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Ahn J, Cho E, Cho IK, Lee D, Kim J, Chung S. Preoccupation with sleep and dysfunctional beliefs about sleep mediate the influence of psychological inflexibility on insomnia in the older adult population. Sleep Breath 2024; 28:2117-2125. [PMID: 39096430 DOI: 10.1007/s11325-024-03128-8] [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: 02/19/2024] [Revised: 06/30/2024] [Accepted: 07/29/2024] [Indexed: 08/05/2024]
Abstract
INTRODUCTION This study aimed to explore whether the Discrepancy between the desired time in Bed and the desired total Sleep Time (DBST) index influences insomnia severity in the older adult population and examined the potential role of psychological inflexibility in this association. METHODS An online survey study was conducted for older individuals aged ≥ 65 via a survey company between January and February 2023. A total of 300 responses and data without personally identifiable information were delivered to the researchers. The survey questionnaires include the DBST, Glasgow Sleep Effort Scale (GSES), Insomnia Severity Index (ISI), Dysfunctional Beliefs about Sleep-2 items (DBS-2), and Acceptance and Action Questionnaire-II (AAQ-II). RESULTS The analysis included 295 older adult participants. The DBST index was significantly correlated with all questionnaires. Linear regression revealed the DBST index was predicted only by the ISI (β = 0.26, p = 0.003). Mediation analysis showed that the GSES (Z = 2.92, p = 0.003) and DBS-2 (Z = 2.17, p = 0.030) mediated the effect of the DBST index on the ISI, while the AAQ-II did not. Path analysis showed that the DBST could be directly predicted by the ISI (Z = 2.94, p = 0.003), GSES (Z = 2.75, p = 0.006), and DBS2 (Z = 2.71, p = 0.007) but not by the AAQ-II itself. However, the AAQ-II exerted a significant indirect effect on the ISI through the DBS-2 (Z = 2.21, p = 0.027) and GSES (z = 2.24, p = 0.025). CONCLUSIONS Our study showed that preoccupation and dysfunctional beliefs about sleep may mediate the relationship between the DBST index and insomnia severity in the older adult population. We opine that psychological inflexibility might play a significant role in insomnia severity via preoccupation with and dysfunctional beliefs about sleep.
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Affiliation(s)
- Junseok Ahn
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Eulah Cho
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, 86 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea
| | - Inn-Kyu Cho
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, 86 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea
| | - Dongin Lee
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, 86 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea
| | - Jiyoung Kim
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, 86 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, 86 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.
- Life Care Center for Cancer Patient, Asan Medical Center Cancer Institute, Seoul, South Korea.
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Baek Y, Jeong K, Lee S. Association of sleep timing, sleep duration, and sleep latency with metabolic syndrome in middle-aged adults in Korea: A cross-sectional and longitudinal study. Sleep Health 2024:S2352-7218(24)00131-1. [PMID: 39174451 DOI: 10.1016/j.sleh.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 05/27/2024] [Accepted: 06/08/2024] [Indexed: 08/24/2024]
Abstract
OBJECTIVE Sleep is a potential risk factor for metabolic syndrome. We investigated the associations of various sleep characteristics with the status and incidence of metabolic syndrome in middle-aged Koreans. METHODS Using data from a community-based Korean Medicine Daejeon Citizen Cohort study on participants aged 30-50years, cross-sectional (n = 1984) and longitudinal (n = 1216, median follow-up: 2.1years) analyses were performed. To study the association of metabolic syndrome and five components with various sleep characteristics, measured using the Pittsburgh Sleep Quality Index, we used Poisson and logistic regression and Cox proportional hazard regression analyses, adjusting for covariates. RESULTS Of 1984 participants, 66%, 19%, and 15% belonged to the non-metabolic syndrome, pre-metabolic syndrome, and metabolic syndrome groups, respectively. After covariate adjustments, the pre-metabolic syndrome group was associated with late mid-sleep time (≥5:00; prevalence ratios 1.61, 95% confidence interval 1.01-2.54) and late bedtime (≥2:00; prevalence ratios 1.55, 95% confidence interval 1.03-2.34), and the metabolic syndrome group was associated with long sleep latency (prevalence ratios 1.33, 95% confidence interval 1.03-1.73), poor sleep quality (prevalence ratios 1.38, 95% confidence interval 1.07-1.78), and early wake time (<6:00; prevalence ratios 1.29, 95% confidence interval 1.01-1.63). Longitudinal analysis of participants without metabolic syndrome at baseline indicated a significant increase in metabolic syndrome risk associated with very short sleep duration (<6 hours; hazard ratio 1.72, 95% confidence interval 1.06-2.79), long sleep latency (>30 minutes; hazard ratio 1.86, 95% confidence interval 1.1-3.12), and early wake time (<6:00 o'clock; hazard ratio 1.73, 95% confidence interval 1.01-2.97). CONCLUSION Sleep characteristics, such as short duration, long latency, and early wake time, were associated with an increased risk of metabolic syndrome in middle-aged adults.
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Affiliation(s)
- Younghwa Baek
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Kyoungsik Jeong
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Siwoo Lee
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea.
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Vereeken S, Bedendo A, Gilbody S, Hewit CE. Drowning in the ripple effect: identifying a syndemic network of health experience (with modifiable health behaviours) using the UK Biobank. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02726-x. [PMID: 39060724 DOI: 10.1007/s00127-024-02726-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 07/05/2024] [Indexed: 07/28/2024]
Abstract
A Syndemic model of health experience in severe mental illness (SMI) involving modifiable health behaviour contributors has been theorised but has not yet been investigated. Over the next 10 years mental ill-health and suicidal behaviours have been predicted to increase which will decrease health experience and increase hospitalisation and associated costs. This paper investigated a Syndemic model of health experience in people with SMI informed by physical activity levels, exposure to nature, personal resilience levels, drugs related (tobacco smoking and alcohol consumption), and sleep behaviours using UK Biobank data. Results implementing SEM indicate partial evidence for a Syndemic model, with personal resilience being at its centre. Contrary to previous findings, drugs related behaviours did not play an important role in the model. Implementing a Syndemic framework approach to current health care strategies could be beneficial in the development of self-management strategies for people with SMI. This is the first paper using SEM analyses to investigate SMI under the Syndemic theory paradigm.
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Affiliation(s)
- Silke Vereeken
- Mental Health and Addiction, Department of Health Sciences, University of York, York, UK.
| | - Andre Bedendo
- Department of Health Sciences, Faculty of Sciences, University of York, York, UK
| | - Simon Gilbody
- Mental Health and Addiction, Department of Health Sciences, University of York, York, UK
- Hull York Medical School, York, UK
| | - Catherine E Hewit
- York Trials Unit, Department of Health Sciences, University of York, York, UK
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Porcheret K, Hopstock LA, Nilsen KB. Prevalence of insomnia in a general adult population cohort using different diagnostic criteria: The seventh survey of the Tromsø study 2015-2016. Sleep Med 2024; 119:289-295. [PMID: 38718598 DOI: 10.1016/j.sleep.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 05/02/2024] [Accepted: 05/02/2024] [Indexed: 06/18/2024]
Abstract
Insomnia disorder is a subjective complaint of sleep dissatisfaction including both night-time and daytime symptoms. Currently there are three commonly used diagnostic manuals each with their own set of criteria, which is often credited for the wide range in insomnia prevalence reported by population-based studies, especially those with self-reported insomnia. However, there are limited studies directly comparing different criteria and little is known about associations with health outcomes. Thus, the aim of this study was to compare the most commonly used diagnostic criteria for insomnia from the literature and to explore the associations with a range of physical and mental health outcomes. We used data from 21,083 women and men from the seventh survey of the population-based Tromsø Study which included adults aged 40-99 years. A revised version of the Bergen Insomnia Scale was used to define insomnia based on the 4th (revised) and 5th edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR and DSM5), the 10th edition of the International Classification of Diseases (ICD-10), and the 3rd edition of the International Classification of Sleep Disorders (ICSD-3). We found the following prevalence of insomnia: DSM-IV-TR 23.6 %, DSM5 8.5 %, ICD-10 9.9 % and ICSD-3 20.0 %. When looking at each symptom, we found over half the participants classified as having insomnia using the DSM-IV-TR and ICSD-3 criteria did not report having impaired daytime functioning at least three days per week. Overall, participants with DSM5 and ICD-10 insomnia appeared to have worse health profiles, based on a higher percentage meeting the cut-off for possible anxiety or depression, reporting a psychological problem or chronic pain, and using antidepressants, painkillers or sleeping pills. However logistic regression models showed largely the same health factors had the same association with the odds for being classified as having insomnia disorder from each set of criteria. Overall, this study suggests that insomnia prevalence may be overestimated if daytime symptoms are not adequately included in accordance with current guidelines.
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Affiliation(s)
- Kate Porcheret
- Section for trauma, disasters and forced migration - children and young people, Norwegian Center for Violence and Traumatic Stress Studies, Norway; Institute of Clinical Medicine, University of Oslo, Norway.
| | - Laila A Hopstock
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Norway
| | - Kristian Bernhard Nilsen
- Department of Neurology and Department of Research and Innovation, Neuroscience Clinic, Oslo University Hospital, Norway
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Nordström EEL, Kaltiala R, Kristensen P, Thimm JC. Somatic symptoms and insomnia among bereaved parents and siblings eight years after the Utøya terror attack. Eur J Psychotraumatol 2024; 15:2300585. [PMID: 38214224 PMCID: PMC10791101 DOI: 10.1080/20008066.2023.2300585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/27/2023] [Indexed: 01/13/2024] Open
Abstract
Background: Levels of prolonged grief symptoms (PGS) and post-traumatic stress symptoms (PTSS) can be high, many years following bereavement after terror, but knowledge concerning somatic health is scarce. Terrorism is a serious public health challenge, and increased knowledge about long-term somatic symptoms and insomnia is essential for establishing follow-up interventions after terrorism bereavement.Objective: To study the prevalence of somatic symptoms and insomnia and their association with PGS, PTSS, and functional impairment among terrorism-bereaved parents and siblings.Methods: A cross-sectional quantitative study included 122 bereaved individuals from the Utøya terror attack in Norway in 2011. The sample comprised 88 parents and 34 siblings aged 19 years and above (Mage = 49.7 years, SDage = 13.8 years, 59.8% females). The participants completed questionnaires 8 years after the attack assessing somatic symptoms (Children's Somatic Symptoms Inventory) and insomnia (Bergen Insomnia Scale) along with measures of PGS (Inventory of Complicated Grief), PTSS (Impact of Event Scale-Revised), and functional impairment (Work and Social Adjustment Scale).Results: Fatigue was the most frequently reported somatic symptom (88% of females and 65% of males). Females reported statistically significantly more somatic symptoms than males. In total, 68% of the bereaved individuals scored above the cut-off for insomnia. There were no statistically significant gender differences for insomnia. Female gender, intrusion, and arousal were associated with somatic symptoms. Intrusion and somatic symptoms were associated with insomnia. Somatic symptoms, avoidance, and hyperarousal were associated with functional impairment.Conclusion: Many bereaved parents and siblings report somatic symptoms and insomnia eight years after the terror attack. Somatic symptoms are associated with functional impairment. Long-term follow-up and support after traumatic bereavement should focus on somatic symptoms and insomnia.
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Affiliation(s)
| | - Riittakerttu Kaltiala
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Adolescent Psychiatry, Tampere University Hospital, Tampere, Finland
- Vanha Vaasa Hospital, Vaasa, Finland
| | - Pål Kristensen
- Center for Crisis Psychology, University of Bergen, Bergen, Norway
| | - Jens C. Thimm
- Center for Crisis Psychology, University of Bergen, Bergen, Norway
- Department of Psychology, UiT The Arctic University of Norway, Tromsø, Norway
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Jensen S, Abeler K, Friborg O, Rosner A, Olsborg C, Mellgren SI, Müller KI, Rosenberger AD, Vold ML, Arntzen KA. Insomnia and sleep-disordered breathing in FKRP-related limb-girdle muscular dystrophy R9. The Norwegian LGMDR9 cohort study (2020). J Neurol 2024; 271:274-288. [PMID: 37695533 PMCID: PMC10770197 DOI: 10.1007/s00415-023-11978-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 08/25/2023] [Accepted: 08/28/2023] [Indexed: 09/12/2023]
Abstract
Limb-girdle muscular dystrophy R9 (LGMDR9) is a progressive and disabling genetic muscle disease. Sleep is relevant in the patient care as it impacts on health, functioning, and well-being. LGMDR9 may potentially affect sleep by physical or emotional symptoms, myalgia, or sleep-disordered breathing (SDB) through cardiorespiratory involvement. The objective was to investigate the occurrence of insomnia and unrecognized or untreated SDB in LGMDR9, associated factors, and relationships with fatigue and health-related quality of life (HRQoL). All 90 adults in a Norwegian LGMDR9 cohort received questionnaires on sleep, fatigue, and HRQoL. Forty-nine of them underwent clinical assessments and 26 without mask-based therapy for respiration disorders additionally underwent polysomnography (PSG) and capnometry. Among 77 questionnaire respondents, 31% received mask-based therapy. The prevalence of insomnia was 32% of both those with and without such therapy but was significantly increased in fatigued respondents (54% vs 21%). Insomnia levels correlated inversely with mental HRQoL. Among 26 PSG candidates, an apnea-hypopnea index (AHI) ≥ 5/h was observed in 16/26 subjects (≥ 15/h in 8/26) with median 6.8 obstructive apneas and 0.2 central apneas per hour of sleep. The AHI was related to advancing age and an ejection fraction < 50%. Sleep-related hypoventilation was detected in one subject. Fatigue severity did not correlate with motor function or nocturnal metrics of respiration or sleep but with Maximal Inspiratory Pressure (r = - 0.46). The results indicate that insomnia and SDB are underrecognized comorbidities in LGMDR9 and associated with HRQoL impairment and heart failure, respectively. We propose an increased attention to insomnia and SDB in the interdisciplinary care of LGMDR9. Insomnia and pulmonary function should be examined in fatigued patients.
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Affiliation(s)
- Synnøve Jensen
- National Neuromuscular Centre Norway and Department of Neurology, University Hospital of North Norway, 9038, Tromsø, Norway.
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø-The Artic University of Norway, Tromsø, Norway.
| | - Karin Abeler
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø-The Artic University of Norway, Tromsø, Norway
- Department of Neurology and Neurophysiology, University Hospital of North Norway, Tromsø, Norway
| | - Oddgeir Friborg
- Department of Psychology, Faculty of Health Sciences, University of Tromsø-The Artic University of Norway, Tromsø, Norway
| | - Assami Rosner
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø-The Artic University of Norway, Tromsø, Norway
- Department of Cardiology, University Hospital of North Norway, Tromsø, Norway
| | - Caroline Olsborg
- Department of Neurology and Neurophysiology, University Hospital of North Norway, Tromsø, Norway
| | - Svein Ivar Mellgren
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø-The Artic University of Norway, Tromsø, Norway
| | - Kai Ivar Müller
- Department of Neurology, Sørlandet Hospital Trust, Kristiansand, Norway
| | - Andreas Dybesland Rosenberger
- National Neuromuscular Centre Norway and Department of Neurology, University Hospital of North Norway, 9038, Tromsø, Norway
| | - Monica L Vold
- Department of Respiratory Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Kjell Arne Arntzen
- National Neuromuscular Centre Norway and Department of Neurology, University Hospital of North Norway, 9038, Tromsø, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø-The Artic University of Norway, Tromsø, Norway
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Barnes A, Andrews JM, Mukherjee S, Bryant RV, Bampton P, Fraser RJ, Mountifield R. Insomnia is common in inflammatory bowel disease (IBD) and is associated with mental health conditions as well as IBD activity. Intest Res 2024; 22:104-114. [PMID: 37904322 PMCID: PMC10850702 DOI: 10.5217/ir.2023.00028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/20/2023] [Accepted: 08/22/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND/AIMS Insomnia is common in people with chronic medical conditions, such as inflammatory bowel disease (IBD), and is readily treatable through cognitive behavioral therapy for insomnia. This study aimed to describe the associations with insomnia in people with IBD and its relationship to IBD-related disability. METHODS An online questionnaire was administered through 3 tertiary IBD centers, social media, and Crohn's Colitis Australia. The questionnaire included the Insomnia Severity Index (ISI), a validated assessment of insomnia. Measures of anxiety, depression, physical activity, and disability were also included. IBD activity was assessed using validated patient reported scores. A multivariate model was constructed for clinically significant insomnia and ISI scores. Subpopulations of Crohn's disease and ulcerative colitis were considered. RESULTS In a cohort of 670 respondents the median age was 41 years (range, 32-70 years), with the majority female (78.4%), the majority had Crohn's disease (57.3%). Increasingly severe disability was associated with worse insomnia score. Clinically significant insomnia was associated with clinically active IBD, abdominal pain, anxiety, and depression, in a multivariate model. In an ulcerative colitis population, Simple Clinical Colitis Activity Index components of general well-being and urgency were associated with worse ISI score in a model including depression and anxiety. In those with Crohn's disease, the multivariate model included Harvey Bradshaw Index score in addition to depression and anxiety. CONCLUSIONS Insomnia is common in people with IBD and is associated with increased disability. Abdominal pain and mental health conditions should prompt consideration for screening for insomnia and referral for cognitive behavioral therapy for insomnia.
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Affiliation(s)
- Alex Barnes
- Department of Gastroenterology, Southern Adelaide Local Health Network (SALHN) Flinders Medical Centre, Bedford Park, Australia
- Adelaide Institute for Sleep Health, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, Australia
| | - Jane M Andrews
- Inflammatory Bowel Disease Service, Department of Gastroenterology and Hepatology, Central Adelaide Local Health Network (CALHN) Royal Adelaide Hospital, Adelaide, Australia
- School of Medicine, Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Sutapa Mukherjee
- Adelaide Institute for Sleep Health, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, Australia
- Department of Respiratory and Sleep Medicine, Southern Adelaide Local Health Network (SALHN) Flinders Medical Centre, Bedford Park, Australia
| | - Robert V Bryant
- School of Medicine, Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, Australia
- Department of Gastroenterology, Queen Elizabeth Hospital, Woodville, Australia
| | - Peter Bampton
- Adelaide Institute for Sleep Health, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, Australia
| | - Robert J. Fraser
- Department of Gastroenterology, Southern Adelaide Local Health Network (SALHN) Flinders Medical Centre, Bedford Park, Australia
- Adelaide Institute for Sleep Health, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, Australia
| | - Réme Mountifield
- Department of Gastroenterology, Southern Adelaide Local Health Network (SALHN) Flinders Medical Centre, Bedford Park, Australia
- Adelaide Institute for Sleep Health, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, Australia
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Canever JB, Cândido LM, Moreira BDS, Danielewicz AL, Cimarosti HI, Lima-Costa MF, Avelar NCPD. A nationwide study on sleep complaints and associated factors in older adults: ELSI-Brazil. CAD SAUDE PUBLICA 2023; 39:e00061923. [PMID: 38018640 PMCID: PMC10642241 DOI: 10.1590/0102-311xen061923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/13/2023] [Accepted: 07/13/2023] [Indexed: 11/30/2023] Open
Abstract
Sleep problems, such as difficulty falling asleep, staying asleep, early awakening with failure to continue sleep, and altered sleep-wake cycle, are common in the general population. This cross-sectional study with 6,929 older adults (≥ 60 years) aimed to estimate the prevalence of different types of sleep problems, their associated factors, and the population-attributable fraction of associated factors among older adults. The outcome variables consisted of self-reported sleep problems: insomnia (initial, intermediate, late, and any type of insomnia), poor sleep quality, and daytime sleepiness. The independent variables were sociodemographic and behavioral characteristics and health conditions. The prevalence proportions were initial insomnia (49.1%), intermediate insomnia (49.2%), late insomnia (45.9%), any type of insomnia (58.6%), poor sleep quality (15.6%), and daytime sleepiness (38.4%). Female sex, presence of two or more chronic diseases, not eating the recommended amount of fruits and vegetables, and regular and bad/very bad self-rated health were positively associated with the sleep problems investigated. Consuming alcohol once a month or more was inversely associated with initial insomnia. Population attributable fraction estimates ranged from 3% to 19% considering two or more chronic diseases, not eating the recommended amount of fruits and vegetables, and regular and bad/very bad self-rated health. High prevalence of self-reported sleep problems was evinced in older adults. These results can be useful to guide public health services in the creation of informational, evaluative, and screening strategies for sleep problems in older Brazilian adults.
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Affiliation(s)
- Jaquelini Betta Canever
- Centro de Ciências, Tecnologias e Saúde do Campus Araranguá, Universidade Federal de Santa Catarina, Araranguá, Brasil
| | - Letícia Martins Cândido
- Centro de Ciências, Tecnologias e Saúde do Campus Araranguá, Universidade Federal de Santa Catarina, Araranguá, Brasil
| | - Bruno de Souza Moreira
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Fundação Oswaldo Cruz/Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Ana Lúcia Danielewicz
- Centro de Ciências, Tecnologias e Saúde do Campus Araranguá, Universidade Federal de Santa Catarina, Araranguá, Brasil
| | | | - Maria Fernanda Lima-Costa
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Fundação Oswaldo Cruz/Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
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Yoshiike T, Kawamura A, Utsumi T, Matsui K, Kuriyama K. A prospective study of the association of weekend catch-up sleep and sleep duration with mortality in middle-aged adults. Sleep Biol Rhythms 2023; 21:409-418. [PMID: 38468822 PMCID: PMC10900010 DOI: 10.1007/s41105-023-00460-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 04/23/2023] [Indexed: 03/13/2024]
Abstract
Health effects of weekend catch-up sleep (CUS) could differ depending on both the ability to obtain sufficient sleep during weekdays and amount of weekend CUS required to compensate for sleep lost during the week. Using data from 3128 middle-aged (40-64 years) participants of the Sleep Heart Health Study, we examined the longitudinal association of these two aspects of sleep with all-cause mortality. CUS was calculated as the difference in self-reported habitual sleep duration between weekends and weekdays, and classified into no, short (1 h), and long (2 h or more) CUS. Polysomnography-measured total sleep time, representing the ability to obtain sufficient sleep, was classified into short (< 360 min) or normal (≥ 360 min) sleep durations. We estimated multivariable-adjusted mortality hazard ratios (HRs) and 95% confidence intervals (CIs) for six groups divided by the extent of CUS and sleep duration. Participants were followed up for a median (interquartile range) of 12.3 (11.3-13.5) years. Short weekend CUS with normal sleep duration was associated with lower mortality compared to no CUS with normal sleep duration (HR, 0.48; 95% CI 0.27-0.83). When stricter cutoffs were applied for sleep durations, while the protective effect of short CUS with normal sleep duration (≥ 390 min) was strengthened (HR, 0.36; 95% CI 0.17-0.78), the harmful effect of short CUS with short sleep duration (< 330 min) emerged (HR, 1.84; 95% CI 1.08-3.14). Results highlight the importance of balancing sleep ability and CUS. Sufficient sleep may reduce weekday sleep debt and only a short CUS would be required on weekends, improving mortality in middle-aged adults. Supplementary Information The online version contains supplementary material available at 10.1007/s41105-023-00460-6.
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Affiliation(s)
- Takuya Yoshiike
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8553 Japan
| | - Aoi Kawamura
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8553 Japan
| | - Tomohiro Utsumi
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8553 Japan
| | - Kentaro Matsui
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8553 Japan
- Department of Laboratory Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Kenichi Kuriyama
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8553 Japan
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Zhang W, Gao T, Liu F, Zhang H, Wang S. Perioperative sleep disorders in gynaecological daycase surgery patients and analysis of risk factors: protocol for a cross-sectional study. BMJ Open 2023; 13:e074677. [PMID: 37751958 PMCID: PMC10533728 DOI: 10.1136/bmjopen-2023-074677] [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: 04/13/2023] [Accepted: 09/11/2023] [Indexed: 09/30/2023] Open
Abstract
INTRODUCTION Sleep disorders are clinical syndromes of disturbed sleep-wake rhythms and abnormal sleep quality. They have various causes, but their main manifestations are difficulty falling asleep, sleep disruption and daytime fatigue. These are common clinical symptoms in perioperative patients, especially in gynaecological patients. There is a lack of research on the factors influencing perioperative sleep disorders in gynaecological patients. The aim of this study is to assess the prevalence of sleep disorders in gynaecological surgery patients and to analyse the possible factors influencing them to provide new ideas for improving sleep disorders in this patient population. METHODS AND ANALYSIS This cross-sectional, descriptive and observational survey is planned to include 480 gynaecological day surgery patients. All patients who meet the inclusion criteria are eligible to join the study. The study will record preoperative diagnosis, surgical procedure, duration of surgery, type of anaesthesia, anaesthetic drugs, sleep quality, anxiety and depression levels and pain indices 30 days before and 1, 2, 3 and 30 days after surgery. ETHICS AND DISSEMINATION The study was approved by the Ethics Committee of Beijing Shijitan Hospital Affiliated with Capital Medical University (Approval Number: sjtkyll-lx-2022(109)) before the start of recruitment. The results of the study will be disseminated through peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER ChiCTR2200064533.
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Affiliation(s)
- Wensi Zhang
- Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China
| | - Teng Gao
- Peking University Sixth Hospital, Beijing, China
- Peking University Institute of Mental Health, Beijing, China
| | - Fanglin Liu
- Peking University, Beijing, China
- Department of Neurobiology, Peking University Health Science Center, Beijing, China
| | - Haijing Zhang
- Department of Anaesthesiology, Capital Medical University, Beijing, China
| | - Shaoheng Wang
- Department of Anaesthesiology and Surgical Critical Care Medicine, Capital Medical University, Beijing, China
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11
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Gonzalez JE, Shea SA, Bowles NP. Daily cannabis use is associated with sleep duration differentially across ages. Sleep Health 2023; 9:181-184. [PMID: 36404265 PMCID: PMC10122692 DOI: 10.1016/j.sleh.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 09/29/2022] [Accepted: 10/14/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess the relationship between frequency of cannabis use and sleep duration across age in a large US population (235,667 people). METHODS Multinomial logistic regression was used to evaluate the association between the frequency of cannabis use and sleep duration using cross sectional data from the 2016-2018 Behavioral Risk Factor Surveillance System. RESULTS When adjusted for sociodemographic factors, health related variables, and stratified by age we found that young adults (18-44 years) who reported daily-use (≥16 uses a month) had an increased risk ratio (RR [95% CI]) for either short or long sleep (1.22 [1.06-1.40] and 1.52 [1.07-2.16]); midlife adults (45-64 years) who reported daily-use had an increased prevalence of long sleep (1.71 [1.03-2.82]); and older adults (≥65 years) who reported daily-use had an increased prevalence of short sleep (1.61 [1.05-2.49]). CONCLUSIONS Compared to those who reported no cannabis use, individuals who reported daily cannabis use demonstrated a greater prevalence for either short or long sleep duration.
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Affiliation(s)
- Joshua E Gonzalez
- Oregon Institute of Occupational Health Sciences, Oregon Health and Sciences University, Portland, Oregon, USA
| | - Steven A Shea
- Oregon Institute of Occupational Health Sciences, Oregon Health and Sciences University, Portland, Oregon, USA
| | - Nicole P Bowles
- Oregon Institute of Occupational Health Sciences, Oregon Health and Sciences University, Portland, Oregon, USA.
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12
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Chan CS, Wong CYF, Yu BYM, Hui VKY, Ho FYY, Cuijpers P. Treating depression with a smartphone-delivered self-help cognitive behavioral therapy for insomnia: a parallel-group randomized controlled trial. Psychol Med 2023; 53:1799-1813. [PMID: 37310329 DOI: 10.1017/s0033291721003421] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Despite its efficacy in treating comorbid insomnia and depression, cognitive behavioral therapy for insomnia (CBT-I) is limited in its accessibility and, in many countries, cultural compatibility. Smartphone-based treatment is a low-cost, convenient alternative modality. This study evaluated a self-help smartphone-based CBT-I in alleviating major depression and insomnia. METHODS A parallel-group randomized, waitlist-controlled trial was conducted with 320 adults with major depression and insomnia. Participants were randomized to receive either a 6-week CBT-I via a smartphone application, proACT-S, or waitlist condition. The primary outcomes included depression severity, insomnia severity, and sleep quality. The secondary outcomes included anxiety severity, subjective health, and acceptability of treatment. Assessments were administered at baseline, post-intervention (week 6) follow-up, and week 12 follow-up. The waitlist group received treatment after the week 6 follow-up. RESULTS Intention to treat analysis was conducted with multilevel modeling. In all but one model, the interaction between treatment condition and time at week 6 follow-up was significant. Compared with the waitlist group, the treatment group had lower levels of depression [Center for Epidemiologic Studies Depression Scale (CES-D): Cohen's d = 0.86, 95% CI (-10.11 to -5.37)], insomnia [Insomnia Severity Index (ISI): Cohen's d = 1.00, 95% CI (-5.93 to -3.53)], and anxiety [Hospital Anxiety and Depression Scale - Anxiety subscale (HADS-A): Cohen's d = 0.83, 95% CI (-3.75 to -1.96)]. They also had better sleep quality [Pittsburgh Sleep Quality Index (PSQI): Cohen's d = 0.91, 95% CI (-3.34 to -1.83)]. No differences across any measures were found at week 12, after the waitlist control group received the treatment. CONCLUSION proACT-S is an efficacious sleep-focused self-help treatment for major depression and insomnia. TRIAL REGISTRATION ClinicalTrials.gov, NCT04228146. Retrospectively registered on 14 January 2020. http://www.w3.org/1999/xlink">https://clinicaltrials.gov/ct2/show/NCT04228146.
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Affiliation(s)
| | | | | | | | | | - Pim Cuijpers
- Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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13
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Bjorvatn B, Waage S, Saxvig IW. Do people use methods or tricks to fall asleep? A comparison between people with and without chronic insomnia. J Sleep Res 2023; 32:e13763. [PMID: 36316962 DOI: 10.1111/jsr.13763] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/07/2022] [Accepted: 10/10/2022] [Indexed: 11/05/2022]
Abstract
The present study estimated the frequency of using methods or tricks to fall asleep in the general Norwegian population. Further, people with chronic insomnia were compared with people without chronic insomnia. A representative sample of 1028 participants aged 18 years or older completed a web-based survey. The response rate was 33.5%. Insomnia symptoms were assessed with the validated Bergen Insomnia Scale, and chronic insomnia based on ICSD-3/DSM-5 criteria. Data were analysed with chi-square tests and logistic regression with adjustment for sex, age, education, and circadian preference. The results showed that 34.3% reported using a method or a trick to fall asleep, with relaxation exercises/breathing exercises being the most common. More females (39.5%) compared with males (29.1%) reported the use of a method/trick to fall asleep with an adjusted odds ratio (aOR) of 1.44. Chronic insomnia was reported by 24.9%, and clearly associated with higher use of such methods/tricks (53.7%; aOR = 3.49). Among the participants without chronic insomnia, 28.1% reported using methods/tricks to fall asleep. In conclusion, most people do not use methods or tricks to fall asleep, but chronic insomnia was associated with a higher frequency of such use. Still, since methods/tricks were also used by some participants without chronic insomnia, this may suggest that, for some people, this strategy may be effective or at least does not seem to disrupt the sleep onset process.
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Affiliation(s)
- Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Siri Waage
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.,Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Ingvild W Saxvig
- Centre for Sleep Medicine, Haukeland University Hospital, Bergen, Norway
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14
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Ellis J, Ferini-Strambi L, García-Borreguero D, Heidbreder A, O’Regan D, Parrino L, Selsick H, Penzel T. Chronic Insomnia Disorder across Europe: Expert Opinion on Challenges and Opportunities to Improve Care. Healthcare (Basel) 2023; 11:716. [PMID: 36900721 PMCID: PMC10001099 DOI: 10.3390/healthcare11050716] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/21/2023] [Accepted: 02/24/2023] [Indexed: 03/06/2023] Open
Abstract
One in ten adults in Europe have chronic insomnia, which is characterised by frequent and persistent difficulties initiating and/or maintaining sleep and daily functioning impairments. Regional differences in practices and access to healthcare services lead to variable clinical care across Europe. Typically, a patient with chronic insomnia (a) will usually present to a primary care physician; (b) will not be offered cognitive behavioural therapy for insomnia-the recommended first-line treatment; (c) will instead receive sleep hygiene recommendations and eventually pharmacotherapy to manage their long-term condition; and (d) will use medications such as GABA receptor agonists for longer than the approved duration. Available evidence suggests that patients in Europe have multiple unmet needs, and actions for clearer diagnosis of chronic insomnia and effective management of this condition are long overdue. In this article, we provide an update on the clinical management of chronic insomnia in Europe. Old and new treatments are summarised with information on indications, contraindications, precautions, warnings, and side effects. Challenges of treating chronic insomnia in European healthcare systems, considering patients' perspectives and preferences are presented and discussed. Finally, suggestions are provided-with healthcare providers and healthcare policy makers in mind-for strategies to achieve the optimal clinical management.
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Affiliation(s)
- Jason Ellis
- Department of Psychology, Northumbria University, Newcastle NE1 8ST, UK
| | - Luigi Ferini-Strambi
- Department of General Psychology, Università Vita-Salute San Raffaele, 20132 Milan, Italy
| | | | - Anna Heidbreder
- Department of Neurology, Innsbruck Medical University, 6020 Innsbruck, Austria
| | - David O’Regan
- Faculty of Life Sciences and Medicine, King’s College, London WC2R 2LS, UK
- Disorder Centre, Guy’s Hospital, London SE1 9RT, UK
| | - Liborio Parrino
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126 Parma, Italy
| | - Hugh Selsick
- Insomnia and Behavioural Sleep Medicine Clinic, University College London Hospitals, London NW1 2PG, UK
| | - Thomas Penzel
- Interdisciplinary Centre of Sleep Medicine, Medicine Centre, Charité Universitätsmedizin, 10117 Berlin, Germany
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15
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Kroeger D, Vetrivelan R. To sleep or not to sleep - Effects on memory in normal aging and disease. AGING BRAIN 2023; 3:100068. [PMID: 36911260 PMCID: PMC9997183 DOI: 10.1016/j.nbas.2023.100068] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 11/03/2022] [Accepted: 01/20/2023] [Indexed: 01/31/2023] Open
Abstract
Sleep behavior undergoes significant changes across the lifespan, and aging is associated with marked alterations in sleep amounts and quality. The primary sleep changes in healthy older adults include a shift in sleep timing, reduced slow-wave sleep, and impaired sleep maintenance. However, neurodegenerative and psychiatric disorders are more common among the elderly, which further worsen their sleep health. Irrespective of the cause, insufficient sleep adversely affects various bodily functions including energy metabolism, mood, and cognition. In this review, we will focus on the cognitive changes associated with inadequate sleep during normal aging and the underlying neural mechanisms.
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Affiliation(s)
- Daniel Kroeger
- Anatomy, Physiology, and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL 36849, United States
| | - Ramalingam Vetrivelan
- Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02215, United States
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16
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Saxvig IW, Bjorvatn B, Waage S. Habitual Sleep Patterns and Chronic Sleep Problems in Relation to Sex, Age, and Circadian Preference in a Population-Based Sample of Norwegian Adults. Clocks Sleep 2023; 5:21-33. [PMID: 36648942 PMCID: PMC9844397 DOI: 10.3390/clockssleep5010003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/23/2022] [Accepted: 12/30/2022] [Indexed: 01/11/2023] Open
Abstract
Sleep patterns and problems vary in relation to internal (e.g., sex, age, circadian preference) and external (e.g., social structures) factors. The main aim of the present study was to describe habitual sleep patterns and chronic sleep problems in a population-based sample of Norwegian adults. During spring 2022, a sample of 1028 adults completed an online survey on sleep habits and problems. Response rate was 33.5%. The survey included the Munich ChronoType Questionnaire and items on circadian preference and chronic sleep problems. Mean workday sleep duration was 7:19 h (±199 min), and shorter in males (p = 0.035) and evening persons (p = 0.003). Short workday sleep duration (<6 h) was reported by 3.1% and was associated with evening preference (p = 0.001). Mean social jetlag was 0:51 h (±75 min), and longer in males (p = 0.036), younger adults (p < 0.001) and evening persons (p < 0.001). Long social jetlag (≥2 h) was reported by 11.2% and associated with younger age (p < 0.001) and evening preference (p < 0.001). Chronic sleep problems (≥3 months) were reported by 44.1%, and associated with female sex (p < 0.001) and evening preference (p = 0.002). Results underscore the importance of considering evening circadian preference as a risk factor for short workday sleep duration, long social jetlag and self-reported chronic sleep problems.
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Affiliation(s)
- Ingvild West Saxvig
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, 5021 Bergen, Norway
| | - Bjørn Bjorvatn
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, 5021 Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway
| | - Siri Waage
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, 5021 Bergen, Norway
- Department of Psychosocial Science, University of Bergen, 5020 Bergen, Norway
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17
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Poluektov MG, Akarachkova ES, Dovgan EV, Kotova OV, Demidova TY, Klimenko AA, Kokorin VA, Ostroumova OD, Ostroumova TM. [Management of patients with insomnia and polymorbidity: expert consensus]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:49-57. [PMID: 37275998 DOI: 10.17116/jnevro202312305249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Sleep disorders are becoming increasingly important due to the high comorbidity with other diseases and a significant impact on the patient's quality of life. Insomnia is the most common sleep disorder both in the general population and in patients with multimorbid pathology. Its prevalence in the general population is 6-15%, while in patients with somatic diseases it increases up to 20-40% and can reach 90% in patients with comorbid mental disorders. Another problem is the development of drug-induced insomnia. Insomnia has negative impact on the prognosis of comorbid diseases, including an increased risk of death, more severe disease, and a worse quality of life. The presence of sleep disorders makes it difficult to effectively treat the underlying disease, so it is extremely important to identify and correct these disorders in the early stages, therefore recommendations for the diagnosis of insomnia in polymorbid patients are proposed. Modern methods of treating acute and chronic insomnia and features of insomnia treatment in polymorbid patients are also discussed.
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Affiliation(s)
- M G Poluektov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - E S Akarachkova
- International society «Stress under control», Moscow, Russia
| | - E V Dovgan
- Smolensk Regional Clinical Hospital, Smolensk, Russia
| | - O V Kotova
- International society «Stress under control», Moscow, Russia
- Peoples' Friendship University of Russia, Moscow, Russia
| | - T Yu Demidova
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - A A Klimenko
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - V A Kokorin
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - O D Ostroumova
- Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - T M Ostroumova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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18
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Larsen A, Hopstock L, Jorde R, Grimnes G. Associations of serum 25-hydroxyvitamin D and subjective sleep measures in an Arctic population: Insights from the population-based Tromsø Study. Sleep Med X 2022; 4:100056. [PMID: 36274862 PMCID: PMC9579360 DOI: 10.1016/j.sleepx.2022.100056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 02/21/2022] [Accepted: 08/28/2022] [Indexed: 11/29/2022] Open
Abstract
Objective To investigate the relation between serum 25-hydroxyvitamin D (s-25(OH)D) and subjective sleep measures in an Arctic population (69°N). Methods Cross-sectional data was collected from 21,083 individuals (aged ≥40 years) participating in the population based Tromsø Study: Tromsø7 (2015–2016). The present study included 20,438 participants, after having excluded respondents missing data on s-25(OH)D (n = 161) and/or subjective sleep measures (including sleep duration, insomnia, and daytime sleepiness)(n = 490). Based on s-25(OH)D (assessed using LC-MS/MS), participants were grouped as deficient (<30 nmol/L), insufficient (30–49.9 nmol/L), sufficient (50–75 nmol/L), or high (>75 nmol/L). Sleep duration was grouped as inadequate (ISD) if < 7 or ≥9 h. Linear and logistic regression were used to calculate unstandardized β-values and odds ratios [95% confidence intervals]. The analyses were adjusted for season, age, BMI, lifestyle factors and relevant comorbidities. Results In both men and women, s-25(OH)D was positively associated with sleep duration, and compared to the sufficient s-25(OH)D group, the insufficient s-25(OH)D group reported significantly shorter sleep duration in both sexes. There was an increased odds of ISD in both men and women but adjusted for confounding factors this was only significant in women (1.16 [1.03, 1.32], p = .017). In men, there were no significant associations between s-25(OH)D and the remaining sleep measures. Women in the high s-25(OH)D group had lower ESS-scores (−0.28 [-0.47, −0.08], p = .006), but higher odds of insomnia (1.16 [1.01, 1.33], p = .036) compared to women in the sufficient group. Conclusions In this Arctic population, a tenuous association was found between s-25(OH)D and subjective sleep measures, predominantly in women. 25(OH)D was associated with self-reported sleep measures in this Arctic population. 25(OH)D was positively associated with self-reported sleep duration in both sexes. Women with sufficient 25(OH)D had lower odds of insomnia. RCTs are needed to determine the role of vitamin D in sleep health.
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Affiliation(s)
- A.U. Larsen
- Department of Clinical Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
- Corresponding author.
| | - L.A. Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - R. Jorde
- Department of Clinical Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, 9038 Tromsø, Norway
| | - G. Grimnes
- Department of Clinical Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, 9038 Tromsø, Norway
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19
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Husberg VH, Hopstock LA, Friborg O, Rosenvinge JH, Bergvik S, Rognmo K. Epidemiology of comorbid hazardous alcohol use and insomnia in 19 185 women and men attending the population-based Tromsø Study 2015-2016. BMC Public Health 2022; 22:844. [PMID: 35477423 PMCID: PMC9047295 DOI: 10.1186/s12889-022-13250-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/19/2022] [Indexed: 11/10/2022] Open
Abstract
Background Hazardous alcohol use is known to be comorbid with insomnia problems. The present study examined the prevalence of insomnia and if the odds of insomnia differed between women and men with a hazardous alcohol use. Methods Cross-sectional data from the seventh survey of the Norwegian population-based Tromsø Study 2015–2016 (participation 65%). The sample included 19 185 women and men 40–96 years. Hazardous alcohol use was defined by the Alcohol Use Disorder Identification Test (AUDIT) and insomnia by the Bergen Insomnia Scale. Covariates included socio-demographics, shift work, somatic conditions and mental distress defined by Hopkins Symptom Check List-10 (HSCL-10). Mental distress was also included as a moderator. Results Insomnia was more prevalent among participants with a hazardous alcohol use (24.1%) than without (18.9%), and participants who had hazardous alcohol use had higher odds of insomnia (odds ratio = 1.49, 95% CI = 1.20, 1.85). The association turned non-significant after adjustment for mental distress. Adding mental distress as a moderator variable revealed a higher odds of insomnia among hazardous alcohol users having no or low-to-medium levels of mental distress, but not among participants with high levels of mental distress. Conclusion Insomnia was more prevalent among women and men reporting hazardous alcohol use. When mental distress was treated as a moderator, hazardous alcohol use did not yield higher odds for insomnia among those with high levels of mental distress. This suggests that mental distress may play an important role in the association between hazardous alcohol use and insomnia. And that the impact of alcohol on insomnia may differ depending on the severity of mental distress. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13250-5.
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Affiliation(s)
- Vendela H Husberg
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Laila A Hopstock
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Oddgeir Friborg
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Jan H Rosenvinge
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Svein Bergvik
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kamilla Rognmo
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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20
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Appleton SL, Reynolds AC, Gill TK, Melaku YA, Adams RJ. Insomnia Prevalence Varies with Symptom Criteria Used with Implications for Epidemiological Studies: Role of Anthropometrics, Sleep Habit, and Comorbidities. Nat Sci Sleep 2022; 14:775-790. [PMID: 35478719 PMCID: PMC9037734 DOI: 10.2147/nss.s359437] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/06/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Estimating insomnia prevalence in epidemiological studies is hampered by variability in definitions and interpretation of criteria. We addressed the absence of a population-based estimate of insomnia in Australia using the widely accepted contemporary International Classification of Sleep Disorders (ICSD-3) criteria, which includes sleep opportunity, and has not been applied in studies to date. Consistent use of these criteria across epidemiological studies, however, requires evidence of the clinical utility of a sleep opportunity criterion for targeting strategies. Methods A cross-sectional national on-line survey (2019 Sleep Health Foundation Insomnia Survey) of Australian adults (18-90 years, n = 2044) was conducted. Chronic insomnia was defined as sleep symptoms and daytime impairment experienced ≥3 times per week, and present for ≥3 months, with adequate sleep opportunity (time in bed (TIB) ≥7.5 hrs). Self-rated general health (SF-1) and ever diagnosed health conditions (including sleep disorders) were assessed. Results Chronic difficulties initiating and maintaining sleep and daytime symptoms (n = 788) were more common in females (41.5%) than males (35.3%), p = 0.004. Excluding participants reporting frequent pain causing sleep disruption and TIB <7.5 hrs generated an insomnia disorder estimate of 25.2% (95% CI: 22.5-28.2) in females and 21.1% (18.4-23.9) in males [23.2% (21.2-25.2) overall]. This compares with 8.6% (7.3-10.0) with insomnia symptoms and TIB <7.5 hrs and 7.5% (6.4-8.7%) ever diagnosed with insomnia. Insomnia symptom groups with TIB <7.5 and ≥7.5 hours demonstrated similar odds of reporting fair/poor health [odds ratio (OR): 3.2 (95% CI: 2.1-4.8) and 2.9 (95% CI: 2.2-3.9) respectively], ≥1 mental health condition, ≥1 airway disease, and multimorbidity. Conclusion Adults with significant sleep and daytime symptomatology and TIB <7.5 hrs did not differ clinically from those with insomnia disorder. Consideration of criteria, particularly adequate sleep opportunity, is required to consistently identify insomnia, and establish health correlates in future epidemiological studies. Further evaluation of the clinical utility of the sleep opportunity criterion is also required.
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Affiliation(s)
- Sarah L Appleton
- Flinders Health and Medical Research Institute – Sleep Health (Adelaide Institute for Sleep Health), College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- The Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Amy C Reynolds
- Flinders Health and Medical Research Institute – Sleep Health (Adelaide Institute for Sleep Health), College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Tiffany K Gill
- The Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Yohannes Adama Melaku
- Flinders Health and Medical Research Institute – Sleep Health (Adelaide Institute for Sleep Health), College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Robert J Adams
- Flinders Health and Medical Research Institute – Sleep Health (Adelaide Institute for Sleep Health), College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
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21
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Porcheret K, Stensland SØ, Wentzel-Larsen T, Dyb G. Insomnia in survivors 8.5 years after the Utøya Island terrorist attack: transition from late adolescence to early adulthood - the Utøya study. Eur J Psychotraumatol 2022; 13:2020472. [PMID: 35096287 PMCID: PMC8794065 DOI: 10.1080/20008198.2021.2020472] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Insomnia is a global health concern, associated with many mental and physical health conditions. Prevalence of insomnia is reported to increase during adolescence and early adulthood. High levels of insomnia are also reported in adolescents up to 2.5 years after a traumatic event. What is less well understood is the prevalence of insomnia in a trauma exposed population transitioning from adolescence to adulthood. OBJECTIVE To assess insomnia in the survivors in the 2011 Utøya Island terrorist attack, 2.5 years and 8.5 years after the attack when the majority of survivors were transitioning from late adolescence to early adulthood. METHOD Participants were 336 survivors of the Utøya Island attack who completed the Utøya Study 2.5 years (T3) and 8.5 years (T4) after the attack. Participants completed a face-to-face interview including the Bergen Insomnia Scale (BIS), which was used to assess insomnia symptoms and prevalence of meeting diagnostic criteria for insomnia. RESULTS Insomnia was indicated in 47.7% of survivors 8.5 years after the attack. Insomnia prevalence did not significantly change from 2.5 to 8.5 years after the attack, though insomnia symptoms (BIS sum score) were found to increase. Age was negatively associated with insomnia at T4, with older age being associated with less insomnia. No significant sex difference was found in insomnia prevalence at T4. CONCLUSION Almost a decade after the Utøya Island terrorist attack, nearly a half of the young survivors in our study reported insomnia and typical age- and sex-related differences in sleep were not always seen. This rate is almost double what is reported in the general population (20-30%) indicating a high level of unmet need in this population. The implications of such sleep disruption during a critical time for physical, mental, social and cognitive development are far reaching.
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Affiliation(s)
- Kate Porcheret
- Section forTtrauma, Catastrophes and Forced Migration - Children and Youths, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Synne Øien Stensland
- Section forTtrauma, Catastrophes and Forced Migration - Children and Youths, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.,Research and Communication Unit for Musculoskeletal Health (FORMI), Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
| | - Tore Wentzel-Larsen
- Section forTtrauma, Catastrophes and Forced Migration - Children and Youths, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.,Centre for Child and Adolescent Mental Health, Oslo, Norway
| | - Grete Dyb
- Section forTtrauma, Catastrophes and Forced Migration - Children and Youths, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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22
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Hysing M, Heradstveit O, Harvey AG, Nilsen SA, Bøe T, Sivertsen B. Sleep problems among adolescents within child and adolescent mental health services. An epidemiological study with registry linkage. Eur Child Adolesc Psychiatry 2022; 31:121-131. [PMID: 33159591 PMCID: PMC8816738 DOI: 10.1007/s00787-020-01676-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/25/2020] [Indexed: 12/16/2022]
Abstract
Sleep problems are prevalent among adolescents, especially among those diagnosed with mental health disorders. There is insufficient knowledge about sleep among adolescents within child and adolescent mental health services (CAMHS) in comparison to the general population. The data are drawn from the youth@hordaland study, a large population-based study conducted in 2012, linked to the Norwegian Patient Registry (NPR) (n = 9077). Psychiatric disorders were based on clinical diagnoses from the NPR, while insomnia, delayed sleep-wake-phase disorder (DSWPD), and other sleep problems/patterns were assessed by self-report questionnaires from youth@hordaland. The prevalence of diagnosed sleep disorders among adolescents seeking mental health services was 0.6%, yielding an estimated prevalence of 0.07% of the population. However, questionnaire-based measurement of insomnia from the youth@hordaland study indicated that insomnia was highly prevalent across disorders in comparison to a reference group of adolescents who were not within mental health care. Insomnia ranged from 29% among adolescents diagnosed with ADHD (PR = 1.79; 95% CI 1.41-2.29) to 48% among adolescents diagnosed with depression (PR = 2.53, 95% CI 2.19-2.92). All diagnostic groups had a mean sleep efficiency below (85%), indicating poor sleep quality. Insomnia, delayed sleep-phase wake disorder, and poor sleep efficiency were confirmed as transdiagnostic sleep problems across psychiatric disorders. In addition, some disorder-specific patterns emerged, such as a higher prevalence of insomnia among adolescents with depression, and DSWPS among adolescents with conduct disorder. This underscores the need for treating sleep problems in CAMHS, and transdiagnostic treatment approaches are warranted.
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Affiliation(s)
- Mari Hysing
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway. .,Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway.
| | - Ove Heradstveit
- grid.509009.5Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway ,grid.412835.90000 0004 0627 2891Center for Alcohol & Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Allison G. Harvey
- grid.47840.3f0000 0001 2181 7878Department of Psychology, University of California, Berkeley, USA
| | - Sondre Aasen Nilsen
- grid.509009.5Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
| | - Tormod Bøe
- grid.7914.b0000 0004 1936 7443Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway ,grid.509009.5Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
| | - Børge Sivertsen
- grid.418193.60000 0001 1541 4204Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway ,Department of Research & Innovation, Helse-Fonna HF, Haugesund, Norway ,grid.5947.f0000 0001 1516 2393Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
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23
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Decker AN, Fischer AR, Gunn HE. Socio-Ecological Context of Sleep: Gender Differences and Couples' Relationships as Exemplars. Curr Psychiatry Rep 2022; 24:831-840. [PMID: 36401678 PMCID: PMC9676909 DOI: 10.1007/s11920-022-01393-6] [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] [Accepted: 10/28/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE OF REVIEW We summarized recent findings on insufficient sleep and insomnia, two prominent sleep issues that impact public health. We demonstrate the socio-ecologial impact of sleep health with findings on gender and couples' relationships as exemplars. RECENT FINDINGS Robust gender differences in sleep duration and insomnia are due to biological and socio-ecological factors. Gender differences in insufficient sleep vary by country of origin and age whereas gender differences in insomnia reflect minoritized identities (e.g., sexual, gender). Co-sleeping with a partner is associated with longer sleep and more awakenings. Gender differences and couples' sleep were affected by intersecting social and societal influences, which supports a socio-ecological approach to sleep. Recent and seminal contributions to sleep health highlight the importance of observing individual sleep outcomes in a socio-ecological context. Novel methodology, such as global measures of sleep health, can inform efforts to improve sleep and, ultimately, public health.
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Affiliation(s)
- Andrea N. Decker
- Department of Psychology, The University of Alabama, 505 Hackberry Lane, Tuscaloosa, AL 35401 USA
| | - Alexandra R. Fischer
- Department of Psychology, The University of Alabama, 505 Hackberry Lane, Tuscaloosa, AL 35401 USA
| | - Heather E. Gunn
- Department of Psychology, The University of Alabama, 505 Hackberry Lane, Tuscaloosa, AL 35401 USA
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24
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Larsen AU, Hopstock LA, Jorde R, Grimnes G. No improvement of sleep from vitamin D supplementation: insights from a randomized controlled trial. Sleep Med X 2021; 3:100040. [PMID: 34881361 PMCID: PMC8567000 DOI: 10.1016/j.sleepx.2021.100040] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 11/11/2022] Open
Abstract
Background Vitamin D has been linked to sleep health in observational studies. Data from randomized controlled trials (RCTs) with vitamin D is scarce. Methods This study presents the results of a secondary analysis of 189 vitamin D insufficient participants (47.1% women) in a previously performed RCT, of which 92 were randomized to vitamin D (100,000 IU (2500 μg) as a bolus dose followed by 20,000 IU (500 μg) per week), and 97 to placebo. At baseline and after 4 months at the end of the study serum 25-hydroxyvitamin D (s-25(OH)D) was measured, and the study questionnaire assessing sleep duration, daytime sleepiness, and symptoms of insomnia, was completed. Results At baseline, mean s-25(OH)D was 35.0 ± 11.8 and 35.5 ± 13.3 nmol/L in the vitamin D and placebo groups, respectively. After four months, we found no statistically significant differences between the intervention groups in any of the assessed sleep outcomes, neither when stratified by sex, nor when performed in subgroups based on baseline or end of study s-25(OH)D level or presence of sleep complaints at baseline. Conclusions We were not able to demonstrate a significant effect of vitamin D supplementation on sleep in this vitamin D insufficient population. RCT investigating vitamin D for 4 months in participants with low vitamin D status. Vitamin D did not improve sleep duration, excessive daytime sleepiness or insomnia. The role of vitamin D in sleep health remains controversial.
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Affiliation(s)
- A U Larsen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - L A Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - R Jorde
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - G Grimnes
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
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25
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Gao Y, Kholghi M, Koprinska I, Zhang Q. Association of Longitudinal Sleep and Next-day Indoor Mobility Measured via Passive Sensors among Community-dwelling Older Adults. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:2400-2404. [PMID: 34891765 DOI: 10.1109/embc46164.2021.9630784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Previous studies have shown there is a relationship between sleep and mobility in older adults by collecting and analysing self-reported data from surveys and questionnaires, or by using objective measures from polysomnography or actigraphy. However, these methods have limitations for long-term monitoring, especially for community-dwelling adults. In this paper, we investigate the association between sleep and indoor mobility using longitudinal data collected over a period of about 12 months for older adults (65 years or older) living at home in Australia. The data was collected objectively and continuously using non-invasive and passive sensors. First, we explored whether sleep and indoor mobility are different across gender and age groups (70s, 80s, and 90s). Second, we investigate the association of sleep and next-day indoor mobility through a stepwise multivariate regression. We found that males and females have significant differences in mobility, time in bed, total time in sleep, number and duration of awakenings and sleep efficiency. Additionally, mobility and all sleep measures significantly vary across the three age groups, except for sleep onset latency between 80s and 90s. Our findings show that sleep efficiency and total sleep time are the key sleep measures affecting next-day mobility, while sleep onset latency has the least effect.Clinical relevance - Our study contributes to a better understanding of the sleep patterns of older adults and how they affect their physical functioning.
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26
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Taillard J, Gronfier C, Bioulac S, Philip P, Sagaspe P. Sleep in Normal Aging, Homeostatic and Circadian Regulation and Vulnerability to Sleep Deprivation. Brain Sci 2021; 11:1003. [PMID: 34439622 PMCID: PMC8392749 DOI: 10.3390/brainsci11081003] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/23/2021] [Accepted: 07/25/2021] [Indexed: 12/30/2022] Open
Abstract
In the context of geriatric research, a growing body of evidence links normal age-related changes in sleep with many adverse health outcomes, especially a decline in cognition in older adults. The most important sleep alterations that continue to worsen after 60 years involve sleep timing, (especially early wake time, phase advance), sleep maintenance (continuity of sleep interrupted by numerous awakenings) and reduced amount of sigma activity (during non-rapid eye movement (NREM) sleep) associated with modifications of sleep spindle characteristics (density, amplitude, frequency) and spindle-Slow Wave coupling. After 60 years, there is a very clear gender-dependent deterioration in sleep. Even if there are degradations of sleep after 60 years, daytime wake level and especially daytime sleepiness is not modified with age. On the other hand, under sleep deprivation condition, older adults show smaller cognitive impairments than younger adults, suggesting an age-related lower vulnerability to extended wakefulness. These sleep and cognitive age-related modifications would be due to a reduced homeostatic drive and consequently a reduced sleep need, an attenuation of circadian drive (reduction of sleep forbidden zone in late afternoon and wake forbidden zone in early morning), a modification of the interaction of the circadian and homeostatic processes and/or an alteration of subcortical structures involved in generation of circadian and homeostatic drive, or connections to the cerebral cortex with age. The modifications and interactions of these two processes with age are still uncertain, and still require further investigation. The understanding of the respective contribution of circadian and homeostatic processes in the regulation of neurobehavioral function with aging present a challenge for improving health, management of cognitive decline and potential early chronobiological or sleep-wake interventions.
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Affiliation(s)
- Jacques Taillard
- Sommeil, Addiction et Neuropsychiatrie, Université de Bordeaux, SANPSY, USR 3413, F-33000 Bordeaux, France; (S.B.); (P.P.); (P.S.)
- CNRS, SANPSY, USR 3413, F-33000 Bordeaux, France
| | - Claude Gronfier
- Lyon Neuroscience Research Center (CRNL), Integrative Physiology of the Brain Arousal Systems (Waking) Team, Inserm UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, F-69000 Lyon, France;
| | - Stéphanie Bioulac
- Sommeil, Addiction et Neuropsychiatrie, Université de Bordeaux, SANPSY, USR 3413, F-33000 Bordeaux, France; (S.B.); (P.P.); (P.S.)
- CNRS, SANPSY, USR 3413, F-33000 Bordeaux, France
- Pôle Neurosciences Cliniques, CHU de Bordeaux, F-33076 Bordeaux, France
| | - Pierre Philip
- Sommeil, Addiction et Neuropsychiatrie, Université de Bordeaux, SANPSY, USR 3413, F-33000 Bordeaux, France; (S.B.); (P.P.); (P.S.)
- CNRS, SANPSY, USR 3413, F-33000 Bordeaux, France
- Pôle Neurosciences Cliniques, CHU de Bordeaux, F-33076 Bordeaux, France
| | - Patricia Sagaspe
- Sommeil, Addiction et Neuropsychiatrie, Université de Bordeaux, SANPSY, USR 3413, F-33000 Bordeaux, France; (S.B.); (P.P.); (P.S.)
- CNRS, SANPSY, USR 3413, F-33000 Bordeaux, France
- Pôle Neurosciences Cliniques, CHU de Bordeaux, F-33076 Bordeaux, France
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27
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Alimoradi Z, Gozal D, Tsang HWH, Lin CY, Broström A, Ohayon MM, Pakpour AH. Gender-specific estimates of sleep problems during the COVID-19 pandemic: Systematic review and meta-analysis. J Sleep Res 2021; 31:e13432. [PMID: 34245055 PMCID: PMC8420603 DOI: 10.1111/jsr.13432] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 05/13/2021] [Accepted: 06/16/2021] [Indexed: 02/05/2023]
Abstract
The outbreak of the novel coronavirus disease 2019 (COVID‐19) changed lifestyles worldwide and subsequently induced individuals’ sleep problems. Sleep problems have been demonstrated by scattered evidence among the current literature on COVID‐19; however, little is known regarding the synthesised prevalence of sleep problems (i.e. insomnia symptoms and poor sleep quality) for males and females separately. The present systematic review and meta‐analysis aimed to answer the important question regarding prevalence of sleep problems during the COVID‐19 outbreak period between genders. Using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guideline and Newcastle–Ottawa Scale checklist, relevant studies with satisfactory methodological quality searched for in five academic databases (Scopus, PubMed Central, ProQuest, Web of Science , and EMBASE) were included and analysed. The protocol of the project was registered in the International Prospective Register of Systematic Reviews (PROSPERO; identification code CRD42020181644). A total of 54 papers (N = 67,722) in the female subgroup and 45 papers (N = 45,718) in the male subgroup were pooled in the meta‐analysis. The corrected pooled estimated prevalence of sleep problems was 24% (95% confidence interval [CI] 19%–29%) for female participants and 27% (95% CI 24%–30%) for male participants. Although in both gender subgroups, patients with COVID‐19, health professionals and general population showed the highest prevalence of sleep problems, it did not reach statistical significance. Based on multivariable meta‐regression, both gender groups had higher prevalence of sleep problems during the lockdown period. Therefore, healthcare providers should pay attention to the sleep problems and take appropriate preventive action.
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Affiliation(s)
- Zainab Alimoradi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - David Gozal
- Department of Child Health and the Child Health Research Institute, The University of Missouri School of Medicine, Columbia, MO, USA
| | - Hector W H Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Anders Broström
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Maurice M Ohayon
- Stanford Sleep Epidemiology Research Center (SSERC), School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.,Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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28
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Cai H, Wang XP, Yang GY. Sleep Disorders in Stroke: An Update on Management. Aging Dis 2021; 12:570-585. [PMID: 33815883 PMCID: PMC7990374 DOI: 10.14336/ad.2020.0707] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 07/07/2020] [Indexed: 12/18/2022] Open
Abstract
Stroke is a leading cause of disability and mortality all over the world. Due to an aging population, the incidence of stroke is rising significantly, which has led to devastating consequences for patients. In addition to traditional risk factors such as age, hypertension, hyperlipidemia, diabetes and atrial fibrillation, sleep disorders, as independent modifiable risk factors for stroke, have been highlighted increasingly. In this review, we provide an overview of common types of current sleep disturbances in cerebrovascular diseases, including insomnia, hypersomnia, breathing-related sleep disorders, and parasomnias. Moreover, evidence-based clinical therapeutic strategies and pitfalls of specific sleep disorders after stroke are discussed. We also review the neurobiological mechanisms of these treatments as well as their effects on stroke. Since depression after stroke is so prevalent and closely related to sleep disorders, treatments of post-stroke depression are also briefly mentioned in this review article.
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Affiliation(s)
- Hongxia Cai
- Department of Neurology, Tong-Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Xiao-Ping Wang
- Department of Neurology, Tong-Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Guo-Yuan Yang
- Med-X Research Institute and School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.
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29
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Sivertsen B, Friborg O, Pallesen S, Vedaa Ø, Hopstock LA. Sleep in the land of the midnight sun and polar night: The Tromsø study. Chronobiol Int 2020; 38:334-342. [PMID: 33249932 DOI: 10.1080/07420528.2020.1845191] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
While some diseases and human behaviors fluctuate consistently with season, the extent of seasonal variations in sleep, especially at high latitudes, is less consistent. We used data from a geographic region (69º North) with extremely large seasonal differences in daylight that had the participants blinded for the current study's hypotheses. Data were derived from the Tromsø Study (2015-2016), an ongoing population-based study in Northern Norway comprising citizens aged 40 years and older (n = 21,083, participation = 64.7%). The sleep parameters included bedtime, rise time, sleep onset latency (SOL), and total sleep time. Insomnia was defined according to recent diagnostic criteria (International Classification of Sleep Disorders; ICSD-3). We found some evidence of monthly or seasonal variation in sleep problems. Insomnia was most common during the winter months among men, but not women. No seasonal or monthly effects were observed for sleep duration. SOL was slightly longer during the winter months, but the differences were small and hardly of any clinical relevance. The small or non-existing seasonal variation in sleep and sleep difficulties indicate that extreme seasonal variation in daylight is of little influence on sleep status. The city of Tromsø is a modern city with considerable level of artificial light, which may contribute to the observed rather stabile sleep patterns throughout the year.
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Affiliation(s)
- Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Research & Innovation, Helse Fonna HF, Haugesund, Norway.,Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Oddgeir Friborg
- Department of Psychology, UiT the Arctic University of Norway, Tromsø, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway.,Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.,Optentia, Vaal Triangle Campus of the North-West University, South-Africa
| | - Øystein Vedaa
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.,Voss District Psychiatric Hospital, NKS Bjørkeli, Voss, Norway.,Department of Research and Development, St Olavs University Hospital, Trondheim, Norway
| | - Laila Arnesdatter Hopstock
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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30
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Majumdar P, Biswas A, Sahu S. COVID-19 pandemic and lockdown: cause of sleep disruption, depression, somatic pain, and increased screen exposure of office workers and students of India. Chronobiol Int 2020; 37:1191-1200. [DOI: 10.1080/07420528.2020.1786107] [Citation(s) in RCA: 118] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Piya Majumdar
- Ergonomics and Occupational Physiology Laboratory, Department of Physiology, University of Kalyani, Kalyani, Nadia, India
| | - Ankita Biswas
- Ergonomics and Occupational Physiology Laboratory, Department of Physiology, University of Kalyani, Kalyani, Nadia, India
| | - Subhashis Sahu
- Ergonomics and Occupational Physiology Laboratory, Department of Physiology, University of Kalyani, Kalyani, Nadia, India
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