of Psychiatry, University of Pisa, Via Roma 67, 56100, Pisa. Italy
| | - Pierre Alexis Geoffroy
- Département de psychiatrie et d'addictologie, AP-HP, Hopital Bichat - Claude Bernard, F-75018 Paris, France; Université de Paris, NeuroDiderot, Inserm U1141, F-75019 Paris. France
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg. Germany
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Adamo D, Calabria E, Coppola N, Lo Muzio L, Giuliani M, Azzi L, Maurino V, Colella G, Rauso R, Montebugnoli L, Gissi DB, Gabriele M, Nisi M, Sardella A, Lodi G, Varoni EM, Giudice A, Antonelli A, Cabras M, Gambino A, Vescovi P, Majorana A, Bardellini E, Campisi G, Panzarella V, Spadari F, Marino S, Pentenero M, Sutera S, Biasotto M, Gobbo M, Guarda Nardini L, Romeo U, Tenore G, Serpico R, Lucchese A, Lajolo C, Rupe C, Aria M, Gnasso A, Mignogna MD. Assessment of sleep disturbance in oral lichen planus and validation of PSQI: A case-control multicenter study from the SIPMO (Italian Society of Oral Pathology and Medicine). J Oral Pathol Med 2021; 51:194-205. [PMID: 34704302 DOI: 10.1111/jop.13255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/29/2021] [Accepted: 10/19/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The wellbeing of oral lichen planus patients (OLPs) may be strongly influenced by a poor quality of sleep (QoS) and psychological impairment. The aims were to analyze the prevalence of sleep disturbance, anxiety, and depression in OLPs and to validate the Pittsburgh Sleep Quality Index (PSQI) in OLPs. METHODS Three hundred keratotic OLPs (K-OLPs), 300 with predominant non-keratotic OLP (nK-OLPs), and 300 controls were recruited in 15 Italian universities. The PSQI, Epworth Sleepiness Scale (ESS), Hamilton Rating Scales for Depression and Anxiety (HAM-D and HAM-A), Numeric Rating Scale (NRS), and Total Pain Rating Index (T-PRI) were administered. RESULTS Oral lichen planus patients had statistically higher scores than the controls in the majority of the PSQI sub-items (p-values < 0.001**). Moreover, OLPs had higher scores in the HAM-D, HAM-A, NRS, and T-PRI (p-values < 0.001**). No differences in the PSQI sub-items' scores were found between the K-OLPs and nK-OLPs, although nK-OLPs suffered from higher levels of anxiety, depression, and pain (p-values: HAM-A, 0.007**, HAM-D, 0.009**, NRS, <0.001**, T-PRI, <0.001**). The female gender, anxiety, depression (p-value: 0.007**, 0.001**, 0.020*) and the intensity of pain, anxiety, and depression (p-value: 0.006**, <0.001**, 0.014*) were independent predictors of poor sleep (PSQI > 5) in K-OLPs and nK-OLPs, respectively. The PSQI's validation demonstrated good internal consistency and reliability of both the total and subscale of the PSQI. CONCLUSIONS The OLPs reported an overall impaired QoS, which seemed to be an independent parameter according to the regression analysis. Hence, clinicians should assess QoS in OLPs and treat sleep disturbances in order to improve OLPs management.
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Affiliation(s)
- Daniela Adamo
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Elena Calabria
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Noemi Coppola
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Michele Giuliani
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Lorenzo Azzi
- Department of Medicine and Surgery, Unit of Oral Medicine and Pathology, ASST dei Sette Laghi, University of Insubria, Varese, Italy
| | - Vittorio Maurino
- Department of Medicine and Surgery, Unit of Oral Medicine and Pathology, ASST dei Sette Laghi, University of Insubria, Varese, Italy
| | - Giuseppe Colella
- Multidisciplinary Department of Medical, Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Raffaele Rauso
- Multidisciplinary Department of Medical, Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Lucio Montebugnoli
- Department of Biomedical and Neuromotor Sciences, Section of Oral Sciences, University of Bologna, Bologna, Italy
| | - Davide Bartolomeo Gissi
- Department of Biomedical and Neuromotor Sciences, Section of Oral Sciences, University of Bologna, Bologna, Italy
| | - Mario Gabriele
- Department of Surgical Pathology, Medicine, Molecular and Critical Area, University of Pisa, Pisa, Italy
| | - Marco Nisi
- Department of Surgical Pathology, Medicine, Molecular and Critical Area, University of Pisa, Pisa, Italy
| | - Andrea Sardella
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Giovanni Lodi
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Elena Maria Varoni
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Amerigo Giudice
- Department of Health Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Alessandro Antonelli
- Department of Health Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Marco Cabras
- Oral Medicine Section, Department of Surgical Science, CIR Dental School, University of Turin, Turin, Italy
| | - Alessio Gambino
- Oral Medicine Section, Department of Surgical Science, CIR Dental School, University of Turin, Turin, Italy
| | - Paolo Vescovi
- Department of Medicine and Surgery, Oral Medicine and Laser Surgery Unit, University Center of Dentistry, University of Parma, Parma, Italy
| | - Alessandra Majorana
- Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Elena Bardellini
- Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Giuseppina Campisi
- Department of Surgical, Oncological, and Oral Sciences, University of Palermo, Palermo, Italy
| | - Vera Panzarella
- Department of Surgical, Oncological, and Oral Sciences, University of Palermo, Palermo, Italy
| | - Francesco Spadari
- Department of Biomedical, Surgical and Dental Sciences, Maxillo-facial and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico. University of Milan, Milan, Italy
| | - Sonia Marino
- Department of Biomedical, Surgical and Dental Sciences, Maxillo-facial and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico. University of Milan, Milan, Italy
| | - Monica Pentenero
- Department of Oncology, Oral Medicine and Oral Oncology Unit, University of Turin, Turin, Italy
| | - Samuele Sutera
- Department of Oncology, Oral Medicine and Oral Oncology Unit, University of Turin, Turin, Italy
| | - Matteo Biasotto
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Margherita Gobbo
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.,Unit of Oral and Maxillofacial Surgery, Ca' Foncello Hospital, Treviso, Italy
| | - Luca Guarda Nardini
- Unit of Oral and Maxillofacial Surgery, Ca' Foncello Hospital, Treviso, Italy
| | - Umberto Romeo
- Department of Oral Sciences and Maxillofacial Surgery, University of Rome La Sapienza, Rome, Italy
| | - Gianluca Tenore
- Department of Oral Sciences and Maxillofacial Surgery, University of Rome La Sapienza, Rome, Italy
| | - Rosario Serpico
- Multidisciplinary Department of Medical, Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Alberta Lucchese
- Multidisciplinary Department of Medical, Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Carlo Lajolo
- Head and Neck Department, School of Dentistry, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Cosimo Rupe
- Head and Neck Department, School of Dentistry, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Massimo Aria
- Department of Economics and Statistics, University Federico II of Naples, Naples, Italy
| | - Agostino Gnasso
- Department of Economics and Statistics, University Federico II of Naples, Naples, Italy
| | - Michele Davide Mignogna
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
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Jiang A, Rosario M, Stahl S, Gill JM, Rusch HL. The Effect of Virtual Mindfulness-Based Interventions on Sleep Quality: A Systematic Review of Randomized Controlled Trials. Curr Psychiatry Rep 2021; 23:62. [PMID: 34297230 PMCID: PMC8300082 DOI: 10.1007/s11920-021-01272-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/04/2021] [Indexed: 11/05/2022]
Abstract
PURPOSE OF REVIEW We summarized peer-reviewed literature investigating the effect of virtual mindfulness-based interventions (MBIs) on sleep quality. We aimed to examine the following three questions: (1) do virtual MBIs improve sleep quality when compared with control groups; (2) does the effect persist long-term; and (3) is the virtual delivery method equally feasible compared to the in-person delivery method? RECENT FINDINGS Findings suggest that virtual MBIs are equivalent to evidence-based treatments, and to a limited extent, more effective than non-specific active controls at reducing some aspects of sleep disturbance. Overall, virtual MBIs are more effective at improving sleep quality than usual care controls and waitlist controls. Studies provide preliminary evidence that virtual MBIs have a long-term effect on sleep quality. Moreover, while virtual MBI attrition rates are comparable to in-person MBI attrition rates, intervention adherence may be compromised in the virtual delivery method. This review highlights virtual MBIs as a potentially effective alternative to managing sleep disturbance during pandemic-related quarantine and stay-at-home periods. This is especially relevant due to barriers of accessing in-person interventions during the pandemic. Future studies are needed to explore factors that influence adherence and access to virtual MBIs, with a particular focus on diverse populations.
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Affiliation(s)
- Amanda Jiang
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
| | - Michael Rosario
- Washington University School of Medicine, St. Louis, MO, USA
| | - Sara Stahl
- TEACCH Autism Program, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jessica M Gill
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
| | - Heather L Rusch
- National Institutes of Health, 3 Center Drive, Building 3, Room 5E/26, Bethesda, MD, 20892, USA.
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Palagini L, Manni R, Aguglia E, Amore M, Brugnoli R, Bioulac S, Bourgin P, Micoulaud Franchi JA, Girardi P, Grassi L, Lopez R, Mencacci C, Plazzi G, Maruani J, Minervino A, Philip P, Royant Parola S, Poirot I, Nobili L, Biggio G, Schroder CM, Geoffroy PA. International Expert Opinions and Recommendations on the Use of Melatonin in the Treatment of Insomnia and Circadian Sleep Disturbances in Adult Neuropsychiatric Disorders. Front Psychiatry 2021; 12:688890. [PMID: 34177671 PMCID: PMC8222620 DOI: 10.3389/fpsyt.2021.688890] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 04/29/2021] [Indexed: 12/14/2022] Open
Abstract
Introduction: Insomnia and circadian rhythm disorders, such as the delayed sleep phase syndrome, are frequent in psychiatric disorders and their evaluation and management in early stages should be a priority. The aim of this paper was to express recommendations on the use of exogenous melatonin, which exhibits both chronobiotic and sleep-promoting actions, for the treatment of these sleep disturbances in psychiatric disorders. Methods: To this aim, we conducted a systematic review according to PRISMA on the use of melatonin for the treatment of insomnia and circadian sleep disorders in neuropsychiatry. We expressed recommendations for the use of melatonin in psychiatric clinical practice for each disorder using the RAND/UCLA appropriateness method. Results: We selected 41 studies, which included mood disorders, schizophrenia, substance use disorders, attention deficit hyperactivity disorders, autism spectrum disorders, neurocognitive disorders, and delirium; no studies were found for both anxiety and eating disorders. Conclusion: The administration of prolonged release melatonin at 2-10 mg, 1-2 h before bedtime, might be used in the treatment of insomnia symptoms or comorbid insomnia in mood disorders, schizophrenia, in adults with autism spectrum disorders, neurocognitive disorders and during sedative-hypnotics discontinuation. Immediate release melatonin at <1 mg might be useful in the treatment of circadian sleep disturbances of neuropsychiatric disorders.
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Affiliation(s)
- Laura Palagini
- Psychiatry Division, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Raffaele Manni
- Unit of Sleep Medicine and Epilepsy, Istituto di Ricovero e Cura a Carattere Scientifico Mondino Foundation, Pavia, Italy
| | - Eugenio Aguglia
- Department of Experimental and Clinical Medicine, Psychiatric Clinic University Hospital “Gaspare Rodolico”, University of Catania, Catania, Italy
| | - Mario Amore
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genoa, Italy
| | - Roberto Brugnoli
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Sapienza University, Rome, Italy
| | - Stéphanie Bioulac
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, and USR CNRS 3413 SANPSY, University Hospital Pellegrin, University of Bordeaux, Bordeaux, France
| | - Patrice Bourgin
- Institut des Neurosciences Cellulaires et Intégratives, CNRS-UPR 3212, Strasbourg, France
- Centre des troubles du sommeil - CIRCSom, Strasbourg University Hospitals, Strasbourg, France
| | - Jean-Arthur Micoulaud Franchi
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, and USR CNRS 3413 SANPSY, University Hospital Pellegrin, University of Bordeaux, Bordeaux, France
| | - Paolo Girardi
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Sapienza University, Rome, Italy
| | - Luigi Grassi
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Régis Lopez
- Service de Neurologie, Centre National de Référence Narcolepsie Hypersomnies, Unité des Troubles du Sommeil, Hôpital Gui-de-Chauliac Montpellier, Montpellier, France
- PSNREC, Univ Montpellier, INSERM, Montpellier, France
| | - Claudio Mencacci
- Department of Neuroscience, Aziende Socio Sanitarie Territoriali Fatebenefratelli Sacco, Milan, Italy
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico, Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Julia Maruani
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, Paris, France
| | - Antonino Minervino
- Department of Psychiatry, Italian Society of Psychosomatic Medicine (SIMP), Parma, Italy
| | - Pierre Philip
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, and USR CNRS 3413 SANPSY, University Hospital Pellegrin, University of Bordeaux, Bordeaux, France
| | | | - Isabelle Poirot
- Service de psychiatrie adulte, Hôpital Fontan, CHU de Lille, Lille, France
| | - Lino Nobili
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico, Child Neuropsychiatry Unit, Giannina Gaslini Institute, Genoa, Italy
| | - Giovanni Biggio
- Department of Life and Environmental Sciences, Institute of Neuroscience, CNR, University of Cagliari, Cagliari, Italy
| | - Carmen M. Schroder
- Institut des Neurosciences Cellulaires et Intégratives, CNRS-UPR 3212, Strasbourg, France
- Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals, Strasbourg, France
| | - Pierre A. Geoffroy
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, Paris, France
- GHU Paris - Psychiatry & Neurosciences, Paris, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, Strasbourg, France
- Université de Paris, NeuroDiderot, Inserm, Paris, France
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Mahmoodi SR, Xie P, Zachs DP, Peterson EJ, Graham RS, Kaiser CRW, Lim HH, Allen MG, Javanmard M. Single-step label-free nanowell immunoassay accurately quantifies serum stress hormones within minutes. SCIENCE ADVANCES 2021; 7:eabf4401. [PMID: 34193414 PMCID: PMC8245048 DOI: 10.1126/sciadv.abf4401] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 05/18/2021] [Indexed: 05/14/2023]
Abstract
A non-faradaic label-free cortisol sensing platform is presented using a nanowell array design, in which the two probe electrodes are integrated within the nanowell structure. Rapid and low volume (≤5 μl) sensing was realized through functionalizing nanoscale volume wells with antibodies and monitoring the real-time binding events. A 28-well plate biochip was built on a glass substrate by sequential deposition, patterning, and etching steps to create a stack nanowell array sensor with an electrode gap of 40 nm. Sensor response for cortisol concentrations between 1 and 15 μg/dl in buffer solution was recorded, and a limit of detection of 0.5 μg/dl was achieved. Last, 65 human serum samples were collected to compare the response from human serum samples with results from the standard enzyme-linked immunosorbent assay (ELISA). These results confirm that nanowell array sensors could be a promising platform for point-of-care testing, where real-time, laboratory-quality diagnostic results are essential.
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Affiliation(s)
| | - Pengfei Xie
- Rutgers University, Piscataway, NJ 08854, USA
| | | | | | | | | | - Hubert H Lim
- University of Minnesota, Minneapolis, MN 55455, USA
| | - Mark G Allen
- University of Pennsylvania, Philadelphia, PA 19104, USA
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Geoffroy PA, Oquendo MA, Courtet P, Blanco C, Olfson M, Peyre H, Lejoyeux M, Limosin F, Hoertel N. Sleep complaints are associated with increased suicide risk independently of psychiatric disorders: results from a national 3-year prospective study. Mol Psychiatry 2021; 26:2126-2136. [PMID: 32355334 DOI: 10.1038/s41380-020-0735-3] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 04/06/2020] [Accepted: 04/14/2020] [Indexed: 12/21/2022]
Abstract
Prior research suggests that sleep disturbances are associated with increased risk of suicide. However, sleep disturbances are associated with a wide range of psychiatric disorders, and it is unknown whether this association is independent of psychopathology. In a large nationally representative prospective survey, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), we used structural equation modeling to examine the shared and specific effects of three sleep complaints (i.e., trouble falling asleep, early morning awakening, and hypersomnia) on the 3-year occurrence of attempting suicide. Because psychiatric disorders increase the risk of suicide attempt almost exclusively through a general psychopathology factor representing their shared effect, covariates included that factor, prior history of suicide attempt, and a wide range of sociodemographic and clinical characteristics. The 3-year prevalence rate of suicide attempt was 0.6% (n = 241). Compared with participants who did not attempt suicide between the two waves, those who did reported significantly more frequently having trouble falling asleep (44.6% vs. 16.6%), early morning awakening (38.9% vs. 12.7%), and hypersomnia (35.0% vs. 10.7%). Following adjustments, effects of sleep complaints on this risk were significant and exerted almost exclusively through a general sleep complaints factor representing the shared effect across all sleep complaints. There were no residual associations of any individual sleep complaint with attempting suicide above that association. Sleep complaints are associated with an increased risk of attempting suicide independently of psychopathology, and should be included in suicide risk assessments as these symptoms may provide targets for reducing the risks of suicidal behaviors.
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Affiliation(s)
- Pierre A Geoffroy
- Paris Diderot University-Paris VII, 5 Rue Thomas Mann, 75013, Paris, France. .,Université de Paris, NeuroDiderot, Inserm, F-75019, Paris, France. .,University Hospital Bichat-Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France.
| | - Maria A Oquendo
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Philippe Courtet
- INSERM, U1061, Neuropsychiatry, University Montpellier, Montpellier, France.,Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, Montpellier, France
| | - Carlos Blanco
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, MD, USA
| | - Mark Olfson
- Department of Psychiatry, New York State Psychiatric Institute/Columbia University, New York, NY, 10032, USA
| | - Hugo Peyre
- Assistance Publique-Hôpitaux de Paris, Robert Debré Hospital, Child and Adolescent Psychiatry Department, Paris, France.,Cognitive Sciences and Psycholinguistic Laboratory, Ecole Normale Supérieure, Paris, France
| | - Michel Lejoyeux
- Paris Diderot University-Paris VII, 5 Rue Thomas Mann, 75013, Paris, France.,University Hospital Bichat-Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France
| | - Frédéric Limosin
- Cognitive Sciences and Psycholinguistic Laboratory, Ecole Normale Supérieure, Paris, France.,Centre Ressource Régional de Psychiatrie du Sujet Agé (CRRPSA), Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, DMU Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, Paris, France.,Faculté de médecine Paris Descartes, Université de Paris, Paris, France.,Inserm U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
| | - Nicolas Hoertel
- Cognitive Sciences and Psycholinguistic Laboratory, Ecole Normale Supérieure, Paris, France.,Centre Ressource Régional de Psychiatrie du Sujet Agé (CRRPSA), Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, DMU Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, Paris, France.,Faculté de médecine Paris Descartes, Université de Paris, Paris, France.,Inserm U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
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Sun Y, Zhao R, Liu R, Li T, Ni S, Wu H, Cao Y, Qu Y, Yang T, Zhang C, Sun Y. Integrated Screening of Effective Anti-Insomnia Fractions of Zhi-Zi-Hou-Po Decoction via Drosophila melanogaster and Network Pharmacology Analysis of the Underlying Pharmacodynamic Material and Mechanism. ACS OMEGA 2021; 6:9176-9187. [PMID: 33842786 PMCID: PMC8028125 DOI: 10.1021/acsomega.1c00445] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/11/2021] [Indexed: 05/05/2023]
Abstract
Insomnia is an anabatic epidemiology, while the mechanism is extremely complicated; it remains one of the major scientific challenges in life sciences. Because of the advantage of having a similar genetic background and circadian rhythm as those of humans, the Drosophila melanogaster model organism is hugely popular in sleep-related drug screening studies. Seven-day-old virgin D. melanogaster was used to establish the sleep deprivation model by repeated light stimulation at night. Using PySolo activity monitoring system and Drosophila activity as indices, the effective fractions of Zhi-Zi-Hou-Po decoction (ZZHPD) for insomnia were screened; the content of monoamine neurotransmitters dopamine (DA), 5-hydroxyindole-3-acetic acid (5-HIAA), Homovanillic acid (HVA), and 5-hydroxytryptamine (5-HT) in the brain of D. melanogaster were determined by high-performance liquid chromatography-electro-chemical detection. The herb-compound-target-disease target network were further constructed through network pharmacology to identify the potential targets and pathways of ZZHPD in the intervention of insomnia. Finally, the molecular docking method was used for evaluating the binding characteristics of important compounds from ZZHPD with related targets. The results showed that a certain dose of ZZHPD and its petroleum ether, dichloromethane, ethyl acetate, and n-butanol fractions could improve sleep. The dichloromethane fraction from ZZHPD extracts showed the best anti-insomnia effect among all extracts. It can also reduce the content of DA and HVA in the brain of D. melanogaster and increase 5-HT and 5-HIAA levels. The network pharmacology showed that the main active ingredients in ZZHPD included magnolol, honokiol, hesperidin, and so forth. According to the screening conditions, there were 71 targets and the result of KEGG enrichment analysis revealed that 73 pathways were associated with insomnia, which were primarily involved in inflammatory response, central neurotransmitter regulation, and apoptosis to relieve insomnia. The molecular docking results clarified that naringenin and apigenin have an intimate relationship with GABAA receptor, histamine H1, orexin receptor type 2, and interleukin-6. The mechanism of relieving insomnia is the result of the interaction of multi-components, multi-targets, and multi-pathways, which provides a certain theoretical basis for the treatment of insomnia and related diseases as well as clinical research.
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Circadian depression: A mood disorder phenotype. Neurosci Biobehav Rev 2021; 126:79-101. [PMID: 33689801 DOI: 10.1016/j.neubiorev.2021.02.045] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 02/18/2021] [Accepted: 02/28/2021] [Indexed: 12/15/2022]
Abstract
Major mood syndromes are among the most common and disabling mental disorders. However, a lack of clear delineation of their underlying pathophysiological mechanisms is a major barrier to prevention and optimised treatments. Dysfunction of the 24-h circadian system is a candidate mechanism that has genetic, behavioural, and neurobiological links to mood syndromes. Here, we outline evidence for a new clinical phenotype, which we have called 'circadian depression'. We propose that key clinical characteristics of circadian depression include disrupted 24-h sleep-wake cycles, reduced motor activity, low subjective energy, and weight gain. The illness course includes early age-of-onset, phenomena suggestive of bipolarity (defined by bidirectional associations between objective motor and subjective energy/mood states), poor response to conventional antidepressant medications, and concurrent cardiometabolic and inflammatory disturbances. Identifying this phenotype could be clinically valuable, as circadian-targeted strategies show promise for reducing depressive symptoms and stabilising illness course. Further investigation of underlying circadian disturbances in mood syndromes is needed to evaluate the clinical utility of this phenotype and guide the optimal use of circadian-targeted interventions.
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Geoffroy PA, Palagini L. Biological rhythms and chronotherapeutics in depression. Prog Neuropsychopharmacol Biol Psychiatry 2021; 106:110158. [PMID: 33152388 DOI: 10.1016/j.pnpbp.2020.110158] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/14/2020] [Accepted: 10/27/2020] [Indexed: 12/28/2022]
Abstract
Depressive syndromes are frequent and heterogeneous brain conditions with more than 90% of patients suffering from sleep complaints. Better characterizing this "sleep" domain may allow to both better treat acute episodes with existing chronotherapeutics, but also to prevent the manifestation or recurrences of mood disorders. This work aims to i) review theoretical and fundamental data of chronotherapeutics, and ii) provide practical recommendations. Light therapy (LT) can be used as a first-line monotherapy of moderate to severe depression of all subtypes. LT can be also used as a combination with antidepressant to maximize patients' response rates, which has a clear superiority to antidepressant alone. Sleep deprivation (SD) is a rapid and powerful chronotherapeutic with antidepressant responses within hours in 45-60% of patients with unipolar or bipolar depression. Different strategies should be combined to stabilize the SD antidepressant effect, including concomitant medications, repeated SD, combination with sleep phase advance and/or LT (triple chronotherapy). Melatonin treatment is of interest in remitted patients with mood disorder to prevent relapses or recurrences, if a complaint of insomnia, poor sleep quality or phase delay syndrome is associated. During the acute phase, melatonin could be used as an adjuvant treatment for symptoms of insomnia associated with depression. The cognitive behavioral therapy for insomnia (CBT-I) can be recommend to treat insomnia during euthymic phases. The Interpersonal and social rhythm therapy (IPSRT) is indicated for the acute treatment of bipolar depression and for the prevention of mood episodes. Chronotherapeutics should always be associated with behavioral measures for healthy sleep.
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Affiliation(s)
- Pierre A Geoffroy
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, F-75018 Paris, France; GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, 75014 Paris, France; Université de Paris, NeuroDiderot, Inserm, F-75019 Paris, France.
| | - Laura Palagini
- Department of Clinical and Experimental Medicine, Psychiatric Section, University of Pisa; Azienda Ospedaliera Universitaria Pisana (AUOP), Pisa, Italy
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de Crom SAM, Haan LD, Schirmbeck F. The association between sleep disturbances and negative symptom severity in patients with non-affective psychotic disorders, unaffected siblings and healthy controls. Psychiatry Res 2021; 297:113728. [PMID: 33493731 DOI: 10.1016/j.psychres.2021.113728] [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: 09/28/2020] [Accepted: 01/13/2021] [Indexed: 10/22/2022]
Abstract
Sleep disturbances in patients with psychotic disorders are common and associated with poor clinical outcomes, but research on negative symptoms is limited. This study aimed to examine the association between subjective sleep disturbances and negative symptoms in 525 patients with non-affective psychotic disorders, 569 unaffected siblings and 265 healthy controls (HC) from the Genetic Risk and Outcome of Psychosis (GROUP) study. Several aspects of subjective sleep disturbances were assessed: sleep satisfaction, sleep onset insomnia, midnocturnal insomnia, early morning insomnia, and hypersomnia. Regression analyses revealed significant negative associations between sleep satisfaction and negative symptoms in all three groups. In addition, significant associations with sleep onset insomnia and hypersomnia were found in patients and with early morning insomnia and hypersomnia in siblings. Exploratory mediation analyses showed that depressive symptoms partly mediated all associations on the subclinical level in siblings and healthy controls, whereas only the association with sleep onset insomnia was mediated in patients. The results of this study implicate specific sleep disturbances and depressive symptoms as potential targets in prevention or intervention strategies focussed on negative symptoms in individuals suffering from, or at risk of non-affective psychotic disorders.
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Affiliation(s)
- Sophia A M de Crom
- Department of Psychiatry, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands; Arkin Institute for Mental Health, Klaprozenweg 111, 1033 NN Amsterdam, the Netherlands
| | - Frederike Schirmbeck
- Department of Psychiatry, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands; Arkin Institute for Mental Health, Klaprozenweg 111, 1033 NN Amsterdam, the Netherlands.
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Liverant GI, Arditte Hall KA, Wieman ST, Pineles SL, Pizzagalli DA. Associations between insomnia and reward learning in clinical depression. Psychol Med 2021; 52:1-10. [PMID: 33634765 DOI: 10.1017/s003329172100026x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Depression and insomnia commonly co-occur. Yet, little is known about the mechanisms through which insomnia influences depression. Recent research and theory highlight reward system dysfunction as a potential mediator of the relationship between insomnia and depression. This study is the first to examine the impact of insomnia on reward learning, a key component of reward system functioning, in clinical depression. METHODS The sample consisted of 72 veterans with unipolar depression who endorsed sleep disturbance symptoms. Participants completed the Structured Clinical Interview for DSM-IV, self-report measures of insomnia, depression, and reward processing, and a previously validated signal detection task (Pizzagalli et al., 2005, Biological Psychiatry, 57(4), 319-327). Trial-by-trial response bias (RB) estimates calculated for each of the 200 task trials were examined using linear mixed-model analyses to investigate change in reward learning. RESULTS Findings demonstrated diminished rate and magnitude of reward learning in the Insomnia group relative to the Hypersomnia/Mixed Symptom group across the task. Within the Insomnia group, participants with more severe insomnia evidenced the lowest rates of reward learning, with increased RB across the task with decreasing insomnia severity. CONCLUSIONS Among individuals with depression, insomnia is associated with decreased ability to learn associations between neutral stimuli and rewarding outcomes and/or modify behavior in response to differential receipt of reward. This attenuated reward learning may contribute to clinically meaningful decreases in motivation and increased withdrawal in this comorbid group. Results extend existing theory by highlighting impairments in reward learning specifically as a potential mediator of the association between insomnia and depression.
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Affiliation(s)
| | | | - Sarah T Wieman
- Department of Psychology, Suffolk University, Boston, MA, USA
| | - Suzanne L Pineles
- National Center for PTSD, Women's Health Sciences Division, Veterans Affairs Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
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Glavin EE, Matthew J, Spaeth AM. Gender Differences in the Relationship Between Exercise, Sleep, and Mood in Young Adults. HEALTH EDUCATION & BEHAVIOR 2021; 49:128-140. [PMID: 33576253 DOI: 10.1177/1090198120986782] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Insufficient sleep is a serious public health problem in college students. Exercise is a widely prescribed behavioral treatment for sleep and mood issues; however, more focused and gender-specific prescriptions are needed. The present study examined relationships between exercise, sleep, and mood in undergraduate men and women. Students (N = 866, 19.6 ± 1.4 years, 38.7% women) were recruited from campus recreation facilities and completed demographic, the Pittsburgh Sleep Quality Index, mood (Patient-Reported Outcomes Measurement Information System), and exercise questionnaires. The Department of Health and Human Services Physical Activity Guidelines were used to dichotomize those who did and did not meet weekly aerobic and strength training exercise recommendations. In men, greater exercise frequency associated with less daytime dysfunction (β = 0.147) and less depressive mood (β = -0.64, ps < .05). In women, greater exercise frequency associated with earlier bedtime (β = -12.6), improved sleep quality (β = 0.17), increased positive affect (β = 0.91), less depressive mood (β = -0.71), and less anger (β = -1.24, ps < .05). Compared to men, women reported earlier bedtime, poorer sleep efficiency, and more anxiety and depressive mood (ps < .05, ηp2 range: 0.01-0.04). Compared to individuals who met physical activity guidelines, those who did not meet the guidelines reported later bedtimes, less positive affect, more anxiety, and more anger (ps < .05 ηp2s = 0.01). Among men, those who met physical activity guidelines reported falling asleep more quickly than those who did not meet guidelines (ηp2 = 0.01, p = .007); however, no relationship between guideline adherence and sleep latency was observed in women. Adhering to physical activity guidelines may be important for optimal sleep and emotional health. Clinicians should consider gender when creating exercise prescriptions for sleep issues.
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Affiliation(s)
- Emily E Glavin
- Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Juliet Matthew
- Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Andrea M Spaeth
- Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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Cong L, Ju Y, Gui L, Zhang B, Ding F, Zou C. The Mediating Role of Self-Efficacy in Sleep Disorder and Depressive Symptoms Among Chinese Caregivers of Stroke Inpatients: A Structural Equation Modeling Analysis. Neuropsychiatr Dis Treat 2021; 17:3635-3643. [PMID: 34934316 PMCID: PMC8684603 DOI: 10.2147/ndt.s338241] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 12/01/2021] [Indexed: 01/20/2023] Open
Abstract
PURPOSE Caregivers of stroke inpatients are at high risk of sleep disorder, which may lead to depressive symptoms. Self-efficacy has always been regarded as a protective factor against psychological disorders such as depressive symptoms. This study aims to investigate the sleep disorder and depressive symptoms of caregivers of stroke inpatients in China and explore the mediating effect of self-efficacy between sleep disorder and depressive symptoms among Chinese caregivers of stroke inpatients. PATIENTS AND METHODS In this cross-sectional study, a total of 305 caregivers who were hospitalized with stroke patients completed the PROMIS Sleep Disorder Short Form Scale, General Self-Efficacy Scale and Patient Health Questionnaire-9 in two general public hospitals in northeast and southeast China. A structural equation model with bootstrap method was performed to determine the mediation of self-efficacy between sleep disorder and depressive symptoms. RESULTS Among the participants, 55.4% of caregivers reported depressive symptoms. Sleep disorder and self-efficacy were significant predictors of depressive symptoms. The direct impact of sleep disorder on depressive symptoms was positive, and the path coefficient of sleep disorder with depressive symptoms was decreased from 0.45 to 0.38 (P < 0.01) after addition of self-efficacy in the model. This indicated that self-efficacy played as mediator. CONCLUSION The caregivers of stroke inpatients were in poor physical and psychological health, and more than half of the caregivers (55.4%) suffered from depressive symptoms. Our research revealed the mediation of self-efficacy between sleep disorder and depressive symptoms, and emphasized the importance of enhancing self-efficacy to reduce depressive symptoms among caregivers of stroke inpatients. These results demonstrate that focusing on self-efficacy interventions can enhance mental health and reduce depressive symptoms effectively.
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Affiliation(s)
- Longjuan Cong
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Yanhong Ju
- Section of Statistics, 4th People's Hospital of Shenyang, Shenyang, Liaoning, People's Republic of China
| | - Ling Gui
- Department of Health Service Management, College of Health Management, China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Bo Zhang
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Fangyan Ding
- Department of Health Service Management, College of Health Management, China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Changqing Zou
- School of Health Humanities, China Medical University, Shenyang, Liaoning, People's Republic of China
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Drews HJ, Drews A. Couple Relationships Are Associated With Increased REM Sleep-A Proof-of-Concept Analysis of a Large Dataset Using Ambulatory Polysomnography. Front Psychiatry 2021; 12:641102. [PMID: 34040553 PMCID: PMC8141649 DOI: 10.3389/fpsyt.2021.641102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 04/07/2021] [Indexed: 11/24/2022] Open
Abstract
Background/Objectives: Rapid Eye Movement (REM) sleep is associated with memory consolidation and several health effects including stress response, mental health, and longevity. Recently, it has been shown that regularly co-sleeping couples have increased and stabilized REM sleep when co-sleeping as compared to sleeping individually. However, it remained unclear whether this is due to a specific effect of altering the usual sleeping environment by partner deprivation or due to a generalizable REM-sleep promoting effect of couple relationships. The present study aims to clarify this ambiguity. Methods: Married or never married individuals were taken from the Sleep Heart Health Study (n = 5,804) and matched regarding sociodemographic and health parameters. Matching was done using propensity score matching (1:1, nearest neighbor) and resulted in two groups of n = 69 each (married vs. never married). After confirmation of successful matching, samples were compared regarding REM sleep and other polysomnographic parameters (paired Students t-tests or Wilcoxon signed-rank tests). Results: Married individuals showed significantly higher levels of total and relative REM sleep as compared to never married individuals (all p's ≤ 0.003). Neither other sleep stages nor REM-sleep fragmentation differed between groups (all p's ≥ 0.29). Results regarding number of sleep cycles were ambiguous. Conclusion: This is the first between-subjects study to show that couple relationships are associated with increased REM sleep. This finding represents a necessary (but not sufficient) condition for the previously hypothesized self-enhancing feedback loop of REM sleep and sociality as well as for REM-sleep promotion as a mechanism through which couple relationships prevent mental illness.
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Affiliation(s)
- Henning Johannes Drews
- Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Psychiatry and Psychotherapy, Christian-Albrechts-University, Kiel, Germany
| | - Annika Drews
- Department of Climate and Environment, SINTEF Ocean AS, Trondheim, Norway
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Yurasek AM, Miller MB, Pritschmann R, Curtis AF, McCrae C. Negative mood as a mediator of the association between insomnia severity and marijuana problems in college students. J Sleep Res 2020; 29:e12985. [PMID: 31997499 PMCID: PMC7387201 DOI: 10.1111/jsr.12985] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 12/01/2019] [Accepted: 12/23/2019] [Indexed: 11/27/2022]
Abstract
Insomnia symptoms have been linked to problematic marijuana use among young adults, but the mechanism underlying this association and whether sex differences exist, remains unclear. Using cross-sectional data, this study examined negative mood as a mediator of the association between insomnia and marijuana problems among male and female college students. Undergraduate students (n = 267; 61% female) reporting marijuana use in the past month completed an online survey assessing insomnia symptoms, negative mood and marijuana problems. Controlling for relevant covariates, negative mood was examined as a mediator of the association between insomnia and marijuana problems using bootstrapped significance tests for indirect effects (n-boot = 1,000). Results indicated that higher levels of insomnia were associated with greater levels of negative mood (regardless of sex), which in turn were associated with greater marijuana-related problems. In conclusion, insomnia symptoms are associated with more negative mood among college students who use marijuana, and this effect on negative mood accounts for a large part of the association of insomnia symptoms with marijuana-related problems. Research is needed to determine if these associations are maintained prospectively.
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Affiliation(s)
- Ali M. Yurasek
- College of Health and Human Performance, Health Education and Behavior Department, University of Florida, Gainesville, FL 32611
| | - Mary Beth Miller
- Department of Psychiatry, 1 Hospital Drive DC067.00, University of Missouri, Columbia, MO 65212
| | - Ricarda Pritschmann
- College of Health and Human Performance, Health Education and Behavior Department, University of Florida, Gainesville, FL 32611
| | - Ashley F. Curtis
- Department of Psychiatry, 1 Hospital Drive DC067.00, University of Missouri, Columbia, MO 65212
| | - Christina McCrae
- Department of Psychiatry, 1 Hospital Drive DC067.00, University of Missouri, Columbia, MO 65212
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